Definitions, Admission Criteria, Program Orientation, Program Components, Behavior Management, Operational Inspections, Program Administration, Staff Training Requirements  


  • RULE NO: RULE TITLE
    63E-6.002: Definitions
    63E-6.003: Admission Criteria
    63E-6.005: Program Orientation
    63E-6.006: Program Components
    63E-6.007: Behavior Management
    63E-6.008: Operational Inspections
    63E-6.009: Program Administration
    63E-6.010: Staff Training Requirements
    NOTICE OF CHANGE
    Notice is hereby given that the following changes have been made to the proposed rule in accordance with subparagraph 120.54(3)(d)1., F.S., published in Vol. 32 No. 30, July 28, 2006 issue of the Florida Administrative Weekly.

    The changes are in response to comments received at a public hearing on August 21, 2006, and to those provided by the Joint Administrative Procedures Committee in an August 25 letter.

     

    63E-6.002 Definitions.

    (1) Alternative Training – authorized physical activities or extra duty assignments, which are imposed by STAR program staff following a youth’s misconduct. Alternative training is intended to correct a youth’s behavior by imposing minor sanctions.

    (2) Critical Life Safety – a condition or conditions in facility buildings and grounds or in the operation of the program that may adversely affect the health or safety of youth and staff.

    (3) Designated Health Authority – a Physician licensed under Chapters 458 or 459, F.S.

    (4) Direct Care – means direct contact with youth for the purpose of providing care, supervision, custody, or control of youth in the STAR program.

    (5) Extenuating Circumstances – a situation or circumstance beyond the control of the program, including but not limited to hurricanes/Acts of God, facility damage or structural problems, and situations involving a youth prior to his or her admission into the program.

    (6) Intensive Mental Health Treatment – treatment for:

    (a) Youth with a Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition, Text Revision (DSM-IV-TR) diagnosis of: Schizophrenia or other Psychotic Disorder; Major Depression, Bipolar Disorder or other Mood Disorder; Generalized Anxiety Disorder or other Anxiety Disorder; Personality Disorder; or

    (b) Youth classified as Severely Emotionally Disabled (SED) or Emotionally Handicapped (EH) by the school system; or

    (c) Youth who have a psychiatric disorder that requires treatment with psychotropic medication; or

    (d) Youth who have a psychiatric disorder (other than Conduct Disorder) and serious impairment in functioning as evidenced by a Global Assessment of Functioning (GAF) Scale rating of 50 or below.

    (7) Minimum Thresholds - defined as at least a 60 percent performance overall rating in the department’s Quality Assurance evaluation system, as referenced in subsection 63E-6.008(1), F.A.C.

    (8) Obstacle Course – a strenuous exercise program, which requires youth to overcome a series of barriers and is designed to promote the development of self-confidence and physical endurance.

    (9) Physical Training – a series of organized group calisthenics and exercises designed to develop the physical fitness of a youth to an optimum level.

    (10) Post-residential Services Counselor – the person supervising the youth’s post-commitment probation or conditional release after residential placement.

    (11) Program Director – a STAR program staff member who is responsible for all aspects of the STAR program, including, but not limited to, program content, staff supervision, youth treatment and facility security.

    (12) Protective Action Response Policy – the departmental policy governing staff’s use of verbal and physical intervention techniques, mechanical restraints, prohibition of aerosol and chemical agents, and Tasers, as referenced in Rule Chapter 63H-1, F.A.C.

    (13) Suicidal Risk History – means youth with any history of: suicide attempt; suicide gesture; intentional self-injurious behavior; suicide ideation or suicide threats.

    Specific Authority 985.3091, 985.405 FS. Law Implemented 985.3091 FS. History–New__________.

     

    63E-6.003 Admission Criteria.

    (1) A youth is eligible for the STAR program if:

    (a) He or she is at least 14 years of age but less than 18 years of age at the time of adjudication; and

    (b) Has been committed to the department for any offense that, if committed by an adult, would be a felony other than a capital felony, a life felony, or a violent felony of the first degree.

    (2) All youth referred to the STAR program shall be screened by the department to determine if they have the physical, psychological and substance abuse profile conducive to successfully completing the rigorous physical aspects and intensive behavioral management inherent in a STAR program. The screening shall include:

    (a) A comprehensive physical assessment prior to admission conducted by a physician (M.D., D.O.) licensed under Chapter 458 or 459, F.S., or an Advanced Registered Nurse Practitioner (ARNP) licensed and certified under Chapter 464, F.S. The assessment shall include a resting electrocardiogram (EKG) to screen for baseline arrhythmias. These assessments shall assist in determining the youth’s fitness for the physical demands of the program and to preliminarily screen out those youth whose health problems would prohibit them from engaging in intensive physical exercise as determined by the program’s physical exercise curricula. Any youth with abnormal EKGs shall be automatically excluded;

    (b) The comprehensive physical assessment and all required tests must be completed within 60 days prior to commencement of performed no earlier than 45 days prior to admission into the STAR program;

    (c) A preadmission comprehensive evaluation with the psychological component conducted by a licensed mental health professional or a Master’s level mental health clinical staff person working under the direct supervision of a licensed mental health professional should be completed no more than six months prior to commencement of the STAR program. A mental health clinical staff person is a person providing mental health services in a DJJ facility or program who has received training in mental health assessment processes and procedures and mental health treatment strategies and techniques. A Master’s level mental health clinical staff person is a person who holds a Master’s degree from an accredited university or college with a major in psychology, social work, counseling or related human services field. Related human services field is one in which major course work includes the study of human behavior and development, counseling and interviewing techniques, and individual, group or family therapy. Licensed mental health professional means a board certified psychiatrist licensed pursuant to Chapter 458, F.S., a psychologist licensed pursuant to Chapter 490, a mental health counselor, clinical social worker or marriage and family therapist licensed pursuant to Chapter 491, or a psychiatric nurse as defined in Section 394.455(23), F.S. This evaluation must be completed prior to admission to screen out those youth whose mental status requires psychotropic medication interventions, who have a developmental disability as defined by an IQ less than 75 80 or classification as “Educable Mentally Handicapped” or “Trainable Mentally Handicapped,” a need for intensive mental health treatment, or reveals suicidal risk histories, a DSM-IV-TR diagnosis of substance abuse, substance dependence, poly substance dependence, substance intoxication or substance withdrawal serious substance abuse histories, or indicates high-risk suicidal tendencies or history of self-injurious behavior.

    (3) Within 24 hours of admission, a preadmission substance abuse screening test must be conducted or ordered by the department, with results of testing reviewed prior to admission to the STAR program.

    Specific Authority 985.3091, 985.405 FS. Law Implemented 985.3091(2), (7)(a) FS. History–New__________.

     

    63E-6.005 Program Orientation.

    (1) The STAR program shall conduct orientation for youth admitted to the program.

    (2) The program orientation shall include, but not be limited to the following:

    (a) A program daily schedule;

    (b) A written, easily understandable statement, and a verbal description of youth rights and grievance procedures, including how to report abuse shall be given to the youth at the time of admission;

    (c) An introduction to the STAR program concept;

    (d) Explanation of program rules, disciplinary procedures and consequences, which result from the violation of program rules;

    (e) A review of dress code, hygiene and grooming requirements; and

    (f) Explanation of sick call procedures and access to health care services, including health care in emergency situations.

    (3) Program orientation and receipt of rules shall be documented with signatures of both the youth and staff.

    (4) The signed copy of the orientation and rules receipt shall be placed in the youth’s file and a copy given to the youth to be kept in his or her possession.

    Specific Authority 985.3091, 985.405 FS. Law Implemented 985.3091(3) FS. History–New__________.

     

    63E-6.006 Program Components.

    (1) The STAR program shall contain the following program components or services:

    (a) Participation in physical training exercises, which are designed to develop optimum physical conditioning of the youth. The physical conditioning may include the use of an obstacle course;

    (b) Educational and vocational services, designed to meet youth abilities, specialized needs and interests;

    (c) Community service or work assignments of a productive nature;

    (d) Personal development counseling, which shall include training in good decision-making, development of social adjustment skills, and life and job skills education. Counseling services shall also be provided to replace criminal thinking, beliefs and values with pro-social thinking, beliefs and values;

    (e) Mental health and substance abuse counseling and services shall be provided, including alcohol and other drug abuse awareness, education, treatment or referral to treatment for youth in need of such services; and

    (f) Health care services, sick call and acute and chronic medical treatment provided by the Designated Health Authority a physician (M.D., D.O.) licensed under Chapter 458 or 459, F.S.), an Advanced Registered Nurse Practitioner (ARNP) licensed and certified under Chapter 464, F.S., or a licensed Registered Nurse licensed under Chapter 464, F.S., at the level appropriate to their training within the scope of their training and practice.

    (2) While the youth is in the program, assessment shall be made for conditional release, providing for the youth’s transition back to his or her home community.

    Specific Authority 985.3091, 985.405 FS. Law Implemented 985.3091(3), (4) FS. History–New__________.

     

    63E-6.007 Behavior Management.

    (1) The program’s behavior management system shall be clear, emphasizing youth rights, encouraging pro-social behaviors and consequences for violations. The behavior management system shall provide a system of privileges and consequences to encourage youth to fulfill programmatic expectations.

    (2) The behavior management system shall clearly state the consequences for violation of program rules. The youth shall have an opportunity to explain the questionable behavior for which behavioral consequences are being considered. Consequences shall have a direct correlation to the inappropriate behavior exhibited. It shall be clear to the youth that the corrective action taken is a logical consequence of his or her behavior. Behavior management consequences are limited to the following:

    (a) Privilege suspension:

    1. Privilege suspension includes denial of the use of the telephone, home visits, recreation or other special activities outside the program and in accordance with the program’s written procedures. Withholding of telephone and visitation privileges shall not include depriving a youth access to his or her attorney, law enforcement, a representative of the clergy, the department’s Central Communications Center, Department of Children and Families’ Abuse Hotline or the Inspector General’s Office.

    2. Prior to any youth having a privilege suspended, the youth shall have the reason(s) for the suspension explained to him or her.

    3. Privilege suspension shall not include the withholding of regular meals, clothing, sleep, health care services, mental health services, toileting facilities, hygiene necessities, school, exercise, correspondence privileges, or legal assistance.

    4. All instances of privilege suspension shall be documented in the youth’s individual record and in the program logbook, dated and signed by the staff implementing the discipline procedure, with the program logbook to be reviewed and signed by supervisory staff at least on a daily basis.

    (b) Alternative training:

    1. Alternative training measures shall be applied on a consistent basis as a behavior management tool, and shall be proportionate to the importance of the rule violation. Prior to alternative training the youth shall have the reasons for the imposition explained to him or her, and be given an opportunity to explain his or her behavior. The youth’s rights shall be protected at all times during alternative training. Alternative training measures shall be documented in the program logbook, dated and signed by implementing staff and subsequently reviewed by supervisory staff on at least a daily basis, and all instances must be documented in the youth’s individual record.

    2. Any staff member of the STAR program has the authority to implement the following alternative training measures to youth:

    a. Extra duty assignments;

    b. Extra physical exercise limited to no more than 30 minutes. Staff shall intervene anytime a youth indicates that he or she is in pain and unable to perform as instructed. Anytime a staff member determines that the health or physical safety of a youth has been compromised or is potentially compromised, the staff member shall remove the youth immediately from all physical activities without prior approval from supervisory or health care staff. If the health care staff cannot determine the cause of the pain or discomfort, the youth shall be immediately transported to the emergency room; and

    c. Verbal counseling directed at changing the youth’s inappropriate behavior.

    (c) Program restriction:

    1. Program restriction is the loss of the earned privilege of leaving the program grounds for the purpose of participating in community activities except as it would restrict exercise of client rights such as school, religious observance, health and exercise needs.

    2. Prior to any youth being placed on program restriction, the youth shall have the reason(s) for the restriction explained to him. The youth shall also be given an opportunity to explain his or her behavior.

    3. Program restriction shall not exceed 30 days.

    4. All instances of program restriction shall be documented in the program logbook, dated and signed by the staff implementing the restriction, with the program logbook to be reviewed and signed by supervisory staff at least on a daily basis.

    (d) Room restriction:

    1. Room restriction is the restriction of a youth to his or her room or other area designated by the program director to protect the safety of the youth. Room restriction shall be used only when a youth is dangerous to self or others or there is substantial evidence to indicate the youth is about to escape. The use of room restriction shall serve only a “cooling off” purpose and shall not exceed two hours without authorization from licensed medical or mental health professionals. Room restriction shall not exceed a total of four hours at any given time.

    2. Prior to a youth being placed on room restriction, the youth shall have the reason(s) for the restriction explained to him or her. The youth shall also be given an opportunity to explain his or her behavior.

    3. Meals, clothing, sleep, health care, prescribed medications, mental health services, toileting facilities, hygiene necessities, religious needs, or staff assistance shall not be denied to a youth on room restriction.

    4. The staff member placing the youth on room restriction shall document the justification for room restriction.

    5. When a youth is placed on room restriction, the staff member shall talk with the youth at least every 30 minutes in order to evaluate the need for continued restriction.

    6. Youth on room restriction shall be visually observed (in person) by a staff member at least every 10 minutes.

    7. Youth who have been assessed to be at risk of suicide shall be provided with continual sight and sound supervision and shall be referred for a mental health evaluation immediately.

    8. Staff observations and contacts with the youth shall be documented in the program logbook, dated, and signed by the staff imposing the restriction, and subsequently reviewed and signed by supervisory staff on at least a daily basis. All instances must be documented in the youth’s individual record.

    (3) The use of harmful psychological intimidation techniques is prohibited in the STAR program.

    (a) For the purpose of this section, the term “harmful psychological intimidation techniques” includes the following actions when intentionally used as a therapeutic or training technique or as a means to encourage compliance with program requirements:

    1. The threat of physical force or violence;

    2. An intentional effort to humiliate or embarrass a child youth;

    3. An intentional effort to diminish a child’s youth    self-confidence or otherwise psychologically break a youth’s will; or

    4. Any action that would be considered child abuse or neglect under Chapters 39 or 827, F.S.

    (b) The term “harmful psychological intimidation techniques” does not include the following actions:

    1. Direct and forceful communication to a child youth of program requirements or legitimate performance expectations prior to or during participation in program activities, including positive, active encouragement of children youth engaged in physical training exercises.

    2. Communication necessary to inform a child youth of noncompliance with program requirements or appropriate actions to remediate such noncompliance.

    3. Communication necessary to inform a child youth of poor performance or appropriate actions to remediate such poor performance.

    4. Communications or other actions necessary to maintain order or safety in a the program.

    5. Any lawful and reasonable communications that are permissible for parents, other juvenile justice programs, school officials, or other adults who have custody of or supervisory responsibilities for youth.

    Specific Authority 985.3091, 985.405 FS. Law Implemented 985.3091(3), (7) FS. History–New________.

     

    63E-6.008 Operational Inspections.

    (1) Evaluations under Section 985.412(5), F.S., of each STAR program shall be conducted quarterly during the first year of the program’s operation. Thereafter, if the program met the minimum thresholds during its most recent evaluation, the program shall be evaluated at least once annually. If a sheriff’s training and respect program fails to meet the minimum thresholds, the department shall cancel the contract for the program. All STAR programs, whether operated by the department, county or municipal government, shall be inspected quarterly during the first year of operations by the department to determine operational compliance. Thereafter, if the program has met the minimum thresholds during the most recent evaluation, the program shall be evaluated at least once annually.

    (2) If a STAR program fails to meet the minimum thresholds, the department shall cancel the contract for the program:

    (a)1. Immediately, if the program has a deficiency in a critical life safety aspect of its operations, or has failed to train its staff as required.

    (b)2. Within three months, iIf the program fails to achieve compliance with the minimum thresholds within three months, unless there are documented extenuating circumstances.

    (2)(3) Upon cancellation of a STAR program contract under subsection (1), the provisions of this section, the program’s operations shall immediately cease and the department shall immediately discontinue any state payments to the program.

    Specific Authority 985.3091, 985.405 FS. Law Implemented 985.3091(8) FS.  History–New________.

     

    63E-6.009  Program Administration.

    (1) The program’s administration shall include, but is not limited to:

    (a) Rule and contract compliance:

    1. The inspection shall include operational compliance with admission criteria and screening, behavior management sanctions and privileges.

    2. A contractual STAR program will comply with the terms and conditions as identified in the contract.

    (b) Safety and security:

    1. The STAR program shall ensure the safety and security of staff and youth, conduct security inspections and checks, and provide preventive maintenance and control of safety and security equipment.

    2. The program shall develop escape prevention and escape response plans.

    3. Youth at the program shall be interviewed by regional program monitors at least quarterly regarding their safety and security at the program.  The interviews shall address availability of services, abuse allegations, grievances, access to treatment services, and overall treatment.

    4. Departmental staff shall meet with STAR program directors to review Protective Action Response reports for trends and conditions that would indicate staff are engaging in excessive or inappropriate use of force.

    (c) Treatment:

    1. The STAR program shall provide youth treatment and activities, youth work assignments, physical training, delivery of specialized treatment services, and youth case management.

    2. The program shall provide for visitation and family involvement, correspondence and telephone communications for the youth in the program.

    3. The program shall include academic and vocational activities, life and job skills, and appropriate decision making training for the youth.

    (d) Behavior management:

    1. The program shall implement a behavior management system, which includes consequences, sanctions and privileges for youth.

    2. The behavior management system shall not deny a youth meals, clothing, sleep, education, exercise or physical and mental health services.

    (e) Medical:

    1. The program shall implement access to and the delivery of medical, substance abuse and mental health services and assessments.

    2. The program shall have a written suicide prevention and suicide response plan.

    3. The program shall have a Designated Health Authority, defined as the physician (M.D. or D.O. licensed pursuant to Chapter 458 or 459, F.S.) who comes on site weekly to perform administrative duties and healthcare services that are beyond the scope of the nurse’s training.

    4. The program shall provide for medication storage, medical documentation, medication monitoring and distribution; sick call and medical appointments; “medical and mental health alerts”; management of health and mental health records and information; and control of infectious and communicable diseases.

    5. Anytime the health care staff determines that the health or physical safety of a youth has been compromised or is potentially compromised, they shall remove the youth from all physical activities without prior approval from program staff.  Staff shall intervene anytime a youth indicates that he or she is in pain and unable to perform as instructed.  Anytime a staff member determines that the health or physical safety of a youth has been compromised or is potentially compromised, the staff member shall remove the youth immediately from all physical activities without prior approval from supervisory or health care staff.  If the health care staff cannot determine the cause of the pain or discomfort the youth should be immediately transported to the emergency room.

    6. Health care services must be provided daily from 7:00 a.m. to 9:00 p.m. by a Registered Nurse licensed under Chapter 464, F.S.  Around-the-clock, on-call access to the Designated Health Authority or Advanced Registered Nurse Practitioner a medical professional (Physician) (ARNP) must be available at all other times.

    7. All STAR program staff shall be CPR and First Aid certified.

    8. All STAR programs shall have Automated External Defibrillators (AEDs) on site within 12 months of opening and at least one staff person on every shift shall be AED certified.

    (f) Administration:

    1. The program shall have a written mission statement.

    2. Requirements for The program shall require the prominent display of the telephone number of the statewide abuse registry hotline and the department’s Central Communication Center and for immediate access by children youth in the program, upon request, to a telephone for the purpose of contacting the statewide abuse registry, the public defender’s office, his or her attorney, or a law enforcement agency.

    (2) All usage of PAR must be documented in accordance with Rule 63H-1.007, F.A.C.

    (3) All alleged violations of PAR shall be reviewed by the department’s Inspector General.

    Specific Authority 985.3091, 985.405 FS. Law Implemented 985.3091(3)-(5), (7), (9) FS.  History–New__________.

     

    63E-6.010  Staff Training Requirements.

    (1) All STAR program staff must complete, at a minimum, the following training requirements within 90 calendar days of that staff person’s hiring date:

    (a) Administrative staff must successfully complete 120 contact hours of department-approved training.  A training plan must be approved by the department’s Bureau of Staff Development and Training.

    (b) Direct care staff who are Criminal Justice Standards and Training Commission (CJSTC) certified correctional, correctional probation or law enforcement officers under Chapter 943, F.S., will adhere to the requirements of Rule 63H-1.016, F.A.C.

    (c) Direct care staff who are not certified correctional, correctional probation or law enforcement officers under Chapter 943, F.S., are to be certified in Protective Action Response and to successfully complete 200 contact hours of department approved training, which must include, but not be limited to:

    1. State and federal laws relating to child abuse;

    2. Adolescent behavior;

    3. Behavior management;

    4. Mental health issues;

    5. Suicide prevention;

    6. Health care;

    7. Communication skills-interpersonal and verbal de-escalation skills;

    8. Human diversity;

    9. Cardiopulmonary resuscitation (CPR)/First Aid certification;

    10. Safety;

    11. Security; and

    12. Emergency procedures.

    (2) All department approved training courses must be taught by one or more persons who are certified as, or who have completed the necessary education and training to be, an instructor for the course being taught.  A training course in counseling techniques must be taught by a person who has at least a bachelor’s degree in social work, counseling, psychology or a related field.

    (3) Prior to successful completion of these training requirements, a STAR program direct care staff must be directly supervised by a person who has successfully completed the training requirements in this section.

    Specific Authority 985.3091, 985.405 FS.  Law Implemented 985.3091(6), (9) FS.  History–New__________.