Current through Reg. 50, No. 187; September 24, 2024
(1) Intensive Inpatient Treatment includes a
planned regimen of evaluation, observation, medical monitoring, and clinical
protocols delivered through an interdisciplinary team approach provided 24
hours-per-day, 7 days per week in a hospital setting.
(2) Admission Criteria. Intensive inpatient
treatment is appropriate for individuals whose acute biomedical, behavioral,
cognitive, and emotional problems are severe enough to require primary medical
and nursing care. These individuals may exhibit violent or suicidal behaviors,
or other severe disturbances due to substance use. Program services may be
offered in an appropriately licensed facility located in a community setting, a
specialty unit in a general or psychiatric hospital, or other licensed health
care facility. In addition to rule
65D-30.004, F.A.C., the
following standards apply to intensive inpatient treatment.
(3) Specialized Services. Providers shall
make provisions to meet the needs of individuals with a co-occurring substance
use and mental health disorder and related biomedical disorders. This includes
protocols for:
(a) Providing clinical services
by an interdisciplinary team of qualified staff daily;
(b) Planning clinical program activities
designed to stabilize acute substance use and other psychiatric symptoms,
adapted to the individual's developmental stage and level of
comprehension;
(c) Monitoring the
individual's compliance in taking prescription medication on a regular basis,
including medication education;
(d)
Reviewing the individual's recent psychiatric history and mental status
examination;
(e) Developing a
comprehensive psychiatric history and conducting a mental status examination as
determined by the individual's needs;
(f) Providing co-occurring enhanced services
utilizing best practices; and
(g)
Providing related biomedical services, as determined by the individual's
needs.
(4) Standard
Services. Standard services shall include a specified number of hours of
counseling as provided for in subsection
65D-30.0061(5),
F.A.C. Each provider shall be capable of providing or arranging for the
services listed below. With the exception of counseling, it is not intended
that all services listed below be provided. Services shall be provided in
accordance with the needs of the individual as identified in the assessment and
treatment plan as follows:
(a) Individual
counseling;
(b) Group
counseling;
(c) Counseling with
family members or members of the individual's support system;
(d) Substance-related and recovery-focused
education, such as strategies for avoiding substance use or relapse,
information regarding health problems related to substance use, motivational
enhancement, and strategies for achieving a substance-free lifestyle;
(e) Life skills training, such as anger
management, communication skills, employability skills, problem solving,
relapse prevention, recovery management, decision-making, relationship skills,
and symptom management;
(f)
Expressive therapies, such as recreation therapy, art therapy, music therapy,
or dance (movement) therapy to provide the individual with alternative means of
self-expression and problem resolution;
(g) Training or provision of information
regarding health and medical issues;
(h) Employment or educational support
services to assist individuals in becoming financially independent;
and
(i) Mental health services for
the purpose of:
1. Managing individuals with
disorders who are stabilized;
2.
Evaluating individuals' needs for in-depth mental health assessment;
3. Training individuals to manage symptoms;
and
4. If the provider is not
staffed to address primary mental health problems which may arise during
treatment, the provider should initiate a timely referral to an appropriate
provider for mental health crises or for the emergence of a primary mental
health disorder in accordance with the provider's policies and
procedures.
(4)
Required Hours of Services. Individuals shall receive services each week in
accordance with subsections
65D-30.0061(2) and
(3), F.A.C., including at least 14 hours of
counseling and 20 hours of other structured activities.
(5) Observation of Individuals. Individuals
requiring close medical observation, as determined and documented by medical
staff, shall be visible and readily accessible to nursing staff. Individuals
who do not require close medical observation shall be in a bed area that allows
for general nursing observation.
(6) Staff Coverage.
(a) There shall be nursing coverage 24 hours
per day, 7 days per week. An R.N. shall supervise all nursing staff and an R.N.
or L.P.N. shall be on-site. Nursing staff shall be responsible for monitoring
each individual's medical progress and medication administration. An R.N. or
L.P.N. shall conduct a mental health focused nursing assessment at the time of
admission. A physician shall be on-call 24 hours per day, 7 days per
week.
(b) A psychiatrist or
psychiatric A.R.N.P. or P.A. shall be available by telephone to assess the
individual's mental condition, if needed. A face-to-face assessment shall be
conducted on individuals with a co-occurring disorder within three (3) calendar
days of admission.
(c) A qualified
professional licensed under chapter 490 or 491, F.S., shall be a member of the
interdisciplinary team and shall be on-site daily. At least one (1) member of
the non-medical clinical staff shall be on-site for eight (8) hours daily and
be on-call thereafter.
(7) Caseload. No primary counselor may have a
caseload that exceeds 10 currently participating individuals.
(8) Transportation. Each provider shall
arrange for or provide transportation services to individuals who are involved
in activities or in need of services that are provided at other
facilities.
Rulemaking Authority
397.321(5) FS.
Law Implemented 397.321(1),
397.4103
FS.
New 12-12-05, Amended
8-29-19.
