63N-1.013. Services for Youths with Developmental Disability

(1) Facility staff shall be trained to recognize signs and symptoms of Developmental Disability. Examples of information and behaviors which suggests Developmental Disability include:

(a) Psychological testing or mental health evaluation indicate an Intelligence Quotient (IQ) below 70.

(b) School exceptional education classification of “Intellectual Disabilities” or “Autism Spectrum Disorder” as specified in Rules 6A-6.03011 and 6A-6.03023, F.A.C.

(c) DSM diagnosis of “mental retardation” or “intellectual disability”.

(d) The youth has difficulty understanding and answering age appropriate questions;

(e) The youth has difficulty understanding and following age appropriate directions; or

(f) The youth’s abilities appear far below other youths his/her age.

(2) Youths identified as possibly having a Developmental Disability must be placed on Constant Supervision until assessed by Mental Health Clinical Staff. Youths determined by Mental Health Clinical Staff to have Developmental Disability based on review of intelligence testing or administration of intelligence testing who are placed in a Detention Center or residential commitment program must be referred to the facility/program treatment team for development of an Individualized Mental Health Treatment Plan with behavior oriented goals.

(3) Determination of Developmental Disability.

(a) Assessment findings and recommendations regarding Developmental Disability shall be based upon administration or review of intelligence testing which includes the current edition of the Wechsler Intelligence Scale for Children (WISC), Wechsler Adult Intelligence Scale (WAIS) or Stanford-Binet Intelligence Scale (SB), and administration or review of adaptive behavior functioning testing. Accepted tests for adaptive behavior functioning include: Vineland Adaptive Behavior Scales, Adaptive Behavior Scale, Adaptive Behavior Assessment System, Adaptive Behavior Evaluation Scale, or Scales of Independent Behavior.

1. An exception is provided in the circumstance where a Licensed Mental Health Professional authorized to administer intelligence tests as specified in paragraph (b) below determines that administration of the current edition of the Wechsler Intelligence Scale for Children (WISC), Wechsler Adult Intelligence Scale (WAIS) or Stanford-Binet Intelligence Scale (SB) is not appropriate due to the youth’s condition or impairment. An alternative standardized intelligence test, administered and interpreted in conformance with instructions provided by the producer of the test, may be used. The results of the alternative standardized intelligence test must include reference to published validity and reliability data for the specified test, and justification for use of the alternative test for the youth. Examples of alternative standardized intelligence tests include the Leiter International Performance Scale and Comprehensive Test of Non-Verbal Intelligence.

2. If an alternative standardized intelligence test is utilized, an adaptive behavior functioning test must also be administered as set forth in paragraph (a) above.

(b) Intelligence testing and adaptive behavior functioning tests shall be administered by a Licensed Mental Health Professional who is qualified by training, education and experience to render such evaluations and is authorized under their licensing board to provide such evaluations.

(c) Concurrent significant deficits in intellectual and adaptive behavior functioning must be present in the intelligence testing and adaptive behavior functioning testing in paragraph (a) above for findings of Developmental Disability.

(4) Treatment Services for Youth with Developmental Disability.

(a) Youths who are placed in a residential commitment program designated for Developmental Disability treatment services shall be referred to the facility’s multidisciplinary treatment team for development of a Developmental Treatment Plan and Developmental Disability Clinical Treatment Services as specified in this section:

(b) Behavior Analysis Services shall be provided by a person who is a Board Certified Behavior Analyst, a Certified Behavior Analyst, a Psychologist licensed under Chapter 490, F.S., or a Licensed Clinical Social Worker, Licensed Mental Health Counselor or Licensed Marriage and Family Therapist licensed under Chapter 491, F.S., with more than three years experience post certification or licensure.

(c) Therapy to promote social skills and life skills of youths with Developmental Disability. For example, therapy focusing on improved coping skills or interpersonal problem solving skills or anger replacement therapy shall be provided 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.

(d) Mental health services for youths with Developmental Disability and Mental Disorder shall be provided 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 as specified in Rules 63N-1.0033 and 63N-1.0081, F.A.C.

(e) Substance abuse services for youths with Developmental Disability and Substance-Related Disorder shall be provided by a Licensed Qualified Professional or a Substance Abuse Clinical Staff Person as specified in Rules 63N-1.0034 and 63N-1.0082, F.A.C.

(f) Developmental Disability Clinical Treatment Services shall be documented in a progress note/treatment note written by the clinician who provided the service.

(5) Treatment Planning and Discharge Planning.

(a) An Individualized Developmental Treatment Plan is required when a youth enters Developmental Disability treatment.

(b) The Individualized Developmental Treatment Plan shall be developed by a multidisciplinary treatment team, including a Board Certified Behavior Analyst, Certified Behavior Analyst, or person licensed under Chapter 490 or 491, F.S., and the youth. Development of an Individualized Developmental Treatment Plan must include the youth’s parent or legal guardian, unless there is documentation of a reason for the parent or legal guardian’s non-involvement in treatment planning.

(c) The Individualized Developmental Treatment Plan must be completed within 30 days of the youth’s admission to the program.

(d) The Individualized Developmental Treatment Plan must contain the following elements:

1. The specific developmental, behavioral, and life skills needs that will be the focus of treatment;

2. Developmental Disability Clinical Treatment goals and objectives, written in achievable and measurable terms, which are responsive to the youth’s Developmental Disorder and address specific behaviors, symptoms, skill deficits, strengths and needs of the youth;

3. The Developmental Disability interventions/strategies to be provided and target dates for completion;

4. The youth’s functional strengths/abilities and needs which may affect his/her success in treatment;

5. The plan must contain the signature of the youth, the multidisciplinary treatment team members who participated in the development of the plan and a Board Certified Behavior Analyst, Certified Behavior Analyst, a Psychologist licensed under Chapter 490, F.S., or a Licensed Clinical Social Worker, Licensed Mental Health Counselor or Licensed Marriage and Family Therapist licensed under Chapter 491, F.S.

a. When a youth in a residential commitment program is identified as an Agency for Persons with Disabilities (APD) client, the residential commitment program shall request and encourage the APD waiver support coordinator to participate in the youth’s multidisciplinary treatment team meetings.

b. When a youth in a residential commitment program has a current behavior support plan or case plan through the Agency for Persons with Disabilities (APD), the program shall coordinate the youth’s Individualized Developmental Treatment Plan with the youth’s APD plan for related issues.

(6) Integrated Developmental and Mental Health/Substance Abuse Treatment Plans. Youths diagnosed with Developmental Disability and Mental Disorder and/or Substance-Related Disorder shall receive integrated treatment services based upon an integrated developmental and mental health/substance abuse treatment plan.

(a) The integrated developmental and mental health/substance abuse treatment plan shall be developed with the input of Developmental Disability and Mental Health Clinical Staff and/or Substance Abuse Clinical Staff.

(b) The integrated developmental and mental health/substance abuse treatment plan shall include the elements described in paragraph (d) above and Rule 63N-1.007, F.A.C.

(7) A review of the Individualized Developmental Treatment Plan must be conducted by the multi-disciplinary treatment team every 30 days as set forth in Rule 63N-1.007, F.A.C.

(8) During the final phase of Developmental Disability treatment, the multidisciplinary treatment team and youth shall establish a discharge plan whereby improvements made during treatment will be maintained upon the youth’s movement from one facility to another, or return to his/her community.

(a) The discharge plan shall document the focus and course of the youth’s Developmental Disability treatment, and recommendations for services upon the youth’s movement out of the facility.

(b) The discharge plan shall be discussed with the youth, parent/legal guardian (when available) and Juvenile Probation Officer prior to the youth’s release from the facility or program. For committed youths served by the Agency for Persons with Disabilities (APD) or the Department of Children and Families (DCF), the residential commitment program shall invite representatives from APD or DCF to the youth’s transition and exit conferences in accordance with subparagraphs 63E-7.010(10)(a)1. and 63E-7.010(10)(b)1., F.A.C.

(c) A copy of the discharge plan will be provided to the youth, the youth’s assigned Juvenile Probation Officer and to the parent/legal guardian, unless there is documentation of a reason for the parent or legal guardian’s non-involvement in treatment planning.

(9) Suicide Prevention, Mental Health Crisis Intervention and Emergency Mental Health and Substance Abuse Services provisions in this rule apply to the provision of Developmental Disability services.

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.