Fifth Judicial District - Department of Correctional Services

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TITLE: Sotp Hormonal Intervention Therapy

POLICY

Iowa Code Section 903B and Iowa Administrative Code 201-38.4 require that all eligible sex offenders be evaluated for the appropriateness of hormonal intervention therapy. The Department will provide hormonal intervention therapy for designated sex offenders whose offense occurred after June 30, 1998. Hormone intervention provides offenders with controlled levels of medroxyprogestrone acetate (MPA) or other approved pharmaceutical agent treatment as a condition of release by the Court or Board of Parole. Offenders may voluntarily undergo a permanent surgical alternative approved by the Court or Board of Parole.

The Department shall contract for psychological services for the psycho-sexual assessment, medical services for the medical assessment and the administration and clinical supervision of the hormonal therapy.

PROCEDURE

  1. A Psycho-Sexual Assessment shall be conducted by, or under the direction of, the Contracted Provider on all "affected" offenders as a part of the pre-sentence investigation (PSI) prior to sentencing or upon entry into Department supervision. The assessment shall include a determination as to the need and effectiveness of hormonal therapy

    "Affected" offenders are all offenders who have been found guilty of the commission of a serious sex offense and ordered by the Court or Board of Parole to participate in Hormonal Intervention Therapy as a condition of release.

    1. The Court may require hormone intervention for the first conviction.
    2. The Court is required to mandate treatment intervention for a second or subsequent convictions, unless a determination is made that the treatment would not be effective.
    3. The Court may include a special sentence for felony sex offenders that require custody/supervision for the rest of the offender's life. The special sentence shall also include hormonal intervention therapy.
  2. When a recommendation for hormonal intervention therapy is being considered and prior to initiating hormonal intervention therapy, a medical assessment of the offender will be completed.
    1. Presentence investigator or supervising agent shall refer the offender to the contracted medical professional for a medical assessment. The presentence investigator or supervising agent shall arrange the appointment with the time, and place of the appointment provided to the offender.
    2. The presentence investigator or supervising agent shall advise the offender they will be responsible for fees for the medical assessment.
  3. A licensed medical practitioner following a medical assessment shall authorize all pharmaceuticals necessary for Hormonal Intervention Therapy.
  4. Pharmaceutical services may be provided by a local pharmacy or by the Department of Corrections pharmacy identified below:
    • Department of Corrections Pharmacy
    • Iowa Medical and Classification Center
    • Box A
    • Oakdale, IA 52319
    • Telephone #319/626-4423
    • Fax #319/626-4498
  5. If hormonal medication is stored or administered within a Department Facility, the following criteria shall govern the security and control of the medication:
    1. Hormonal medication shall be maintained in the facility only under the authorization of medical personnel.
    2. All such medication shall be packaged and labeled in accordance with Section 657-8.14(155A) of the Iowa Administrative Code.
    3. Prescribed medications at the facility shall be kept in a secure manner at all times.
    4. Only authorized personnel shall have access to the medications.
  6. Hormonal Intervention Therapy is to be used in conjunction with a sex offender education/treatment program. These medications are not to be used as a sole method of treatment. Hormonal Intervention Therapy should be coupled with appropriate monitoring and counseling within a comprehensive treatment plan. To improve effectiveness, the offender should participate in cognitive behavioral treatment designed to address other aspects of the deviant behavior in addition to sexual interests.
  7. Initiation of Hormonal Intervention Therapy
    1. Hormonal Intervention Therapy shall use medroxyprogestrone acetate (MPA) or other approved pharmaceutical agents as prescribed by a physician.
    2. Hormonal Intervention Therapy shall be initiated at least sixty (60) days prior to release from incarceration. The supervising agent shall coordinate initiation of treatment with county jail staff.
    3. The offender shall be referred to contracted health professionals to administer and provide clinical supervision for hormonal therapy.
    4. The supervising agent shall document a description of the type of treatment initiated, modified, or terminated. Documentation shall be kept in the offender file.
    5. The offender will be responsible for any fees for the hormonal intervention therapy.
    6. The Department's Contracted Provider shall assess requests for hormonal therapy by sex offenders who do not meet the criteria previously described.
    7. At any time during the course of supervision, the Contracted Provider may conduct a reassessment to determine if hormonal therapy should be considered or reconsidered as part of the treatment plan.
  8. Monitoring/Termination of Hormonal Therapy
    1. The supervising agent shall regularly monitor the offender's compliance with the hormonal therapy.
    2. While most offenders will remain on hormonal therapy for their entire period of supervision, the supervising agent may refer the offender to the Contracted Provider for assessment for modification or termination of hormonal therapy if deemed necessary. Provider recommendations for termination of the condition for hormonal therapy will be made to the Court or Board of Parole.
    3. Hormonal Therapy may be discontinued without medical authorization per the offender's written request. Since maintaining hormonal therapy is a condition of release, termination without medical authorization is grounds for revocation.
    4. Hormonal therapy shall be discontinued per order of a physician under contract with the Department. Documentation by the physician of the conditions that endanger the offender's health shall be required.
  9. Maintenance/Transfer of Records
    1. Offender file information shall be available to all institutional and community based corrections staff and shall be transformed whenever the offender is transferred to another agency. The materials shall include:
      1. Presentence Investigation
      2. Minutes of Testimony
      3. Status of Relationship with Victim
      4. Sex Offender Risk Assessment
      5. Psycho-Sexual Assessment
      6. Medical Assessment
      7. Chronological summary of all treatment intervention
      8. Summary of the offender's participation and progress in treatment whenever the offender is transferred to another agency.
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