ORDER N0.29079 JUVENILE DETENTION FACILITY SEX OFFENDER TREATMENT PROGRAM Came to be heard this the 14~' day of March 2005 with a motion made by Commissioner Baldwin, seconded by Commissioner Letz. The Court unanimously approved by vote of 4-0-0 the Sex Offender Treatment Program that is being proposed at the Juvenile Detention Facility. / ~' COMMISSIONERS' COURT AGENDA REQUEST ~~~~~ PLEASE FURNISH ONE ORIGINAL AND NINE COPIES OF THIS REQUEST AND DOCUMENTS TO BE REVIEWED BY THE COURT . ~ ~~~ ~1 MADE BY: H.A. "Bu dwin OFFICE: Commissioner, Pct. 1 MEETING DATE: March 14, 2005 TIME PREFERRED: SUBJECT: Consider, discuss and take appropriate action on Programs offered and to be offered at the Kerr County Juvenile Detention Facility. Becky Harris, Director of the Juvenile Detention Facility will give a presentation on programs. EXECUTIVE SESSION REQUESTED: (PLEASE STATE REASON) NAME OF PERSON ADDRESSING THE COURT: Commissioner, Pct. 1 ESTIMATED LENGTH OF PRESENTATION: IF PERSONNEL MATTER -NAME OF EMPLOYEE: Time for submitting this request for Court to assure that the matter is posted in accordance with Title 5, Chapter 551 and 552, Government Code, is as follows: Meeting scheduled for Mondays: 5:00 P.M. previous Tuesday. THIS REQUEST RECEIVED BY: THIS REQUEST RECEIVED ON: All Agenda Requests will be screened by the County Judge's Office to determine if adequate information has been prepared for the Court's formal consideration and action at time of Court Meetings. Your cooperation will be appreciated and contribute towards you request being addressed at the earliest opportunity. See Agenda Request Rules Adopted by Commissioners' Court. The Juvenile Detention Facility has several programs that are in place at this time and programs that are being proposed, such as the Sex Offender Treatment Program and it is my opinion that the Court should approve each and every program at our Facility. l~eCY~1y ~ °o ~Ge hil e ~11 aCl Kerr County Juvenile Facility 3 501 Legion Drive Kerrville, Texas 78028 (830) 257-6110 MISSION STATEMENT The Kerr County Juvenile Facility is committed to the protection of the public and provision of services to residents ages 10-17, placed in the facility for violations of the law. As mandated in the Juvenile Justice Code, the facility provides services including treatment, rehabilitation, education, and incarceration, while emphasizing responsibility and accountability for the child's conduct and offering the most opportunities for those residents placed in the facility. PROGRAMS BEHAVIOR MODIFICATION PROGRAM During placement, residents are encouraged to recognize the impact and consequences of their offenses. Residents are required to follow program expectations and maintain adequate levels of constructive behavior, and the progress of residents is continuously monitored and encouraged through a behavioral phase-based system. Every resident starts off at the lowest phase, and residents are reviewed at specific time intervals for a phase change. Residents progress through all five phases by following the rules of the facility and the instructions given by staff, and by fulfilling all educational and therapeutic requirements. SUBSTANCE ABUSE PROGRAM The substance abuse program at Kerr County Juvenile Facility is a combination of several components. The residents meet weekly in a group setting where they are able to increase their knowledge of the harmful effects of alcohol, tobacco, and other drugs. Because of a group setting, residents are able to share and process the negative effects their drug abuse has had on their lives and the lives of their peers. The residents are also provided with skills to help them cope with their addiction and prepare for the temptations that are waiting for them when they return home. The Hill Country Council on Alcohol and Drug Abuse (HCCADA) implemented acurriculum-based class called "Reconnecting Youth" that is taught on a weekly basis. The emphasis on this class is to teach social skills and coping skills to better equip the residents with the temptations of alcohol, tobacco, and other drugs. Also, this class focuses on decreasing the risk factors that are associated with drug use. The residents also, on a weekly basis, participate in the AA Group where they are introduced to the 12-step plan of addiction and get to work closely with a sponsor. The residents also have individual sessions weekly where drug and alcohol issues are targeted with a therapist. SEXUAL OFFENDER PROGRAM Residents who are involved in the Sex Offender Program at Kerr County Juvenile Facility participate in a group setting two to three hours a week. In these groups residents learn about the importance of human sexuality and the value behind it. In their group setting, residents concentrate on a variety of topics with the major focus being on thinking errors, all forms of abuse, empathy for others (including victims), taking responsibility for one's own actions, finding respect for others and themselves, self-esteem and honesty. The purpose of this group is to break the re-offense chain of abstinence, SUD (seeming unimportant decisions), dangerous situations, lapse, giving up, and re-offending by using the "Relapse Prevention Treatment Program for Youth" developed by the Safe Society Press. INDIVIDUALIZED PROGRAMS THE FOLLOWING PROGRAMS ARE DONE ON AN INDIVIDUALIZED, AS NEEDED, BASIS: SEXUAL ABUSE: Estimates now indicate that at least 17% of all males and 2S% of all females have been sexually abused at one time in their life. The penal system recognizes that these percentages are far greater in these populations. Indeed, these abusive acts have become a road map of failure for many youths that will continue unless something changes. Identifying and learning to cope with the past helps these individuals start to remap their lives on a more successful course. CHEMICAL ABUSE: Without proper parental supervision, many of the juveniles have tried alcohol. Some find that they are alcoholics. Some have experimented with drugs, while others find themselves addicted to some chemicals. Through programs aimed at learning to live with this disease, as well as learning other ways to cope, these individuals can start on the road to recovery while at Kerr County Juvenile Facility. Intensive chemical treatment modalities are utilized. VICTIM SENSITIVITY: Through victimization programming, Kerr County Juvenile Facility's rehabilitative team tries to show the offender how his offense has impacted the life of someone else. There are no truly victimless crimes. Helping the juveniles understand this helps prevent further offenses. HUFFER EDUCTION: This is one of the most difficult groups of abusers to deal with. This program starts at a very elementary level and helps the abuser understand how his inhalant habit had led to irreparable damage and helps the huffer understand the full impact of further abusing substances. GANGS: Quickly becoming the largest population we see, gangs have successfully reached hundreds of thousands of youth in our country by offering a sense of belonging and affiliation so necessary to the psyche of the juvenile. By showing how this illusion has led the youth astray and by demonstrating the dangers and price that this affiliation has, Kerr County Juvenile Facility hopes to break the cycle once the juvenile is in treatment at the facility. This often requires coordination with our Aftercare Counselor and the sending County in finding ways to keep the juvenile from going back into the same environment where he is likely to fall back into gang activity. IMPULSE AND ANGER CONTROL: Juveniles explore methods of behavior where they acted without look- ing at all the options. It reinforces problem solving and coping skills for the juvenile to help him gain control over his impulsiveness and/or anger. The facility's treatment team spends a large amount of energy helping residents go from "I feel ... so I react" to "I feel ... I think ... I act". CHILDREN OFALCOHOLICS: Growing up with an alcoholic family can have serious repercussions on juveniles forced to play roles that family's illness is not revealed. These juveniles are able to identify how their family has played a role in their delinquent behavior and helps the youth develop skills to prevent this from happening in the future. IDENTITY ISSUES: 30% of all teenage suicides are the result of confusion over identity. This helps individuals resolve questions they have about all identity issues in their life, be they culture, racial, social, familial, or sexual. Kerr County Juvenile Facility has specially designed programs to address and help residents solve problems in these areas. DEALING WITH ILLNESSES: When youth are depressed, the most common method for showing this de- pression is aggression. Depression can be, in itself, an illness, or it can be secondary to other illnesses that the youth is learning to cope with, including STDs, diabetes, or the illness of a loved one. Helping the youth to manage grief and reach acceptance of this illness often will help the youth get past his aggression. AUXILIARY PROGRAMS DRUG/ALCOHOL TREATMENT: This treatment is offered to all appropriate post-adjudicated residents. SASSIs are done on all residents to determine the level of chemical dependency that exists. Kerr County Juvenile Facility residents identify their substance problem through various treatment modalities such as drug awareness, AA, NA, intensive problem solving and reasoning training and cognitive restructuring. Education about sub- stances is provided in group therapy. Treatment issues are addressed in individual and group therapy by facility therapists. The local council on drug and alcohol also provides additional group therapy. LIFE SKILLS TRAINING: This training is provided to all post-adjudicated residents. Kerr County Juvenile Facility acknowledges that many of the residents leaving our program will be going back into a community that is largely unsympathetic to their needs, and thus they will have to make decisions on their o~vn. Training on conflict resolution, problem solving, shov~~ing and being respectful to others, as well as basic training on how to prepare simple meals, how to look for a job, go on an interview, find an apartment, budget money, balance a checkbook, maintain a vehicle, and nutrition and personal hygiene are all covered in this training. ENVIRONMENTAL ANALYSIS: This is a group process with the facility therapists. Sometimes, juvenile offenders are victims of a bad environment. In some cases, if elements of the environment had been removed or avoided, the juvenile may not have offended. Understanding the world around them and the impact it has on their behavior is paramount to understanding themselves. With the help of the facility staff, residents can talk about the home and culture and what changes need to be made for them to return and not re-offend, yet still taking full responsibility for their behavior. OFFENSE ANALYSIS: Helping the juvenile understand why he offended and the precipitating factors that led to his offense, Kerr County Juvenile Facility believes, will make the juvenile: 1) more responsible for his actions; 2) able to identify areas that may cause recidivism. Therapists help residents understand the cycle of their behavior that leads to offending and helps them develop the tools to be able to identify and stop this cycle. PROBLEM SOLVING COPING SKILLS, PEER INTERACTION, AND CONSEQUENCE TRAINING: These are all group and individual processes with the facility therapists. The goal is to help the youth develop positive interpersonal and independent living skills that can have an impact on the youth in society. Teaching the youth methods of respect and ways to solve problems without lawless behavior provide the juvenile with tools to succeed back in his environment. SEXUAL AWARENESS AND EDUCATION: Focuses on puberty and sexually transmitted disease education. Many of the individuals who come to Kerr County Juvenile Facility are or have been sexually active, and some have STDs. All are at the age where sex is mystical and there are more questions than the juvenile seems to be able to find answers for. This program encourages frank discussion about what is happening to the youth's body and hormones and how to handle these changes and feelings. Abstinence is strongly encouraged but safe sex methods are discussed with youths as well. HEALTH CLASSES: The importance of nutrition and exercise are discussed in these classes. Emphasis is placed on healthy lifestyle training. How to prepare healthy meals, why exercise is important, how to find medical or dental help when needed, and how to handle emergency situations is all covered in this educational programming. CPR and First Aid classes are taught to residents. TEAM BUILDING, SELF ESTEEM AND INDIVIDUALISM: This is done through experiential therapy type activities in recreation therapy style. Because feeling good about the world they live in starts with feeling good about themselves, these achievement and affiliation based exercises teach individuals that seemingly impossible tasks can be solved if they have the courage to rely on others for help, and to ask for help when needed. The sense of achievement helps to bolster self-esteem and this helps combat the preconceived notion the juvenile has that he is a "failure", "bad kid", or "worthless". T_ _ reatment Program for Youth with Sexual Behavior Problems Kerr County Juvenile Facility Treatment Components 1. Sexual Behavior Risk Assessment- This is the initial stage of treatment providing the foundation for treatment planning. A Sexual Behavior Risk Assessment provides detailed information about the oftense(s}, sexual history, family issues, school issues, addictive behaviors and other variables that may affect an individual's risk to continue sexual behavior problems. The Sexual Behavior Risk Assessment should be completed by an RSOTP or ASOTP (preferably before entering the treatment program). Interview format risk assessments using the JSOAP-II and ERASOR 2.0 available on site if needed. Victim's statements are an essential component for this assessment and evaluation of a youth's progress in taking full responsibility for their sexually aggressive behavior. 2. Educational Grouo-This is a 12 session educational group that covers the following topics-defining sexual aggression, motivation for sexual aggression, victim issues, basic human sexuality, understanding consent, , ,'1 and introduction to specialized sexual behavior problem treatment. This group provides a working knowledge ~J base for youth to benefit from the next treatment stage. This group can also be beneficial for youth that have been identified as displaying at risk sexual behavior problems (e.g., deferred adjudication, family concern, school behavioral report of sexual behavior issue, etc.). Sessions are 1 hour in length per week. 3. Parent Education Groua- This 6 session group is designed to provide educational information to parents/caretakers of youth identified to have sexual behavior problems. The content parallels the youth education group format with additional education regarding supervision issues and parental liabilities in chaperoning a youth with sexual behavior problems. Sessions are 1 hour in length one day per month. 4. Process Groua Process group meets weekly for 90 minutes. Treatment completion varies induration depending on the juvenile's individual issues, motivation, and treatment progress. This group is the core work toward treatment goals and best practice method for treating individuals with sexual behavior problems. Group work addresses comprehensive life issues such as taking responsibility for their behavior, understanding consequencPS of actions, empathy, coping skills, and social skills that improve the youth's ability to create and maintain a successful relapse prevention plan. (Adotescent~ (ages 13-17} Average duration may range from 12-18 months. Adolescents complete Pathways: A Guided Workbook for Youth Beginning Treatment (3~ Edition, Kahn) in addition to the weekly group exercises. ~t_atency Age~,(ages 10-12) An average duration may be approximately 12 months. Youth complete Roadmaps to Recovery: A guided Workbook for Young People in Treatment (Kahn, ages 8+J in addition to weekly exercises. Group activities will also include topics from STOP! Just for Kids (Allred & Burns) and Sfeps to Heaffhy Touching (MacFarlane & Cunningham). 5. Adjunct tndividual and Family Therauv-to facilitate treatment progress and reinforce group process teaming. Individual therapy sessions will be approximately 1 hour in length per week and family sessions scheduled as needed. Treatment Program for Youth with Sexual Behavior Problems Kerr County Juvenile Facility .Sample Treatment Goals for Youth with Sexual Behavior Problems 1) Leam and demonstrate adequate knowledge of: effects of sexual victimization; victim empathy; age- appropriate sexual knowledge; thinking errors; consent v. coercion; sexual behavior problem specialized treatment, and relapse prevention 2) Disclose and fully accept responsibility for behavior-including sexual offending history 3) Demonstrate awareness of emotions and behaviors and how they relate to various life situations 4) Develop empathic skills and demonstrate awareness of victim's feelings 5) Develop and demonstrate use of coping skills to handle feelings, stress, and promote appropriate problem- solving 6) Develop and demonstrate anger management skills 7) Develop an awareness of one's own needs and improve ability to meet needs appropriately 8) Demonstrate age-appropriate sexual knowledge and abstain from inappropriate sexual behavior 9} Develop positive goals and realistic expectations 10) Demonstrate a healthier and improved self-concept 11) Develop improved communication and social skills 12) Refrain from substance abuse and other addictive behaviors 13) Resolve own victimization issues as applicable 14) Develop and demonstrate adequate knowledge of a Relapse Prevention Plan 14) Satisfactorily complete the workbook at own pace 15) Caretakers to appropriately supervise the youth, support treatment progress, improve family functioning dynamics, consistency, and structure in the home environment 16) Comply with conditions of sex offender treatment contract .Therapy Services Provided by: Dana Truman-Schram has a M.A. in Clinical/Community Psychology from the University of North Carolina at Charlotte. She has 6 years experience providing treatment to sexually aggressive youth in a community mental health setting in North Carolina. Ms. Truman-Schram was a clinical member of the North Carolina Association for the Management and Treatment of Sex Offenders. She is currently accruing additional training to pursue registration with the Council on Sex Offender Treatment in Texas. Ms. Truman-Schram is running this program under the supervision of Mark Steege, LCSW, LPC, RSOTP (Registered Sex Offender Treatment Provider). KERR COUNTY JUVENILE FACILITY LICENSED SUBSTANCE ABUSE TREATMENT PROGRAM I. Scone of Work YEAR ROUND PROGRAMMING A. The Kerr County Juvenile Facility maintains a secure and safe environment for juvenile males and females court ordered to the facility for long-term residential placement. The facility maintains 18 beds, licensed by the Texas Department of State Health Services (DSHS), for substance abuse treatment and 30 beds for residents with behavioral and emotional maladies. The level of care provided at the facility falls under the definition of TXDPRS IV and V descriptions. Court-ordered juveniles are sent to the facility for a minimum of 6 months to 1 year. Residents placed at the facility are 10 to 17 years of ___ -age. 'ITie cost fo~acing counties~or the Long-term residential care is 583.00/day/resident. SPECIAL SUMMER PROGRAM B. During the summer months, beginning the last Monday in May and ending the second Friday in August, the facility will offer a summer program designed to accommodate residents who habitually commit delinquent acts during the summer months. The residents are court- ordered to the facility for approximately 82 days during the summer where they work and focus on anger management, positive decision making, TAKS tutoring, social skills, and other specific curriculum based instruction and treatment This short-term program falls under the definition of TXDPRS IV and V descriptions for level of care. The cost to placing counties for the summer program is at a reduced rat IL Program Goals A. Ken County Juvenile Facility provides intensive treatment and behavior management programs designed to develop behavioral and attitudinal changes that result in a youth's successful return to the community. Specific goals include the following for residential care: • To provide a safe and therapeutic environment for court-ordered male/female adolescents between the ages of 10 and 17. • To provide effective clinical services specializing in chemical dependency and behavior management to the residents and their families. • To provide each youth with agoal-directed treatment plan. • To expand training opportunities for staff to improve overall resident services. • To assist the resident in successfully reintegrating into the community. • To prevent any further delinquency resulting in placement in a more restrictive environment. • To foster increased participation on the part of residents in productive community activities such as employment, skills training, and educational activities. • To assist residents in accessing community resources and teach them to properlyutiiizo-avaii~ble assistance:- - - - -- • To enable residents to strengthen their self-esteem and learn to interact more appropriately with their environment so that there will be a reduction over time in the nature and frequency of acting out behaviors. • To assist families in improving communication and reducing dysfunctional inter-action dynamics. • To provide a therapeutic milieu of services to allow the residents the greatest opportunity to achieve and maintain academic progress. • To provide a therapeutic milieu of services encompassing group, individual and family therapy, education, recreation, medical services, employment training, life skills training and basic needs. • To remain drug and delinquent-free. B. Program Services Ken County Juvenile Facility will accept male adolescents between the ages of 10 and 17 who exhibit one or more of the following characteristics: • A history of chemical dependency issues • The facility has designed a substance abuse curriculum that is designed to address 4 major areas of a youth's life that are impacted by the use of drugs and substances. The mind which changes the reality of our world when drug use exists; the body which reminds us of the limitations we face during drug use; the spirit that is broken and allow us to think of ourselves in negative ways; and the community that awaits our contributions for renewal and sustainability. • At the core of substance abuse treatment is the removal of the mystique surrounding abuse of substances and the culture of the abusing population. Once demystified, a very sophisticated defense structure becomes useless in the face of new knowledge, and education of the resident begins in earnest. The resident will be schooled in every aspect of addictive disease so that he is not ever again able to invoke ignorance as the excuse far substance abusing behaviors. Through a series of manuals, films, books, discussions, role-play, and other pre-planned activities, the resident will be saturated with easily understood information on the disease and its impact oneself, family, friends, careers, and all other aspects of one's life. Upon completion, the resident will be able to identify his past behaviors and causal relationship between them and his current situation, as well as their effect on his health, physical and mental, his stability and potential for success in the "real world" as opposed to sub-culture he has become a part. This will include gang involvement as well as drug sub-culture, not necessarily gang related. • A history of assaultive and/or destructive behavior • An intellectual level of functioning below that of the recorded IQ •~ history -0f physical~buse, sexual abuse-and/or neglect _- - - • An inability to function effectively in public schools, and/or • Difficulty living at home and a history of runaway behavior and family conflict. The Kerr County Juvenile Facility will accept any youth court-ordered for placement by counties on a statewide basis with the above outlined characteristics, provided all referral criteria are met. Kerr County Juvenile Facility staff will notify designated staff at appropriate counties of acceptance within 48 hours of receipt of application packet. The program is designed to work with delinquent youth that are able to respond to treatment in a secure setting. Acceptance to this program will be based on individual needs, the welfare of the residents already in the program and the ability of the program to provide the level of security and services required. C. Description of Services 1. Facility Philosophy The philosophy of the facility is that there are no bad kids, but rather, good kids who are simply put into bad situations and make bad choices. In addition, we utilize the "Holistic" philosophy when dealing with the children. This philosophy identifies each child as being made up of three elements: physical, psychological, and spiritual. Our program is designed to address and enhance each of these components. By treating the residents with respect, the residents in turn learn to give respect and respect themselves. 2.The Kerr County Juvenile Facility is designed to deal with the following types of youth: • Youth who demonstrate an inability to function effectively in current residential placements including home placements. • Youth who demonstrate an inability to function effectively in public school as evidenced by truancy, suspension and/or expulsion from school. • Youth who have had a difficulty living at home with the parents or guardians as evidenced by runaway behavior, family requiring intervention by the juvenile court system and/or human service agencies and/or refusal by parents to allow youth to live at home. • Youth with a history of substance abuse. • Youth taking psychotropic medication • Youth with a history of suicide threats/attempts who have been off suicide alert for at least 30 days. • Youth with histories of violent or aggressive behavior and have not caused incidents resulting in serious bodily injury in the last 30 days. - - - - - - ~~ie~~rr-C~unt}~ Juvenile Pacility~li not accept: • Youth who are actively psychotic without medication control and have been recommended for placement in a psychiatric institution. • Youth who are severely physically and/or mentally handicapped. 3. Average length of stay & criteria determining length of stay The average length of stay for residents court-ordered for the long-term treatment program is 7.5 months. Residents are sent to the facility for a minimum of 6 months with a maximum length of stay being 12 months. Youth sent to the facility for substance abuse treatment receive services outlined by DSHS for Specialized and Intensive treatment. Treatment programs consist of individual, family and group therapy, relapse prevention and psycho-educational groups. Group sessions will cover a variety of topics including but not limited to accountability, thinking errors, offense sequence, drug addiction, victim empathy, trauma, social skills, personal growth, and re-offense prevention. The 12-Step Program will be an integral part of the Drug Treatment Program. The facility has incorporated 12 Spiritual Principles, which coincide with each step of the 12-step program. These principles include honesty, integrity, respect, courage, self-awareness, etc. Youth who are sent to the facility for behavior modification incorporate the 12 Spiritual Principles in their daily goals. Residents work through their programs via a 4-level system. The residents earn daily points based on their behavior, anger management, leadership skills, peer interaction, academic progress, and individual treatment progress. When a resident is eligible for his next level in the program, he completes a "Level Application" form. He must define why he believes he has earned his next level. KCJF staff "check off' on the application stating why or why not to award the resident his level. The counselor assigned to the resident acquires the resident's daily points sheets, level application, staff input, incident reports, and counseling notes. This information is formulated into the decision to award or deny the resident's level. If the resident does not earn his level at the stated time, his probation officer is notified as to the delay with the conclusive information. The designated time-delay is then added to the length of stay for the resident causing him to stay at the facility longer than the court- orderedminimum of 6 months. If the resident is denied his level for a second time, the treatment team reviews the resident's treatment plan. The counselor and resident decide new strategies for treatment success. 4. Counseling Services The facility provides Chemical Dependency Counseling on a weekly basis _ _ provided bya child p~chiatrist. The chemical dependency__e__ducaton_ groups are conducted by a master degreed psychology major and a bachelor degreed psychology major with pre-master degree graduate work. Both counselors are experienced chemical dependency educators. If the resident is classified as DSHS Specialized, he/she receives 30 minutes of individual counseling one time per week. If the resident is classified as DSHS Intensive, he/she receives 1 hour of individual counseling one time per week. If the resident is sent to the facility for behavior management, the facility provides individual counseling services as outlined in the psychological evaluation provided by the placing county. The facility maintains a child psychiatrist on contract for these purposes. All residents have two one-hour group sessions per day. Chemical dependency education classes are provided for 1 hour each day, 5 days per week for all residents. Family counseling sessions are scheduled for all parents at least once per month. 5. Staff Qualifications All staff providing constant supervision of the residents are Juvenile Detention Officers certified by the Texas Juvenile Probation Commission. The JDOs maintain 40-hours of annual training including Handle With Care, physical restraint technique, CPR/Ist. Aid, HIV, TB, Hepatitis C training, aggression replacement training, behavior management, child development, suicide prevention/protocol, child abuse and reporting, client rights, client confidentiality, and other facility/treatment topics. The JDOs facilitate two group sessions per day with the residents. The substance abuse treatment-counseling personnel are on full time work status and/or contract status. The child psychiatrist who provides the individual counseling is awell-known psychiatrist who has written curriculum and designed programs for substance abuse treatment for juveniles. The psychiatrist is available for medication evaluations and analysis of severe behavior maladies. A licensed professional counselor is on contract status as well. This person conducts psychologicals as requested by probation departments and on occasion conducts suicide alert assessments. A physician monitors residents taking psychotropic medications as well as the child psychiatrist. 6. Certificates and Reference Letters The Texas Department of State Health Services for Specialized and Intensive substance abuse treatment licenses the facility. This license is renewed every two years. The Texas Juvenile Probation Commission certifies the Kerr County Juvenile Facility. III. Communicated Information A. Notification of 1. License Violations If the facility receives a serious violation from DSHS, each county who has a resident(s) will be provided a copy of the violation and a written plan-of-action response along with a time line for rectifying the violation. If the facility receives a serious sanction from TJPC, each county who has a resident(s) will be provided a copy of the sanction and a written plan-of- action response along with a time line for rectifying the sanction. 2. Serious Incidents All serious incidents occurring at the facility are reported to TJPC. If the resident is at the facility for substance abuse treatment, DSHS is notified as well. Verbal notification to DSHS, TJPC, the resident's probation officer, and the local authorities via telephone, is completed within a short period of time following the reporting of the incident by facility staff. An internal investigation is conducted regarding the incident. Once the internal investigation is complete, a written report with investigation conclusion is sent to the resident's probation officer, DSHS, TJPC, and the local authorities within 24 hours of the time of the incident. b 3. Initial Medication Prescribed/Changed If a resident comes to the facility with medication, the placing probation officer is notified prior to the resident's arrival to the facility that all incoming medications are counted and logged in the facility medical log upon intake. The facility has found that physicians prescribing the incoming medication(s) will not prescribe refills when the resident can no longer go to the physician for medication monitoring. Therefore, the facility requires written authorization from the placing probation officer to take the resident(s) to a local physician or child psychiatrist for a medication evaluation/monitoring visit(s) so the medication may be maintained, modified, discontinued, and/or refilled. The cost of the physician office call is billed directly to the placing county. All medication initial fillings and refills are paid for by the facility at time of filling. This cost is then billed to the placing county for reimbursement to Kerr County Juvenile Facility. If a resident(s) is not taking medication at the time of intake, but through the course of their treatment at the facility the treatment staff determines the resident(s) may need medication therapy, the assigned counselor notifies the placing probation officer of the recommendation to take the resident to the physician or child psychiatrist. The counselor has continuously kept the probation officer abreast of the resident(s) treatment _ _pr~ess/regress. The facility then_requires_ written authorzation_from the _ _ __ placing probation officer to have the resident seen by a physician or child psychiatrist for possible medication therapy. If the resident requires emergency medical care, the facility will transport the resident(s) to a local emergency hospital. The placing probation officer will be notified within 24 hours of the medical emergency. The placing county will be billed directly for the emergency medical treatment and all follow-up physician visits. At no time will the Kerr County Juvenile Facility/Kerr County be financially responsible for medical treatment or medication prescriptions. B. Lowering Level of Care The level of care programming at the facility is designed to be completed within 6 to 9 months depending on the compliance of the individual resident. Therefore, the facility does not recommend the lowing of the level of care status for a resident during his stay at the facility. Once the resident leaves the facility successfully, the facility counselor along with the suggestions of the placing probation officer, may include recommendations of lowing the level of care in the discharge summary. IV. Prosram Evaluation A. Evaluation Components The Kerr County Juvenile Facility maintains monthly statistics regarding the number of intakes, discharges (successfuUunsuccessful), and average population. A yearly average of the above stated criteria is computed in order to collect data on a consecutive yearly basis as to ascertain the facility stability and progress. Statistics are kept on discharged residents from the facility. The facility treatment staff "track" individual residents on a monthly basis for 90 days as required by DSHS licensure. Record is kept regarding substance abuse relapse and/or delinquent re-offence. This gives the facility a picture of the success of programming. Since the successful completion of the program is contingent upon the positive progression through the various components of the outlined treatment plan, all aspects of programming are analyzed and computed on a daily basis. These components include, but not limited to, problem solving, decision- making, peer interaction, communication skills, and social skills. The facility daily points system incorporates these components. As the resident improves these skills and behaviors, his leadership qualities arise thus earning him more privileges and level advancement within the 4-Level system. Level advancement/denial is included in the monthly progress reports sent to the resident's probation officer. The facility uses positive solution-based curriculum which is a cognitive __ life skills curriculum. It__is designed to_heln_the resident examine_wh~~h~~ ure_ _- _ _ __ so they can better understand their thoughts and their decision-making habits. The residents learn the building blocks for success. Since this curriculum is "discovery" based in nature, the residents are not evaluated on a "pass or fail" status. We believe it is imperative that a proper balance be reached between motivating and challenging the youth to pursue constructive avenues and not crossing their level of tolerance for frustration, attention and impulse control so that they can experience success and avoid the repeated pattern of failure so common among our residents. The techniques and skills learned in this group setting reveals themselves in other areas of their program. For example, treating others with more respect, feeling compassion for their fellow peers and others, volunteering to help an angry peer de-escalate, and many other social and individual values. Experiential exercises are presented around values clarification, decision-making skills, goal setting and correlating resident interests, skills and the realistic availability of opportunities in the job market. Each resident's vocational or career interests are evaluated. The results of these evaluations become part of the resident's Individualized Treatment Plan. Staff assists the residents with materials aimed at teaching youth the importance of career awareness and j ob preparation. Staff provides counseling and role-play interviews, information on locating a job, completing a job application, etc. This curriculum helps residents make life-changing decisions in their lives. By improving communication and problem-solving techniques, the residents are successful in obtaining maximum daily points, which leads to level advancement within the program. Status reports involving the resident's progress in these areas is included in the monthly progress report sent to the resident's probation officer. Successful discharge occurs when the resident successfully completes all 4 levels of the program. Recreational activities provide an important tool to meet the residents' needs. Activities are used to teach resident's appropriate and fun ways to spend free time, to strengthen the relationship between resident and staff, to develop social and peer interaction skills, to provide a constructive outlet for aggressive energy, to develop a sense of responsibility of and mastery over their environment, to experiment with new roles and to build self-esteem. In addition, the staff uses this time to assess the needs of residents, to assess residents' progress programmatically, to get ideas for future recreational activities for residents and to build a positive resident/staff relationship. The residents are enrolled in the Kerrville Independent School District. State certified teachers are at the facility teaching the residents academics in Math, Science, English, and Social Studies. When a resident arrives at the facility, previous school records are reviewed and the resident is given an assessment exam to find the proper grade level placement. Once the proper grade level has been determined for the resident, he is given an individualized education plan to follow. Upon successful completion of the education plan, the resident is awarded secondary academic credits in each academic area outlined by the plan. If the resident is placed in junior high/middle school ___ areas the resident earns_pass or fail hours. in_each academic area. Academic __ -- - progress/grades are included in the probation officer's monthly progress report. Ken County Juvenile Facility provides crisis intervention services to both residents and their families 7 days/week, 24 hours/day, 365 days/year. These crisis intervention services, as well as all other services, are provided through a team approach. The members of the treatment team are fully informed about the residents on each other's caseload and are capable of delivering quality services to these residents as well as to their own. At all times one of the counselors, assistant facility director, facility director, or shift supervisor can be located immediately in case of an emergency. V. License/Certification Requirements The Texas Department of State Health Services licenses the facility for 18-substance abuse treatment beds. The Texas Juvenile Probation Commission certifies the facility annually. 9 INDIVIDUAL COUNSELING INDIVIDUAL COUNSELING SESSIONS Each therapist meets with each resident on his/her caseload at least once a week for an hour or more. During individual sessions, therapists afford the opportunity for residents, in an environment where trust and emotional security is paramount, to learn a great deal about • peer pressure • depression • family dynamics • foregiveness • domestic violence • anger management • self-control • personal values • career development • decision making • substance abuse • sex offenses Individual sessions are required from the resident's date of arrival to their date of release. Each week all therapists meet with a Licensed Professional Counselor to staff residents who need a modified therapeutic program, in order to meet emotional needs of all residents. Upon the resident's release, he/she has had the benefit of feeling supported, respected, and heard by the therapeutic staff at Kerr County Juvenile Facility. GROUP COUNSELING CONFLICT RESOLUTION GROUP The Conflict Resolution Group taught at Kerr County Juvenile Facility was created in order to teach the residents problem solving techniques, along with the proper expression of emotion when conflict arises in the dorms. Because these residents are accustomed to resolving conflict with violence or other aggressive behaviors in their normal environment, this particular group provides each resident the opportunity to be heard, understood, and held to fair standards. Ultimately, the purpose of this group is to teach each participating resident what a healthy dynamic is between peers, how to function as a dorm when conflict does exist, and why instigating a conflict or provoking others is both unhealthy and dangerous. The members of the group establish the rules governing the activities for the group, and the therapist leading the group is merely a moderator there to assist if needed. Because fair judgement and mutual respect between residents is necessary for the group to operate, this _ experience effectively teaches the tools to successfully resolve conflicts both inside and outside of detention. CASELOAD GROUP Each therapist at Kerr County Juvenile Facility is assigned a caseload of residents with whom they work very closely. Twice weekly, the therapist will meet with every resident on his/her caseload in a group setting. This envir+~nment proves effective because the therapist is acutely aware of the issues and traumas that each resident on his/her caseload is burdened with. The therapist leading the group can therefore strategically assign a topic of discussion or therapeutic activity that will suit the needs of the group in its entirety. In addition, each resident feels a sense of comfort and familiarity with the group leader as this is the therapist that they work with on an individual basis. The purpose of this group is for the participating resident to get the most out of his/her group time and have the opportunity to engage in topics that he/she can relate to and learn from. DRAMA GROUP Residents rehearse and perform scenes and monologues that pertain to their real life. Topics include gangs, being an outcast, sexuality, drugs, suicide, abuse, and rape to name a few. This gives the residents not only self-confidence, but also a chance to examine their own situations in a healthy outlet. Kerr County Juvenile Facility is proud to give all residents a creative and unique channel to demonstrate their talents. In the drama group, residents have the opportunity to act, write scripts, and create scenery and backdrops. EDUCATION EDUCATIONAL PROGRAMMING Kerrville ISD has been recognized as one of the nation's most quality schools. Able to fit a curriculum around the needs of the individual student in order to succeed makes Kerrville ISD the top in its class. At Kerr County Juvenile Facility, our teachers have the unique and enviable tasks of only teaching. Juvenile Detention Officers handle any and all discipline, so the classroom is turned into a positive and successful expereience for the residents. We find that this experience helps the juvenile develop an appreciation for school. However, some juveniles have been out of school for a long period of time and are so far off grade level that they will not be successful in high school. In these cases, residents will receive their GED and in some cases can begin their college education while in the facility. Kerr County Juvenile Facility helps residents find funding for continued education, whether it is college or trade school. Emphasis is put on developing future goals that are attainable and realistic for the resident. Having the resident leave with a positive outlook and a goal oriented future does much for keeping them from reoffending and breaking the cycle of delinquency.