63N-1.002. Definitions

(1) “Active Mental Health/Substance Abuse Treatment File” ‒ A temporary file maintained in a designated area of the DJJ facility or program which contains mental health and substance abuse information collected during the course of a youth’s on-going mental health or substance abuse treatment in the facility or program.

(2) “Acute Emotional or Psychological Distress” means the rapid onset of an intense mental state of arousal, unrest and/or disorganization which is often accompanied by an intense sense of being unable to cope with or control the mental state and associated behavioral response. Examples include extreme anxiety, fear, panic, paranoia, impulsivity, agitation or rage.

(3) “Assessment of Suicide Risk” ‒ An evaluation of a youth’s Suicide Risk Factors or Suicide Risk Behaviors to determine whether the youth is a Potential Suicide Risk and the level of risk. The form MHSA 004 documents Assessment of Suicide Risk conducted in a DJJ facility or program.

(4) “At Risk” – Within this Rule, means factors or behaviors which indicate suicidal tendencies, Suicide Risk Factors or Suicide Risk Behaviors.

(5) “Authority for Evaluation and Treatment” – Form HS 002, that when signed by a parent or legal guardian, gives the Department the authority to assume responsibility for the provision of routine mental and physical healthcare to a youth within its physical custody.

(6) “Baker Act” ‒ Within this Rule, the term Baker Act refers to Section 394.451, F.S., covering involuntary mental health examination and placement for persons with mental illness.

(7) “Behavior Analysis Services” – Within this Rule, means the use of scientific methods derived from behavioral science specifically to increase skill acquisition, reduce problematic behavior and improve socially significant behaviors.

(8) “Board Certified Behavior Analyst” – A person who has obtained certification by the Behavior Analyst Certification Board Inc.

(9) “Certified Addiction Professional” ‒ A person who is certified through a Department of Children and Families recognized certification process for substance abuse treatment services pursuant to Chapter 397, F.S. and Chapter 65D-30, F.A.C.

(10) “Certified Behavior Analyst” – A person who is certified as a behavior analyst by the Agency for Persons with Disabilities pursuant to Chapter 393, F.S. and Chapter 65G-4, F.A.C.

(11) “Clinical Coordinator” – A Licensed Mental Health Professional or a non-licensed Mental Health Clinical Staff Person who has received training specifically in mental health and substance abuse services coordination, and who is responsible for coordinating and verifying implementation of Necessary and Appropriate Mental Health and Substance Abuse Treatment Services in the facility or program where they have been named coordinator.

(12) “Clinical Mental Health and Substance Abuse Screening” – The preliminary appraisal of a youth conducted by a Licensed Mental Health Professional or a Licensed Qualified Professional utilizing validated and reliable mental health screening instruments to determine the presence of a mental health or substance abuse problem, substantiate that the youth is positive in respect to some mental health or substance abuse factor and to identify the need for in-depth mental health or substance abuse evaluation.

(13) “Close Supervision” – The observation by a staff member assigned to monitor a youth at intervals not to exceed five minutes throughout the youth’s stay in his/her room and/or sleeping area. Visual checks must be made of the youth’s condition (i.e., outward appearance, behavior, position in the room) at intervals not to exceed five minutes.

(14) “Comprehensive Assessment” – The assessment defined in Rule 63D-8.001, F.A.C.

(15) “Comprehensive Mental Health Evaluation” – An in-depth assessment conducted by a Licensed Mental Health Professional or a non-licensed Mental Health Clinical Staff Person working under the direct supervision of a Licensed Mental Health Professional to determine the presence of, or nature and complexity of, a Mental Disorder.

(16) “Comprehensive Substance Abuse Evaluation” – An in-depth assessment conducted by a Licensed Qualified Professional or a Substance Abuse Clinical Staff Person to determine the presence of, or nature and complexity of, a substance related disorder.

(17) “Constant Supervision” – The continuous and uninterrupted observation of a youth by a staff member assigned to monitor the youth who has a clear and unobstructed view of the youth, and unobstructed sound monitoring of the youth at all times.

(18) “CORE” – The department’s computer-based training system.

(19) “Crisis” – Within this rule means a state of Acute Emotional or Psychological Distress associated with a distressing event, situation or turning point in a youth’s life.

(20) “Crisis Assessment” – A detailed evaluation of a youth presenting Acute Emotional or Psychological Distress which is extreme and does not respond to ordinary intervention conducted by a Licensed Mental Health Professional or a non-licensed Mental Health Clinical Staff Person working under the direct supervision of a Licensed Mental Health Professional to determine the severity of his/her distressing symptoms, level of risk to self or others and recommendations for treatment and follow-up.

(21) “Detention Center” – A facility operated or contracted by the department for the temporary care of youth, pending adjudication, disposition, or placement.

(22) “Designated Mental Health Clinician Authority” – A Licensed Mental Health Professional who, through employment or contract, is responsible for ensuring appropriate coordination and implementation of mental health and substance abuse services in a departmental facility or program.

(23) “Developmental Disability” – A term defined in Section 393.063, F.S. Within this Rule, the term “Developmental Disability” is used interchangeably with the term “intellectual disability” which refers to significantly subaverage intellectual functioning (an IQ score below 70) on standardized intelligence tests existing concurrently with related limitations in adaptive functioning.

(24) “Developmental Disability Clinical Treatment Services” – Within this Rule, means psychological, behavioral analysis or psychotherapeutic services designed specifically for youths with Developmental Disability provided by a Licensed Mental Health Professional, Board Certified Behavior Analyst or Certified Behavior Analyst or a non-licensed Mental Health Clinical Staff Person working under the direct supervision of a Licensed Mental Health Professional. The term does not include school instruction or school services provided under Chapter 1003, F.S.

(25) “Direct Supervision for Mental Health Clinical Staff” means that a Licensed Mental Health Professional has at least one hour per week of on-site face-to-face interaction with a non-licensed Mental Health Clinical Staff Person individually or in group format, for the purpose of overseeing and directing the mental health services that he or she is providing in the facility, as permitted by law within his or her state licensure.

(26) “Direct Supervision for Substance Abuse Clinical Staff” means that a Qualified Professional has at least one hourly session per week of on-site face-to-face interaction with a non-licensed or non-certified Substance Abuse Clinical Staff Person who is an employee of a Service Provider licensed under Chapter 397, F.S., or an employee in a facility licensed under Chapter 397, F.S., individually or in group format, for the purpose of overseeing and directing the substance abuse services that he or she is providing in the facility.

(27) “Drug” means any substance listed in Section 893.03, F.S.

(28) “The Diagnostic and Statistical Manual of Mental Disorders” ‒ A manual published by the American Psychiatric Association which presents guidelines and diagnostic criteria for various Mental Disorders, including substance related disorders. The Diagnostic and Statistical Manual of Mental Disorder, Fifth Edition is the latest edition of this manual.

(29) “Follow-Up Assessment of Suicide Risk” – An evaluation conducted after a youth has received an Assessment of Suicide Risk and is on Suicide Precautions to evaluate the youth’s current level of suicide risk and determine whether the youth is to be maintained on or removed from Suicide Precautions. The form MHSA 005 documents Follow-Up Assessment of Suicide Risk conducted in a DJJ facility or program.

(30) “Health Status Checklist” ‒ The form HS 08 which documents the youth’s physical condition upon his/her placement in a Secure Observation Room due to suicide risk. The Health Status Checklist is also utilized in residential commitment programs to document the youth’s physical condition upon his/her placement in a controlled observation room.

(31) “Imminent Threat of Suicide” means to present a real and present threat of suicide.

(32) “Individual Healthcare Record” – The permanent departmental file containing the unified cumulative hard-copy collection of clinical records, histories, assessments, treatments and diagnostic tests which relate to a youth’s medical, mental health, substance abuse, Developmental Disability, behavioral health and dental health which have been obtained to facilitate care or document care provided while the youth is in a Detention Center, residential commitment program or day treatment program.

(33) “Individualized Developmental Treatment Plan” – A written guide which structures the focus of a youth’s Developmental Disability Clinical Treatment Services.

(34) “Individualized Mental Health Treatment Plan” – A written guide which contains goals and objectives of mental health treatment and structures the focus of a youth’s ongoing mental health treatment, including treatment with Psychotropic Medication.

(35) “Individualized Substance Abuse Treatment Plan” – A written guide which contains goals and objectives of substance abuse treatment and which structures the focus of a youth’s ongoing substance abuse treatment.

(36) “Initial Mental Health Treatment Plan” – A written preliminary guide which contains goals and objectives of mental health treatment and structures the focus of a youth’s initial mental health treatment.

(37) “Initial Psychiatric Diagnostic Interview” – Within this Rule refers to an assessment conducted by a Psychiatrist or psychiatric advanced registered nurse practitioner (ARNP) within 14 days of referral to determine the presence of any psychiatric conditions, formulate a diagnosis, and determine suitability for particular types of therapeutic interventions.

(38) “Initial Substance Abuse Treatment Plan” – A preliminary, written plan of goals and objectives intended to inform the youth of substance abuse service expectations and to prepare him/her for substance abuse service provision.

(39) “Integrated Mental Health and Substance Abuse Treatment Plan” or “Individualized Mental Health/Substance Abuse Treatment Plan” – A written, individualized guide which structures the focus of a dually diagnosed youth’s ongoing mental health and substance abuse treatment. The Integrated Mental Health and Substance Abuse Treatment Plan may also be referred to as an individualized mental health/substance abuse treatment plan.

(40) “Juvenile Assessment Center” – Section 985.135, F.S. establishes juvenile justice assessment centers which are designed to serve as a point of intake and screening for juveniles referred to the Department.

(41) “Juvenile Justice Information System” or JJIS – The department’s electronic system used to gather and store information on youth having contact with the department.

(42) “Juvenile Probation Officer” or JPO – A person meeting the definition in Section 985.03(30), F.S. and Rule 63D-8.001, F.A.C.

(43) “Licensed Clinical Social Worker”. A person licensed pursuant to Chapter 491, F.S., to practice clinical social work.

(44) “Licensed Marriage and Family Therapist”. A person licensed pursuant to Chapter 491, F.S., to practice marriage and family therapy.

(45) “Licensed Mental Health Counselor”. A person licensed pursuant to Chapter 491, F.S. to practice mental health counseling.

(46) “Licensed Mental Health Professional” – Within this Rule means a Psychiatrist licensed pursuant to Chapter 458 or 459, F.S., who is board certified in Child and Adolescent Psychiatry or Psychiatry by the American Board of Psychiatry and Neurology or has completed a training program in Psychiatry approved by the American Board of Psychiatry and Neurology for entrance into its certifying examination, a Psychologist licensed pursuant to Chapter 490, F.S., a Licensed Mental Health Counselor, Licensed Marriage and Family Therapist, or Licensed Clinical Social Worker licensed pursuant to Chapter 491, F.S., or a Psychiatric Nurse as defined in Section 394.455(23), F.S.

(47) “Licensed Qualified Professional” – Within this Rule means a physician or physician assistant licensed under Chapter 458 or 459, F.S., a Psychologist licensed under Chapter 490, F.S., or a Licensed Clinical Social Worker, Licensed Marriage and Family Therapist or Licensed Mental Health Counselor under Chapter 491, F.S., who is exempt from Chapter 397, F.S., licensure pursuant to Section 397.405, F.S.

(48) “Marchman Act” – Within this Rule refers to Section 397.675, F.S., covering involuntary substance abuse assessment and admissions for persons with substance abuse impairment.

(49) “Massachusetts Youth Screening Instrument, Second Version” or MAYSI-2 – A 52-item true-false screening instrument designed to identify signs of mental disturbance or emotional distress authorized by DJJ for use at intake into the juvenile justice system and upon admission to a day treatment or residential commitment program. The MAYSI-2 is published by Professional Resource Press.

(50) “Mental Disorder” means a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress or impairment in one or more important areas of functioning, or with a significantly increased risk of suffering death, pain, disability, or significant loss of freedom.

(51) “Mental Health Alert” – A designation in the Department’s Juvenile Justice Information System (JJIS) and in the facility used to identify youths in DJJ facilities/programs who have mental health conditions, symptoms or behaviors which may pose safety or security risks.

(52) “Mental Health Clinical Staff Person” – Within this Rule means a person responsible for providing mental health evaluation and treatment who, if not otherwise licensed as a Licensed Mental Health Professional, must hold, at a minimum, a Bachelor’s degree from an accredited university or college with a major in psychology, social work, counseling or Related Human Services Field.

(53) “Mental Health Crisis Intervention” means short-term therapeutic processes which focus on rapid resolution of Acute Emotional or Psychological Distress which is extreme and does not respond to ordinary intervention. The purpose of such intervention is generally to determine the severity of the problem, potential for harm, and to prevent harm to the individual or others.

(54) “Mental Health Provider” – Within this Rule means a Psychiatrist licensed under Chapter 458 or 459, F.S., a Psychologist licensed under Chapter 490, F.S., or a Licensed Mental Health Counselor, Licensed Clinical Social Worker, or Licensed Marriage and Family Therapist licensed under Chapter 491, F.S., a Psychiatric Nurse as defined in this rule, a Community Mental Health Center or Clinic as defined in Section 394.455, F.S., or a public or private mental health agency eligible to provide mental health services under Chapter 394, F.S., who through employment, contract, subcontract or agreement provides mental health services in a DJJ facility or program.

(55) “Mental Health and Substance Abuse Screening” – The brief procedures used by trained direct care staff or clinical staff to determine the presence of a mental health or substance abuse problem, substantiate that the youth is positive in respect to some mental health or substance abuse factor and to identify the need for further mental health or substance abuse evaluation.

(56) “Mental Health/Substance Abuse Treatment Discharge Plan” – The form, 011, which summarizes the focus and course of a youth’s mental health and/or substance abuse treatment, and provides recommendations for mental health and/or substance abuse treatment or services upon the youth’s movement out of a DJJ facility or program.

(57) “Mental Status Examination” – A structured assessment of a youth’s psychological and behavioral functioning. It provides a description of the youth’s appearance, attitude, motor activity, affect, mood, speech, thought content, perception, insight and judgment based upon the examiner’s observations of the youth and the youth’s answers to specific questions.

(58) “Mental Health Supportive Services” – Within this rule refers to therapeutic activities provided by Licensed Mental Health Professional or Mental Health Clinical Staff Person for a youth who is on Suicide Precautions or Mental Health Alert. Therapeutic activities include supportive counseling, crisis counseling, Mental Status Examination and must include on-going daily examination of the youth’s risk to self or others.

(59) “Necessary and Appropriate Mental Health and Substance Abuse Treatment and Services” – Essential mental health or substance abuse care or services which are reasonably expected to become necessary in the course of custody and care of juveniles, and which are consistent with generally acceptable professional standards for mental health and substance abuse services.

(60) “One-to-One Supervision” – The supervision of one youth by one staff member who remains within five feet of the youth at all times and must maintain constant visual and sound monitoring of the youth at all times.

(61) “Positive Achievement Change Tool” or PACT – The Department-approved criminogenic risk and needs screening and assessment tool incorporated in Rule 63D-9.001, F.A.C.

(62) “PACT Mental Health and Substance Abuse Screening Report and Referral Form” – The referral form defined in Rule 63D-8.001, F.A.C., and incorporated in Rule 63D-9.004, F.A.C.

(63) “Potential Suicide Risk” – Refers to a latent possibility or likelihood of manifesting deliberate self-destructive or self-injurious behavior with possible life-threatening consequences.

(64) “Precautionary Observation” – A Suicide Precaution method which provides for the Constant Supervision of a youth with Suicide Risk Factors in designated observation areas of the facility or program which are safe and secure.

(65) “Psychiatric Nurse”. A licensed registered nurse who has a master's degree or a doctorate in psychiatric nursing and two years post-master's clinical experience under the supervision of a physician. A licensed and certified psychiatric advanced registered nurse practitioner (ARNP) under Chapter 464, F.S., with a master’s degree or doctorate in psychiatric nursing or mental health nursing and two years post-master’s clinical experience under the supervision of a physician would meet this definition.

(66) “Psychiatric Services” – Within this rule refers to provision of Initial Diagnostic Psychiatric Interviews, psychiatric evaluations, prescribing Psychotropic Medications and monitoring Psychotropic Medications rendered by a Psychiatrist or psychiatric advanced registered nurse practitioner (ARNP).

(67) “Psychiatrist”. A physician licensed pursuant to Chapter 458 or 459, F.S. who is board certified in Child and Adolescent Psychiatry or Psychiatry by the American Board of Psychiatry and Neurology, or has completed a training program in Psychiatry approved by the American Board of Psychiatry and Neurology for entrance into its certifying examination. A Psychiatrist who is board certified in Forensic Psychiatry by the American Board of Psychiatry and Neurology or the American Board of Forensic Psychiatry may provide services in DJJ facilities or programs, but must have prior experience and training in psychiatric treatment with children or adolescents.

(68) “Psychologist”. A licensed Psychologist is a person licensed pursuant to Section 490.005(1), F.S., and a licensed school Psychologist is a person licensed pursuant to Section 490.006, F.S.

(69) “Psychotropic Medication” – Medications capable of affecting the mind, emotions and behavior that are used to treat mental illness. The medications, include, but are not limited to the following major categories: antipsychotics, antidepressants, antianxiety drugs, mood stabilizers and stimulants.

(70) “Qualified Professional” means a person meeting the requirements in Section 397.311(26), F.S. and Rule 65D-30.002, F.A.C.

(71) “Related Human Services Field” is a college major which includes the study of human behavior and development, counseling and interviewing techniques, and individual, group or family therapy. Examples of a college major in a Related Human Services Field include rehabilitation counseling, family studies, developmental psychology, health psychology and special education.

(72) “Secure Observation” – A suicide precaution method which provides for the use of a Secure Observation Room for placement of youths demonstrating At Risk or Suicide Risk Behaviors and either One-to-One Supervision or Constant Supervision of the youth in the Secure Observation Room.

(73) “Secure Observation Room” ‒ A room used when placing a youth in Secure Observation due to At Risk or Suicide Risk Behaviors.

(74) “Serious Self-Inflicted Injury” means any deliberate action taken by the youth to harm himself/herself with potentially serious or life-threatening consequences, but is not associated with Suicide Ideation or Suicide Intent.

(75) “Significant Change in Dosage of Medication” – Any increase or decrease in dosage beyond a small increment or beyond the normal dosage range for youths of similar age.

(76) “Specialized Treatment Services” ‒ Refers to the following mental health, substance abuse, Developmental Disability, sex offender and or behavioral health services provided in DJJ residential commitment programs: Comprehensive Services for Major Disorders; Intensive Mental Health Services; Specialized Mental Health Services; Substance Abuse Treatment Services (SAT); Developmental Disability Services; Sex Offender Treatment Services; Mental Health Overlay Services (MHOS); and Substance Abuse Treatment Overlay Services (SAT Overlay Services).

(77) “Substance Abuse Clinical Staff Person” – Within this Rule means a person who is licensed under Chapter 397, F.S., or exempt from Chapter 397, F.S., licensure under Section 397.405, F.S. or is an employee of a Service Provider licensed under Chapter 397, F.S., or in facility licensed under Chapter 397, F.S., who holds, at a minimum, a Bachelor’s degree from an accredited university or college with a major in psychology, social work, counseling or Related Human Services Field.

(78) “Substance Abuse Service Provider” or “Service Provider” – Within this Rule means a public agency, a private for-profit or not-for profit agency, a physician or physician assistant licensed under Chapter 458 or 459, F.S., a Psychologist licensed under Chapter 490, F.S., or a Clinical Social Worker, Marriage and Family Therapist or Mental Health Counselor licensed under Chapter 491, F.S., licensed under Chapter 397, F.S., or exempt from licensure under Chapter 397, F.S., who through employment, contract, subcontract or agreement provides substance abuse services in a DJJ facility or program.

(79) “Substance-Related Disorder” – A DSM diagnostic category which includes substance use disorders and substance-induced disorders. Substance use disorders include abuse and dependence. Substance-induced disorders include intoxication, withdrawal, and various mental states such as anxiety, mood disorder or psychosis that a substance induces when it is used.

(80) “Suicide Attempt” – Any action deliberately undertaken by the youth with Suicide Ideation or Suicide Intent which, if carried out, would result in his/her death.

(81) “Suicide Gesture” – Any action deliberately undertaken by the youth with Suicide Ideation or Suicide Intent which, if carried out, would not result in his/her death.

(82) “Suicide Rescue Tool” – A tool utilized in DJJ facilities responding to Suicide Attempts to cut the youth free from material used in the Suicide Attempt.

(83) “Suicide Response Kit” – A designated metal or hard coated box which contains a DJJ approved Suicide Rescue Tool, wire cutters, needle nose pliers, and first aid items such as a one-way CPR mask, microshield or face shield, non-latex gloves and first aid supplies for use in the event of a Suicide Attempt or incident of Serious Self-Inflicted Injury.

(84) “Suicide Risk Alert” – A designation made in JJIS and in the departmental facility to identify youths with Suicide Risk Factors who are placed on Suicide Precautions.

(85) “Suicide Risk Behaviors” – Refers to recent or current events, statements, or actions which suggest that the youth is a Potential Suicide Risk. Suicide Risk Behaviors include intentional self-injurious behavior; statements, notes or drawings which suggest thoughts, intent or plans to harm self; behaviors that suggest intent or plans to harm self, such as tying of clothing or sheet in a noose; statements suggesting hopelessness or preoccupation with death or dying; or extreme withdrawal or lack of interest in surroundings.

(86) “Suicide Risk Factors” – Refers to events, actions or conditions which suggest the youth is a possible suicide risk. Examples of Suicide Risk Factors include past history or recent: Suicide Attempt, Suicide Gesture, Suicide Ideation or Suicide Threat; intentional self-injurious behavior; statements, drawings or notes which suggest suicide, hopelessness or preoccupation with death or dying; extreme withdrawal or lack of interest in surroundings; serious psychiatric disturbance (particularly depression, mood swings, psychosis); substance dependence; or recent major loss such as death of parent, sibling or best friend.

(87) “Suicide Risk Screening Instrument” or SRSI – The form MHSA 002 which documents the standardized questions asked by trained designated staff at intake into the juvenile justice system and upon admission to a Detention Center to identify Suicide Risk Factors and need for referral for Assessment of Suicide Risk.

(88) “Suicidal Ideation” means thoughts, wishes or desire to deliberately take one’s own life.

(89) “Suicidal Intent” means an identified decision and/or plan to take one’s own life.

(90) “Suicide Precautions” – Use of Precautionary Observation or Secure Observation for supervising, observing, monitoring and housing the youth who has been identified as a Potential Suicide Risk. Suicide Precautions require that specific action be taken within a DJJ facility or program to protect a youth considered At Risk of suicide from potential self injury or suicide.

(91) “Suicide Threat” means a warning direct or indirect, verbal or non-verbal, that reasonably suggests that a youth plans to attempt suicide.

Rulemaking Authority 985.64(2) FS. Law Implemented 985.601(3)(a), 985.14(3)(a), 985.145(1), 985.18, 985.48(4), 985.64(2) FS. History–New 3-16-14.