DEPARTMENT OF JUVENILE JUSTICE L. Gale Buckner / Commissioner 3408 Covington Highway, Decatur, Georgia 30032 404-508-6500 FAX: 404-508-7340 TRANSMITTAL #12-11 May 21, 2012 TO: DJJ Staff FROM: L. Gale Buckner Commissioner RE: DJJ 8.30, Physical Intervention Continuum DJJ 8.31, Restraint of Youth DJJ 8.32, Security Emergency Response Teams DJJ 8.33, Use and Control of Chemical Agents DJJ 10.2, Transportation Unit Radio Operations DJJ 10.10, Referrals for Transportation Services DJJ 11.3, Medical Classification DJJ 11.17, Hunger Strikes DJJ 11.40, Medical Autonomy DJJ 11.41, Clinic Space, Equipment and Supplies DJJ 13.1, School District DJJ 13.4, Educational Staffing and Professional Staff Development DJJ 15.10, Language Assistance Programs DJJ 8.30, Physical Intervention Continuum, states that Department of Juvenile Justice staff shall use a positive approach to building healthy relationships including effective communication, making empathetic connections, and establishing a structured, consistent environment. This policy replaces the existing DJJ 8.30, Safe Crisis Management and the existing DJJ 8.30, Use of Physical Control Measures. All secure facilities and community service offices will now use this policy. This policy does not require local operating procedures. Substantial changes have been made to this policy, so please review it in its entirety. DJJ 8.31, Restraint of Youth, states the Department of Juvenile Justice staff shall use the least restrictive alternative needed to restrain a youth. This policy replaces the existing DJJ 8.31, Restraint of Youth. This policy requires local operating procedures. The following changes were made: Staff will not carry youth in an attempt to move them from one place to another. (See Section III.D.) A youth will only be placed in a restraint chair when he/she continues violent behavior after being restrained with a side waist chain and cuffs and is being physically held by staff or as indicated in a Special Management Plan. (See Section III.H.12.) The therapeutic restraint episode must be ordered by a Physician, Psychologist or Psychiatrist. (See Section V.A.2.) AN EQUAL OPPORTUNITY EMPLOYER
If a youth should remove his/her therapeutic restraints, he/she will be reassessed to determine whether restraints are still needed. The mere removal of the restraints is not sufficient in itself to reapply the restraints. Restraints will be re-applied only in those situations in which the youth has not regained control and still meets the clinical criteria for restraint. A new order for the therapeutic restraint must be issued. (See Section V.C.2.) The Designated Mental Health Authority (DMHA) will conduct an annual inventory of all therapeutic restraint to ensure that each restraint is operable, usable, and meets the clinical needs of the current population. (See Section V.F.) o The DMHA will document this inventory on the Therapeutic Restraint Annual Inventory Form (Attachment E). o The DMHA will send a copy of the completed form to the facility Director and to the Regional Behavioral Health Services Administrator. The DMHA will also file a copy in the facility program plan. The restraint inventory form must be located with the restraints. (See Section VI.A.) At the discretion of the facility Director, the Shift Supervisor may be assigned and carry handcuffs for the duration of his/her shift. The Security Emergency Response Team will be assigned its own handcuffs in accordance with DJJ 8.32, Security Emergency Response Team. (See Section VI.E.) DJJ 8.32, Security Emergency Response Teams, states that Department of Juvenile Justice secure facilities may operate a Security Emergency Response Team to assist other staff and enhance facility safety and security. This policy replaces the existing DJJ 8.32, Security Emergency Response Teams. This policy requires local operating procedures. The following changes were made: The definition for physical intervention continuum was added. All Safe Crisis Management language was changed to physical intervention continuum. The Security Emergency Response Team will maintain and document its daily activities in a logbook. (See Section III.D.) The Security Emergency Response Team will perform drills on a monthly basis, at minimum. (See Section IV.B.) The SERT team will use physical intervention techniques as taught by the Office of Training. The SERT Lieutenant will document all drills on the Drill Report Form (Attachment A). The Drill Report Forms will be maintained in a file in the Lieutenant s office. (See Section IV.C.) The SERT team may use pepper ball guns as trained by the Office of Training. (See Section IV.D.) DJJ 8.33, Use and Control of Chemical Agents, states that staff shall use the least restrictive alternative when ensuring the safety of youth in their care. The Commissioner shall issue authorization in writing for those facilities approved to use a chemical agent. This policy replaces the existing DJJ 8.33, Use and Control of Chemical Agents. This policy requires local operating procedures. The following changes were made: Each pepper ball launcher will be stored in accordance with DJJ 8.32, Security Emergency Response Teams. (See Section III.C.3.) The Chemical Agent Inventory Sheet will be maintained according to the facility s local operating procedure. (See Section III.C.4.) For facilities without a Security Emergency Response Team, OC products will be used only by a properly trained shift supervisor or his/her supervisor (not by other security staff) after authorization from the Director, Associate Director, Assistant Director(s), or Administrative Duty Officer. (See Section III.D.5.) Use of OC products will be videotaped with a hand-held video camera. (See Section III.D.10.) Page 2 of 6
Following the use of OC product, health care staff will immediately be notified, and the youth will not be left unattended while experiencing symptoms from the OC product, or for a minimum of one hour. (See Section III.D.12.) Immediately (30-60 seconds) after the use of OC product, the youth may be mechanically restrained to prevent further aggressive behavior. (Youth will be restrained only for the time necessary to gain and maintain control) (See Section III.E.) The on call medical services staff will return to the facility as clinically indicated to evaluate the youth in person, or advise emergency medical treatment. (See Section III.E.1.b.) Post-intervention care will be provided in accordance with Attachment D, Post-Chemical Intervention Care. (See Section III.E.2.) Staff exposed to an OC product will be decontaminated as described in Attachment C Post Chemical Intervention Care. (See Section III.F.) The facility Regional Administrator will be immediately notified of all OC product use through the chain of command. (See Section III.G.2.) DJJ 10.2, Transportation Unit Radio Operations, states that Department of Juvenile Justice Transportation Unit Officers shall use wireless communication devices with a push to talk function to communicate information essential to operations and the safety and security of the staff and youth. This policy replaces the existing DJJ 10.2, Transportation Unit Radio Operations. This policy does not require local operating procedures. The following changes were made: On calls of a serious nature (such as riots, fires, serious injuries, or officer in need of assistance) the Communication Officer will immediately notify the supervisor, the Captain and the Deputy Commissioner of Support Services, through the chain of command. (See Section IV.H.) OTIS will provide text messaging with proper justification and funding as approved by the Chief Information Officer. (See Section V.D.3.) DJJ 10.10, Referrals for Transportation Services, states that the Department of Juvenile Justice Transportation Unit shall provide secure transports, single transports, and courtesy transports upon request. This policy replaces the existing DJJ 10.10, Referrals for Transportation Services. This policy does not require local operating procedures. The following changes were made: If any information in the request changes, the requestor must notify the Transportation Unit administrative staff immediately of the change via email to transportationrequest@djj.state.ga.us. (See Section III.A.3.) The community case manager will notify youth who are scheduled to arrive from a community placement (including home) to an RYDC for transport in advance that they must arrive no later than 5:00 AM the day of transport. The community case manager will coordinate with the facility to ensure that medical staff are aware of the youth s arrival and are present if necessary. (See Section III.B.) The RYDC will ensure that the intake process is complete and the youth is ready for transport by 7:00 AM. (See Section III.B.3.) Staff will request a single transport in JTS, providing at least 72 hours advance notice of the need for the transport. (See Section III.C.1.) Transportation Unit Administrative Staff will handle requests for a courtesy transport on a case-bycase basis. (See Section III.D.1.) When a youth is transported by the DJJ Transportation Unit, the sending facility will attach the PBS to the Officer Transfer Form. (See Section III.E.) DJJ 11.3, Medical Classification, states that to ensure a safe environment for all youth, the Department of Juvenile Justice shall objectively classify youth with special medical needs. This policy replaces the Page 3 of 6
existing DJJ 11.3, Medical Classification. This policy does not require local operating procedures. The following changes were made: The medical alerts list has been updated. (See Section III.A.) With the exception of asthma, seizure disorder and diabetes alerts, medical services staff will not indicate the youth's medical diagnosis in the medical alerts. (See Section III.B.) The Designated Health Authority will review all medical alerts weekly and will ensure that the alerts are accurate. (See Section III.E.) DJJ 11.17, Hunger Strikes, states that any youth who declares, initiates, or participates in a hunger strike shall have a Special Management Plan developed by medical services and behavioral health staff. This policy replaces the existing DJJ 11.17, Hunger Strikes. This policy does not require local operating procedures. The following changes were made: Instead of the Chiefs of Psychiatry and Psychology Services being notified of a youth s hunger strike, the Director of OBHS or his/her designee will be notified. (See Section III.E.) Parents/legal guardians will only be notified of a youth s hunger strike if the youth is under the age of 18. Mental health and medical services staff will jointly develop a Special Management Plan within 72 hours of the youth declaring the hunger strike (see DJJ 12.22, Special Management Planning). If a youth is placed on a Special Management Plan due to the hunger strike, the youth will also be referred to the Behavioral Health Placement Review Panel. (See Section III.G.) DJJ 11.40, Medical Autonomy, states that the Office of Health Services shall provide quality health care services to youth housed in all DJJ secure facilities. This policy replaces the existing DJJ 11.40, Medical Autonomy. This policy requires local operating procedures. The following changes were made: In accordance with DJJ 11.43, Health Care Staffing, the DJJ Medical Director will determine the level and type of staffing, the job responsibilities of the health care staff, and positions assigned to each facility. (See Section III.A.) Each facility s Designated Health Authority will prepare schedules that reflect appropriate staffing levels for health care and dental staff, in accordance with DJJ 11.43, Health Care Staffing. The DHA will submit each monthly schedule to the Regional Health Services Administrator within 5 business days before the start of each schedule. (See Section III.B.) Designated Health Authorities are responsible for documenting services in JTS within the appropriate module and applicable time frames. (See Section III.D.) Non-medical personnel will not compromise medical decisions, to include interfering with offsite transports for medical care. (See Section III.F.4.) For all Injury Severity Ratings of 4 and above, the Regional Health Services Administrator, DJJ Medical Director, and Deputy Commissioner of Programs and Education will be notified via email as soon as possible but no later than 12 hours after the decision is made. (See Section III.I.) The Regional Health Services Administrator will have input into the annual evaluation of job performance for lead nurses and nurses managers. (See Section III.L.) The Designated Health Authority, responsible physician, Regional Health Services Administrator, and the facility Director will sign all health and medical services local operating procedures. (See Section III.M.) DJJ 11.41, Clinic Space, Equipment and Supplies, states that the designated health services area of each secure facility shall have sufficient space, equipment, and supplies to support the provision of health care services to the youth assigned to the facility. This policy replaces the existing DJJ 11.41, Clinic Space, Equipment and Supplies. This policy does not require local operating procedures. The following changes were made: If the youth refuses to take the medication and refuses to give the medication back to the nurse, the security staff that is observing the administration will immediately confiscate the medication. Page 4 of 6
(See Section III.A.3.) When the presence of security staff is requested or necessary, medical services staff will make efforts to provide auditory and visual privacy consistent with safety and security concerns. (See Section III.A.5.) The Regional Health Services Administrator and the Designated Health Authority will ensure that medical services staff maintain appropriate equipment and technological connectivity to allow entry of medical information into the electronic health record. (See Section III.L.) DJJ 13.1, School District, states that as a Special School District with all of the powers, privileges and authority of any other school district, the Department of Juvenile Justice shall follow all applicable rules and regulations of the State Board of Education. This policy replaces the existing DJJ 13.1, School District. This policy does not require local operating procedures. The following changes were made: The Associate School Superintendent will visit each facility to observe the education program not less than twice a year. (See Section III.D.2.) The Associate Superintendent will supervise all Regional Principals, Area Supervisors, and RYDC and YDC Principals. (See Section III.D.4.) The Associate Superintendent of Schools will assign Regional Principals and Areas Supervisors to schools within DJJ s regions and districts to ensure that educational services are appropriate to achieve identified goals and student outcomes. (See Section III.D.) o Regional Principals and Areas Supervisors are required to visit their assigned sites no less than twice a month. Within 10 business days after a site visit, Regional Principals and Areas Supervisors will provide a written report of the site visit findings to the Associate Superintendent, facility Director, Principal and Lead Teachers. o The Associate Superintendent of Schools may designate Area Supervisors to serve as YDC Principals. Teachers, in coordination with the Principal or Area Supervisor will ensure that technology and software are functional and are utilized as prescribed by the Office of Education Services. Principals will work directly with the Associate Superintendent and the Office of Technology Services to address any identified problems until they are resolved. (See Section III.E.3.) DJJ 13.4, Educational Staff and Professional Staff Development, states that Department of Juvenile Justice professional educational personnel shall hold valid Georgia certificates, work in their fields of certification, and meet minimum criteria for licensure developed by the Georgia Professional Standards Commission. This policy replaces the existing DJJ 13.4, Educational Staffing and Professional Staff Development. This policy does not require local operating procedures. Substantial changes have been made to this policy, so please review it in its entirety. DJJ 15.10, Language Assistance Services, states that the Department of Juvenile Justice shall prohibit discrimination based on limited English proficiency. To ensure effective communication with all youth at all points of contact and meaningful access to all programs and services, language assistance services shall be provided to youth with limited English proficiency. This is a new policy. This policy does not require local operating procedures. INSTRUCTIONS: DJJ Policy Manual Remove the following policies from the policy manual DJJ 8.30, Safe Crisis Management (previous SCM locations) DJJ 8.30, Use of Physical Control Measures (previous non- SCM locations) Page 5 of 6
DJJ 8.31, Restraint of Youth (for both previous SCM and non-scm locations) DJJ 8.32, Security Emergency Response Teams DJJ 8.33, Use and Control of Chemical Agents DJJ 10.2, Transportation Unit Radio Operations DJJ 10.10, Referrals for Transportation Services DJJ 11.3, Medical Classification DJJ 11.17, Hunger Strikes DJJ 11.40, Medical Autonomy DJJ 11.41, Clinic Space, Equipment and Supplies DJJ 12.22, Behavior and Risk Management (previous non- SCM locations) DJJ 13.1, School District DJJ 13.4, Educational Staffing and Professional Staff Development Place the following policies in the policy manual DJJ 8.30, Physical Intervention Continuum DJJ 8.31, Restraint of Youth DJJ 8.32, Security Emergency Response Teams DJJ 8.33, Use and Control of Chemical Agents DJJ 10.2, Transportation Unit Radio Operations DJJ 10.10, Referrals for Transportation Services DJJ 11.3, Medical Classification DJJ 11.17, Hunger Strikes DJJ 11.40, Medical Autonomy DJJ 11.41, Clinic Space, Equipment and Supplies DJJ 12.22, Special Management Planning (for those facilities who were not previously using this policy) DJJ 13.1, School District DJJ 13.4, Educational Staffing and Professional Staff Development DJJ 15.10, Language Assistance Services Make the proper notations. Page 6 of 6