TREATMENT MODULES D-370 FRESNO COUNTY SHERIFF'S OFFICE
JAIL DIVISION POLICIES AND PROCEDURES
TITLE: THERAPEUTIC TREATMENT MODULES NO: D-370
FILE: TREATMENT MODULES
EFFECTIVE DATE: 04-25-16 REVISED:
AUTHORITY: Sheriff J. Zanoni APPROVED BY: Assistant Sheriff T. Gattie
REFERENCE: Fresno County Sheriff's Office Policies and Procedures Section No. 102;
and Hall, et al. v. County of Fresno, 1-11-CV-02047-LJO-BAM (2015).
PURPOSE:
The purpose of this policy is to establish standards and procedures for the use of
Therapeutic Treatment Modules in order to facilitate educational and therapeutic activities
for administratively segregated inmates.
POLICY:
It is the policy of the Fresno County Sheriffs Office Jail Division to use secure Therapeutic
Treatment Modules for the provision of health services to ensure that all seriously mentally
ill inmates housed in administrative segregation single-cell housing units have equal access
to individual and group therapy.
It is the policy of the Fresno County Sheriffs Office Jail Division to use secure Therapeutic
Treatment Modules for the provision of educational and therapeutic activities for any
administratively segregated inmate when necessary to facilitate small group learning and
interaction, in a protected and safe environment.
While the primary use of the Therapeutic Treatment Modules is to facilitate mental health
treatment and programming for administratively segregated inmates, the enclosures may
also be used to accommodate temporary seclusion as addressed in this policy. Under no
circumstances shall the Therapeutic Treatment Modules be used for punishment or as a
substitute for treatment. Any placement into and removal from a Therapeutic Treatment
Module shall be documented via the OffenderTrak system.
PROCEDURES:
Page 1 of 4
FRESNO COUNTY SHERIFF'S OFFICE
JAIL DIVISION POLICIES AND PROCEDURES
TITLE: THERAPEUTIC TREATMENT MODULES NO: D-370
FILE: TREATMENT MODULES
I. THERAPEUTIC TREATMENT MODULES
A. The Therapeutic Treatment Modules (TTM's) are specifically designed for
inmates who pose a threat to staff and/or inmate safety.
1. The TTM's are steel and mesh individual enclosures that allow the
enclosed inmates to view staff and each other while participating in
group learning or therapy sessions.
2. Each module contains a built-in stool that is spring-loaded and can flip
up to allow for wheelchair access. Inmates who require a wheelchair
will remain seated in the wheelchair and can either self-ambulate or be
assisted into the TTM. Some modules are also equipped with a monitor
and spring-loaded desk.
B. The goal is to provide inmates with a therapeutic environment that allows
contact with mental health clinicians and other program facilitators (e.g.,
social workers, educators), as well as other group participants, while
maintaining a safe environment for all, during group and individual
therapeutic/educational sessions.
II. SERIOUSLY MENTALLY ILL INMATES
Seriously mentally ill (SMI) inmates who require single-cell housing (i.e., MJ
FF, SAJ 2D)shall be offered out-of-cell structured behavioral health services a
minimum of three (3)times per week, each lasting approximately one (1) hour
with appropriate duration to be determined by a mental health clinician. The
out-of-cell mental health contacts shall consist of structured individual or group
therapeutic/educational treatment and programming, and shall take place
utilizing the therapeutic enclosures.
III. STAFF RESPONSIBILITY
A. The pass-throughs shall be utilized to handcuff/uncuffthe inmates. Officers
shall utilize safety precautions and be cognizant of the inmate's ability to
reach through the pass-through.
1. Inmates who require single-cell housing should have their handcuffs
Page 2 of 4
FRESNO COUNTY SHERIFF'S OFFICE
JAIL DIVISION POLICIES AND PROCEDURES
TITLE: THERAPEUTIC TREATMENT MODULES NO: D-370
FILE: TREATMENT MODULES
removed after being placed into the TTM. If the inmate is compliant
with direction from staff, the inmate shall be instructed to place their
hands through the pass-through for the purpose of being uncuffed.
2. The handcuffs shall be reapplied prior to removal from the TTM.
3. Shackles shall not be removed until the inmate is returned to their cell.
B. Security/Floor/Escort officers shall coordinate efforts to ensure that the
appropriate OffenderTrak entries are made to reflect the inmate's
movement/attendance. Refusal of any event shall be documented as such.
C. Staff shall not refer to the TTM's as "cages" or by any other derogatory
term. Such references are demeaning and counterproductive to the
therapeutic goal.
IV. AUTHORIZED USE
A. The primary use of the TTM's is to facilitate SMI mental health treatment
and programming, however, the enclosures can also be used to
accommodate:
1. Other administrative segregation inmates who require a secure
environment to participate in group and individual therapeutic/
educational sessions.
2. Video visitations.
3. Telemedicine and telepsychiatry interviews.
4. The brief seclusion of an inmate in a temporary holding cell.
B. Under no circumstances shall the TTM's be used for punishment or as a
substitute for treatment.
C. The maximum time an inmate can remain in a TTM for programming or
group therapy is two (2) hours. Inmates placed in a TTM for the purpose
of visitation or interview shall be removed upon completion of the visit or
interview.
V. TEMPORARY HOLDING CELL
Page 3 of 4
FRESNO COUNTY SHERIFF'S OFFICE
JAIL DIVISION POLICIES AND PROCEDURES
TITLE: THERAPEUTIC TREATMENT MODULES NO: D-370
FILE: TREATMENT MODULES
A. A TTM may be used as a temporary holding cell to briefly seclude an
inmate, and only under the following circumstances-
1. To separate an inmate who appears to be experiencing emotional or
behavioral distress, anxiety, or other crisis that necessitates referral to
Health Services. An inmate may be placed into a TTM while waiting for
Health Services staff to respond, evaluate, and determine an
appropriate plan for the inmate's safety and well-being.
2. To provide for the separation of inmates, enabling the reestablishment
of order subsequent to an altercation or other disturbance. The TTM's
may be used in conjunction with other areas of separation that include
the gymnasiums and classrooms, while waiting for Population
Management to determine the resultant housing transfers.
B. Anytime a TTM is used as a temporary holding cell, the Facility Sergeant
shall be notified.
C. The maximum time an inmate can remain in a TTM for the purpose of
temporary seclusion is one (1) hour. The time of placement, as well as the
projected maximum time requiring removal shall be documented on a dry
erase board, posted adjacent to the TTM.
D. The inmate's placement into and removal from the TTM shall be
documented via the OffenderTrak system via the barcode scanner or by
manual input.
E. Inmates placed in a TTM may be handcuffed if they are not compliant with
direction from staff. Inmates should be uncuffed when safe to do so to
assist in deescalating the situation.
F. The use of the TTM shall be noted on any corresponding incident report.
Page 4 of 4