The purpose and effect of the proposed rulemaking is to refine the input to be provided before disciplinary action is taken to include a clinical assessment from a psychologist or psychiatrist. The proposed changes specify when security restraints ...

 

DEPARTMENT OF CORRECTIONS

RULE NO.: RULE TITLE:
33-404.108: Discipline and Confinement of Mentally Disordered Inmates

PURPOSE AND EFFECT: The purpose and effect of the proposed rulemaking is to refine the input to be provided before disciplinary action is taken to include a clinical assessment from a psychologist or psychiatrist. The proposed changes specify when security restraints are applied. The composition and duties of the risk assessment team are amended to include a psychologist or psychiatrist and to update timeframes.

SUMMARY: The proposed rulemaking clarifies the input to be provided before disciplinary action, requires a clinical assessment from a psychologist or psychiatrist, and amends the composition and timeframes of the risk assessment team.

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: Upon review of the proposed changes to these rules, the department has determined that the amendments will not exceed any one of the economic analysis criteria in a SERC as set forth in Section 120.541(2)(a), F.S.

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: 944.09, 945.49 FS.
LAW IMPLEMENTED: 944.09, 945.49 FS.

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

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Laura Gallagher, 501 S. Calhoun Street, Tallahassee, Florida 32399

 

THE FULL TEXT OF THE PROPOSED RULE IS:

33-404.108 Discipline and Confinement of Mentally Disordered Inmates.

Inmates with a diagnosed mental illness shall be subject to the provisions of Rules 33-601.301-.314, F.A.C., Inmate Discipline, except as noted in the following sections.

(1) Mental health staff are authorized to provide written or verbal input to the disciplinary team before disciplinary action is taken against any inmate who has a diagnosed mental illness, or who is impaired due to mental retardation or who is otherwise cognitively impaired. The input shall be provided by either a psychologist or psychiatrist and of mental health staff shall be limited to description of the role, if any, that mental impairment may have played in the behavior in question. Written input by either a psychologist or psychiatrist shall be provided for inmates who are patients in isolation management, transitional care, crisis stabilization care, or in a corrections mental health treatment facility. The input shall be limited to whether the patient’s mental illness, mental retardation or cognitive impairment may have contributed to the alleged disciplinary offense and, if so, a recommendation for disposition or sanction options or alternative actions.

(2) Inmates who are patients in isolation management, transitional care, crisis stabilization care, or acute mental health hospital care shall not be subjected to administrative confinement, disciplinary confinement, or close management unless the inmate has been assessed by clinical staff as mentally competent and responsible and accountable for his or her behavior. The results of the clinical assessment shall be communicated to classification and documented in the health record by a psychologist or psychiatrist mental health staff professional. If the inmate is found to be competent and responsible, Tthe disciplinary team shall determine the appropriate discipline, including confinement, in accordance with Rules 33-601.301-.314, F.A.C. Any such confinement shall be performed within the inpatient setting, in accord with unit operating procedures and the individualized services plan. Documentation of all such incidents shall also be considered as part of the ongoing assessment of risk for violence by the risk assessment team as described in subsection (4) of this rule.

(3) When inmates are admitted to, transitional care, crisis stabilization care, or a corrections mental health treatment facility acute hospital care, any prior confinement, or close management status shall be suspended until the inmate is discharged from the specialized care setting. Security restraints shall be applied when inmates admitted to transitional care, crisis stabilization care, or a corrections mental health facility from maximum management or close management status I and II are out of their cells or other secure areas such as exercise yards, shower areas or holding cells.

(4) Within 72 hours of an inmate’s admission to transitional care, crisis stabilization care, or a corrections mental health treatment facility When an inmate in confinement or close management status is determined to be in need of inpatient mental health care, an assessment of risk for violence shall be completed by a risk assessment team. The risk assessment team shall consist of a psychologist or psychiatrist and a staff member from mental health, security and classification. This risk assessment shall be the basis for recommendations for restrictions on the inmate’s movement, housing program participation and clinical activities while the inmate is in an inpatient unit. The assessment of risk for violent behavior shall include a review of the health and institutional record, the inmate’s adjustment to incarceration, and the inmate’s disciplinary or confinement status at the time of the referral for inpatient treatment. Restrictions shall be determined based on staff and inmate safety, and institutional security, and shall be documented in the health record.

(5) Once the inmate is admitted to the inpatient unit, Tthe risk assessment shall be reviewed by a risk assessment team within 14 working days of the initial risk assessment and clinical, classification and security staff at the time of admission, and at least every 90 60 days thereafter, to determine the appropriateness of restrictions on housing, movement, and activities. Modifications shall be documented in the inmate’s health record. Disagreement among the risk assessment team related to the level of risk presented by the inmate, or the determination of restrictions to be recommended for inclusion in the individualized service plan shall be referred to the warden for resolution. The warden is authorized to contact the regional mental health consultant and director of mental health services or his/her designee in and central office for recommendations when needed.

(6) An inmate transferred to an inpatient setting from protective management may still need protection while in a crisis stabilization, or transitional care unit, or a corrections mental health treatment facility. Protective management status or requests shall be evaluated with written or verbal input from the clinical staff, in accordance with Rule 33-602.220 and Rule 33-602.221, F.A.C., as applicable.

Rulemaking Specific Authority 944.09, 945.49 FS. Law Implemented 944.09, 945.49 FS. History–New 5-27-97, Amended 7-9-98, Formerly 33-40.008,________.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Dr. Dean Aufderheide, Director of Mental Health Services

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Kenneth S. Tucker, Secretary

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: April 9, 2012

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAW: April 27, 2012