reglab/statecodes huggingface dataset:
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-5 - SUPPORTED LIVING SERVICES › Section 65G-5.009 - Annual Survey and Renewal of Certification

Current through Reg. 50, No. 138; July 16, 2024
(1) The area office shall conduct an annual
				unannounced survey of each supported living coaching and personal assistance
				provider to monitor compliance with the requirements of this rule, including
				all items covered in the provider's application for certification.
(2) A survey report shall be completed within
				30 calendar days after the survey and a copy shall be forwarded to the provider
				within three working days of the report's completion.
(3) When the survey determines that the
				provider is in compliance with the requirements of this rule, the area office
				shall issue a certification that will be valid for no more than one
				year.
(4) When it is determined
				through the survey, or otherwise comes to the attention of the area office,
				that a provider is out of compliance with the requirements of this rule, the
				provider shall be required to develop a plan of correction, which must be
				accepted by the area office before its implementation. This corrective action
				plan must be submitted to the area office within ten working days after the
				provider is notified of the unsatisfactory rating by means of the survey
				monitoring report.
(5) Within 60
				calendar days after acceptance of the corrective action plan, area office staff
				shall revisit the provider to determine if the plan has been successfully
				implemented to bring the provider into compliance with the requirements of this
				rule. If the provider is determined to be in compliance at the time of this
				visit, the area office shall issue a certification to provide services that
				will be valid for no more than one year.
(6) If the provider is still found to be out
				of compliance with the requirements of this rule, a moratorium shall be imposed
				on referrals of individuals to the provider and the provider shall be notified
				of the moratorium in writing within ten working days after completion of the
				monitoring visit. This notification shall also inform the provider of the need
				to develop a second corrective action plan to address continuing
				deficits.
(7) The second corrective
				action plan must be submitted to the area office within ten working days after
				the provider receives notification. The plan must be implemented within 30
				calendar days of its acceptance by the area office, which shall conduct
				follow-up monitoring as necessary to verify the provider's compliance. If
				monitoring determines that deficiencies have been corrected, the provider shall
				be issued a certification to provide services that shall be valid for no more
				than one year.
Rulemaking Authority
					 393.510(1) FS.
					 Law Implemented 393.065(45),
					 393.066
					 FS.
New 1-18-95, Formerly 10F-11.011,
					 65B-11.011.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-5 - SUPPORTED LIVING SERVICES › Section 65G-5.010 - Suspension of Provider Certification

Current through Reg. 50, No. 138; July 16, 2024
(1)
				The area office shall suspend a provider's certification when there is good
				faith reason to believe that the provider has engaged in any of the following:
(a) Submitted false information on the
				application for certification;
(b)
				Submitted a fraudulent invoice for services;
(c) Abused, neglected, or exploited a person
				as defined by Chapter 415, F.S., or committed any action that violates the
				minimum standards for good moral character set forth in Section
				 393.0655, F.S.;
(d) Failed, if an agency provider, to
				terminate or reassign a direct service staff person who has abused, neglected,
				or exploited a person as defined by Chapter 415, F.S., or committed any action
				that violates the minimum standards for good moral character set forth in
				Section  393.0655, F.S.;
(e) Lost a required professional
				certification, licensure or registration;
(f) Financially benefited by borrowing or
				otherwise using an individual's personal funds, or
(g) Engaged in conduct, whether while
				directly performing the services to be provided under the terms of the
				certification or not, that adversely affects the provider's ability to continue
				to perform his or her work thereunder or adversely affects the Agency's ability
				to carry out its assigned mission. This includes any act or acts rendering the
				provider ineffective in his or her role under the terms of the certification,
				or affecting the provider's ability for acceptance or trust by the Agency,
				citizens of the state, clients or individuals. Providers are required to
				conduct themselves in a manner that reflects favorably upon the state, the
				Agency, and themselves.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-5 - SUPPORTED LIVING SERVICES › Section 65G-5.011 - Termination of Provider Certification

Current through Reg. 50, No. 138; July 16, 2024
(1) If
				a provider fails to fully correct continuing deficits as identified in Rule
				 65G-5.013, F.A.C., within 30
				calendar days after notice, the area office shall terminate the provider's
				certification.
(2) If a provider
				fails to respond to a notice of suspension issued according to Rule
				 65G-5.010, F.A.C., the
				provider's certification shall be terminated.
(3) If, following a provider's timely
				response to a notice of suspension issued according to Rule
				 65G-5.010, F.A.C., the area
				office continues to believe in good faith that the reason for the provider's
				suspension is valid, the provider's certification shall be
				terminated.
(4) The area office
				shall notify the provider of the proposed termination of the provider's
				certification in writing by certified mail and shall provide a copy to the
				Agency's central office. The written notice shall include the reason for
				termination and a statement of the provider's right to an administrative
				hearing in accordance with Chapter 120, F.S., provided the hearing is requested
				within twenty calendar days. The termination shall be effective on the 21st day
				after issuance of the notice unless a hearing is requested.
(5) Any provider who voluntarily wishes to
				terminate certification shall notify the area office in writing at least 30
				calendar days prior to the anticipated termination date. Within three working
				days of receipt, the area office shall send a copy of the provider's
				termination notice to the Agency's central office.
(6) Individuals receiving supported living
				services from a provider whose certification is suspended or pending
				termination shall be notified of the pending change. They shall be advised of
				their right to continue receiving services from another certified provider and
				shall be assisted in the selection of a new provider.
(7) The agency shall maintain a list of
				providers willing to temporarily provide services to the individuals of
				providers whose certifications are suspended or
				terminated.
Rulemaking Authority
					 393.501(1) FS.
					 Law Implemented 393.063(45),
					 393.066,
					 393.0655
					 FS.
New 1-18-95, Formerly 10F-11.013,
					 65B-11.013.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-5 - SUPPORTED LIVING SERVICES › Section 65G-5.012 - Documentation of Services

Current through Reg. 50, No. 138; July 16, 2024
The provider shall maintain documentation that the supports
				  and services for which billings or invoices are submitted have been provided.
				  For providers of supported living coaching and personal assistance this shall
				  include written documentation of the dates, times and summary of support
				  provided during contact with the individual.
Rulemaking Authority
					 393.501(1) FS.
					 Law Implemented 393.063(45),
					 393.066
					 FS.
New 1-18-95, Formerly 10F-11.014,
					 65B-11.014.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-5 - SUPPORTED LIVING SERVICES › Section 65G-5.013 - Rates and Payments

Current through Reg. 50, No. 138; July 16, 2024
(1) The area office
				shall establish a rate agreement with each provider based on reasonable and
				necessary costs. Rates for services provided through the CSLA Medicaid state
				plan option or the DS/HCBS waiver shall not exceed the maximum rates
				established by Medicaid.
(2)
				Payments for services provided through CSLA or the Developmental Disabilities
				Home and Community-Based Services Waiver will be made to the provider by
				Medicaid's fiscal agent. Payments for services provided solely through state
				general revenue funds will be made to the provider by the Florida state
				comptroller.
Rulemaking Authority
					 393.501(1) FS.
					 Law Implemented 393.063(45),
					 393.066
					 FS.
New 1-18-95, Formerly 10F-11.015,
					 65B-11.015.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-6 - FOSTER CARE, GROUP HOME, DEVELOPMENTAL TRAINING, AND SUPPORTED EMPLOYMENT PROGRAMS TRUST FUND › Section 65G-6.001 - Authority to Loan; Provisions and Determination of Eligibility

Current through Reg. 50, No. 138; July 16, 2024
(1) Eligible Expenses - Trust Funds under
				this chapter are for the purpose of granting loans to eligible programs.
				Initial costs of development are those permissible costs for establishment of
				new programs and those permissible costs necessary for an already established
				program to initiate the accommodation of hard to place clients. Cost of
				development may include structural modification, purchase of equipment and fire
				and other safety devices, and the purchase of insurance. Cost of structural
				modification shall include only those changes required for compliance with
				building, fire safety and health codes and those changes necessary for the
				implementation of the intended program. Purchase of equipment shall include
				only those basic furnishings, equipment, and appliances necessary to furnish,
				equip, and maintain the premises and considered essential to the operation of
				the intended program. Such cost shall not include the actual construction,
				lease or any other costs of acquisition of the program.
(2) Amounts of Loans - An eligible program
				may receive a lump sum loan in one payment, not to exceed the approved rate for
				providing two months of residential or non-residential service to each Agency
				client to be placed in the program by the Agency. Loans granted to programs
				shall not be in lieu of payment for residential or non-residential service and
				care provided, but shall stand separate and distinct. The amount of the monthly
				care and maintenance payment shall be determined by the appropriate rate or
				rate formula for the category of client.
(3) Terms of the Loan - Any loan granted
				through the Trust Fund shall be repaid in five equal annual installments
				without interest.
(4) A program
				receiving a loan under the act and operating as a nonprofit corporation meeting
				the requirements of Section 501(c)3., of the Internal Revenue Code, shall
				submit to the Agency a report setting forth the service it has provided during
				the year and upon approval of each such annual statement, the Agency shall
				forgive 20 per cent of the principal of such loan. The report shall include:
(a) A brief narrative description of the
				facility and programs;
(b) The age,
				functioning level and handicapping conditions of the client served;
(c) Client-staff ratio;
(d) The average number of clients served per
				month for the previous 12 months;
(e) A list of actual loan
				expenditures;
(f) A report by
				Agency staff who have surveyed the operation of the facility;
(g) Proof of compliance with health, fire,
				building and zoning regulations;
(h) Proof of compliance with Section 501(c)3.
				of the Internal Revenue Code; and,
(i) A recommendation from the Area
				Administrator that the loan be forgiven.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-7 - MEDICATION ADMINISTRATION › Section 65G-7.001 - Definitions

Current through Reg. 50, No. 138; July 16, 2024
The terms and phrases used in this chapter shall have the
				  meanings defined below:
(1)
				"Administration of medication" means the obtaining and giving of one or more
				doses of medicinal substances by an authorized person to an Agency client for
				his or her consumption.
(2)
				"Administration route" means the path through which medication or prescribed
				formula is delivered to a client. For purposes of this chapter, administration
				routes include the following:
(a) "Enteral, "
				which means medication or prescribed enteral formula is delivered by
				gastrostomy jejunostomy tube, or gastrostomy-jejunostomy tube, via the body's
				gastrointestinal system.
(b)
				"Inhaled, " which means medication is administered as nose drops or nose spray,
				or medication is inhaled by mouth, such as an inhaler or nebulizer.
(c) "Ophthalmic, " which means solution or
				ointment medication is instilled into the eye or applied on or around the
				eyelid.
(d) "Oral, " which means
				medication including, but not limited to, tablet, capsule, liquid, or powder
				form is introduced into the gastrointestinal tract by mouth.
(e) "Otic, " which means solutions or
				ointment medication is placed in the outer ear canal or applied around the
				outer ear.
(f) "Parenteral, " which
				means medication is injected into the body through some route other than the
				digestive tract, such as subcutaneous, intra-dermal, intra-muscular, or
				intravenous administration.
(g)
				"Rectal, " which means any medication including, but not limited to, capsule,
				enema, gel, or suppository is administered via the rectum.
(h) "Topical, " which means medication
				including, but not limited to, salve, lotion, ointment, cream, spray, shampoo,
				or solution is applied locally to a body part.
(i) "Transdermal, " which means a patch
				containing a pre-measured or measured amount of topical medication that is
				absorbed into the body via the epidermis (outer layer of skin).
(j) "Vaginal, " which means any medication
				including, but not limited to, capsule, cream, or ointment that is administered
				via the internal vagina. This route does not include medications applied to the
				epidermis external to the vagina.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-7 - MEDICATION ADMINISTRATION › Section 65G-7.002 - Authorization for Medication Administration and Informed Consent Requirement

Current through Reg. 50, No. 138; July 16, 2024
(1) An Agency client's need for assistance
				with medication administration or ability to self-administer medication without
				supervision must be documented by the client's physician, PA, or APRN on an
				"Authorization for Medication Administration, " APD Form
				 65G-7.002 A, effective April
				2019, incorporated here by reference, which may be obtained at
http://www.flrules.org/Gateway/reference.asp?No=Ref-10587
.
(a) The client's current Authorization Form
				must be maintained in the client's current place of residence, with a copy of
				the form in the client's record. The WSC is responsible for assuring that all
				providers that assist a client with medications have an up-to-date copy of the
				Authorization.
(b) The
				Authorization Form must be reviewed and updated by the client's physician, PA,
				or APRN at least annually and upon any change in the client's medical condition
				or self-sufficiency that would affect the client's ability to self-administer
				medication or tolerate particular administration routes. Any provider who
				accompanies a client to a medical professional when a change to the
				Authorization Form is made is responsible for notifying the WSC of any new
				Authorization Form.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-7 - MEDICATION ADMINISTRATION › Section 65G-7.0025 - Self-Administration of Medication Without Supervision

Current through Reg. 50, No. 138; July 16, 2024
A client who is authorized by his or her health care
				  practitioner to self-administer medication without the supervision of a MAP or
				  a licensed or authorized nurse, as set forth in the Authorization for
				  Medication Administration Form, APD Form
				   65G-7.002 A adopted in rule
				   65G-7.002, F.A.C., may do so.
				  Any provider who helps the client may do so by making the medication available
				  and reminding the client to take his or her own medication at appropriate
				  times. This does not negate the requirement that the client be capable of
				  self-administering his or her own medications without any supervision,
				  monitoring, verbal prompting, physical assistance, or cuing from staff.
				  Medications for the self-administering client may be stored pursuant to rule
				   65G-7.007, F.A.C., and the
				  entire container of medications provided to the client at the appropriate
				  time(s), without further assistance. A pill organizer (also known as "pill
				  minder" or "pill box") may be utilized by a client who self-administers without
				  supervision, however the client must fill the pill organizer without any
				  supervision, monitoring, verbal prompting, physical assistance, or cuing from
				  staff. MAPs may not transfer the medications from the original container to any
				  other container.
Rulemaking Authority
					 393.501,
					 393.506 FS. Law Implemented
					 393.506
					 FS.
New 7-1-19.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-7 - MEDICATION ADMINISTRATION › Section 65G-7.003 - Medication Administration Trainer Requirements

Current through Reg. 50, No. 138; July 16, 2024
(1) RNs or LPNs must receive Agency approval
				before providing or offering to provide either of the following two medication
				administration courses to MAP applicants:
(a)
				Basic Medication Administration Training; or
(b) Prescribed Enteral Formula Administration
				Training.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-7 - MEDICATION ADMINISTRATION › Section 65G-7.0033 - Medication Administration Training Course Curriculum Requirements

Current through Reg. 50, No. 138; July 16, 2024
(1) The Agency shall provide Medication
				Administration Training curriculum for the following courses:
(a) Basic Medication Administration course;
				and
(b) Prescribed Enteral Formula
				Administration course.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-7 - MEDICATION ADMINISTRATION › Section 65G-7.0035 - Validation Trainer Requirements

Current through Reg. 50, No. 138; July 16, 2024
(1)
				Individuals must first receive Agency approval as a Validation Trainer before
				validating or offering to validate the competency of a MAP or MAP applicant to
				provide either:
(a) Basic medication
				administration assistance; or
(b)
				Prescribed enteral formula administration.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-7 - MEDICATION ADMINISTRATION › Section 65G-7.004 - Medication Assistance Provider Training and Validation Requirements

Current through Reg. 50, No. 138; July 16, 2024
(1)
(a)
				Unless otherwise authorized by law in the State of Florida, an individual shall
				not administer medication or supervise the self-administration of medication to
				Agency clients unless he or she has successfully completed an Agency-provided
				medication administration training course and obtained a current validation for
				the route by which the medication is administered. These requirements are
				necessary in order for an individual to become or remain a MAP.
(b) Unless otherwise authorized by law in the
				State of Florida, individuals who are not currently recognized by the Agency as
				a MAP permitted to administer prescribed enteral formulas or supervise the
				self-administration of prescribed enteral formulas to Agency clients are
				prohibited from doing so. MAPs or other unlicensed direct service providers
				administering prescribed enteral formulas who have previous training in the
				administration of prescribed enteral formula at the time this rule becomes
				effective shall have until December 31, 2019 to obtain the training and
				validation required to continue administering prescribed enteral formulas to
				clients, during which time they may continue to administer prescribed enteral
				formulas.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-7 - MEDICATION ADMINISTRATION › Section 65G-7.005 - Medication Administration Procedures

Current through Reg. 50, No. 138; July 16, 2024
(1)
				Upon receipt of the Basic Medication Administration training certification and
				validation certification, MAPs are authorized to administer medications or to
				supervise the self-administration of medications via the following medication
				routes for which the MAP has been validated:
(a) Oral;
(b) Enteral, with the exception of prescribed
				enteral formulas;
(c)
				Transdermal;
(d) Otic;
(e) Ophthalmic;
(f) Rectal;
(g) Inhaled; and
(h) Topical.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-7 - MEDICATION ADMINISTRATION › Section 65G-7.006 - Medication Errors

Current through Reg. 50, No. 138; July 16, 2024
(1) A "medication
				error" is any of the following:
(a)
				Administration or supervision of self-administration of a wrong medication,
				including:
1. Administration or supervision
				of self-administration of medication for any symptom, illness, or reason other
				than the one for which the medication was prescribed;
2. Administration or supervision of
				self-administration of medication for which there is no current prescriber
				order;
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-7 - MEDICATION ADMINISTRATION › Section 65G-7.007 - Storage Requirements

Current through Reg. 50, No. 138; July 16, 2024
(1) MAPs and
				licensed health care practitioners must observe the following medication
				storage requirements:
(a) Store each
				medication at the temperature appropriate for that medication, including
				refrigeration if required;
(b)
				Destroy any prescription medication that has expired per the pharmacist's label
				or the label provided by the manufacturer on OTC medications, or is no longer
				prescribed and document the medication disposal on a "Medication Destruction
				Record, " APD Form  65G-7.007 A, effective April
				2019, incorporated herein by reference, which may be obtained at
http://www.flrules.org/Gateway/reference.asp?No=Ref-10756
.
				The MAP or licensed health care practitioner must sign the Record before a
				third-party witness;
(c) Maintain
				medication samples in their original containers labeled by the dispensing
				health care practitioner with the client's name, the practitioner's name, and
				the directions for administering the medication. The MAP or licensed health
				care practitioner must initial and add to the label the date the medication is
				opened;
(d) Maintain OTC
				medications in their original stock containers. OTC medications in original
				stock containers are not required to have individual client's names provided on
				the container;
(e) Store the
				medications centrally in a locked container in a secured enclosure if the
				client requiring the medication assistance is residing or receiving services in
				a facility setting;
(f) Organize
				and maintain stored medications in a manner that ensures their safe retrieval
				and minimizes medication errors;
(g) Store all medications that require
				refrigeration in a refrigerator, in their original containers either within a
				locked storage container that is clearly labeled as containing medications, or
				in a medication dedicated refrigerator located in a locked, secured medication
				storage room;
(h) Return each
				medication to its portable or permanent storage unit immediately following
				medication administration assistance.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-7 - MEDICATION ADMINISTRATION › Section 65G-7.008 - Documentation and Record Keeping

Current through Reg. 50, No. 138; July 16, 2024
(1) MAP and
				licensed health care practitioner shall maintain an up-to-date MAR for each
				client requiring assistance with medication administration, except when the
				client is off-site. The MAP and licensed health care practitioner must document
				the administration of medication or supervision of self-administered medication
				immediately on the MAR. The MAP and licensed health care practitioner may
				utilize the Agency's Medication Administration Record Form, APD Form 65G-7.008
				A, effective April 2019, adopted and incorporated by reference herein, which
				may be obtained at
http://www.flrules.org/Gateway/reference.asp?No=Ref-10601
,
				or on an alternative MAR form that includes the following information:
(a) The client's name;
(b) Any client food or medication
				allergies;
(c) The name of each
				medication prescribed for the client;
(d) The medication strength (e.g., 5mg/
				tsp);
(e) The prescribing health
				care practitioner for each medication;
(f) The date that the medication was ordered
				and any date the medication was changed (including D/C date);
(g) Prescribed dosage for each
				medication;
(h) Scheduled time of
				administration for each medication;
(i) Prescribed route of administration for
				each medication;
(j) Prescribed
				instructions for crushing, mixing or diluting of specific medications, if
				applicable;
(k) The dates each
				medication was administered;
(l)
				The initials and signature of the MAP or licensed health care practitioner who
				administered or supervised the self-administration of medications;
(m) A record of any medication dosage refused
				or missed, documented by the MAP or licensed health care practitioner
				responsible for administering the scheduled dosage, by drawing a circle around
				the appropriate space on the MAR form and initialing it; and,
(n) The reasons for not administering a
				medication, annotated and initialed by the MAP or licensed health care
				practitioner in the comments section on the MAR form.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-7 - MEDICATION ADMINISTRATION › Section 65G-7.009 - Off-site Medication Administration

Current through Reg. 50, No. 138; July 16, 2024
(1) If
				a client who has his or her medications administered to him or her or who is
				supervised with self-administration of medication will be away from a licensed
				residential facility or supported living home and requires assistance with
				medications during that time by persons other than the MAP or licensed health
				care practitioner, the MAP or licensed health care practitioner must comply
				with the following requirements to assure that the client has appropriate
				medications during his or her absence:
(a)
				Provide an adequate amount of medication for administration of all dosages the
				client will require while away;
(b)
				Perform a count of the medication amounts provided to the client for
				administration during the absence and a second count of the medication amounts
				received upon the client's return;
(c) Record both medication counts in an
				"Off-site Medication Form, " APD Form
				 65G-7.009 A, effective April
				2019, incorporated herein by reference, which may be obtained at
http://www.flrules.org/Gateway/reference.asp?No=Ref-10602
.
				The MAP or licensed health care practitioner shall not use an alternative
				Off-Site Medication Form. The MAP or licensed health care practitioner must
				retain a copy of the original form and send a copy with the client and the
				responsible person.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-8 - REACTIVE STRATEGIES › Section 65G-8.002 - Approved Emergency Procedure Curriculum

Current through Reg. 50, No. 138; July 16, 2024
(1) All providers and facilities that use
				reactive strategies must utilize an emergency procedure training curriculum
				approved by the Agency, and require all staff utilizing reactive strategies to
				be trained in that curriculum.
(2)
				The training curriculum must meet the following minimum requirements for
				approval:
(a) It has a history of applied use
				to persons with developmental disabilities;
(b) It includes an ongoing training
				program;
(c) It requires
				certification of the persons administering the curriculum training;
(d) It provides for periodic review of both
				trainer and participant competency;
(e) It does not include reactive strategy
				procedures prohibited by this rule chapter or any other Florida law or
				rule;
(f) It requires at least
				twelve direct training hours;
(g)
				It includes non-physical crisis intervention techniques;
(h) The curriculum incorporates training in
				the provisions of this rule chapter;
(i) It provides for supervised practice and
				performance-based competency evaluation, including a written test with a
				minimum passing achievement score of 80%;
(j) It includes training in criteria for use
				of reactive strategies, and methods for reducing physical
				interventions;
(k) It incorporates
				quality assurance and safety measures as well as incident data collection and
				review;
(l) It provides
				participants with a certificate displaying the name of the curriculum, the name
				of the trainer, the date(s) of training; and the date of certificate
				expiration;
(m) The curriculum
				includes instruction in reactive strategy precautions and potential hazards;
				and,
(n) It includes a "release"
				criterion (e.g., a stated period of calm behavior) that is of short duration
				and that is client-driven or initiated.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-8 - REACTIVE STRATEGIES › Section 65G-8.003 - Reactive Strategy Policy and Procedures

Current through Reg. 50, No. 138; July 16, 2024
(1) All facilities or providers subject to
				this rule shall develop and implement policies and procedures consistent with
				the provisions of this rule chapter, including adoption of an approved
				emergency procedure curriculum, appropriate staff training, record maintenance,
				reporting and recording the use of any reactive strategy, training in the
				provisions of this rule chapter, data collection, and maintenance of reactive
				strategy consent information in client records, and any other requirements
				established in this rule chapter.
(2) Facility or provider policies and
				procedures may include only the reactive strategies provided in the
				Agency-approved curriculum. No change to the approved curriculum or variation
				of a specific reactive strategy may be employed without an Agency-approved
				variance or waiver obtained in advance through Section
				 120.542, F.S. A proposed
				variance to a reactive strategy must demonstrate that it is designed for a
				specific client and the variance request must include documented evidence of
				need and benefit. Variance requests will be evaluated by the Local Review
				Committee and the Agency's Senior Behavior Analyst.
(3) Providers and facilities that employ
				reactive strategies are required to implement procedures to ensure the safety
				of staff and clients during the use of reactive strategies and to ensure that
				Agency clients are not placed at risk because of existing medical
				conditions.
(4) All staff
				implementing reactive strategies must be certified in advance for all reactive
				strategy techniques used or approved for use by the facility or
				provider.
(5) A variation of a
				specific reactive strategy may be employed only if it is designed for a
				specific client with documented evidence of need and benefit, and only if
				evaluated and approved in advance of implementation by the Local Review
				Committee and the Agency's Senior Behavior Analyst.
(6) The provider or facility must conduct an
				internal review of its emergency procedures at least annually with a written
				evaluation that addresses the following issues:
(a) Proposed methods of reducing the use of
				reactive strategies;
(b) Policy
				evaluations and proposals to ensure that all applications of reactive
				strategies are being conducted in accordance with the Agency-approved emergency
				procedure curriculum and administered in a safe manner; and,
(c) Compliance with this rule chapter,
				including appropriate records and reports of reactive strategies.
The facility or provider must maintain this written
				  evaluation for a minimum of five years and make it available to the Agency upon
				  request.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-8 - REACTIVE STRATEGIES › Section 65G-8.004 - Initial Assessments

Current through Reg. 50, No. 138; July 16, 2024
(1) Upon an
				individual's admission to a facility or program and at least annually
				thereafter, the facility or provider must obtain information and documents
				relevant to the use of reactive strategies from a variety of sources for the
				individual's records. Appropriate sources include the individual, his or her
				family members, treating medical professionals, and other informants familiar
				with the individual. The individual's records must include the following
				documentation:
(a) A physician's report of
				medical conditions or physical limitations that would place him or her at risk
				of physical injury during restraint or seclusion, or otherwise preclude the use
				of one or more reactive strategies; and,
(b) Documentation of any history of trauma,
				such as a history of sexual or physical abuse, that the informants, individual,
				facility, or providers believe to be relevant to the use of reactive
				strategies.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-8 - REACTIVE STRATEGIES › Section 65G-8.005 - Authorizations for Specific Reactive Strategies

Current through Reg. 50, No. 138; July 16, 2024
(1) Upon initiating any reactive strategy,
				staff must immediately notify the highest-level direct care
				supervisor.
(2) Each use of a
				reactive strategy requires continuous staff supervision.
(3) The following reactive strategies can be
				approved only by the following authorizing agents:
(a) The authorizing agent for medical
				protective equipment or chemical restraint must be a physician licensed under
				Chapter 458 or 459, F.S;
(b) The
				authorizing agent for behavioral protective devices must be either a Certified
				Behavior Analyst certified by the Behavior Analyst Certification
				Board®, Inc.; a behavior analyst certified by
				the Agency pursuant to Section
				 393.17, F.S., and by Rule
				 65G-4.003, F.A.C.; a
				psychologist licensed under Chapter 490, F.S.; or a clinical social worker,
				marriage and family therapist, or mental health counselor licensed under
				Chapter 491, F.S.
(c) The
				authorizing agent for mechanical restraint must be a Certified Behavior Analyst
				certified by the Behavior Analyst Certification
				Board®, Inc.; a behavior analyst certified by
				the Agency pursuant to Section
				 393.17, F.S., and by Rule
				 65G-4.003, F.A.C.; a physician
				licensed under Chapter 458 or 459, F.S.; a psychologist licensed under Chapter
				490, F.S.; or a clinical social worker, marriage and family therapist, or
				mental health counselor licensed under Chapter 491, F.S.
(d) The authorizing agent or staff person
				with approval authority for seclusion must have at least a bachelor's degree,
				two years of experience serving individuals with developmental disabilities,
				and be certified in reactive strategies through an Agency-approved emergency
				procedure curriculum; and,
(e) The
				authorizing agent or staff person with approval authority for manual restraint
				must be certified in reactive strategies through an Agency-approved emergency
				procedure curriculum.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-8 - REACTIVE STRATEGIES › Section 65G-8.006 - Limitations on Use and Duration of Reactive Strategies

Current through Reg. 50, No. 138; July 16, 2024
(1) All authorizations for a reactive
				strategy must include a clear rationale for its use.
(2) Reactive strategies must not be
				implemented automatically or as part of a deceleration plan for undesirable
				behaviors, as punishment, as a substitute for an implementation plan, or for
				the convenience of staff.
(3) At
				the onset of seclusion or restraint implementation, staff will notify the
				appropriate authorizing agent of the conditions leading up to the use of the
				reactive strategy. The authorizing agent is responsible for terminating any
				procedure not in compliance with this rule.
(4) Each use of a reactive strategy requires
				continuous staff monitoring.
(5) A
				reactive strategy must provide for the least possible restriction consistent
				with its purpose.
(6) A reactive
				strategy must be terminated immediately when the emergency ends.
(7) Reactive strategies must be implemented
				in a manner that permits the greatest possible amount of comfort and protection
				from injury to the individual.
(8)
				The Agency may disapprove the use of any emergency procedure, system, strategy,
				or program that does not meet the above requirements or that contains
				procedures the Agency determines to be unsafe.
(9) If an individual exhibits behavior
				requiring a reactive strategy at a frequency of more than two times in any
				thirty-day period, or six times in any twelve-month period, then the facility
				or provider should submit a request for behavior analysis services for that
				individual, including documentation of the frequency of reactive strategy
				use.
(10) The facility or provider
				must provide written behavioral criteria for termination of a reactive
				strategy, conforming to the Agency-approved emergency procedure curriculum, to
				all staff trained in those techniques.
(11) Reactive strategies must be terminated
				within five minutes after predetermined behavioral criteria have been met.
				Providers and facilities may seek an exemption from this requirement through
				the variance and waiver process authorized by Section
				 120.542, F.S.
(12) Reactive strategies must be limited to
				one hour in duration; additional time for a reactive strategy requires
				reauthorization.
Rulemaking Authority 393.501, 393.13(4)(h)2.,
					 916.1093(2) FS.
					 Law Implemented 393.13(4)(h),
					 916.1093(2)
					 FS.
New 8-7-08.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-8 - REACTIVE STRATEGIES › Section 65G-8.007 - Seclusion and Restraint

Current through Reg. 50, No. 138; July 16, 2024
(1) Every effort
				should be made to avoid unnecessary use of seclusion and restraint; therefore,
				staff should try to redirect and diffuse problem behavior before employing the
				reactive strategy of seclusion and restraint.
(2) Seclusion and restraint as a reactive
				strategy may be utilized only if certified staff persons are available in
				sufficient number to ensure its safe implementation.
(3) Staff must continuously observe the
				client during restraint procedures, monitor respiration rate, and determine
				when release criteria have been met.
(4) Seclusion and restraint procedures
				exceeding one hour require approval by an authorizing agent.
(5) Seclusion and restraint may not exceed
				two hours without visual review and approval of the procedure by an authorizing
				agent or the agent's on-site designee.
(6) Staff must obtain additional
				authorization for use of seclusion and restraint for a behavioral episode
				occurring more than fifteen minutes after termination of a prior procedure, and
				document the additional use in the individual's record.
(7) Before initiating a seclusion or
				restraint procedure, staff must inspect the environment and the individual in
				order to ensure that any foreign objects that might present a hazard to the
				individual's safety are removed.
(8) Any room in which the individual is held
				must have sufficient lighting and ventilation to permit the individual to see
				and breathe normally, and must have enough space to permit him or her to lie
				down comfortably.
(9) The door to
				any room in which an individual is secluded without an attending staff person
				must not be locked; however, the door can be held shut by a staff person using
				a spring bolt, magnetic hold, or other mechanism that permits the individual in
				seclusion to leave the room if the caregiver leaves the vicinity. Forensic
				facilities may seek a waiver or variance from this requirement through Section
				 120.542, F.S.
(10) An individual mechanically restrained
				for more than one hour must be permitted an opportunity for motion and exercise
				for at least ten minutes of each hour that the individual is
				restrained.
Rulemaking Authority 393.501, 393.13(4)(h)2.,
					 916.1093(2) FS.
					 Law Implemented 393.13(4)(h),
					 916.1093(2)
					 FS.
New 8-7-08.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-8 - REACTIVE STRATEGIES › Section 65G-8.008 - Chemical Restraint

Current through Reg. 50, No. 138; July 16, 2024
(1) Chemical
				restraint is used for behavioral control; it is not standard treatment for
				medical or psychiatric conditions.
(2) An individual may be given a chemical
				restraint only on the written order of an authorized physician who has
				determined that the chemical is the least restrictive, most appropriate
				alternative available.
(3) The
				authorizing physician either must be present at the onset of the emergency
				requiring restraint, or must provide telephone consultation with an authorized
				staff person who is present and has personally examined the
				individual.
(4) If the authorizing
				physician is not present to write the order, he or she must dictate the order's
				contents to another on-site licensed medical professional.
(5) An order for chemical restraint must be
				recorded in the individual's record on the same date it is issued, along with
				the expected results of the medication and a detailed description of the
				behaviors that justified the use of chemical restraint.
(6) A licensed medical professional must
				conduct a face-to-face evaluation of the individual within one hour of
				administration of a chemical restraint, if the restraint was ordered by
				telephone. The medical professional must record the results of this evaluation
				in the individual's record and document whether the administration of
				medication achieved the expected results.
(7) Staff must monitor an individual who has
				been chemically restrained at least once every half-hour and record the effects
				of the restraint in the individual's record.
Rulemaking Authority 393.501, 393.13(4)(h)2.,
					 916.1093(2) FS.
					 Law Implemented 393.13(4)(h),
					 916.1093(2)
					 FS.
New 8-7-08.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-8 - REACTIVE STRATEGIES › Section 65G-8.009 - Prohibited Procedures

Current through Reg. 50, No. 138; July 16, 2024
The following reactive strategies are prohibited:
(1) Reactive strategies involving noxious or
				painful stimuli, as prohibited by Section
				 393.13(4)(g),
				F.S.;
(2) Untested or experimental
				procedures;
(3) Any physical crisis
				management technique that might restrict or obstruct an individual's airway or
				impair breathing, including techniques whereby staff persons use their hands or
				body to place pressure on the client's head, neck, back, chest, abdomen, or
				joints;
(4) Restraint of an
				individual's hands, with or without a mechanical device, behind his or her
				back;
(5) Physical holds relying on
				the inducement of pain for behavioral control;
(6) Movement, hyperextension, or twisting of
				body parts;
(7) Any maneuver that
				causes a loss of balance without physical support (such as tripping or pushing)
				for the purpose of containment;
(8)
				Any reactive strategy in which a pillow, blanket, or other item is used to
				cover the individual's face as part of the restraint process;
(9) Any reactive strategy that may exacerbate
				a known medical or physical condition, or endanger the individual's
				life;
(10) Use of any containment
				technique medically contraindicated for an individual;
(11) Containment without continuous
				monitoring and documentation of vital signs and status with respect to release
				criteria; and,
(12) Use of any
				reactive strategy on a "PRN" or "as required" basis.
Rulemaking Authority 393.501, 393.13(4)(h)2.,
					 916.1093(2) FS.
					 Law Implemented 393.13(4)(h),
					 916.1093(2)
					 FS.
New 8-7-08.
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-8 - REACTIVE STRATEGIES › Section 65G-8.010 - Documentation and Notification

Current through Reg. 50, No. 138; July 16, 2024
(1) Staff
				must document the following information in the individual's record as soon as
				possible, but no later than the end of the work shift following the use of a
				reactive strategy:
(a) The behavior that
				necessitated a reactive strategy;
(b) The reactive strategy used;
(c) The date and time the reactive strategy
				was implemented and the time the strategy was terminated; and,
(d) The person(s) who initiated, applied,
				authorized, and terminated the reactive strategy;
Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65G - Agency for Persons with Disabilities › Chapter 65G-8 - REACTIVE STRATEGIES › Section 65G-8.011 - Access to Rules

Current through Reg. 50, No. 138; July 16, 2024
(1) The provider or
				facility employing reactive strategies must maintain on-site a copy of Rule
				Chapter 65G-8, F.A.C, accessible by staff, clients, parents, guardians, and
				guardian advocates.
(2) The
				requirements established in this rule chapter are to be incorporated into all
				staff pre-service training programs related to the use of reactive
				strategies.
Rulemaking Authority 393.501, 393.13(4)(h)2.,
					 916.1093(2) FS.
					 Law Implemented 393.13(4)(h),
					 916.1093(2)
					 FS.
New 8-7-08.