SOP_NUMBER: 209.09-att-1 TITLE: Tier III Program Assignment Request Form REFERENCE_CODE: IIB09-0004 DIVISION: Facilities TOPIC_AREA: 209 Policy-Facilities Control/Discipline/Segregation EFFECTIVE_DATE: 2025-04-23 WORD_COUNT: 442 POWERDMS_URL: https://public.powerdms.com/GADOC/documents/512950 URL: https://gps.press/sop-data/209.09-att-1/ SUMMARY: This form is used to request assignment of an offender to the Tier III Program within the Special Management Unit (SMU). Wardens submit this form when an offender's behavior or history poses security concerns requiring enhanced management and separation from the general population. The form documents specific reasons for assignment, allows for emergency placement requests, and ensures the offender receives notice and a hearing within 48 hours to respond to the assignment request. KEY_TOPICS: Tier III Program, Special Management Unit, SMU, offender assignment, security threat, escape risk, violent behavior, disciplinary infractions, weapons possession, riot participation, hostage taking, disruptive behavior, assaultive offender, emergency placement, 48-hour hearing, institutional file ATTACHMENTS: 1. Tier III Program Assignment Request Form URL: https://gps.press/sop-data/209.09-att-1/ 2. Special Management Unit: Tier III Program Assignment Memo URL: https://gps.press/sop-data/209.09-att-2/ 4. Special Management Unit: Tier III Program 90-Day Review Hearing Form URL: https://gps.press/sop-data/209.09-att-4/ 5. Special Management Unit: Tier III Program 60-Day Review Hearing Form URL: https://gps.press/sop-data/209.09-att-5/ 6. Special Management Unit: Tier III Program Privileges Chart URL: https://gps.press/sop-data/209.09-att-6/ 7. Tier III Program 90-Day Review_Classification Appeal Form URL: https://gps.press/sop-data/209.09-att-7/ 8. Tier III Program 60 Day Review_Classification Appeal Form URL: https://gps.press/sop-data/209.09-att-8/ 9. Special Management Unit: Tier III Program Cell Check Sheet URL: https://gps.press/sop-data/209.09-att-9/ 10. Tier III Program Checklist URL: https://gps.press/sop-data/209.09-att-10/ 11. Special Management Unit: Tier III Program Offender Management Plan URL: https://gps.press/sop-data/209.09-att-11/ 12. Tier III Program Over 2-Years 90-Day Quarterly Review Hearing Form URL: https://gps.press/sop-data/209.09-att-12/ ======================================================================== FULL TEXT: ======================================================================== SOP 209.09 Attachment 1 04/23/25 Page 1 of 2 **SPECIAL MANAGEMENT UNIT:** **TIER III** **PROGRAM** **OFFENDER ASSIGNMENT REQUEST FORM** **I.** **Assignment Request** **Date:** **Facility:** **Referring Warden:** **Warden Signature:** **Offender Name:** **Offender GDC#:** `☐` Approved/ `☐` Disapproved **ASSIGNMENT REQUESTED FOR THE FOLLOWING REASON(S):** `☐` The offender participated in or was associated with activity such that greater management of the offender’s interaction with other persons is necessary to ensure the safety, security, or orderly operation of GDC facilities, or protection of the public. `☐` Escape involving violence or serious threat of violence. `☐` Multiple escapes or escape attempts within the previous three (3) years from a close security institution. `☐` Participation in a major disturbance or riot during the previous five (5) years involving; (a) ten (10) or more offenders; and/or (b) the serious threat of loss of life or actual major property damage. `☐` Killing or causing serious injury to another person within the previous five (5) years. `☐` Participation in a hostage taking within the previous five (5) years. `☐` Possession of a firearm or an explosive device within the previous (5) years. `☐` Two (2) or more disciplinary infractions for possession of a weapon within the previous five (5) years. `☐` Three (3) or more disciplinary charges within the previous 12 months that involve excessive disruptive behavior of either a Great or High severity level as defined in SOP 209.01, Offender Discipline. `☐` Offender with assaultive history; or `☐` Offender that is considered to be a person of notoriety and placement in the Tier III Program is necessary to maintain the safety and security of a facility or the GDC system. **Describe Specific Reasons:** Retention Schedule: Upon completion, this form shall be placed in the offender’s institutional file. SOP 209.09 Attachment 1 04/23/25 Page 2 of 2 **II.** **Request for Emergency Placement in SMU:** `☐` **YES** `☐` **NO** **Reasons for Emergency Placement in SMU:** **_________________________________________________________________________________** **_________________________________________________________________________________** **_________________________________________________________________________________** **_________________________________________________________________________________** **_________________________________________________________________________________** **_________________________________________________________________________________** **Director, Field Operations (or designee) Decision on Emergency Placement:** `☐` **APPROVED** `☐` **DISAPPROVED** **_____________________________________________** **Director, Field Operations (or designee)** **Signature/Date** **III.** **Service of Assignment Request and 48-Hr Notice of Hearing:** **____________________________________ ___________________________** _**Offender Signature**_ _**Date/Time**_ ****Provide offender copy of Attachment 1**** _**Offender 48-Hr Hearing Rights:**_ _1._ _To be served copy of Tier III Program Assignment Request Form (Attachment 1);_ _2._ _The offender has the right to attend the 48-Hr hearing. The hearing may be done by video (if the_ _offender is at another facility) or in-person (if the offender has been placed at SMU as an_ _emergency placement. The offender may forfeit this right if he or she is disruptive, and this_ _disruption shall be documented);_ _3._ _The offender has the right to make a statement and to present documents. However, the offender_ _does not have the right to call witnesses; and_ 4. _The offender has the right to submit a written statement._ Retention Schedule: Upon completion, this form shall be placed in the offender’s institutional file.