Definitions, Discharge from Receiving and Treatment Facilities, Emergency Treatment Orders for the Administration of Phychotropic Medications, Transportation, Minimum Standards for Involuntary Examination ....
DEPARTMENT OF CHILDREN AND FAMILIES
RULE NOS.:RULE TITLES:
65E-5.100Definitions
65E-5.1303Discharge from Receiving and Treatment Facilities
65E-5.1703Emergency Treatment Orders for the Administration of Phychotropic Medications
65E-5.260Transportation
65E-5.2801Minimum Standards for Involuntary Examination Pursuant to Section 394.463, F.S
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. 49 No. 66, April 5, 2023 issue of the Florida Administrative Register.
65E-5.100 Definitions.
As used in this chapter the following words and phrases have the following definitions:
(1) through (17) No change.
(18) “Physician assistant” as defined in Section 394.455, F.S.
(19)(18) “Pro re nata (PRN)” means an individualized order issued at the discretion of a physician or psychiatric nurse, as circumstances require.
(19) through (28) are redesignated (20) through (29) No change.
(30)(29) “Signature” means either a written or an electronic signature. In accordance with s. 668.004, F.S., an electronic signature shall have the same force and effect as a written signature.
(30) through (32) are redesignated (31) through (33) No change.
Rulemaking Authority 394.457(5), 394.46715 FS. Law Implemented 394.455, 394.457, 394.4655 FS. History–New 11-29-98, Amended 4-4-05, 1-8-07, 5-7-08, 4-9-13. Amended _____________.
65E-5.1303 Discharge from Receiving and Treatment Facilities.
(1) Before discharging an individual who has been admitted to a facility, the individual shall be encouraged to actively participate in treatment and discharge planning activities and shall be notified in writing of his or her right to seek treatment from the professional or agency of the individual’s choice and the individual shall be assisted in making appropriate discharge plans. The individual shall actively be involved in and assisted with discharge planning activities.
(2) Discharge planning and procedures shall include the requirements in Section 394.468(2), F.S. In addition, the facility shall document consideration of the following:
(a) through (b) No change.
(c) How assistance in securing needed living arrangements or shelter will be provided to individuals who are at risk of re-admission within the next 3 weeks due to homelessness or transient status and prior to discharge shall request a commitment from a shelter provider that assistance will be rendered; If the individual is experiencing homelessness, notification to the managing entity or the individual’s Medicaid managed care plan to assist with care coordination and housing resources available in the community;
(d) Assistance in obtaining a timely aftercare appointment for needed services, including continuation of prescribed psychotropic medications. Aftercare appointments for psychotropic medication, and care coordination, or and case management shall be requested to occur not later than seven (7) days after the expected date of discharge. If the discharge is delayed, the facility shall notify the aftercare provider. The facility shall coordinate with the aftercare service provider and shall document the aftercare planning;
(e) through (f) No change.
(g) The individual shall be provided with information on any needed resources, and services, and community-based peer support services that are available in the community;
(h) through (j) No change.
(k) For individuals who are diagnosed with an intellectual or developmental disability according to Chapter 393, F.S., the facility shall provide ensure that the parents or guardians with have information on how to access appropriate resources from the Agency for Persons with Disabilities, and shall assist with a referral when indicated.
(l) No change.
(3) No change.
(4) The provider shall implement policies and procedures outlining their strategies for how they will comprehensively address the needs of the following individuals to avoid or reduce future use of crisis stabilization services:
(a) Individuals who demonstrate a high utilization of receiving facility services; or
(b) Adults awaiting involuntary placement into a state mental health treatment facility (SMHTF) or awaiting discharge from a SMHTF back into the community; or
(c) Children and adolescents awaiting admission into a psychiatric residential treatment facility (PRTF) or awaiting discharge from a PRTF back into the community.
(5) The policies and procedures for individuals meeting the criteria in subsection (4) shall consist of the following:
(a) A warm hand-off to one of the following: a case manager, or a care coordinator.
(b) The warm hand-off process includes:
1. Engaging the individual in the referral process;
2. Providing transparency of the referral process and the information being shared on behalf of the individual; and
3. Documenting the post discharge follow-up with the aftercare provider, or care coordinator, or case manager, or insurer.
(6) through (7) are redesignated (4) through (5) No change.
Rulemaking Authority 394.457(5), 394.46715 FS. Law Implemented 394.4573, 394.459(11), 394.460 FS. History–New 11-29-98, Amended 4-4-05, 4-9-13. Amended _______________.
65E-5.1703 Emergency Treatment Orders for the Administration of Psychotropic Medications.
(1) through (2) No change.
(3) The physician’s initial order for emergency treatment may be by telephone or by telehealth but such a verbal order must be reduced to writing upon receipt and signed by a physician within 48 24 hours.
(4) Each emergency treatment order shall only be valid and shall be authority for emergency treatment only for a period not to exceed 48 24 hours. For state mental health treatment facilities, emergency treatment orders are valid for 48 hours.
(5) through (10) No change.
Rulemaking Authority 394.457(5), 394.46715 FS. Law Implemented 394.459(3), 394.4598, 394.463(2)(f), 394.46715 FS.. History–New 11-29-98, Amended 4-4-05, 4-9-13. Amended ________.
65E-5.260 Transportation.
(1) Each law enforcement officer or other transporter who takes an individual into custody for involuntary examination under the Baker Act or involuntary admission under the Marchman Act shall provide the receiving facility or access center the original or an electronic copy of one of the following:
(a) Form CF-MH 3001, (insert date), “Ex Parte Order for Involuntary Examination,” which is incorporated by reference in 65E-5.280, F.A.C., or other form provided by the court;
(b) Form CF-MH 3052a, (insert date), “Report of a Law Enforcement Officer Initiating Involuntary Examination,” which is incorporated by reference in 65E-5.280, F.A.C.; or
(c) Form CF-MH 3052b, (insert date), “Certificate of Professional Initiating Involuntary Examination,” which is incorporated by reference in 65E-5.280, F.A.C., and
(d) All forms required by Section 397.321(19), F.S.
(2) Each law enforcement officer or other transporter who takes an individual into custody for involuntary admission under the Marchman Act shall provide the receiving facility or access center the original or an electronic copy of one of the following:
(a) Form CF-MH 4057, (insert date), “Certificate of Professional for Emergency Assessment for Substance Abuse Services,” which is incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-XXX; or
(b) Form CF-M 4002, (insert date), “Report of Law Enforcement Officer Initiating Protective Custody,” which is incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-XXX.
(2) is redesignated (3) No change.
Rulemaking Authority 394.457(5) FS. Law Implemented 394.462, 394.463 FS. History–New 11-29-98, Amended 4-4-05, 1-8-07, 7-5-16. Amended ________________.
65E-5.2801 Minimum Standards for Involuntary Examination Pursuant to Section 394.463, F.S.
The involuntary examination is also known as the initial mandatory involuntary examination.
(1) Whenever an involuntary examination is initiated by a circuit court, a law enforcement officer, or a mental health professional as provided in section 394.463(2), F.S., an examination by a physician or clinical psychologist or psychiatric nurse must be conducted in person or via telehealth and documented in the person’s clinical record. The examination, conducted at a facility licensed under chapter 394 or 395, F.S., must contain:
(a) through (d) No change.
(2) through (7) No change.
(8) Disposition Upon Initial Mandatory Involuntary Examination.
(a) The release of a person from a receiving facility requires the documented approval of a psychiatrist, clinical psychologist, or psychiatric nurse in accordance with s. 394.463(2)(f), F.S. If if the receiving facility is a hospital, the release may also be approved by an attending emergency department physician after the completion of an initial mandatory involuntary examination. Form CF-MH 3111, (insert date), “Approval for Release of Person on Involuntary Status from a Receiving Facility,” which is incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-XXX, may be used for this purpose. A copy of the form used shall be retained in the person’s clinical record.
(b) No change.
(c) A person for whom an involuntary examination has been initiated shall not be permitted to consent to voluntary admission until after examination by a physician or psychiatric nurse to confirm his or her ability to provide express and informed consent to treatment. Form CF-MH 3104, “Certification of Individual’s Competence to Provide Express and Informed Consent,” which is incorporated in Rule 65E-5.270, F.A.C., may be used for documentation.
(d) through (e) No change.
Rulemaking Authority 394.457(5), 394.46715 FS. Law Implemented 394, 394.463, 394.4655, 395 FS. History–New 11-29-98, Amended 4-4-05. Amended _______________.
