Current through Reg. 49, No. 38; September 20, 2024
(a) Facilities providing adolescent
residential services shall:
(1) maintain
separation between adults and adolescents;
(2) have separate sleeping areas, bedrooms,
and bathrooms for adults and adolescents, and for males and females;
(3) provide access to education approved by
the Texas Education Agency within three school days of admission when treatment
is expected to last more than 14 days;
(4) in addition to the service requirements
set forth in §148.903(d)(3), provide five hours of planned, structured
activities during evenings and weekends. Recreational and leisure activities
shall be included in the structured time. The total number of hours of planned,
structured activities must be at least 15. Attendance in school may be counted
toward this requirement;
(5) ensure
the direct care staff-to-client ratio is at least 1:8 during waking hours
(including program-sponsored activities away from the facility) and 1:16 during
sleeping hours;
(6) ensure clients
are under direct supervision at all times. During sleeping hours, staff shall
conduct and document hourly bed checks;
(7) facilitate regular communication between
an adolescent client and the client's family and shall not arbitrarily restrict
any communications without clear individualized clinical justification
documented in the client record; and
(8) have written procedures addressing
notification of parents or guardians in the event an adolescent leaves a
residential program without authorization.
(b) Facilities providing outpatient services
shall:
(1) maintain separation between adults
and adolescents; and
(2) provide
access to education approved by the Texas Education Agency within three school
days of admission when treatment is expected to last more than 14 days, if
required by law.
(c)
Facilities providing day treatment shall provide at least 15 hours of services
per week, comprised of at least:
(1) one hour
of individual counseling; and
(2)
14 hours of additional counseling, chemical dependency education, life skills
training, and relapse prevention education. Attendance in school may not be
counted toward this requirement.
(d) All facilities shall:
(1) ensure the program's treatment services,
lectures, and written materials are age-appropriate and easily understood by
clients;
(2) involve the client's
family or an alternate support system in the treatment process or document why
this is not possible; and
(3)
develop and implement a mechanism to ensure that all direct care staff in
adolescent programs have the knowledge, skills, and abilities to provide
services to adolescents, as they relate to the individual's job duties.
Providers must be able to demonstrate through documented training, credentials
and/or experience that all direct care staff are proficient in areas pertaining
to adolescent services, including but not limited to areas regarding:
(A) chemical dependency problems specific to
adolescent treatment;
(B)
appropriate treatment strategies, including family engagement strategies;
and
(C) emotional, developmental,
and mental health issues for adolescents.
(e) Adolescent programs may serve children 13
to 17 years of age. However, young adults aged 18 to 21 may be admitted to an
adolescent program when the screening process indicates the individual's needs,
experiences, and behavior are similar to those of adolescent clients.
(f) Adult programs serve individuals 18 years
of age or older. However, adolescents aged 17 may be admitted to an adult
program when they are referred by the adult criminal justice system or when the
screening process indicates the individual's needs, experiences, and behavior
are similar to those of adult clients.
(g) Every exception to the general age
requirements shall be clinically justified and documented and approved in
writing by a QCC.
