The Department intends to create Rule 65C-28.021, Qualified Residential Treatment Programs, to comply with the Family First Prevention Services Act, P.L. 115-123.

 

DEPARTMENT OF CHILDREN AND FAMILIES

Family Safety and Preservation Program

RULE NO.:RULE TITLE:

65C-28.021Qualified Residential Treatment Programs

PURPOSE AND EFFECT: The Department intends to create Rule 65C-28.021, Qualified Residential Treatment Programs, to comply with the Family First Prevention Services Act, P.L. 115-123.

SUMMARY: The rule establishes standards for admittance to Qualified Residential Treatment Programs; delineates educational and experiential background requirements and scope of duty for qualified individuals who conduct qualifying assessments; specifies placement options; specifies documentation and time requirements, including length of stay; sets forth child welfare professional responsibilities, and establishes discharge and support requirements.

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.

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: 409.175(5), F.S.

LAW IMPLEMENTED: 409.175, F.S.

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: Jodi Abramowitz. Jodi can be reached at 850-717-4470 or [e-mail].

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

65C-28.021 Qualified Residential Treatment Programs

(1)  Placement of a child in a qualified residential treatment program (QRTP) is for the specific purpose of addressing the child’s emotional and behavioral health needs through observation, diagnosis, and treatment in a treatment setting. QRTPs shall not be used for emergency placements or to provide secure shelter for the child. If the child is in acute psychiatric crisis, the child shall be referred to a crisis stabilization unit for emergency screening and stabilization in accordance with Sections 394.463 and 394.467, F.S.

(2) The community-based care lead agency shall maintain documentation of a child's placement in a QRTP and is responsible for ensuring that each child receives a “qualifying assessment” no later than 30 calendar days after placement. The community-based care may request an assessment prior to the child being placed in the QRTP. 

(3) A “qualifying assessment” includes the development of short term and long term mental and behavioral health goals and the use of  the Child and Adolescent Needs and Strengths (CANS) Trauma Comprehension assessment tool,  March 2013, incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-XXX, by a qualified individual (QI) to make a determination of placement in a QRTP setting concerning a child who has a serious emotional or behavioral disorder or disturbance. 

(4) The qualifying assessment must be conducted by a QI who meets the following requirements:

(a) Is a licensed clinician or a master’s level practitioner under supervision of a licensed clinician;

(b) Has at least 3 years' experience working with children or adolescents involved in the child welfare system of care;

(c) Has no actual or perceived conflict of interest with placement in a QRTP; and

(d) Has completed training pertaining to the population of children in the child welfare system. Training topics shall include, but are not limited to, trauma-informed care and human trafficking.

(5)  The QI must conduct a review of prior treatment records and speak with relevant parties in the child’s life, including, but not limited to, the guardian ad litem, case manager, current caregiver, the child’s family, Department of Juvenile Justice worker, treating clinical professional, and the permanency team.

(a) The treating clinical profession shall be a member of the permanency team.

(b) The QI shall consider the recommendation of the child’s treating clinical professional when conducting the assessment.

(6)  The QI must conduct an interview with the child.

(a) Interviews may be completed via video conferencing if the child is outside a 50-mile radius from the location of the QI or in the event of a declared emergency.

(b) When a child refuses to participate in the interview, the QI shall make good faith efforts to engage the child. Good faith efforts are defined as documented efforts that demonstrate the QI took all steps in light of the child’s age, intelligence, emotional development and stability, and demeanor to enable the child to participate in a conversation with the QI that could aide or assist in obtaining information to determine whether the child meets the criteria for needing placement in a residential treatment center, even if those efforts were not fully successful.  Marginal or token efforts to communicate with the child are not sufficient to constitute good faith efforts.

(7) The QI shall recommend one of the following placement options:

(a) Placement in a QRTP;

(b) Placement in a less restrictive setting with wraparound services; or 

(c) Referral for a suitability assessment. 

(8) The QI may only recommend placement in a residential treatment center if he or she meets the qualifications of a qualified evaluator (QE) pursuant to Section 39.407, F.S, and is part of the network contracted with the Department.

(9)  If the QI was not provided with all components of the clinical record prior to the assessment or the child has experienced a decompensation in mental or behavioral health functioning since the assessment, the assigned child welfare professional may request a reconsideration.

(10) If the QI determines the child does not meet criteria for placement in a QRTP, the child’s multidisciplinary team shall offer to assist in developing a plan for necessary treatment and support services for the child in the community.

(11) When the qualifying assessment does not recommend placement in a QRTP, the child welfare professional must make arrangements to have the child moved from the program within 30 calendar days of the recommendation.

(12) Within 60 calendar days after initial placement in a QRTP, the Department shall request the court to approve or disapprove the placement and to consider the qualified residential treatment assessment, determination, and documentation made by the qualified individual. If the court orders the child to be placed in a QRTP after the QI does not recommend placement, the assigned child welfare professional shall request a reconsideration.

(13) If placement in the QRTP is approved by the initial 60-day court review, the QI must conduct an independent qualifying assessment review at least every 90 days after the child’s initial placement so long as the child remains placed in a qualified residential treatment program. It is the child welfare professional’s responsibility to request a 90-day review from the QI.

(14) If at any time the court denies the motion to place the child into a QRTP or orders the placement of the child into a less restrictive setting during a review hearing, the child welfare professional will follow local protocol to coordinate the referral and placement of the child into the least restrictive setting that is best suited to meet the child’s needs. The child welfare professional must make arrangements to have the child moved from the program within 30 calendar days of the determination.

(15) A copy of the qualifying assessment must be provided to the Department, community-based care agency or case management agency, the guardian ad litem, and the court having jurisdiction over the child, all of whom must be provided with the opportunity to discuss the findings with the evaluator.  

(a) The initial qualifying assessment shall include, at minimum, the outcome of the face to face interview with the child, review of prior treatment records, contact with relevant parties, recommendation for placement in a QRTP, and attachment of the Department-approved evidenced-based functional assessment tool.

(b) The 90-day independent qualifying assessment review may be an addendum to the initial assessment and shall include, at minimum, the outcome of a new face to face interview with the child, review of new treatment records, attachment of the Department-approved evidenced-based functional assessment tool, documentation of any psychosocial changes, and recommendation for continued placement in a QRTP. 

(16) A child may not be placed in a QRTP for more than 12 consecutive months or 18 nonconsecutive months, or in the case of a child who has not attained age 13, for more than 6 consecutive or non-consecutive months, without approval of the Department’s Regional Managing Director (RMD) or DCF designee. Requests for approval shall be made using the Qualified Residential Treatment Program (QRTP) Extended Placement Request Form, CF-FSP 5450, date, incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-XXX.  The RMD or DCF designee shall consider the recommendations of the multidisciplinary team staffing conducted within the last 60 calendar days and the most recent qualifying assessment recommending in making a decision whether to approve the continued placement. The RMD or DCF designee shall consult with a Department of Substance Abuse and Mental Health (SAMH) clinical professional regarding their decision to approve.  A copy of the signed approval shall be attached to the child’s case plan. 

(17) Discharge and Aftercare Support

(a) Discharge planning and aftercare support shall be developed to meet the needs of the child with intent for the child to reside in the most appropriate, least restrictive setting. Planning shall include input from the child, child’s parent or guardian, caregiver, the child’s case management team, and guardian ad litem.

(b) Aftercare support must be offered to all children who have a qualifying assessment and court order recommending placement in a QRTP setting. Aftercare support is not required for youth who discharge to another QRTP setting or higher level of care to include Statewide In-Patient Psychiatric Program (SIPP) or Specialized Therapeutic Group Home (STGH).  

(c) Aftercare support must be provided for a minimum of 6 months post discharge.

(d) When a child is discharged to a placement setting outside a 50-mile radius of the provider, the lead community-based care agency shall resume responsibilities of the aftercare support services offered to the child once coordinated by the child-caring agency.

(e) Written aftercare progress reports provided to the child welfare professional by the child-caring agency shall be uploaded into the state’s official system of record and the child welfare professional shall notify the court of the child’s progress during a judicial review. 

(18) A child who elopes or is Baker Acted from a QRTP may be readmitted into the same or newly identified QRTP without an additional assessment so long as the child returns within seven (7) calendar days from the date of the occurrence.

(19) If a child transfers from one QRTP to another without a lapse in placement, a new assessment is not required. The community-based care shall coordinate a multidisciplinary staffing with both QRTP providers to discuss the child’s identified needs and sharing of records to allow for adequate continuation of services and treatment.

Rulemaking Authority 409.175(5), F.S.            Law Implemented 409.175, F.S.  New

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Tanisha Lee

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Chad Poppell

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: December 14, 2020

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: December 23, 2020