Florida Administrative Code
65 - DEPARTMENT OF CHILDREN AND FAMILIES
65E - Mental Health Program
Chapter 65E-5 - MENTAL HEALTH ACT REGULATION
Section 65E-5.400 - Baker Act Funded Services Standards

Universal Citation: FL Admin Code R 65E-5.400

Current through Reg. 50, No. 187; September 24, 2024

(1) Applicability. Designation as a public receiving facility is required for any facility licensed under the authority of Chapter 395 or 394, F.S., to be eligible for payment from Baker Act appropriations. Designation does not in and of itself represent any agreement to pay for any services rendered pursuant to Chapter 394, Part I, F.S., or this chapter. Public receiving facilities, under contract with the department, serve as a local focal point for district or region public information dissemination and educational activities with other local Baker Act involved entities and public agencies.

(2) Baker Act Funding.

(a) Only public receiving facilities, pursuant to Section 394.455(25), F.S., and only the costs of eligible Baker Act services provided to diagnostically and financially eligible persons may be paid with Baker Act appropriations.

(b) Baker Act services shall first be provided to acutely ill persons who are most in need of mental health services and are least able to pay.

(c) Persons receiving Baker Act funded services must meet financial eligibility criteria as established by the federal poverty guidelines. Public receiving facilities may provide Baker Act funded services to acutely ill persons who are financially ineligible if the total number of days of service paid for with Baker Act funds for financially ineligible persons does not exceed 20 percent of the total number of days paid for with Baker Act funds.

(d) An individual's diagnostic and financial eligibility shall be documented on mandatory form CF-MH 3084, Feb. 05, "Baker Act Service Eligibility, " which is incorporated by reference and may be obtained pursuant to Rule 65E-5.120, F.A.C., of this rule chapter.

(3) This section applies to all Baker Act funded providers. All services including hospital inpatient facilities, crisis stabilization units, short-term residential treatment programs, and children's crisis stabilization units providing services purchased by the department under this chapter shall be consistent with licensure requirements and must comply with written facility policies and procedures.

(4) Training. The training required in Rule 65E-5.330, F.A.C., is required for all direct service staff employed by publicly funded Baker Act service providers.

(5) Emergency Reception and Screening.

(a) Providers authorized by the department shall have a policy and procedure manual for the specific service being provided. The administration of the provider organization shall ensure the completeness and accuracy of the manual and that organizational operations are in accordance with the manual. The manual must be approved by the respective departmental district or regional office for completeness and consistency in implementing this chapter and Chapter 394, Part I, F.S. The manual shall be consistent with the provisions of Chapter 394, Part I, F.S., and with Chapter 65E-5, F.A.C., and must include the following:
1. Procedures for responding to requests for services that specify a prompt screening to determine the person's immediacy of need, and for prioritizing access to services with limited availability. Staff skills shall be specific to the unique needs of the persons to be served,

2. A description of the services offered, recipient eligibility criteria, how eligible recipient facilities or individuals are informed of service availability, service locations, costs, criteria for response, hours of operation, staffing with staff qualifications and supervision, and organizational line of authority to the operating entity,

3. Procedures to be utilized to implement and document staff training in accord with Rule 65E-5.330, F.A.C., staff proficiency or competency including the performance of any subcontractors employed to provide services, and how training will be used to effect remediable identified deficiencies,

4. Procedures for a complaint and grievance system that provide a prompt response to the individuals served, and mechanisms to monitor and evaluate service quality, and the outcomes attained by individuals served. Facility personnel shall provide each person served with a listing of his or her rights and a telephone number to which complaints may be directed,

5. Procedures to determine if the individual has a case manager from a mental health center or clinic, as well as notification and coordination of activities with the case manager,

6. Procedures to maintain a clinical record for each individual served and its safeguarding in accordance with Section 394.4615, F.S.; and,

7. Procedures to inform the public of the availability of services.

(b) Procedures must assure that a psychiatrist or a physician shall be available on-call for consultation at all times and hours during which emergency reception and screening services are operated.

(6) Mobile Crisis Response Service and Mental Health Overlay Program Requirements.

(a) The criteria and operational requirements for a mobile crisis response service and a mental health overlay program is defined in Sections 394.455(19) and 394.455(17), F.S., respectively. The operation of these services is expressly limited to the program's contract with the department.

(b) Providers authorized by the department to provide mobile crisis response services and mental health overlay programs shall have a policy and procedure manual for the specific service being provided. The administration of the provider organization shall ensure the completeness and accuracy of the manual and that organizational operations are in accordance with the manual. The manual must be approved by the departmental district or regional office in which the facility is located. The manual shall be consistent with the provisions of Chapter 394, Part I, F.S., and these rules, and shall include:
1. A description of the services offered, eligibility criteria, how eligible recipient facilities or individuals are informed of service availability, criteria for response, hours of operation, staffing with staff qualifications and supervision, and organizational line of authority to the operating entity,

2. Procedures to be utilized to implement the provisions of Section 394.4625, F.S., including staff training, proficiency or competency assessment instruments to be administered, credentialing, and distribution of results obtained,

3. A description of on-site evaluation, educational, assistance or supportive services, if provided, to be rendered by mental health overlay programs. The extent and frequency of services offered must be described. Staff skills shall be specific to unique needs of the persons to be served,

4. Procedures for the provision of a complaint and grievance procedure to be used by individuals served, and mechanisms to monitor and evaluate the service's quality and the outcomes attained by individuals served. Personnel shall provide each person served with a listing of his or her rights and a telephone number to which complaints may be directed,

5. Procedures that require the provider's issuance of, and the employees wearing of identification badges including a photograph of employee, organization's name, and employees name and identification number, if full name is not used, for all employees responding to, or working in, off-site situations,

6. Procedures that assure determination of whether the individual has a case manager from a mental health center or clinic, and require notification and coordination of activities with the case manager; and,

7. Procedures that require the maintenance of a clinical record for each individual served and safeguarding it in accordance with Section 394.4615, F.S.

(c) Procedures must require employee's clinical activities and performance, as opposed to primarily administrative functions, are supervised by one of the following: a psychiatrist, physician, clinical psychologist, clinical social worker, mental health counselor, marriage and family therapist, or psychiatric nurse, as defined in Section 394.455, F.S.

(d) Procedures must assure that a physician or psychiatrist shall be available on-call for consultation at all times and hours during which mental health overlay programs and mobile crisis response services are operated.

(e) Procedures must be consistent with Section 394.462, F.S., and these rules, and must limit transportation of an involuntary person by the mental health overlay program or mobile crisis response service to only directly transporting individuals to the nearest designated receiving facility. In addition, the following provisions shall be met and described in the manual:
1. Liability insurance of no less than $100, 000 per person shall be provided.

2. The vehicle shall be equipped with a Type 2A10BC fire extinguisher, seat belts, 2-way communication radio or cellular telephone with accompanying emergency telephone numbers, and a functioning air conditioner and heater.

3. Staff having the responsibility for transporting people shall be trained and experienced in transporting people with mental illness and substance abuse who may become confused, volatile, or combative.

4. At least 2 members shall be present to transport an individual. The total number of people in the vehicle at any time shall not exceed the legal seating capacity.

5. Firearms shall not be worn or carried in the vehicle.

6. Physical restraints, such as canvas cuffs, shall not be used except by personnel trained in their use, and only when necessary to protect the person being transported from injury to themselves or others. Any use of physical or mechanical restraints shall be fully and completely documented in the person's clinical record.

7. The vehicle used to transport people shall be unmarked, maintained and operated in accordance with Chapter 316, F.S., and in a manner that protects the individual's rights, dignity and physical safety.

8. Procedures must require the immediate reporting of any unusual incidents or injuries, upon arrival at the intended destination.

(7) Requirements for Mental Health Overlay Programs in Nursing Homes, Assisted Living Facilities, Adult Day Care Centers, and Adult Family Care Homes.

(a) All plans, contracts and activities shall recognize that the primary responsibility for the care and treatment of individuals rests with the nursing home, assisted living facility, adult day care center, or adult family care home.

(b) Activities representative of those services appropriate to be provided by a mental health overlay program include:
1. Assisting in the development or implementation of individual care plans,

2. Assessing and making recommendations for needed physical or psychiatric services to the facility administrator; and,

3. Providing training to facility staff or residents in various mental health skills or knowledge, such as anger management, psychotropic medications, depression, loss, physical and sexual trauma, and competency to consent determinations.

(c) Personnel shall provide each person served with a list of his or her rights pursuant to Chapter 394, Part I, F.S.

Rulemaking Authority 394.457(3), (5)(c), (6)(a) FS. Law Implemented 316, 394, Part I, 394.455(2), (4), (17), (19), (21), (23), (25), (34), (35), 394.4615, 394.462, 394.4625, 394.463, 395 FS.

New 11-29-98, Amended 4-4-05, 1-8-07.

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