Florida Administrative Code
59 - AGENCY FOR HEALTH CARE ADMINISTRATION
59A - Health Facility and Agency Licensing
Chapter 59A-36 - ASSISTED LIVING FACILITY
Section 59A-36.020 - Limited Mental Health
Universal Citation: FL Admin Code R 59A-36.020
Current through Reg. 50, No. 187; September 24, 2024
(1) LICENSE APPLICATION.
(a) Any facility
intending to admit one or more mental health residents must obtain a limited
mental health license from the agency before accepting the mental health
resident.
(b) Facilities applying
for a limited mental health license that have uncorrected deficiencies or
violations found during the facility's last survey, complaint investigation, or
monitoring visit will be surveyed before the issuance of a limited mental
health license to determine if such deficiencies or violations have been
corrected.
(2) RECORDS.
(a) A facility with a limited mental health
license must maintain an up-to-date admission and discharge log containing the
names and dates of admission and discharge for all mental health residents. The
admission and discharge log required in rule
59A-36.015, F.A.C., satisfies
this condition provided that all mental health residents are clearly
identified.
(b) Staff records must
contain documentation that designated staff have completed limited mental
health training as required by rule
59A-36.011, F.A.C.
(c) Resident records must include:
1. Documentation, provided by a mental health
care provider within 30 days of the resident's admission to the facility, that
the resident is a mental health resident as defined in section
394.4574, F.S., and that the
resident is receiving social security disability or supplemental security
income and optional state supplementation as follows:
a. An affirmative statement on the Alternate
Care Certification for Optional State Supplementation (OSS) form, CF-ES 1006,
October 2005, which is hereby incorporated by reference and available for
review at:
http://www.flrules.org/Gateway/reference.asp?No=Ref-03988,
that the resident is receiving SSI or SSDI due to a mental disorder,
b. Written verification provided by the
Social Security Administration that the resident is receiving SSI or SSDI for a
mental disorder. Such verification may be acquired from the Social Security
Administration upon obtaining a release from the resident permitting the Social
Security Administration to provide such information, or
c. A written statement from the resident's
case manager or other mental health care provider that the resident is an adult
with severe and persistent mental disorder. The case manager or other mental
health care provider must consider the following minimum criteria in making
that determination:
(I) The resident is
eligible for, is receiving, or has received mental health services within the
last 5 years, or
(II) The resident
has been diagnosed as having a severe or persistent mental
disorder.
2. An
appropriate placement assessment provided by the resident's mental health care
provider within 30 days of admission to the facility that the resident has been
assessed and found appropriate for residence in an assisted living facility.
Such assessment must be conducted by a psychiatrist, clinical psychologist,
clinical social worker, psychiatric nurse, or an individual supervised by one
of these professionals.
a. Any of the
following documentation that contains the name of the resident and the name,
signature, date, and license number, if applicable, of the person making the
assessment, meets this requirement:
(I)
Completed Alternate Care Certification for Optional State Supplementation (OSS)
form, CF-ES Form 1006,
(II)
Discharge Statement from a state mental hospital completed no more than 90 days
before admission to the assisted living facility provided it contains a
statement that the individual is appropriate to live in an assisted living
facility, or
(III) Other signed
statement that the resident has been assessed and found appropriate for
residency in an assisted living facility.
b. A mental health resident returning to a
facility from treatment in a hospital or crisis stabilization unit will not be
considered a new admission and will not require a new assessment. However, a
break in a resident's residency that requires the facility to execute a new
resident contract or admission agreement will be considered a new admission and
the resident's mental health care provider must provide a new
assessment.
3. A
Community Living Support Plan. Each mental health resident and the resident's
mental health case manager must, in consultation with the facility
administrator, prepare a plan within 30 days of the resident's admission to the
facility or within 30 days after receiving the appropriate placement assessment
in paragraph (2)(c), whichever is later, that:
a. Includes the specific needs of the
resident that must be met in order to enable the resident to live in the
assisted living facility and the community,
b. Includes the clinical mental health
services to be provided by the mental health care provider to help meet the
resident's needs, and the frequency and duration of such services,
c. Includes any other services and activities
to be provided by or arranged for by the mental health care provider or mental
health case manager to meet the resident's needs, and the frequency and
duration of such services and activities,
d. Includes the obligations of the facility
to facilitate and assist the resident in attending appointments and arranging
transportation to appointments for the services and activities identified in
the plan that have been provided or arranged for by the resident's mental
health care provider or case manager,
e. Includes a description of other services
to be provided or arranged by the facility,
f. Includes a list of factors pertinent to
the care, safety, and welfare of the mental health resident and a description
of the signs and symptoms particular to the resident that indicate the
immediate need for professional mental health services,
g. Is in writing and signed by the mental
health resident, the resident's mental health case manager, and the assisted
living facility administrator or manager and a copy placed in the resident's
file. If the resident refuses to sign the plan, the resident's mental health
case manager must add a statement that the resident was asked but refused to
sign the plan,
h. Is updated at
least annually or if there is a significant change in the resident's behavioral
health,
i. May include the
Cooperative Agreement described in subparagraph (2)(c)4. If included, the
mental health care provider must also sign the plan; and,
j. Must be available for inspection to those
who have legal authority to review the document.
4. Cooperative Agreement. The mental health
care provider for each mental health resident and the facility administrator or
designee must prepare a written statement, within 30 days of the resident's
admission to the facility or receipt of the resident's appropriate placement
assessment, whichever is later. The statement:
a. Provides procedures and directions for
accessing emergency and after-hours care for the mental health resident. The
provider must furnish the resident and the facility with the provider's 24-hour
emergency crisis telephone number;
b. Must be signed by the administrator or
designee and the mental health care provider, or by a designated representative
of a Medicaid prepaid health plan if the resident is on a plan and the plan
provides behavioral health services in section
409.912, F.S.;
c. May cover all mental health residents of
the facility who are clients of the same provider; and,
d. May be included in the Community Living
Support Plan described in subparagraph (2)(c)3.
5. Missing documentation will not be the
basis for administrative action against a facility if the facility can
demonstrate that it has made a good faith effort to obtain the required
documentation from the appropriate party. A documented request for such missing
documentation made by the facility administrator within 72 hours of the
resident's admission will be considered a good faith effort. The documented
request must include the name, title, and phone number of the person to whom
the request was made and must be kept in the resident's
file.
(3) RESPONSIBILITIES OF FACILITY. In addition to the staffing and care standards of this rule chapter to provide for the welfare of residents in an assisted living facility, a facility holding a limited mental health license must:
(a) Meet the facility's obligation to assist
the resident in carrying out the activities identified in the Community Living
Support Plan;
(b) Provide an
opportunity for private face-to-face contact between the mental health resident
and the resident's mental health case manager or other treatment personnel of
the resident's mental health care provider;
(c) Observe resident behavior and functioning
in the facility, and record and communicate observations to the resident's
mental health case manager or mental health care provider regarding any
significant behavioral or situational changes that may signify the need for a
change in the resident's professional mental health services, supports, and
services described in the community living support plan, or that the resident
is no longer appropriate for residency in the facility;
(d) If the facility initiates an involuntary
mental health examination pursuant to section
394.463, F.S., the facility must
document the circumstances leading to the initiation of the
examination;
(e) Ensure that
designated staff have completed limited mental health training as required by
rule 59A-36.011, F.A.C.;
and,
(f) Maintain facility, staff,
and resident records in accordance with the requirements of this rule
chapter.
Rulemaking Authority 429.41 FS. Law Implemented 429.075, 429.26, 429.41 FS.
New 8-15-90, Amended 9-30-92, Formerly 10A-5.029, Repromulgated 10-30-95, Amended 6-2-96, 11-2-98, 7-30-06, Amended 4-17-14, 5-10-18, Formerly 58A-5.029, 7-1-19.
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