Notice is hereby given that the following changes have been made to the proposed rule in accordance with subparagraph 120.54(3)(d)1., F.S., published in Vol. 33 No. 35, August 31, 2007 issue of the Florida Administrative Weekly.

63E-6.002 Definitions.

(1) through (6) No change.

(7) Intensive Mental Health Treatment – treatment for:

(a) through (d) No change.

(e) Youth who have a behavior history of sexual offending ~~deviance~~.

(8) through (14) No change.

Specific Authority 985.4891, 985.645 FS. Law Implemented 985.4891 FS. History–New 11-19-06, Amended ________.

63E-6.003 Admission Criteria.

(1) No change.

(2) All youth referred to the STAR program shall be screened by the department to determine if they have the physical, psychological and substance abuse profile conducive to successfully completing the rigorous physical aspects and intensive behavioral management inherent in a STAR program. The screening shall include:

(a) through (b) No change.

(c) A preadmission comprehensive evaluation with the psychological component conducted by a licensed mental health professional or a Master’s level mental health clinical staff person working under the direct supervision of a licensed mental health professional should be completed no more than six months prior to referral to the STAR program. A mental health clinical staff person is a person providing mental health services for DJJ involved youth who has received training in mental health assessment processes and procedures and mental health treatment strategies and techniques. A Master’s level mental health clinical staff person is a person who holds a Master’s degree from an accredited university or college with a major in psychology, social work, counseling or related human services field. Related human services field is one in which major course work includes the study of human behavior and development, counseling and interviewing techniques, and individual, group or family therapy. Licensed mental health professional means a board certified psychiatrist licensed pursuant to Chapter 458, F.S., a psychologist licensed pursuant to Chapter 490, F.S., a mental health counselor, clinical social worker or marriage and family therapist licensed pursuant to Chapter 491, F.S., or a psychiatric nurse as defined in Section 394.455(23), F.S. This evaluation must be completed prior to admission to screen out those youth whose mental status requires psychotropic medication interventions, who have a developmental disability as defined by an IQ less than 75 or classification as “Educable Mentally Handicapped” or “Intellectual Disabilities,” a need for intensive mental health treatment, reveals suicidal risk histories, a DSM-IV-TR diagnosis of substance abuse, substance dependence, poly substance dependence, substance intoxication or substance withdrawal, or indicates high-risk suicidal tendencies or history of self-injurious behavior. Youth diagnosed with substance abuse or substance abuse dependence disorders may be considered for placement if the STAR program has been designated by the Department as meeting the requirements to provide residential substance abuse treatment overlay services (RSAT Overlay Services) pursuant to Rule 63E-6.012, F.A.C.

(3) No change.

Specific Authority 985.4891, 985.645 FS. Law Implemented 985.4891(2), (7)(a) FS. History–New 11-19-06, Amended ________.

63E-6.006 Program Components.

(1) The STAR program shall contain the following program components or services:

(a) through (d) No change.

(e) Mental health and substance abuse counseling and services shall be provided, including alcohol and other drug abuse awareness, education, treatment or referral to treatment for youth in need of such services. If a STAR program is designated for residential substance abuse treatment overlay services (RSAT Overlay Services), the STAR program must provide those services in accordance with Rule 63E-6.0012, F.A.C.

(f) No change.

(2) No change.

Specific Authority 985.4891, 985.645 FS. Law Implemented 985.4891(3), (4) FS. History–New 11-19-06, Amended ________.

63E-6.012 Residential Substance Abuse Treatment Overlay Services.

(1) No change.

(2) Residential Substance Abuse Treatment Overlay Services (RSAT Overlay Services), are defined as: substance abuse assessments; substance abuse education; substance abuse treatment activities such as substance abuse counseling, skills training (e.g., substance refusal skills, coping skills, interpersonal problem solving skills) and relapse prevention. These services shall provided as follows:

(a) Provided for youths with a diagnosed Substance-Related Disorder and functional impairment associated with substance abuse or substance dependence. The youth may also have a co-occurring mental disorder other than those mental disorders identified in subsection 63E-6.002(6), F.A.C. However, substance abuse must be the primary disorder. Substance abuse services ~~in DJJ facilities~~ must be provided in accordance with subsection 65D-30.003(15), F.A.C. (12-12-05).

(b) Clinical Staffing Requirements:

1. Designated Mental Health Authority- The provider shall designate a single licensed mental health professional as the Designated Mental Health Authority. The role and function of the Designated Mental Health Authority shall be clearly articulated in a written agreement between the Provider and the Designated Mental Health Authority. There must be clear organizational lines of authority and communication between the Designated Mental Health Authority and the clinical staff who are delivering on-site mental health and substance abuse services in the program.

2. Qualified Professional – must be on-site at least five days per week wherein services are provided under Chapter 397 licensure as specified in paragraph 65D-30.003(15)(a) or (b), F.A.C. (12-12-05).

3. Substance Abuse Clinical Staff: A substance abuse clinical staff person must be on-site 7 days of the week in facilities where services are provided under Chapter 397 licensure as specified in paragraph 65D-30.003(15)(a) or (b), F.A.C. (12-12-05). A substance abuse clinical staff must be on-site each day Substance Abuse Overlay Services are billed.

4. Licensed Qualified Professional-: must be on-site daily (7 days of the week) in DJJ facilities that are not licensed under Chapter 397, F.S., or where services are not provided by a service provider licensed under Chapter 397, F.S. The licensed qualified professional must be on-site and provide a substance abuse service each day Substance Abuse Overlay Services are billed.

5. Psychiatrist – must be on-site bi-weekly for consultation, medication management and to participate in treatment planning for youths receiving psychotropic medication. The psychiatrist must be available for emergency consultation 24 hours a day, 7 days a week.

1. Qualified Professional – A physician licensed under Chapter 458 or 459, F.S.; a professional licensed under Chapter 490 or 491, F.S.; or a person meeting the qualifications in ~~who is certified through a DCF recognized certification process of substance abuse treatment services and who holds, at a minimum, a bachelor’s degree and meets all the requirements in (See~~ Section 397.311 (25), F.S.)

2. Licensed Qualified Profession – a person who is a physician licensed under Chapter 458 or 459, F.S., a psychologist licensed under Chapter 490, F.S., or a mental health counselor, clinical social worker or marriage and family therapist licensed under Chapter 491, F.S.

3. Certified Addiction Professional: A person who is certified through a Department of Children and Families recognized certification process for substance abuse treatment services and who holds, at a minimum, a bachelor's degree. A person who is certified in substance abuse treatment services by a state-recognized certification process in another state at the time of employment with a licensed service provider in this state must meet the requirements set forth in Section 397.311(25), F.S.

4. Substance Abuse Clinical Staff: A non-licensed substance abuse clinical staff person may provide substance abuse services in a DJJ residential commitment program only as an employee of a service provider licensed under Chapter 397 or in facility licensed under Chapter 397, Florida Statutes as specified in paragraph 65D-30.003(15)(a), or (b), F.A.C. (12-12-05). The non-licensed substance abuse clinical staff person must hold a Bachelor’s degree from an accredited university or college with a major in psychology, social work, counseling or related human services field and meet the training requirements provided in Chapter 65D-30, F.A.C. (12-12-05) and work under the direct supervision of a qualified professional under Section 397.311(25), F.S.

5. Licensed Mental Health Professional: A psychiatrist licensed under Chapter 458 or 459, F.S., who is board certified in Child and Adolescent Psychiatry or Psychiatry by the American Board of Psychiatry and Neurology or has completed a training program in Psychiatry approved by the American Board of Psychiatry and Neurology for entrance into its certifying examination, a psychologist licensed under Chapter 490, F.S., a mental health counselor, clinical social worker or marriage and family therapy licensed under Chapter 491, F.S., or a psychiatric nurse as defined in Section 394.455(23), F.S.

6. Mental Health Clinical Staff Person: A mental health clinical staff person, if not otherwise licensed, must have, at a minimum, a Bachelor’s degree from an accredited university or college with a major in psychology, social work, counseling or a related human services field. Related human services field is one in which major course work includes the study of human behavior and development, counseling and interviewing techniques, and individual, group or family therapy.

7. A non-licensed mental health clinical staff person providing mental health services in the program must meet one of the following qualifications and comply with d.

a. Hold a master’s degree from an accredited university or college in the field of counseling, social work, psychology, or related human services field; or

b. Hold a bachelor’s degree from an accredited university or college in the field of counseling, social work, psychology or related human services field and have two years experience working with (e.g., assessing, counseling, treating) youths with serious emotional disturbance or substance abuse problems; or

c. Hold a bachelor’s degree from an accredited university or college in the field of counseling, social work, psychology or related human services field and have 52 hours of pre-service training prior to working with youths. The 52 hours of pre-service training must include a minimum of 16 hours of documented training in their duties and responsibilities. When pre-service training has been successfully completed, the non-licensed person may begin working with youths, but must be trained for one year by a mental health clinical staff person who holds a master’s degree. Pre-service training must cover, at a minimum: basic counseling skills, basic group skills, program philosophy, therapeutic milieu, behavior management, client rights, crisis intervention, early intervention and de-escalation, documentation requirements, normal and abnormal adolescent development and typical behavior problems.

d. Non-licensed mental health clinical staff person must work under the direct supervision of a licensed mental health professional. Direct Supervision means that the licensed mental health professional has at least one hour per week of on-site face-to-face interaction with the non-licensed mental health clinical staff person for the purpose of overseeing and directing (as permitted by law within his or her State of Florida licensure) the mental health services that the non-licensed mental health clinical staff person is providing in the facility. The licensed mental health professional must assure that mental health clinical staff (whether licensed or non-licensed) working under their direct supervision are performing services that they are qualified to provide based on education, training and experience.

(d) Required Components.

1. Substance abuse screening at the time of admission;

2. Comprehensive substance abuse evaluation or updated evaluation;

3. Substance abuse treatment planning, updating and review;

4. Daily substance abuse services for each youth; (7 days of the week) provided by substance abuse clinical staff;

5. Individual, group and family substance abuse counseling; (substance abuse counseling provided to each youth at least 5 days of the week);

6. Psychiatric services as needed, and is required for youths receiving psychotropic medication A psychiatrist must be on-site bi-weekly to provide psychiatric evaluations, medication management and participate in treatment planning for youths receiving psychotropic medication;

7. Mental health evaluation and treatment for youths with co-occurring mental disorders;

8. Routine and Random urinalysis drug testing with positive tests followed by appropriate clinical intervention and sanctions. (Including drug screening upon the youth’s initial intake into the program);

9. Crisis Intervention and Suicide Prevention services;

10. 24-hour response capability;

11. All provided services must be documented.

Specific Authority 985.4891, 985.645 FS. Law Implemented 985.4891(3) FS. History–New ________.