The purpose of this rule amendment is to clarify the requirements for providers and others to report incidents to the Agency.

 

DEPARTMENT OF CHILDREN AND FAMILIES

Agency for Persons with Disabilities

RULE NO.: RULE TITLE:

65G-2.001   Definitions

65G-2.010   Fire and Emergency Procedures

PURPOSE AND EFFECT: The purpose of this rule amendment is to clarify the requirements for providers and others to report incidents to the Agency.

SUMMARY: New definitions for the following terms: Community-Based Service Location, Other Location, Provider, and School. Also clarifies requirements for incident reporting to the Agency.

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.

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: 393.501(1), 393.067, 120.54 FS.

LAW IMPLEMENTED: 393.067, 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: Lisa Kuhlman, Senior Attorney

Agency for Persons with Disabilities, 4030 Esplanade Way, Suite 335, Tallahassee, FL 32399, [e-mail], [phone]

 

THE FULL TEXT OF THE PROPOSED RULE IS:

65G-2.001 Definitions.

For the purposes of this chapter, the term:

(1) through (6) No change.

(7) “Community-Based Service Location” means for purposes of the incident reporting requirements under Section 393.067, F.S., any location within the community where the resident or client may be located while the individual is under the supervision of a covered person.

(8)(7) “Controlling entity” means:

(a) The applicant or licensee;

(b) A person or entity that serves as an officer of, is on the board of directors of, or has a 5-percent or greater ownership interest in the applicant or licensee;, or

(c) A person or entity that serves as an officer of, is on the board of directors of, or has a 5-percent or greater ownership interest in the management company or other entity, related or unrelated, with which the applicant or licensee contracts to manage the facility.

(d) This term does not include a voluntary board member.

(9)(8) “Covered person" means any owner, employee, paid staff member, volunteer, or intern of the licensee, any person under contract with the Agency, and any person providing care or support to a client on behalf of the Agency or its providers.

(10)(9) “Direct Care Core Competency Training” means the training described and mandated by the Florida Medicaid Developmental Disabilities Waiver Services Coverage and Limitations Handbook, which is incorporated by reference in Rule 59G-13.083, F.A.C.

(11)(10) “Direct service provider” is as defined in Section 393.063, F.S.

(12)(11) “Emotional harm” means an inferred negative emotional state indicated by agitation, withdrawal, crying, screaming, or other behavioral indicators.

(13)(12) “Entity” means an individual, partnership, association, joint venture, company, sole proprietorship, corporation, limited liability corporation, professional limited liability corporation, or any other form of business.

(14)(13) “Facility” means a foster care facility, group home facility, residential habilitation center, or comprehensive transitional education program as defined in Section 393.063, F.S. The individual centers and units that comprise a comprehensive transitional education program collectively constitute a single “facility.”

(15)(14) “Household members” means residents, live-in staff, family members of live-in staff, and any other person residing in the facility.

(16)(15) “Licensee” means a person or entity which has been issued and currently maintains a non-expired residential facility license from the Agency.

(17)(16) “Live-in staff” means direct service providers whose primary residence is the same as that of the residents for whom they are providing supports and services.

(18)(17) “Local Review Committee (LRC)” means the committee established pursuant to Rule 65G-4.008, F.A.C., to provide oversight of behavioral services to Agency clients in a service region.

(19)(18) “Operator” means the person and/or entity responsible for the management and administration of a facility.

(20) “Other Location” means for purposes of the incident reporting requirements under Section 393.067, F.S., any location within the community where the resident or client may be located while not under the supervision of a covered person.

(21)(19) “Parcel” means the same as a “lot” as that term is defined in Section 177.031, F.S.

(22)(20) “Physical harm” means a bodily injury or illness requiring first aid or other medical procedures.

(23) “Provider” means any program or facility for the care, treatment, training, residence or habilitation of persons with developmental disabilities that is licensed by the Agency or receives funds from the Agency through a contract. A provider does not include a spouse, family member or guardian with whom a person with developmental disabilities resides or a provider covered under the provisions of Part VIII of Chapter 400, F.S.

(24)(21) “Regional Office” means the primary office for a service region of the Agency for Persons with Disabilities.

(25)(22) “Repeat violation” means the re-occurrence of a violation of the same standard that occurs within 12 months.

(26)(23) “Resident” means any person with a developmental disability whose primary place of residence is a facility, whether or not such person is a client of the Agency.

(27) “School” is as defined in Section 1003.01, F.S., for purposes of the incident reporting requirements under Section 393.067, F.S.

(28)(24) “Self-determination” is as defined in Section 393.063, F.S.

(29)(25) “Sexual activity” is as defined in Section 393.135, F.S.

(30)(26) “Sexually aggressive resident” means a minor who is an alleged juvenile sexual offender, as defined in Section 39.01, F.S., or an adult who is documented to have committed an act of sexual abuse as that term is defined in Section 415.102, F.S.

(31)(27) “Survey” means an on-site inspection conducted by Agency staff for the purpose of determining compliance with facility standards.

(32)(28) “Voluntary board member” means a board member of a not-for-profit corporation or organization who serves solely in a voluntary capacity, does not receive any remuneration for services to the corporation or organization, and has no financial interest in the corporation or organization.

(33)(29) “Welfare” means care which promotes those rights enumerated in Sections 393.13(3) and (4), F.S.

(34)(30) “Zero Tolerance” means Agency initiated activities, such as education and training, which are intended to prevent occurrences of abuse, neglect, exploitation, and abandonment involving persons with developmental disabilities and facilitate quicker identification and reporting of potentially harmful situations and environments in which abuse, neglect, exploitation, or abandonment may arise.

Rulemaking Authority 393.501(1), 393.067 FS. Law Implemented 393.067, 393.13 FS. History‒New 7-1-14, Amended       . 

 

65G-2.010 Fire and Emergency Procedures.

(1) through (4) No change.

(5) INCIDENT REPORTING. In all cases involving known or suspected abuse, neglect or exploitation, the incident shall be reported immediately to the Florida Abuse Hotline as required under Sections 39.201 and 415.1034, F.S. The Provider or Covered person must take immediate action in the situation to resolve the emergency and ensure the individual’s health and safety. This action may include, but is not limited to, calling 911, or performing Cardiopulmonary Resuscitation (CPR) for recipients without a pulse, who are not breathing and do not have a Do Not Resuscitate (DNR) Order, or back blows and abdominal thrust maneuvers for choking. In addition, all incidents must be reported to the Regional Office in the following manner and according to the specified timeframes utilizing the APD Incident Reporting Form APD OP 3-0006. APD Incident Reporting Form APD 10-002 (effective April 1, 2014) https://www.flrules.org/gateway/reference.asp?NO=Ref-04209, which is herein incorporated by reference. A copy of this form may be obtained from the Regional Office.

(a) Critical incidents must be reported to the appropriate Regional Office by telephone or in person within 1 one hour after facility staff become aware of the incident. If this occurs after normal business hours or on a weekend or holiday the person reporting the incident shall call the Regional Office after-hours designee. If the incident occurs between the hours of 8:00 p.m. and 8:00 a.m., a telephonic or in-person an oral contact must be made with the Regional Office no later than 9:00 a.m. It shall be within the provider’s discretion and judgment to determine the appropriateness of waiting until the following morning. A supervisor may be the one to make the verbal report. Telephonic or in-person Oral contacts should be followed up with the submission of a completed APD Incident Reporting Form to the Regional Office within 1 one business day following the critical incident. This form should be faxed, electronically mailed, or personally delivered to the Regional Office. The information contained in the first page must be provided by the person with firsthand knowledge of the incident. Additionally, any and all follow-up measures taken by a Provider or Covered Person to protect a resident or client, gain control or manage the situation must be noted on the second page of the incident reporting form, which may be completed and submitted to the Regional Office at a later date, not to exceed five business days. The measures must specify what actions will be taken to mitigate a recurrence of the same type of incident. Critical incidents include the following:

1. The unexpected death of a resident or a client;,

2. Any sexual activity, as defined described in Section 393.135, F.S., between a covered person facility staff and a resident or client regardless of the consent of the resident or client, incidents of nonconsensual sexual activity between residents or clients, sexual activity involving any resident or client who is a minor; child resident, and nonconsensual sexual activity between a resident or client and any person in the community.

3. The unexpected absence or unknown whereabouts, beyond one hour, of a resident or client who is a minor or an adult resident or client who has been adjudicated incompetent;,

4. Any unusual occurrence or circumstance such as a tornado, kidnapping, riot or hostage situation, which jeopardizes the health, safety or welfare of a resident,

4.5. A resident or client has sustained a life-threatening injury or illness;,

5.6. Negative news media reports regarding the operation of the facility or the care of residents or clients;,

6.7. The arrest of a resident or client for a violent criminal offense; ,or

7. The arrest of a covered person for a potentially disqualifying offense specified in Section 393.0655, F.S.; or

8. The Department of Children and Families has made a finding of verified abuse, neglect, exploitation, or abandonment by the provider or the provider’s employees.

(b) Other reportable incidents must be reported to the Regional Office within one business day following the incident through the completion of a written incident report which may be faxed, electronically mailed, or personally delivered to the Regional Office. Additionally, any and all follow-up measures taken by a Provider or Covered Person to protect a resident or client, gain control or manage the situation must be noted on the second page of the incident reporting form, which may be completed and submitted to the Regional Office at a later date, not to exceed five business days. Reportable incidents include:

1. The death of a resident or client that does not constitute an unexpected death;,

2. Physical altercations occurring between a resident or client and a member of the community, a resident or client and direct service providers, or two or more residents or clients, that results in law enforcement contact;,

3. Any injury to a resident or client due to an accident, act of abuse, neglect or other incident sustained or allegedly sustained while receiving services from a covered person that which requires the resident or client to receive medical treatment attention in an urgent care center, emergency room or physician office setting or requires admission to a hospital;,

4. The arrest of a resident or client for a non-violent offense while that resident or client is under the care of a provider; or the arrest of a direct service provider, or licensee,

5. The unexpected absence or unknown whereabouts of a legally competent adult resident or client beyond eight hours;,

6. Any act which clearly reflects the physical attempt by a resident or client to cause his or her own death;

7. The commitment of a resident or client to mental health services pursuant to Chapter 394, F.S., also known as the “Baker Act;” or ; and

8. Any illness sustained or allegedly sustained while receiving services from a covered person that requires the resident or client to receive medical treatment in an urgent care center, emergency room or physician office setting, or requires admission to a hospital.

8. Any other event that places a resident’s health, safety or welfare in jeopardy. Examples include: severe weather conditions, alleged criminal activity by licensees, employees or residents, fires or other hazardous events or conditions.

(c) through (e) No change.

Rulemaking Authority 393.501(1), 393.067 FS. Law Implemented 393.067 FS. History‒New 7-1-14, Amended         .

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Jackie Schaffer

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Barbara Palmer

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: 03/19/2018

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: 11/14/2017