Current through Register Vol. 51, No. 6, December 1, 2024
RELATES TO:
KRS
17.500, 17.550-17.576,
17.991,
197.010
NECESSITY, FUNCTION, AND CONFORMITY:
KRS
17.564 authorizes the Sex Offender Risk Assessment
Advisory Board to promulgate administrative regulations to establish the minimum
requirements for treatment of sex offenders. This administrative regulation
establishes minimum treatment requirements for providers.
Section 1. Definitions.
(1) "Adjunctive therapy" means additional
interventions or programs that enhance gains made in evidence based treatment
sessions, directly target criminogenic risk factors, and may include interventions
that are considered promising as well as evidence based.
(2) "Approved provider" is defined by
KRS
17.550(3).
(3) "Board" is defined by
KRS
17.550(1).
(4) "Criminogenic needs" means factors that if
targeted in treatment, can reduce sexual re-offending.
(5) "Department" is defined by
KRS
197.010(3).
(6) "Dynamic risk factors" means factors that:
(a) If targeted and changed during treatment, can
result in a reduction in sexual re-offending; and
(b) Research has proven to reduce sexual
recidivism.
(7) "Evidence
based standards of care" means standards and practices that:
(a) Are based on the best available clinical
scientific research or evidence for treatment of sex offenders;
(b) Take into account the offender's current
clinical state and circumstances that may influence treatment gain; and
(c) Are generally accepted.
(8) "Non-criminogenic needs" means factors that if
targeted can assist with removing obstacles to effectively targeting criminogenic
factors, for example, self-esteem, fear of punishment.
(9) "Responsivity factors" means factors that
impact an offender's ability to begin, engage in, and complete treatment and can
interfere with the ability of the offender to respond to treatment.
(10) "Risk" means the risk of sexual
reoffending.
(11) "Risk assessment tool"
means a validated instrument designed to measure risk of sexually
reoffending.
(12) "Session" means at
least forty-five (45) minutes for an individual session or ninety (90) minutes for a
group session.
(13) "Static factors"
means factors that do not change but predict future sexual re-offending.
(14) "Stages of change" means the change process
occurs gradually over time and includes levels or stages as follows:
(a) Precontemplation, in which the individual does
not intend to make a change in the behavior;
(b) Contemplation, in which the individual has an
awareness of the problem and may consider the pluses and minuses of
change;
(c) Preparation, in which the
individual intends to take action within one (1) month and may make small behavioral
changes;
(d) Action, in which the
individual modifies the problem behavior for one (1) to six (6) months;
and
(e) "Maintenance, in which the
behavior change extends from six (6) months and the individual works to prevent
relapse.
Section
2. General Procedures for Treatment of All Sex Offenders.
(1) Treatment shall conform to evidence based
standards of care, and shall include:
(a) A
diagnosis from one (1) of the manuals below, using the edition that is in effect at
the time of diagnosis:
1. Diagnostic and
Statistical Manual (DSM); or
2.
International Statistical Classification of Diseases and Related Health Problems
(ICD); and
(b) A written
treatment plan based on a comprehensive, psycho-sexual evaluation consistent with
the risk-need-responsivity (RNR) principles or RNR model of assessment and
treatment. The plan shall include:
1. Goals and
objectives consistent with the individual client's risk level considering:
c. Criminogenic and non-criminogenic
needs;
d. Responsivity factors;
and
2. Systems and modalities of treatment
and the rationale therefor.
(2) Treatment shall be conducted using a cognitive
behavioral approach including individual or group sessions.
(3) Treatment may utilize psychoeducational and
other adjunctive therapy components if indicated.
(4) Prior to providing treatment, an approved
provider shall:
(a) Obtain written informed consent
for treatment from the offender;
(b)
Contact the offender's supervising probation and parole officer to discuss the
offender and obtain offender information;
(c) Obtain or make a good faith effort to obtain
the offender's mental health records; and
(d) Submit a general treatment curriculum to the
board that includes the required elements in Sections 2 and 3 of this administrative
regulation. If the approved provider intends to treat an offender who has already
completed a sex offender treatment program, then the approved provider shall also
submit a treatment curriculum that includes the required elements in Section 4 of
this administrative regulation. If an approved provider changes the submitted
treatment curriculum, the approved provider shall submit a treatment curriculum with
the changes to the board.
(5)
An approved provider shall:
(a) Provide
psychological services, pharmaco-therapy services, testing, or adjunctive therapy as
needed or make the appropriate referral and act as liaison for the provision of
services;
(b) Provide treatment
consistent with current professional literature that minimizes the risk of
reoffending and emphasizes community safety;
(c) Maintain an individual record, which shall
include documentation of the offender's attendance and evaluative progress
notes;
(d) Obtain a release of
information signed by the sex offender, which allows the approved provider to
release information to probation and parole personnel responsible for the sex
offender's supervision and the Sex Offender Risk Assessment Advisory
Board;
(e) Notify the offender's
supervising probation and parole officer in writing if the offender fails to attend
a treatment session or fails to make a good faith effort to participate in the
treatment;
(f) Provide the Required
Monthly Progress Report to the supervising probation and parole officer each
month;
(g) Cooperate fully with the
probation and parole supervision team responsible for a sex offender under the
approved provider's treatment;
(h)
Prepare a treatment summary at discharge from treatment; and
(i) Provide written notice of the sex-offender's
discharge from treatment and the reasons for discharge to the supervising probation
and parole officer within ten (10) days of discharge.
Section 3. Procedures for Treatment of
Sex Offenders Who Have Not Completed a Sex Offender Treatment Program. If a sex
offender has not completed a sex offender treatment program, an approved provider
shall:
(1) Use a treatment curriculum which, at a
minimum, shall include:
(a) Integrated treatment
services as necessary to meet the sex offender specific and mental health needs of
the individual offender including:
1. Sex offender
specific treatment:
a. The cycle of sexual
abuse;
c. Deviant arousal and its reduction;
d. Cognitive restructuring;
f. Partner and family interactions and support, if
applicable;
g. Victim empathy awareness;
and
h. Relationship skills;
and
2. Mental health
treatment:
b. Mental health including personality
disorder;
e. Mood problems including depression and
anxiety;
g. Psychotropic medication; and
h. Pornography addiction;
(b) Treatment dosage based on risk
level;
(c) An emphasis on motivating the
offender to move through the stages of change and towards acceptance of
responsibility for present and past sexual offending behavior; and
(d) Gender and culture specific
programming;
(2) For a low
risk offender, provide between sixty (60) to 100 hours of face-to-face, evidence
based, cognitive behavioral treatment sessions with at least thirty (30) hours in
the first year. If denial or other risk-need-responsivity factors are present in a
low risk offender, treatment hours may be increased to focus on treatment readiness
or other responsivity factors identified by the treatment provider;
(3) For a medium risk offender, between 160 to 200
hours of face-to-face, evidence based, cognitive behavioral treatment sessions with
at least eighty (80) hours in the first year. If denial or other
risk-need-responsivity factors are present in the medium risk offender, treatment
hours may be increased to focus on treatment readiness or other responsivity factors
identified by the treatment provider; and
(4) For a high risk offender, provide between 400
to 540 hours of face-to-face evidence based, cognitive behavioral treatment sessions
with at least 200 hours in the first year. If denial or other risk-need-responsivity
factors are present in the high risk offender, treatment hours may be increased to
focus on treatment readiness or other responsivity factors identified by the
treatment provider.
Section
4. Procedures For Treatment of Sex Offenders Who Have Completed a Sex
Offender Treatment Program.
(1) If a sex offender
has completed a sex offender treatment program, an approved provider shall:
(a) Obtain documentation from the sex offender
treatment program showing completion of the program;
(b) Assess and document whether the offender can
demonstrate acceptable levels of skills and knowledge of treatment areas listed in
Section 3(1)(a)1 of this administrative regulation;
(c) Assess the offender's current risk level using
risk assessment tools;
(d) Based on the
offender's level of risk and need, determine which of the following is required:
1. A full treatment program;
2. A partial treatment program to address sex
offender specific treatment concerning missing skills or knowledge; or
3. Maintenance sessions including supportive
counseling; and
(e) Implement
a treatment program that meets the following:
1. A
full treatment program shall follow the requirements in Section 3 of this
administrative regulation;
2. A
maintenance program shall include:
a. For a low
risk offender, forty-five (45) to sixty (60) hours of supportive counseling sessions
focused on re-entry issues for a minimum of twelve (12) months and thereafter as
needed, including booster sessions, unless the approved provider determines that
this level of treatment may be detrimental to the offender based on current
scientific treatment studies;
b. For a
moderate risk offender:
(i) Provide a maintenance
relapse prevention program with sessions two (2) times per month for the first year
after release and then as needed, including booster sessions; and
(ii) Provide or refer for adjunctive therapies as
needed; or
c. For a high
risk offender:
(i) Provide a maintenance program
with sessions one (1) time per week for the first year after release and thereafter
as needed, including booster sessions; and
(ii) Provide or refer for adjunctive therapies as
needed; or
3. For a
partial treatment program:
a. Determine the
additional hours above the minimum hours required for a maintenance program needed
to address the missing skills or knowledge and include those additional hours of
treatment with the required hours for a maintenance program; and
b. Document in the treatment file how the approved
provider determined the skills and knowledge in required areas were met in prior
treatment.
(2) Based on the determination of whether a full,
partial, or maintenance program is required, the approved provider shall use a
treatment curriculum which, at a minimum, shall target and include:
(a) Treatment dosage based on current risk
level;
(b) Treatment readiness and stage
of change;
(d) Development of treatment
partner relationship, including partner alert sessions;
(e) Collaborative development of a practical
living skills plan;
(f) Existing sex
offender specific treatment needs identified in subsection (1)(b) of this section
integrated with the mental health needs as stated in Section 3(1)(a)(2) of this
administrative regulation; and
(g) A
plan for family and children reintegration options, if appropriate, and the victim
approves.
(3) Reintegration.
(a) Reintegration with a victim shall not be
considered unless it is approved by the approved provider and the probation and
parole officer.
(b) If the offender
victimized a child, reintegration with other children shall not be considered unless
approved by the approved provider and the probation and parole officer.
(c) The approved provider and probation and parole
officer shall address at a minimum the following when considering reintegration of
an offender with a child victim or other children:
1. Assessment of quality of parental
relationship;
2. Assessment of victim's
progress if participating in treatment;
3. Assessment of age and sex of child victims and
offender potential for cross-over;
4.
Assessment of how the offender accessed prior child victims and similarities to
situations and persons with whom he is currently considering to reside;
5. Assessment of adult partner's knowledge and
insight into offender's dynamics; and
6.
A written, gradual reintegration process plan.
Section 5. Incorporation by Reference.
(1)The Sex Offender Risk Assessment Advisory Board
form "Required Monthly Progress Report", 2020, is incorporated by
reference.
(2) This material may be
inspected, copied, or obtained, subject to applicable copyright law, at the Justice
and Public Safety Cabinet, Office of Legal Services, 125 Holmes Street, Frankfort,
Kentucky 40601, phone (502) 564-3279, fax (502) 564-6686, Monday through Friday, 8
a.m. to 4:30 p.m. This material may be obtained from the Department of Corrections
Web site in the sex offender treatment area at
https://corrections.ky.gov/Divisions/healthservices/Pages/sotp.asp.
This is to certify that the Sex Offender Risk Assessment Advisory
Board approved this administrative regulation prior to its filing by the Department
of Corrections with the Legislative Research Commission as required by
KRS
13A.120(3) and
13A.220(6)(a)
as reflected by the signature below.
STATUTORY AUTHORITY:
KRS
17.564