Section 380.8767 - Crisis Stabilization Unit(a) Purpose. The purpose of this rule is to establish criteria and a process for admitting youth who are experiencing a psychiatric crisis into a crisis stabilization unit (CSU) operated by the Texas Juvenile Justice Department (TJJD).(b) Definitions. (1) Designated Mental Health Professional--has the meaning assigned by § 380.9187 of this chapter.(2) Psychiatric Provider--has the meaning assigned by § 380.9187 of this chapter.(c) References. (1) For due process procedures for mental health status reviews, see § 380.9571 of this chapter.(2) For emergency mental health placements, see § 380.8771 of this chapter.(d) Admissions. (1) Admission Criteria. A youth may be admitted to a CSU only when the following criteria are met: (A) the youth demonstrates serious dysfunction in behavior, judgment, thinking, or mood; and(B) the dysfunction is the result of a current neurological deficit, emotional disturbance, and/or psychiatric disorder (e.g., psychosis, major affective disorder, organic disorder, or anxiety disorder) and the dysfunction is not the result of a primary conduct disorder or antisocial personality disorder; and(C) the youth: (i) presents a risk of serious harm to self or others; or(ii) if not treated, will continue to suffer severe and abnormal mental, emotional, or physical distress and will continue to experience deterioration in the youth's ability to function independently, as evidenced by the youth's inability to attend to basic needs, such as food, health, personal hygiene, or safety; and(D) a CSU is the least restrictive intervention that is appropriate and available to safely and effectively meet the treatment needs and to control the dysfunctional behavior.(2) Referral Documents. The referral must include a current psychiatric evaluation from a psychiatric provider and a psychological evaluation approved by the designated mental health professional, unless the referral is due to an emergency mental health placement under § 380.8771 of this chapter.(3) 72-Hour Admission Review Process. A mental-health-status review hearing must be held for each youth within 72 hours after arrival at the unit. If the 72-hour period ends on a Saturday, Sunday, or official holiday, the hearing must be held on the next workday. The hearing is held to determine whether criteria for unit admission have been met.(A) If the youth does not meet criteria for admission, the youth is not retained in the CSU. Youth who are not admitted are returned to the referring program/location.(B) If the youth meets criteria for admission, the youth is retained and treated in the CSU.(C) If the youth's treatment needs and appropriateness for admission cannot be determined during the hearing, the youth may be temporarily admitted to the CSU for diagnostic and assessment purposes for up to 45 days from the date of arrival. (i) A youth may be temporarily admitted for diagnostic and assessment purposes only if the hearing manager determines: (I) the youth exhibits evidence of psychiatric dysfunction;(II) the youth has recently engaged in behavior that presents a danger to self or others or has demonstrated a chronic failure to progress in the youth's prior programming;(III) the youth is in need of comprehensive psychiatric and psychological evaluation in a specialized setting; and(IV) the CSU is the least restrictive setting in which to effectively accomplish this evaluation.(ii) Before the end of the 45-day diagnostic and assessment period, the CSU staff must: (I) hold a mental-health-status review hearing to seek admission to CSU; or(II) transfer the youth out of CSU if a hearing is not held or if the youth is not admitted to CSU.(e) Program Requirements. (1) The program focus is on stabilization of the psychiatric dysfunction.(2) Services are provided in a self-contained unit.(3) An individualized treatment program, including treatment goals and objectives, is developed for and with each youth.(4) The treatment team reviews the youth's progress weekly.(5) The youth must be transferred out of the CSU within 90 days after the admission hearing unless an extension is granted.(f) Extensions. (1) Extension Criteria. An extension may be granted beyond 90 days only if:(A) the youth continues to meet admission criteria and the youth's treatment plan has been implemented appropriately; or(B) the youth has symptoms of mental illness and continued treatment in the CSU is deemed to be in the youth's best interest.(2) Due Process Requirements for Extensions. (A) The due process required to determine whether extension criteria have been met is a mental-health-status review hearing. A youth on parole status, as defined in § 380.9550 of this chapter, will remain on parole status.(B) If an extension is recommended, the mental-health-status review hearing must be held: (i) approximately 75 days but no later than 90 days after the last mental-health-status review hearing; or(ii) within two workdays after the youth returns to the unit if the youth's is in a state hospital at the time the hearing is required.(C) Multiple extensions may be granted by following procedures in this subsection.(3) Release and Transition Options.(A) The extension of time to treat the psychiatric dysfunction must be terminated when placement in a CSU is no longer needed for the primary purpose of treatment of the dysfunction, as determined by a majority vote of the youth's treatment team.(B) Following termination of the extension, future placement decisions, including the youth's return to home parole placement, are made in accordance with other applicable policies and procedures.(C) No youth may be discharged from TJJD jurisdiction directly from a CSU unless TJJD's jurisdiction ends by statute.37 Tex. Admin. Code § 380.8767
The provisions of this §380.8767 adopted to be effective June 24, 1997, 22 TexReg 5765; amended to be effective January 31, 2001, 26 TexReg 765; amended to be effective July 31, 2001, 26 TexReg 4876; amended to be effective April 15, 2002, 27 TexReg 2830; amended to be effective September 21, 2005, 30 TexReg 5955; amended to be effective September 1, 2009, 34 TexReg 5551; transferred effective June 4, 2012, as published in the Texas Register June 22, 2012, 37 TexReg 4639; amended by Texas Register, Volume 39, Number 47, November 21, 2014, TexReg 9259, eff. 12/1/2014; Amended by Texas Register, Volume 49, Number 28, July 12, 2024, TexReg 5151, eff. 7/15/2024