Florida Administrative Code › 65 - DEPARTMENT OF CHILDREN AND FAMILIES › 65E - Mental Health Program › Chapter 65E-9 - LICENSURE OF RESIDENTIAL TREATMENT CENTERS › Section 65E-9.002 - Definitions

Current through Reg. 50, No. 138; July 16, 2024
(1) "Abuse" means any willful or threatened
				act that results in any physical, mental, or sexual injury or harm that causes
				or is likely to cause the child's physical, mental, or emotional health to be
				significantly impaired. Abuse of a child includes acts or omissions. Corporal
				discipline of a child by a parent or legal custodian for disciplinary purposes
				does not in itself constitute abuse when it does not result in harm to the
				child.
(2) "Administrator" means
				the chief executive or administrative officer of a residential treatment center
				or therapeutic group home or his or her designee.
(3) "Agency" or "AHCA" means the Agency for
				Health Care Administration and the terms are used interchangeably to refer to
				the Agency for Health Care Administration.
(4) "Assessment" means the appraisal or
				evaluation of a child's current condition based on but not limited to clinical
				and functional data, physical examination, medical history, and current
				symptomatology.
(5) "Behavior
				analysis" is the science in which procedures derived from the principles of
				behavior are systematically applied to increase skill acquisition and reduce
				problematic behavior, to improve socially significant behavior to a meaningful
				degree and to demonstrate experimentally that the procedures used were
				responsible for the improvement in behavior.
(6) "Child" means any person under the age of
				18 and, as used in this rule unless otherwise specified, includes the term
				"adolescent" as defined in Section
				 394.492(1),
				F.S.
(7) "Collocation" means the
				simultaneous operation by a provider of two or more programs on the same
				grounds or in the same building with complete separation of the children served
				by the programs.
(8) "Cultural
				competence" means attaining and applying knowledge, skills, and attitudes that
				respect the child and family's individual values and beliefs, so far as to
				enable administrators and staff to provide effective care and treatment for
				diverse populations.
(9)
				"Department" means the Department of Children and Family Services (DCF) unless
				otherwise specified.
(10) "DSM"
				means the latest edition of the Diagnostic and Statistical Manual of Mental
				Disorders of the American Psychiatric Association.
(11) "Direct care staff" means a staff member
				who has direct contact with the child and has primary responsibility,
				identified in their job description, for providing personal care, assistance,
				and supervision to a child.
(12)
				"Drug used as restraint" means the administration of any drug to help control a
				child's behavior or restrict the child's freedom of movement, and is not a
				standard treatment for the child's medical or psychiatric condition.
(13) "Emergency safety intervention" means
				the use of restraint or seclusion as an immediate response to an emergency
				safety situation.
(14) "Emergency
				safety situation" means unanticipated child behavior that places the child or
				others at immediate risk for serious injury if no intervention
				occurs.
(15) "Employee" means all
				salaried and hourly wage personnel of the residential treatment center,
				including therapeutic group home, as well as contracted persons, who may be
				professionals and licensed or certified pursuant to Florida law or other
				persons who may meet qualifications as set forth in this rule.
(16) "Family" means the child's biological,
				adoptive or foster parent(s), guardian, siblings, grandparents, aunts and
				uncles, and other related or unrelated persons who have a significant
				relationship with the child. For children placed pursuant to Chapter 39, F.S.,
				the term family also includes the child's guardian ad litem.
(17) "Family centered care" means an approach
				to the planning, delivery and evaluation of health care services that is
				governed by mutually beneficial partnerships between health care providers and
				the family. Family centered care is characterized by collaborating with the
				family, focusing on the families' strengths, recognizing the families'
				expertise, fostering family empowerment, promoting information sharing among
				all parties in a complete and unbiased manner, and programs that are
				flexible.
(18) "Governing body"
				means the board of trustees, the partnership, the corporation, the association,
				or the person or group of persons who maintain and control the provider
				organization and which is legally responsible for the operation of the provider
				organization.
(19) "Mechanical
				restraint" means any device attached or adjacent to a child's body that the
				child cannot easily remove that restricts freedom of movement or normal access
				to the child's body. However, mechanical restraint does not include physical
				devices, such as orthopedic prescribed appliances, surgical dressings and
				bandages, protective helmets and supportive body bands, or other physical
				holding when necessary for routine physical examinations and tests for
				orthopedic, surgical and other similar medical treatment purposes or when used
				to provide support for the achievement of functional body position or proper
				balance or to protect a patient from falling out of bed or to permit a patient
				to participate in ongoing activities without the risk of physical
				harm.
(20) "Medically stable" means
				good physical health, with no acute or chronic health problems for which
				medical treatment beyond routine medical care is required or anticipated.
				Children with a chronic, but stable illness, managed with medication and
				routine monitoring, such as diabetes or a well controlled seizure disorder, may
				be considered medically stable.
(21) "Medication administration" means the
				obtaining and giving of a single dose of medication, prescription or
				over-the-counter, by an authorized person to a child for his or her
				consumption.
(22)
				"Multidisciplinary team" means the group of individuals brought together to
				plan and coordinate mental health and related services to meet the needs of the
				child and their family in the most appropriate and least restrictive setting.
				Members of the team should include the child, unless clinically
				contraindicated, the child's parent or legal guardian and other caregivers,
				such as: the foster parent; the child welfare service worker; the child's
				therapist; the child's behavioral analyst; the child's Individual Education
				Plan surrogate; and others who have information or services to offer for the
				child's treatment plan.
(23)
				"Neglect" means when a child is deprived of, or is allowed to be deprived of,
				necessary food, clothing, shelter, or medical treatment or a child is permitted
				to live in an environment when such deprivation or environment causes the
				child's physical, mental, or emotional health to be significantly impaired or
				to be in danger of being significantly impaired. The foregoing circumstances
				shall not be considered neglect if caused primarily by financial inability
				unless actual services for relief have been offered to and rejected by such
				person. A parent or legal custodian legitimately practicing religious beliefs
				in accordance with a recognized church or religious organization who thereby
				does not provide specific medical treatment for a child shall not, for that
				reason alone, be considered a negligent parent or legal custodian. Neglect of a
				child includes acts or omissions.
(24) "Physical restraint" means the
				application of physical force without the use of any device, for the purpose of
				restricting the free movement of a child's body. The term restraint does not
				include briefly holding without undue force a child in order to calm or comfort
				him or her, or holding a child's hand to safely escort him or her from one area
				to another. Such term may also be known as "personal restraint."
(25) "Plan of correction" means a written
				document that specifies actions a provider will take and the time frame within
				which the provider will come into compliance with Chapter 394, F.S., or these
				rules.
(26) "Primary diagnosis"
				means the principal mental disorder, per the most recent edition of the
				Diagnostic and Statistical Manual of the American Psychiatric Association, that
				is the medically necessary reason for clinical care and the primary focus of
				treatment.
(27) "Provider" means an
				individual, organization, corporation, including subcontractor, that is under
				contract with the department to provide children's mental health services in a
				residential treatment center.
(28)
				"Psychotropic medication" means any drug prescribed with the primary intent to
				stabilize or improve mood, mental status, behavioral self-control, or mental
				illnesses.
(29) "Residential
				treatment center" means a 24-hour residential program, including a therapeutic
				group home, which provides mental health treatment and services to children as
				defined in Section  394.492(5) or
				(6), F.S., and which is a private for-profit
				or not-for-profit corporation under contract with the department or the agency.
				This rule does not change the Chapter 419, F.S., designation of a program as a
				"community residential home."
(30)
				"Restraint" means a "drug used as restraint", "mechanical restraint" or
				"personal or physical restraint", as defined in this section. Physical escort
				is excluded from this definition.
(31) "Screening" means the act of assessing
				the background of personnel and volunteers.
(32) "Seclusion" means the involuntary
				confinement of a resident alone in a room or an area that the resident is
				physically prevented from leaving.
(33) "Serious injury" means any significant
				impairment of the physical condition of the child as determined by qualified
				medical personnel. This includes, but is not limited to, burns, lacerations,
				bone fractures, substantial hematoma, and injuries to internal organs, whether
				self-inflicted or inflicted by someone else as defined in  42 C.F.R., §
										483.352.
(34) "Staff" means all
				owners, operators, employees, whether full-time, part-time and/or volunteers
				working in a residential treatment center, or other facility licensed by this
				rule, who may be employed or contracted by or do volunteer work for a person,
				corporation, or organization. The term does not include those who do not work
				on the premises where treatment is provided or either have no direct contact
				with a child or have no contact with a child outside of the presence of the
				child's parent or guardian.
(35)
				"Supervision of self-administration of medications" means the provision of
				overseeing, guiding and assisting a child in the self-administration of a dose
				of medication, including prescription and over-the-counter
				medications.
(36) "Therapeutic
				group home" means a 24-hour residential program providing community-based
				mental health treatment and mental health support services in a home-like
				setting to no more than 12 children who meet the criteria in Section
				 394.492(5) or
				(6), F.S.
(37) "Time-out" means the restriction of a
				child for a brief period of time (30 minutes or less) to a designated area from
				which the child is not physically prevented from leaving, for the purpose of
				providing the child an opportunity to regain self-control and when the use is
				consistent with the child's treatment plan. This procedure is sometimes known
				as "brief isolation." Regardless of name, the actions taken define the
				procedure and are therefore subject to this rule.
(38) "Treatment" means the planned,
				individualized program of medical, psychological, and/or rehabilitative
				services designed to promote resiliency and facilitate recovery of function, in
				part through remediation of symptoms of a primary diagnosis, and/or other
				medical or behavioral condition that significantly impacts the treatment of a
				primary diagnosis.
(39) "Treatment
				plan" means the written summary of the child's individualized treatment goals,
				measurable objectives and treatment services to be provided. The treatment plan
				is the goal-oriented, time limited, individualized plan of action, which
				directs the treatment and services provided for the child and
				family.
Specific Authority
					 394.875(8) FS.
					 Law Implemented 394.875
					 FS.
New 7-25-06, Amended
					 9-24-08.