Add conditional designations pursuant to Chapter Law 2023-270 and clarify criteria and procedures for conditional, suspension, or withdraw of designation.

 

DEPARTMENT OF CHILDREN AND FAMILIES

Mental Health Program

RULE NO.:RULE TITLE:

65E-5.353Criteria and Procedures for Suspension or Withdrawal of Designation of Receiving Facilities

PURPOSE AND EFFECT: Add conditional designations pursuant to Chapter Law 2023-270 and clarify criteria and procedures for conditional, suspension, or withdraw of designation.

SUMMARY: Amendments add in the conditional designation status, add a corrective action plan for providers with identified violations, and eliminates language.

SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS AND LEGISLATIVE RATIFICATION:

The Agency has determined that this will not have an adverse impact on small business or likely increase directly or indirectly regulatory costs in excess of $200,000 in the aggregate within one year after the implementation of the rule. A SERC has not been prepared by the Agency.

A SERC has not been prepared.

The Agency has determined that the proposed rule is not expected to require legislative ratification based on the statement of estimated regulatory costs or if no SERC is required, the information expressly relied upon and described herein: The Department used a checklist to conduct an economic analysis and determine if there is an adverse impact or regulatory costs associated with this rule that exceeds the criteria in section 120.541(2)(a), F.S. Based upon this analysis, the Department has determined that the proposed rule is not expected to require legislative ratification.

Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.

RULEMAKING AUTHORITY: 394.461(6) FS.

LAW IMPLEMENTED: 394.461 FS.

IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE SCHEDULED AND ANNOUNCED IN THE FAR.

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Elizabeth Floyd. Elizabeth can be reached at [e-mail].

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

65E-5.353 Criteria and Procedures for Conditional, Suspension or Withdrawal of Designation of Receiving Facilities.

(1) After the Department issues an initial designation, pursuant to 65E-5.350 and 65E-12, F.A.C., the Department has the ability to issue the following:

(a) Conditional Designation. A conditional designation may be issued when the Department determines failure to meet one or more of the standards for designation or maintenance of designation under this chapter, and the provider is implementing a corrective action plan in response to violations issued by the Department or the Agency for Health Care Administration.

The district or regional offices of the department shall continuously collect and monitor information relative to complaints or allegations against designated facilities from sources such as individuals, local advocacy or self-help groups, local organizations including law enforcement, the Agency for Health Care Administration, and the Florida Local Advocacy Council. When a district or region mental health and substance abuse program supervisor recommends to the Secretary, or the Secretary’s designee, withdrawal or suspension of designation, at least the following information must be submitted with the recommendation:

(a) Description of violations such as extent of violations of Chapter 394, F.S., and this rule chapter, and the extent and seriousness of known injuries or injury including the severity and number of violations, severity and chronic violation of rights, and any pattern of inadequate supervision, injury or harm to individuals; and,

(b) Mitigating circumstances including the responsiveness and extent of any actions taken by the facility to remediate, compensate, or correct the situation, as well as the facility’s recent history of charitable public service to persons with psychiatric disabilities in the community, and compliance and responsiveness to any prior violations or complaints.

(b)(2) Suspension of Designation. When the Department district or region determines that it is more likely than not that a facility, or its related entities, has failed to consistently meet one or more of the standards for designation or maintenance of designation under this chapter, it may suspend designation pending corrective action plan implementation. During the suspension period, no persons on involuntary status may be admitted to the facility. No re-application for designation as a receiving facility is required for reinstatement of designation.

(c)(3) Withdrawal of Designation.

1.(a) Designation may be withdrawn upon approval of the Department when it determines Secretary, or the Secretary’s designee, when the district or region determines that it is more likely than not that any pattern of violations, or combination of violations, of Chapter 394, F.S., this rule chapter, and Chapter 65E-12, F.A.C., exists such as deficient admission, transfer or care practices, deficient observation or documentation of rights abuses, deficient discharge practices, deceptive or misleading practices in marketing, admission recruitment or referral practices; fraudulent clinical or billing practices; or patient brokering is evident. Examples of such offenses include violations by the facility, or parties acting on behalf of or in concert with the facility, or acting under its supervision, having engaged in deceptive, fraudulent, exploitative, abusive, or neglect type violations of Florida law, including Chapters 394 and 415, F.S., Sections 817.505 and 458.331, F.S.

2.(b) Upon re-application after withdrawal of designation, the Department department must have clear and convincing evidence that the problems with the facility, or its practitioners, leading to withdrawal of designation have been corrected and will not reoccur. This may include required internal and external monitoring to document continued satisfactory performance.

(2) The Department shall continuously collect and monitor information relative to complaints or allegations against designated facilities from sources such as individuals, local advocacy or self-help groups, local organizations including law enforcement, the Agency for Health Care Administration, and the Florida Local Advocacy Council.

(3) A corrective action plan (CAP) must be completed to address any violations identified by the Department.

(4) The facility must submit a written corrective action plan (CAP) to the Department within seven calendar days from the date of written notification of violations. The CAP must be signed by the executive director or designee of the provider.

(a) The CAP shall include the following:

1. Identify the violation;

2. The actions the facility will take to correct each of the violations identified;

3. The date by which the violation shall be corrected; and

4. The actions the facility will take to ensure the violation identified does not occur again.

(b) Unless a date is directed or extended by the Department, the date to resolve the violation shall not exceed 30 days from the date of the written notification of the violation.

(5) The Department will reject any proposed corrective action plan that fails to identify all the information described in paragraph (4) of this rule or reflects a plan of action that does not address the violation(s). If the Department rejects a proposed corrective action plan, the Department shall notify the provider in writing of the reasons for rejection and require the provider to submit an amended corrective action plan addressing the violation or violations within five calendar days of receipt of the Department’s notice rejecting the corrective action plan.

Rulemaking Authority 394.461(6) 394.461(5) FS. Law Implemented 394, 394.455(26), 394.461, 395, 415, 458.331, 817.505 FS. History–New 11-29-98, Amended 4-4-05. Amended _________________.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Courtney Smith

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Shevaun L. Harris

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: November 28, 2023

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: October 31, 2023