Current through Reg. 50, No. 187; September 24, 2024
(1) Facility
staff shall be trained to recognize signs and symptoms of Developmental
Disability. Examples of information and behaviors which suggests Developmental
Disability include:
(a) Psychological testing
or mental health evaluation indicate an Intelligence Quotient (IQ) below
70.
(b) School exceptional
education classification of "Intellectual Disabilities" or "Autism Spectrum
Disorder" as specified in Rules 6A-6.03011 and 6A-6.03023, F.A.C.
(c) DSM diagnosis of "mental retardation" or
"intellectual disability."
(d) The
youth has difficulty understanding and answering age appropriate
questions;
(e) The youth has
difficulty understanding and following age appropriate directions, or
(f) The youth's abilities appear far below
other youths his/her age.
(2) Youths identified as possibly having a
Developmental Disability must be placed on Constant Supervision until assessed
by Mental Health Clinical Staff. Youths determined by Mental Health Clinical
Staff to have Developmental Disability based on review of intelligence testing
or administration of intelligence testing who are placed in a Detention Center
or residential commitment program must be referred to the facility/program
treatment team for development of an Individualized Mental Health Treatment
Plan with behavior oriented goals.
(3) Determination of Developmental
Disability.
(a) Assessment findings and
recommendations regarding Developmental Disability shall be based upon
administration or review of intelligence testing which includes the current
edition of the Wechsler Intelligence Scale for Children (WISC), Wechsler Adult
Intelligence Scale (WAIS) or Stanford-Binet Intelligence Scale (SB), and
administration or review of adaptive behavior functioning testing. Accepted
tests for adaptive behavior functioning include: Vineland Adaptive Behavior
Scales, Adaptive Behavior Scale, Adaptive Behavior Assessment System, Adaptive
Behavior Evaluation Scale, or Scales of Independent Behavior.
1. An exception is provided in the
circumstance where a Licensed Mental Health Professional authorized to
administer intelligence tests as specified in paragraph (b), below, determines
that administration of the current edition of the Wechsler Intelligence Scale
for Children (WISC), Wechsler Adult Intelligence Scale (WAIS) or Stanford-Binet
Intelligence Scale (SB) is not appropriate due to the youth's condition or
impairment. An alternative standardized intelligence test, administered and
interpreted in conformance with instructions provided by the producer of the
test, may be used. The results of the alternative standardized intelligence
test must include reference to published validity and reliability data for the
specified test, and justification for use of the alternative test for the
youth. Examples of alternative standardized intelligence tests include the
Leiter International Performance Scale and Comprehensive Test of Non-Verbal
Intelligence.
2. If an alternative
standardized intelligence test is utilized, an adaptive behavior functioning
test must also be administered as set forth in paragraph (a),
above.
(b) Intelligence
testing and adaptive behavior functioning tests shall be administered by a
Licensed Mental Health Professional who is qualified by training, education and
experience to render such evaluations and is authorized under their licensing
board to provide such evaluations.
(c) Concurrent significant deficits in
intellectual and adaptive behavior functioning must be present in the
intelligence testing and adaptive behavior functioning testing in paragraph
(a), above, for findings of Developmental Disability.
(4) Treatment Services for Youth with
Developmental Disability.
(a) Youths who are
placed in a residential commitment program designated for Developmental
Disability treatment services shall be referred to the facility's
multidisciplinary treatment team for development of a Developmental Treatment
Plan and Developmental Disability Clinical Treatment Services as specified in
this section:
(b) Behavior Analysis
Services shall be provided by a person who is a Board Certified Behavior
Analyst, a Certified Behavior Analyst, a Psychologist licensed under Chapter
490, F.S., or a Licensed Clinical Social Worker, Licensed Mental Health
Counselor or Licensed Marriage and Family Therapist licensed under Chapter 491,
F.S., with more than three years experience post certification or
licensure.
(c) Therapy to promote
social skills and life skills of youths with Developmental Disability. For
example, therapy focusing on improved coping skills or interpersonal problem
solving skills or anger replacement therapy shall be provided by a Licensed
Mental Health Professional or a non-licensed Mental Health Clinical Staff
Person working under the direct supervision of a Licensed Mental Health
Professional.
(d) Mental health
services for youths with Developmental Disability and Mental Disorder shall be
provided by a Licensed Mental Health Professional or a non-licensed Mental
Health Clinical Staff Person working under the direct supervision of a Licensed
Mental Health Professional as specified in Rules 63N-1.0033, and 63N-1.0081,
F.A.C.
(e) Substance abuse services
for youths with Developmental Disability and Substance-Related Disorder shall
be provided by a Licensed Qualified Professional or a Substance Abuse Clinical
Staff Person as specified in Rules 63N-1.0034, and 63N-1.0082, F.A.C.
(f) Developmental Disability Clinical
Treatment Services shall be documented in a progress note/treatment note
written by the clinician who provided the service.
(5) Treatment Planning and Discharge
Planning.
(a) An Individualized Developmental
Treatment Plan is required when a youth enters Developmental Disability
treatment.
(b) The Individualized
Developmental Treatment Plan shall be developed by a multidisciplinary
treatment team, including a Board Certified Behavior Analyst, Certified
Behavior Analyst, or person licensed under Chapter 490 or 491, F.S., and the
youth. Development of an Individualized Developmental Treatment Plan must
include the youth's parent or legal guardian, unless there is documentation of
a reason for the parent or legal guardian's non-involvement in treatment
planning.
(c) The Individualized
Developmental Treatment Plan must be completed within 30 days of the youth's
admission to the program.
(d) The
Individualized Developmental Treatment Plan must contain the following
elements:
1. The specific developmental,
behavioral, and life skills needs that will be the focus of treatment,
2. Developmental Disability
Clinical Treatment goals and objectives, written in achievable and measurable
terms, which are responsive to the youth's Developmental Disorder and address
specific behaviors, symptoms, skill deficits, strengths and needs of the youth,
3. The Developmental Disability
interventions/strategies to be provided and target dates for completion,
4. The youth's functional
strengths/abilities and needs which may affect his/her success in treatment,
5. The plan must contain the
signature of the youth, the multidisciplinary treatment team members who
participated in the development of the plan and a Board Certified Behavior
Analyst, Certified Behavior Analyst, a Psychologist licensed under Chapter 490,
F.S., or a Licensed Clinical Social Worker, Licensed Mental Health Counselor or
Licensed Marriage and Family Therapist licensed under Chapter 491, F.S.
a. When a youth in a residential commitment
program is identified as an Agency for Persons with Disabilities (APD) client,
the residential commitment program shall request and encourage the APD waiver
support coordinator to participate in the youth's multidisciplinary treatment
team meetings.
b. When a youth in a
residential commitment program has a current behavior support plan or case plan
through the Agency for Persons with Disabilities (APD), the program shall
coordinate the youth's Individualized Developmental Treatment Plan with the
youth's APD plan for related issues.
(6) Integrated Developmental and Mental
Health/Substance Abuse Treatment Plans. Youths diagnosed with Developmental
Disability and Mental Disorder and/or Substance-Related Disorder shall receive
integrated treatment services based upon an integrated developmental and mental
health/substance abuse treatment plan.
(a) The
integrated developmental and mental health/substance abuse treatment plan shall
be developed with the input of Developmental Disability and Mental Health
Clinical Staff and/or Substance Abuse Clinical Staff.
(b) The integrated developmental and mental
health/substance abuse treatment plan shall include the elements described in
paragraph (d), above, and Rule 63N-1.007, F.A.C.
(7) A review of the Individualized
Developmental Treatment Plan must be conducted by the multi-disciplinary
treatment team every 30 days as set forth in Rule 63N-1.007, F.A.C.
(8) During the final phase of Developmental
Disability treatment, the multidisciplinary treatment team and youth shall
establish a discharge plan whereby improvements made during treatment will be
maintained upon the youth's movement from one facility to another, or return to
his/her community.
(a) The discharge plan
shall document the focus and course of the youth's Developmental Disability
treatment, and recommendations for services upon the youth's movement out of
the facility.
(b) The discharge
plan shall be discussed with the youth, parent/legal guardian (when available)
and Juvenile Probation Officer prior to the youth's release from the facility
or program. For committed youths served by the Agency for Persons with
Disabilities (APD) or the Department of Children and Families (DCF), the
residential commitment program shall invite representatives from APD or DCF to
the youth's transition and exit conferences in accordance with subparagraphs
63E-7.010(10)(a) 1., and 63E-7.010(10)(b) 1., F.A.C.
(c) A copy of the discharge plan will be
provided to the youth, the youth's assigned Juvenile Probation Officer and to
the parent/legal guardian, unless there is documentation of a reason for the
parent or legal guardian's non-involvement in treatment
planning.
(9) Suicide
Prevention, Mental Health Crisis Intervention and Emergency Mental Health and
Substance Abuse Services provisions in this rule apply to the provision of
Developmental Disability services.
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.
New 3-16-14.