63N-1.00951. Precautionary Observation

(1) Precautionary Observation shall be utilized as a Suicide Precaution method in Detention Centers, residential commitment programs and day treatment programs.

(2) A youth shall be placed on Precautionary Observation if the youth is identified by intake screening or staff observations as having Suicide Risk Factors, or is determined to be a Potential Suicide Risk by an Assessment of Suicide Risk and the youth’s Suicide Risk Behaviors indicates that his/her condition requires observation and monitoring beyond that which is normally provided, but is not in need of Secure Observation. Precautionary Observation shall not be used for youth who present an Imminent Threat of Suicide. Such youth shall be referred for emergency mental health services as set forth in Rule 63N-1.011, F.A.C.

(3) A youth on Precautionary Observation shall be limited to activities in the safe housing areas in the facility or program. The safe housing areas must meet the following specifications:

(a) The areas must be designed to eliminate or prohibit devices or materials which might aid in self-harm such as devices or materials which would enable a youth to hang him/herself, sharp objects which could be used to inflict physical damage to self or others or materials or substances which would enable the youth to burn or poison him/herself.

(b) The areas must be immediately accessible to the direct care staff maintaining Constant Supervision of the youth.

(c) The safe housing areas shall not limit the youth’s activity to an individual cell, whether locked or unlocked, or a confinement room of any kind, nor shall it restrict a youth to his/her sleeping room as a suicide precaution.

(d) The safe housing areas of the facility shall be regularly inspected to ensure that the area is safe and secure. Documented daily safety/security checks of the facility will suffice as an inspection provided that the daily safety/security checks include the areas of the facility designated for Precautionary Observation.

(4) The At Risk youth shall be permitted to participate in selected activities with other youths in the DJJ facility/program while being maintained on Precautionary Observation.

(5) Youth Placement on Precautionary Observation.

(a) The superintendent/program director or designee shall confer with the facility’s Designated Mental Health Clinician Authority or Licensed Mental Health Professional as to the whether Precautionary Observation is appropriate for a specific youth.

(b) When the decision has been made to place a youth on Precautionary Observation, the superintendent/program director or designee shall identify in writing the specific safe housing areas of the facility and activities which the youth will be allowed to utilize, based upon the individualized needs of the youth. The safe housing areas of the facility and activities will be documented on the Suicide Precautions Observation Log (MHSA 006, August 2006) which is incorporated by reference and is available at http://www.flrules.org/Gateway/reference.asp?No=Ref-03790 or may be obtained by contacting: DJJ, Office of Health Services, 2737 Centerview Drive, Tallahassee, FL 32399.

(6) Youths placed on Precautionary Observation shall receive Mental Health Supportive Services, based upon the individualized needs of the youth as determined by the Mental Health Clinical Staff Person. Mental Health Supportive Services shall be documented in the youth’s Active Mental Health/Substance Abuse File and reviewed and signed by a Licensed Mental Health Professional if provided by a non-licensed Mental Health Clinical Staff Person.

(7) Supervision Requirements for Precautionary Observation.

(a) The staff person assigned to monitor the youth in a Precautionary Observation area shall maintain One-to-One Supervision or Constant Supervision of the youth and document his/her observations of the youth’s behavior on the Suicide Precautions Observation Log (MHSA 006) at 30 minute intervals. The Suicide Precautions Observation Log (MHSA 006) is reviewed and signed by the shift supervisor each shift and by a Mental Health Clinical Staff Person daily.

(b) The shift supervisor is responsible for ensuring that a listing of youths currently placed on Precautionary Observation is passed on to the next shift, and that any concerns or observations regarding youths on Precautionary Observation shall be documented and communicated to the next shift.

(8) Discontinuation of Precautionary Observation.

(a) The Assessment of Suicide Risk findings and recommendations must be reviewed by the superintendent/program director or designee and Licensed Mental Health Professional. Based upon the Assessment of Suicide Risk findings, the Licensed Mental Health Professional and facility superintendent/program director or designee will determine whether Suicide Precautions are continued.

(b) If the Assessment of Suicide Risk findings and recommendations indicate the need for continued Suicide Precautions, the youth shall be maintained on Precautionary Observation until subsequent Follow-Up Assessment of Suicide Risk indicates Suicide Precautions may be discontinued and the facility superintendent, program director or and the Licensed Mental Health Professional concurs with the findings.

(c) If the Assessment of Suicide Risk or Follow-Up Assessment of Suicide Risk findings and recommendations indicate Suicide Precautions can be discontinued, and deemed appropriate by the Licensed Mental Health Professional and superintendent or program director or designee, the youth may be removed from Precautionary Observation and transitioned to normal routine as specified in Rule 63N-1.00953, F.A.C.

(d) Discontinuation of Precautionary Observation and supervision upon removal from Precautionary Observation shall be documented by Mental Health Clinical Staff and superintendent/program director, or designee, on the Assessment of Suicide Risk Form (MHSA 004) or the Follow-Up Assessment of Suicide Risk Form (MHSA 005), as applicable.

(9) Youths removed from Precautionary Observation shall continue to be monitored during the transition back into the facility/program’s normal routine, until deemed stable by the facility’s Designated Mental Health Clinician Authority or Licensed Mental Health Professional. The procedures set forth in Rule 63N-1.00953, F.A.C., shall be followed.

Rulemaking Authority 985.64(2) FS. Law Implemented 985.601(3)(a), 985.14(3)(a), 985.145(1), 985.18, 985.48(4), 985.64(2) FS. History–New 3-16-14.