Appendix Four: Sample Contract for Participation

No. ___________________________

IN THE MATTER OF: § IN THE DISTRICT COURT

§
§ 386TH JUDICIAL DISTRICT
§
____________________________ § BEXAR COUNTY, TEXAS

CROSSROADS COURT CONTRACT

I hereby request to be considered for the Crossroads Court Program. I understand that the opportunity to
participate in this program is a privilege, not a right.

I understand that any verbal or written statements made to the Crossroads team regarding the conduct giving
rise to my inclusion in the Crossroads program can not be used against me in any court proceedings. However,
any statements or admissions can be considered by the team in determining my treatment plan, phase
advancements, sanctions, incentives and overall progress in the program. I also understand that it is important
for me to be honest and forthcoming about my situation so that the Crossroads team may be better able to help
me. Knowing this, I hereby voluntarily admit that I did engage in conduct for which I could be formally
prosecuted: ______________________________________ ______ ( initials)

I acknowledge that if I am accepted, the following will apply to me as long as I am a participant in the program:

1. I understand that if I am accepted as a participant in Crossroads Court, the Judge will

order that participation in the program is a condition of probation. I must comply with the
requirements of the program in addition to all other conditions of probation that are imposed by the
Judge. Termination from Crossroads Court may result in the State requesting that my probation be
revoked.

2. I represent that I have never been found True or placed under supervision of any type for any
violent offense anywhere.

3. I will appear at all Crossroads Court Hearings as instructed by any member of the Crossroads
Court Team. The Team is comprised of representatives from the District Attorney’s Office, my
defense counsel, court staff, treatment providers, the Bexar County Juvenile Probation Department, and
the Crossroads Court Judge.

4. I understand that I may be required to provide urine, breath or other samples at any time while I
am in this program. Failure to provide a timely, valid sample will be considered a failed test for
purposes of phase advancement and may result in a sanction or termination from the program.

5. I understand that I may be required to complete a breathalyzer exam to determine alcohol

or tobacco use. Failure to provide a timely, valid sample will be considered a failed test for
purposes of phase advancement and may result in a sanction or termination from the program.

Revised 3/09
6. A psychiatric, psychological or other assessment may be required to determine whether my
participation in Crossroads Court is appropriate. I will cooperate with the evaluator. I will
report to the evaluator for my assessment on the date and time scheduled by my probation officer.

7. I will report to my mental health treatment provider as instructed. Treatment sessions may be
extended or shortened if deemed necessary by the Crossroads Court Team.

8. I agree to sign an individualized treatment plan with a Crossroads team member and to
participate in the accomplishment of the goals and objectives as designated. Failure to make
progress may result in increased treatment. If my treatment plan requires me to enter residential
treatment, I understand that I may be required to pay some or all of the expenses related to residential
treatment.

9. I understand that my counselor may develop a plan for me that focuses on issues in
addition to those dealing with mental health. If given an opportunity to choose my treatment
providers, I agree to first select a provider that will address my mental health issues.

10. I consent to allow information concerning me to be given to all Crossroads Court team
members as needed to carry out official tasks of the Program. This includes, but is not limited to:
assessment reports, test results, treatment attendance, doctor’s appointments, office visit compliance,
school attendance, and overall program progress.

11. I understand that statements made by me to any Crossroads Court team member regarding
my mental health issues will not be used against me as the basis of a motion to modify. However,
statements may be considered in modifying my treatment plan and may also be the basis for a
sanction.

12. I agree to fully participate in the mental health treatment that will be delivered in the following
Crossroads Court phases. Advancement to a higher phase will be conditional upon
recommendation of the Crossroads Court team and final approval of the Judge. Phase
advancements will be considered by the Crossroads Court team at the staffings immediately
following successful completion of all phase requirements. Approval of phase advancements will
be announced by the Judge at the Crossroads Court docket following the staffings. As a result, all
phase start dates will coincide with Crossroads Court docket dates.

Phase I
1. Orientation/Overview of program
2. Assessment and initial treatment plan development.
3. Treatment plan will be finalized by the Crossroads Court team and may include:
Family Intervention
Individual counseling
Classes or Programs
4. Two random urinalysis, breath or other tests per week
5. Two Court appearances per month
6. No unexcused school absences or absences from Crossroads appointments.
7. Minimum of two visits with assigned treatment provider per week. Visits may be held at the Probation
offices, school or home.
8. 6:00 p.m. curfew with random curfew and school checks occurring twice a week.
9. Continued participation in pre-qualified extra-curricular activities.
Revised 3/09
 Advancement Criteria for Phase I
No positive urinalysis, breath or other test results for minimum 4 weeks prior to advancement;
No unexcused absences from scheduled services for minimum 4 weeks prior to advancement; and

No unexcused absences from an educational or other structured program (ex: school, GED, summer program etc.) for
minimum 4 weeks prior to advancement.

Phase II
1. Ongoing review and updating of treatment plan.
2. Treatment plan will be determined by the Crossroads Court team and may include:
Family Intervention
Individual counseling
Classes or Programs
3. One random urinalysis, breath or other test per week
4. Two Court appearances per month
5. Minimum of one visit with assigned treatment provider per week. Visits may be held at the Probation
offices, school or home.
6. 8:00 p.m. curfew with random curfew checks occurring once a week.
7. Recreational fellowship and continued participation in pre-qualified extra-curricular activities.

Advancement Criteria for Phase II

No positive urinalysis, breath or other test results for minimum 6 weeks prior to advancement;
No unexcused absences from scheduled services for minimum 6 weeks prior to advancement; and
No unexcused absences from an educational or other structured program (ex: school, GED, summer program etc.) fo
minimum 6 weeks prior to advancement

Phase III
1. Ongoing review and updating of treatment/transition plans.
2. Treatment plan will be determined by the Crossroads Court team and may include:
Family Intervention
Individual counseling
Classes or Programs
3. One random urinalysis, breath or other test every two weeks.
4. One Court appearance per month
5. One visit with assigned treatment provider every two weeks. Visits may be held at
the Probation offices, school or home.
6. 9:00 p.m. curfew with random curfew checks occurring once every two weeks.
7. Recreational fellowship and continued participation in pre-qualified extra-curricular activities.

Advancement Criteria for Phase III - Graduation

No positive urinalysis, breath or other test results for minimum 8 weeks prior to advancement;
No unexcused absences from scheduled services for minimum 8 weeks prior to advancement; and
No unexcused absences from an educational or other structured program (ex: school, GED, summer program etc.) fo
minimum 8 weeks prior to advancement

Revised 3/09
13. I will take all medications prescribed to me by my doctors and will immediately notify my
probation officer of any changes to my medications.

14. I will not use alcohol, illegal drugs, cigarettes, tobacco or medications prescribed to others.

15. I will not enter an establishment whose primary purpose is to sell alcoholic beverages, nor will I
remain at a location where alcohol is the main item for sale or consumption.

16. I must disclose all over the counter medications that I take to the Crossroads Court team prior
to taking the medications. I will pre-register any and all medications, prescribed or over-the-counter,
with my treatment provider and the Crossroads Court, and will only take medication as directed. I will
not use prescription drugs without a valid prescription. I may be required to sign a medical release for
access to medical records.

17. I understand that Probation Officers employed by Bexar County will conduct supervisory
contacts concerning me. These contacts may occur at my home, my school, the treatment center, the
Juvenile Justice Center, or anywhere deemed necessary, consistent with the confidentiality of my
treatment. I will report when and where as directed by these officers.

18. I understand that I can expect to receive incentives when I progress in the program and sanctions
when I do not. Various forms of positive reinforcement will be used by the Team to encourage me to
progress in the program. Failure to attend required counseling sessions, doctor’s appointments,
meetings, probation office visits, urinalysis tests, failure to remain drug and alcohol free, failure to take
prescribed medications, or failure to demonstrate progress in treatment will result in a review of my case
by the Crossroads Court Judge. Sanctions might include the loss of curfew privileges, additional
required community service hours, written assignments, tighter supervision, detention, or termination
from the program.

19. I agree to promptly and truthfully answer all questions asked by any member of the Crossroads
Court team.

20. I agree to obey all directions given to me by any Crossroads Court team member.

21. I agree to reside locally and to not change my address without the approval of the Crossroads
Court team.

22. I agree not to change my education status without the approval of the Crossroads Court team.

23. I will not violate the law or associate with any person engaged in criminal activity.

24. I agree not to posses any illegal weapon of any form at any time, and I will disclose the presence of
any weapons by anyone in my household.

25. I will not leave Bexar County without the approval of the Crossroads Court team.

26. I will attend all court hearings, counseling/treatment sessions and probation meetings. Failure to
attend a court hearing may result in the issuance of a warrant. I understand that if I am unable to attend

Revised 3/09
 a court hearing, treatment session or probation meeting, I will contact my probation officer at least two
hours before the scheduled time. Only excused absences will be allowed to be made up.

27. I will complete all tasks as directed by the Crossroads Court Judge. Examples of such tasks may
include, but are not limited to: paying restitution, staying in school, life skills education, recreational
fellowship, community resource referrals, and community service work.

28. I understand that I am not allowed to possess gang-related material and/or clothing at any time.
This prohibition includes, but is not limited to, possessing gang-related material and/or clothing at
school, court hearings, counseling sessions and at home.

29. I understand that I must dress appropriately for school, court hearings and counseling sessions.
Sagging, body piercings and gang-affiliated clothing and jewelry are strictly forbidden. Wearing teeth
grills is also prohibited.

30. I understand that should I be terminated from Crossroads Court, my case will be heard by
the associate judge. If I, my attorney or another party objects to the associate judge, my case will be
transferred to another district judge.

31. I understand that participation in the Crossroads Court involves a minimum time commitment
of six months.

32. I understand that my probation officer may search me, my room and/or my possessions at any
time while I am in Crossroads Court.

Revised 3/09
I understand and accept the contents of this form which I have read or have had read to me.

__________________________________________ ___________________________________________
Assistant District Attorney Probation Officer

__________________________________________ _____________________________________________
Respondent / Date Defense Counsel / Date

__________________________________________ _____________________________________________
Respondent’s Parent / Date Respondent’s Parent / Date

_______________________________________________
Judge Laura L. Parker

Revised 3/09