Chapter 65E-5, Florida Administrative Code, is being amended to comply with the new Chapter 2006-171, Laws of Florida, (amends Chapter 394, Part I, the Baker Act) which adds mental health counselors, and marriage and family therapists to certain ...

DEPARTMENT OF CHILDREN AND FAMILY SERVICES
Mental Health Program

RULE NO: RULE TITLE
65E-5.100: Definitions
65E-5.115: Mental Health Personnel
65E-5.260: Transportation
65E-5.280: Involuntary Examination
65E-5.285: Involuntary Outpatient Placement
65E-5.290: Involuntary Inpatient Placement
65E-5.300: Continued Involuntary Inpatient Placement at Treatment Facilities
65E-5.400: Baker Act Funded Services Standards
PURPOSE AND EFFECT: Chapter 65E-5, Florida Administrative Code, is being amended to comply with the new Chapter 2006-171, Laws of Florida, (amends Chapter 394, Part I, the Baker Act) which adds mental health counselors, and marriage and family therapists to certain sections of the Act.
SUBJECT AREA TO BE ADDRESSED: 1. Revision of eight rule sections to add mental health counselors, and marriage and family therapists.
2. Revision of five Baker Act forms to include mental health counselors, and marriage and family therapists, as well as technical changes.
SPECIFIC AUTHORITY: Chapter 2006-171, L.O.F., 394.457, 394.46715 FS.
LAW IMPLEMENTED: 394.455, 394.457, 394.4573, 394.459, 394.4599, 394.4615, 394.462, 394.4625, 394.463, 394.4655, 394.467, 395, 397.675, 400, 491, 765 FS.
A RULE DEVELOPMENT WORKSHOP WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:
TIME AND DATE: Thursday, September 28, 2006, 9:00 a.m.
PLACE: Building 6, Conference Room A, Winewood Office Complex, 1317 Winewood Blvd., Tallahassee, Florida.
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE DEVELOPMENT AND A COPY OF THE PRELIMINARY DRAFT, IF AVAILABLE, IS: Ron Kizirian, Medical/Healthcare Program Analyst, Mental Health Program Office, 1317 Winewood Blvd., Building 6, Room 211, Tallahassee, Florida 32399-0700. Telephone: [phone]

THE PRELIMINARY TEXT OF THE PROPOSED RULE DEVELOPMENT IS:

65E-5.100 Definitions.

As used in this chapter the following words and phrases have the following definitions:

(1) through (9) No change.

(10) Mental Health Counselor means an individual who is licensed as a mental health counselor under Chapter 491, F.S.

(10)(11) Person means an individual of any age, unless statutorily restricted, with a mental illness served in or by a mental health facility or service provider.

(11)(12) PRN means an individualized order for the care of an individual person which is written after the person has been seen by the practitioner, which order sets parameters for attending staff to implement according to the circumstances set out in the order.

(12)(13) Protective medical devices mean a specific category of restraint that includes devices, or combinations of devices, to restrict movement for purposes of protection from falls or complications of physical care, such as geri-chairs, posey vests, mittens, belted wheelchairs, sheeting, and bed rails. The requirements for the use and documentation of use of these devices are for specific medical purposes rather than for behavioral control.

(13)(14) Restraint means the immobilization of a person’s body in order to restrict free movement or range of motion, whether by physical holding or by use of a mechanical device. For purposes of this chapter, restraint includes all applications of such procedures, specifically including emergency treatment orders and emergency medical procedures which includes protective medical devices for ambulating safety, or furniture used to protect mobility-impaired persons from falls and injury. The use of walking restraints when used during transportation under the supervision of trained staff is not considered restraint.

(14)(15) Seclusion means an emergency response in which, as a means of controlling a person’s immediate symptoms or behavior, the person’s ability to move about freely has been limited by staff or in which a person has been physically segregated in any fashion from other persons. Seclusion requires a written emergency treatment order by a physician except as described and authorized in Rule 65E-5.1602, F.A.C., of this rule chapter.

(15)(16) Standing order means a broad protocol or delegation of medical authority that is generally applicable to a group of persons, hence not individualized. As limited by this chapter, it prohibits improper delegations of authority to staff that are not authorized by the facility, or not permitted by practice licensing laws, to independently make such medical decisions; such as decisions involving determination of need, medication, routes, dosages for psychotropic medication, or use of restraints or seclusion upon a person.

Specific Authority 394.457(5), 494.46715 FS. Law Implemented 394.455(1), 394.457, 394.4573(1)(b), 394.459(2), 394.4625, 394.4655, 394.467, 491, 765.101, 765.401 FS. History–New 11-29-98, Amended 4-4-05,____________.

 

65E-5.115 Mental Health Personnel.

Whenever the term physician, psychiatrist, clinical psychologist, clinical social worker, psychiatric nurse, marriage and family therapist, or mental health counselor is used in these rules, the term is as defined in Section 394.455, F.S., or this rule chapter.

Specific Authority 394.457(5), 394.46715 FS. Law Implemented 394.455, 394.457(5)(a) FS. History–New 4-4-05, Amended________.

 

65E-5.260 Transportation.

(1) Each law enforcement officer who takes a person into custody upon the entry of recommended form CF-MH 3001, Feb. 05, “Ex Parte Order for Involuntary Examination,” which is incorporated by reference and may be obtained pursuant to Rule 65E-5.120, F.A.C., of this rule chapter, or other form provided by the court, or the execution of mandatory form CF-MH 3052b, Sept. 06 Feb. 05, “Certificate of Professional Initiating Involuntary Examination,” which is hereby incorporated by reference and may be obtained pursuant to Rule 65E-5.120, F.A.C., of this rule chapter or completion of mandatory form CF-MH 3052a, Sept. 06 Feb. 05, “Report of a Law Enforcement Officer Initiating Involuntary Examination,” which is incorporated by reference and may be obtained pursuant to Rule 65E-5.120, F.A.C., of this rule chapter shall ensure that such forms accompany the person to the receiving facility for inclusion in the person’s clinical record.

(2) No change.

Specific Authority 394.457(5) FS. Law Implemented 394.462, 394.462(1) FS. History–New 11-29-98, Amended 4-4-05,_________.

 

65E-5.280 Involuntary Examination.

(1) No change.

(2) Law Enforcement.

(a) If a law enforcement officer, in the course of his or her official duties, initiates an involuntary examination, the officer shall complete the mandatory form CF-MH 3052a, Feb. 05, “Report of Law Enforcement Officer Initiating Involuntary Examination,” as referenced in subsection 65E-5.260(1), F.A.C.

(b) No change.

(3) through (4) No change.

(5) In order for the department to implement the provisions of Section 394.463(2)(e), F.S., and to ensure that the Agency for Health Care Administration will be able to analyze the data it receives pursuant to that section, designated receiving facilities shall forward copies of each recommended form CF-MH 3001, “Ex Parte Order for Involuntary Examination,” as referenced in subsection 65E-5.260(1), F.A.C., or other order provided by the court, mandatory form CF MH 3052a, “Report of Law Enforcement Officer Initiating Involuntary Examination,” as referenced in subsection 65E-5.260(1), F.A.C., mandatory form CF-MH 3052b, “Certificate of Professional Initiating Involuntary Examination,” as referenced in subsection 65E-5.260(1), F.A.C., accompanied by mandatory form CF-MH 3118, Sept. 06 Feb. 05, “Cover Sheet to Agency for Health Care Administration,” which is hereby incorporated by reference and may be obtained pursuant to Rule 65E-5.120, F.A.C., of this rule chapter to: BA Reporting Center, FMHI-MHC 2737, 13301 Bruce B. Downs Boulevard, Tampa, Florida 33612-3807.

(6) through (8) No change.

Specific Authority 394.457(5) FS. Law Implemented 394.463, 394.463(2)(e), (h), 400 FS. History–New 11-29-98, Amended 4-4-05, ________.

 

65E-5.285 Involuntary Outpatient Placement.

(1) Petition for Involuntary Outpatient Placement.

(a) No change.

(b) Petition Filed by Receiving Facility Administrator.

1. through 2. No change.

3. The administrator of the receiving facility or a designated department representative shall identify the service provider that will have the responsibility of developing a treatment plan and primary responsibility for service provision under an order for involuntary outpatient placement, unless the person is otherwise participating in outpatient psychiatric treatment and is not in need of public financing for that treatment. Recommended form CF-MH 3140, Sept. 06 Feb. 05, “Designation of Service Provider for Involuntary Outpatient Placement,” which is incorporated by reference and may be obtained pursuant to Rule 65E-5.120, F.A.C., of this rule chapter may be used for this purpose.

4. A treatment plan, complying with the requirements of Section 394.4655, F.S., and this rule, shall be attached to the petition, along with a certification from the service provider that:

a. The proposed services are available in the person’s local community;

b. There is space available in the program or service for the person;

c. Funding is available for the program or service;

d. The service provider agrees to provide those services; and

e. Proposed services have been deemed to be clinically appropriate by a physician, clinical psychologist, clinical social worker, mental health counselor, marriage and family therapist, or psychiatric nurse, as defined in Section 394.455 394.4599, F.S., who consults with, is employed by, or has a contract with the service provider.

5. Recommended form CF-MH 3145, Sept. 06 Feb. 05, “Proposed Individualized Treatment Plan for Involuntary Outpatient Placement and Continued Involuntary Outpatient Placement”, which is incorporated by reference and may be obtained pursuant to Rule 65E-5.120, F.A.C., of this rule chapter may be used for the development of a treatment plan.

6. through 7. No change.

(c) Petition Filed by Treatment Facility Administrator

1. through 3. No change.

4. The petition shall have attached an individualized treatment or service plan that addresses the needs identified in the discharge plan developed by the treatment facility as represented by form CF-MH 3145, Feb. 05, “Proposed Individualized Treatment Plan for Involuntary Outpatient Placement and Continued Involuntary Outpatient Placement,” as referenced in subparagraph 65E-5.285(1)(b)54., F.A.C. The plan must have been deemed to be clinically appropriate by a physician, clinical psychologist, psychiatric nurse, mental health counselor, marriage and family therapist, or clinical social worker, as defined in Section 394.455, F.S.

5. No change.

(2) No change.

(3) Court Order.

(a) No Change.

(b) Upon receipt of the court order for Involuntary outpatient placement, the administrator of a treatment facility will provide a copy of the court order and adequate documentation of a person’s mental illness to the service provider, including any advance directives, a psychiatric evaluation of the person, and any evaluations of the person performed by a clinical psychologist, mental health counselor, marriage and family therapist, or clinical social worker.

(c) In order for the department to implement the provisions of Section 394.463(2)(e), F.S., and to ensure that the Agency for Health Care Administration will be able to analyze the data it receives pursuant to that section, service providers shall forward copies of each recommended form CF-MH 3155, “Order for Involuntary Outpatient Placement or Continued Involuntary Outpatient Placement,” as referenced in paragraph 65E-5.285(3)(a), F.A.C., or other order provided by the court, accompanied by mandatory form CF-MH 3118, Feb. 05, “Cover Sheet to Agency for Health Care Administration,” as referenced in subsection 65E-5.280(5), F.A.C., to: BA Reporting Center, FMHI-MHC 2637, 13301 Bruce B. Downs Boulevard, Tampa, Florida 33612-3807.

(d) No change.

(e) If a physician has determined the person who is subject to a court order for involuntary outpatient placement has failed or has refused to comply with the treatment ordered by the court, and in his or her clinical judgment, efforts were made to solicit compliance and the person meets the criteria for involuntary examination, the person may be brought to a receiving facility pursuant to Section 394.463, F.S. Mandatory form CF-MH 3052b, Feb. 05, “Certificate of a Professional Initiating Involuntary Examination,” as referenced in subsection 65E-5.260(1), F.A.C., shall be used.

(4) Continued Involuntary Outpatient Placement.

(a) through (h) No change.

(i) In order for the department to implement the provisions of Section 394.463(2)(e), F.S., and to ensure that the Agency for Health Care Administration will be able to analyze the data it receives pursuant to that section, service providers shall forward copies of each recommended form CF-MH 3155, “Order for Involuntary Outpatient Placement or Continued Involuntary Outpatient Placement,” as referenced in paragraph 65E-5.285(3)(a), F.A.C., or other order provided by the court, accompanied by mandatory form CF-MH 3118, Feb. 05, “Cover Sheet to Agency for Health Care Administration,” as referenced in subsection 65E-5.280(5), F.A.C., to: BA Reporting Center, FMHI-MHC 2637, 13301 Bruce B. Downs Boulevard, Tampa, Florida 33612-3807.

(j) No change.

(k) If a physician has determined the person who is subject to a court order for involuntary outpatient placement has failed or has refused to comply with the treatment ordered by the court, and in his or her clinical judgment, efforts were made to solicit compliance and the person meets the criteria for involuntary examination, the person may be brought to a receiving facility pursuant to Section 394.463, F.S. Mandatory form CF-MH 3052b, Feb. 05, “Certificate of a Professional Initiating Involuntary Examination,” as referenced in subsection 65E-5.260(1), F.A.C., shall be used.

(5) No change.

Specific Authority 394.46715 FS. Law Implemented 394.455, 394.455(18), 394.4599, 394.463, 394.4655, 394.4655(2)(a), 397.675 FS. History–New 4-4-05, Amended________.

 

65E-5.290 Involuntary Inpatient Placement.

(1) through (9) No change.

(10) In order for the department to implement the provisions of Section 394.463(2)(e), F.S., and to ensure that the Agency for Health Care Administration will be able to analyze the data it receives pursuant to that section, designated receiving facilities and treatment facilities shall forward copies of each recommended form CF-MH 3008, “Order for involuntary Inpatient Placement,” as referenced in paragraph 65E-5.1302(1)(b), F.A.C., or other order provided by the court, accompanied by mandatory form CF-MH 3118, Feb. 05, “Cover Sheet to Agency for Health Care Administration,” as referenced in subsection 65E-5.280(5), F.A.C., to: BA Reporting Center, FMHI-MHC 2637, 13301 Bruce B. Downs Boulevard, Tampa, Florida 33612-3807.

Specific Authority 394.457(5), 394.46715 FS. Law Implemented 3994.463(2)(e), 394.467, 397.675 FS. History–New 11-29-98, Amended 4-4-05,________.

 

65E-5.300 Continued Involuntary Inpatient Placement at Treatment Facilities.

(1) through (5) No change.

(6) In order for the department to implement the provisions of Section 394.463(2)(e), F.S., and to ensure that the Agency for Health Care Administration will be able to analyze the data it receives pursuant to that section, designated receiving facilities and treatment facilities shall forward copies of each recommended form CF-MH 3031, “Order for Continued Involuntary Inpatient Placement or Release,” as referenced in subsection 65E-5.300(5), F.A.C., accompanied by mandatory form CF-MH 3118, Feb. 05, “Cover Sheet to Agency for Health Care Administration,” as referenced in subsection 65E-5.280(5), F.A.C., to: BA Reporting Center, FMHI-MHC 2637, 13301 Bruce B. Downs Boulevard, Tampa, Florida 33612-3807.

Specific Authority 394.457(5), 394.46715 FS. Law Implemented 394.463(2)(e), 394.467(6),(7) FS. History–New 11-29-98, Amended 4-4-05, Amended ________.

 

65E-5.400 Baker Act Funded Services Standards.

(1) through (5) No change.

(6) Mobile Crisis Response Service and Mental Health Overlay Program Requirements.

(a) through (b) No change.

(c) Procedures must require employee’s clinical activities and performance, as opposed to primarily administrative functions, are supervised by one of the following: a psychiatrist, physician, clinical psychologist, clinical social worker, mental health counselor, marriage and family therapist, or psychiatric nurse, as defined in Section 394.455, F.S.

(d) through (e) No change.

(7) No change.

Specific Authority 394.457(3), (5)(c), (6)(a) FS. Law Implemented 316, 394, Part I, 394.455(2), (4), (17), (19), (21), (23), (25), (34), (35), 394.4615, 394.462, 394.4625, 394.463, 395 FS. History–New 11-29-98, Amended 4-4-05,________.