Current through Reg. 50, No. 187; September 24, 2024
(1) Each state civil mental health treatment
facility shall make telephones available for residents. Any restriction on
telephone usage shall be documented in the clinical record. Such documentation
shall specify the reason for the restriction, its duration, and the treatment
goals and interventions aimed at lifting the restriction. At no time, shall
there be a restriction of telephone access to his or her legal counsel, the
Florida Abuse Registry, Local or Statewide Advocacy Councils, or the Advocacy
Center for Persons with Disabilities.
(2) The Department shall protect the
confidentiality of records within the facility and in transport to other
facilities and other therapeutic services.
(3) Each state civil mental health treatment
facility shall post instructions conspicuously in living areas and visiting
areas where residents and visitors can read the instructions on how to report a
complaint.
(4) Each state civil
mental health treatment facility shall establish visiting hours for each of its
residential units. The visiting hours shall be based on the needs of residents
and their visitors and shall minimize interruption of the individual's
treatment program schedules. Each state civil mental health treatment facility
shall post its visiting hours in places where residents and visitors frequent.
Visiting hours shall be provided to the resident, family, and representatives
at the time of admission. Visitors may request exceptions to posted visiting
hours with the Unit Director or treatment team leader.
(5) Each state civil mental health treatment
facility shall establish with the local county supervisor of elections, a
process for allowing eligible residents to register and to vote in public
elections. The process shall be published and provided to each resident and
conspicuously posted in living areas where residents can read it. The
resident's representative shall also be informed of the process. The facility
shall make available voter registration forms, applications for absentee
ballots, and absentee ballots.
(6)
No state civil mental health treatment facility shall initiate any mental
health treatment, including psychotropic medication, until express and informed
consent for psychiatric treatment is obtained from a person legally qualified
to give it, except in the following situations:
(a) Where emergency psychotropic medication
treatment is ordered by a physician, as defined in Section
394.455(21),
F.S., to preserve the immediate safety of the resident or others in the
facility;
(b) When a person is
admitted to a state mental health treatment facility and has a current
prescription for psychotropic medication(s), is unable to provide express and
informed consent, is determined by the admitting physician to be in need of the
medication prescribed prior to admission and an alternative decision maker is
being pursued through the court, or
(c) When a Court Order is obtained after
adequate notice and hearing.
(7)
(a) Any
limitation or restriction of a resident's access to the grounds or treatment
program shall be based on clearly documented evidence of risks to self or
others.
(b) The time span during
which residents are allowed access to the grounds shall be specified
conspicuously and posted in living areas. Access to grounds may be limited
during the hours a resident is scheduled to attend prescribed programming.
Access to grounds status shall be established and documented in the clinical
record for all newly admitted persons within 72 hours of admission.
(c) An individualized plan shall be developed
and documented in the clinical record for residents who have been identified by
the treatment team as experiencing significant loss of independent access to
grounds.
(d) Those residents
certified by the facility as experiencing long-term loss of independent access
to grounds based on physical health issues or adaptive deficits shall be
provided opportunities to go outside unless medically
contraindicated.
(e) Any change to
access to the grounds status shall be based on the treatment team's assessment.
An assessment of risk shall consider, at a minimum, the following categories of
risk:
1. Suicide attempts or threats,
2. Intentional self-injury,
3. Homicide,
4. Assault,
5. Elopement,
6. Substance abuse,
7. Physically vulnerable,
8. Psychotropic medication issues; and,
9. Other potentially harmful
behaviors.
(f) Decisions
about changes in access to grounds status shall be based in part on an
assessment of risk, with criteria influencing access changes being documented
and filed in the person-centered record.
(g) Teams shall show progressive actions
taken to manage significant, recurring issues for residents in the least
restrictive manner possible. The exception shall be those changes where a
resident's access to the grounds is limited due to serious, acute health/safety
matters. Interventions must be documented in order to show the use of the least
intrusive, most positive methods for the restoration of freedom of movement and
follow through with treatment before the use of more restrictive
options.
(h) Residents who disagree
with limitations to grounds access shall have a right to a review of those
limitations. Each treatment facility shall publish procedures to insure the
limitations are reviewed. The resident or the resident's representative may
appeal the restriction to the facility administrator through the grievance
process.
(i) Residents shall retain
their access to grounds status when transferred from one residential area to
another, unless their psychological or physical condition has changed, based on
a comprehensive risk assessment.
(j) Residents who do not have full access to
the grounds shall be provided the opportunity to exit the building for outside
time and physical exercise on a daily basis, excluding severe weather
conditions, for at least a half-hour per day. Residents have the right to
decline to go outside, if they so choose.
(k) All residents with full or prescribed
access to grounds (as indicated in their individualized service plan) shall be
provided with an orientation to grounds and boundaries of the
facility.
Rulemaking Authority
394.457(5) FS.
Law Implemented 394.457(2),
394.459(5),
(12)
FS.
New 2-1-04.
