Effective Date: 10/02                   NUMBER: A-08.10
           HEALTH CARE                Reviewed: 04/07
          POLICY MANUAL               Replaces:
                                                                              Page     1    of   3
                                      Formulated: 10/02

POLICY:      The Program for the Aggressive Mentally Ill Offender (PAMIO) is a 390-bed facility (includes
             14 crisis management beds and 14 intermediate care beds) located at the William P. Clements,
             Jr. Facility in Amarillo, Texas. The program provides mental health evaluation and treatment
             for the aggressive mentally ill offender. The treatment program consists of a multi-disciplinary
             approach through specific modalities.


I.           Program Admission Criteria

             A. Offender/patient must be male and from a TDCJ-ID facility;
             B. Current Axis I clinical disorder or current Axis II personality disorder other than only
                Antisocial Personality Disorder;
             C. History of assaultive, predatory, exploitive, or self-directed aggression, as evidenced in the
                disciplinary record;
             D. IQ of 73 or above;
             E. Offenders in Administrative Segregation or Close Custody* status;
                *Close Custody offenders may be accepted if it is clear to the sending treatment staff that
                the offender is likely to be soon classified as Administrative Segregation if adequate
                intervention is not taken;
             F. Physical medical needs that can be met at the William P. Clements Facility;
             G. A signed voluntary consent form for PAMIO treatment is obtained.

II.          Program Re-admission Criteria
             Offenders who have had an opportunity to work the PAMIO but were discharged, or
             demanded to be released before completing the program, will be considered on an individual
             basis after an interim period of at least 6 months out of the Program.

III.         Program Exclusionary Criteria

             A. Confirmed membership in a group identified as a current specific threat by the TDCJ
                Security Threat Group. A list of the current groups in this classification is maintained by
                security, or you may contact PAMIO, for verification of any offender’s affiliation.
                Note: confirmed membership in a “disruptive group”, as defined by TDCJ, is not a
                barrier in itself to Program access, only those groups identified as stated above will be
                excluded from consideration for admission.
             B. Offender is identified as “at risk” and in need of Protective Custody.
                                  Effective Date: 10/02                   NUMBER: A-08.10
       HEALTH CARE                Reviewed: 04/07
      POLICY MANUAL               Replaces:
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                                  Formulated: 10/02

         C. Offender has had three (3) previous admissions to the PAMIO. Note: Exceptions to this
            exclusion will require special justification by the referring clinician and specific approval
            by the PAMIO admissions committee.
         D. Offender has an IQ below 73. Note: Offenders with an IQ below 73 should be referred to
            the Mentally Retarded Offender Program (MROP)

IV.      Referrals process to PAMIO

         A. Referring facility responsibilities:
            1. Complete the attached Admission/Referral Application (Attachment A). The packet
                includes information about the offender/patient’s mental health status and his
                behavioral history.
                Note: Information that is available in the TDCJ database will be checked when the
                referral packet is received at the PAMIO, to insure accuracy at the time of the
                admission decision.
            2. Attach the most recent copies of the psychiatric, psychological, and social (or
                psychosocial) evaluations available.
            3. Insure that the referral packet is signed by the referring clinician, and includes the
                signed consent form HSP-16.
         B. PAMIO responsibilities:
            1. Once the referral application is received at the PAMIO, the Admission/Discharge
                Committee will review the application and make an admission decision on the
            2. The offender/patient’s referring clinician will be notified by e-mail of the committee’s
            3. Information for the offender/patient accepted into the PAMIO will be submitted to the
                Classification and Records Office for transfer to the Clements Facility.
                Note: There is often a waiting period before the Office of Classification and Records
                actually moves the offender to the Clements Facility. If the wait seems unusually long,
                please call PAMIO and/or the TDCJ Health Services Liaison for assistance.
         C. Physician Transfers/Referrals:
            “Doctor-to-Doctor” referrals and transfers are generally not made. The PAMIO is not an
            acute inpatient treatment program and Crisis Management cells are limited. Therefore, it
            should be rare that an offender/patient would need to be transported as an emergency
            admission. If such instances arise however, the referring facility’s staff will need to
            complete the referral application with signed consent form HSP-16 and fax it to the
            PAMIO for immediate review. The sending physician/psychiatrist will contact the PAMIO
            Clinical Director for an admission decision. If a doctor to doctor transfer is made, it must
            be approved by the Classification and Records Office to address security issues.
                                       Effective Date: 10/02                 NUMBER: A-08.10
       HEALTH CARE                     Reviewed: 04/07
      POLICY MANUAL                    Replaces:
                                                                             Page    3    of   3
                                       Formulated: 10/02

For questions related to a PAMIO referral, please contact the Clinical Director at (806) 381-7080 ext. 474.

To expedite the referral process, referral packets may be sent US Mail to: PAMIO/TTUHSC: William P.
Clements Facility; 9601 Spur 591, Bldg. 25; Amarillo, TX 79107-9606; Attn: Director of Psychology, or may
be faxed to (806) 383-3720. Truck mail is available, but takes much longer.

Index:                MROP admission
                      PAMIO referrals

Reference:            2008 NCCHC Standard P-A-08, Communication on Patients’ Health Needs (essential)
                      2008 NCCHC Standard P-E-05, Mental Health Screening and Evaluation (essential)
                      2008 NCCHC Standard P-E-12, Continuity of Care During Incarceration (essential)

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