Fla. Admin. Code Ann. R. 65E-5.602 - Rights of Residents of State Mental Health Treatment Facilities

(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.

Notes

Fla. Admin. Code Ann. R. 65E-5.602

Rulemaking Authority 394.457(5) FS. Law Implemented 394.457(2), 394.459(5), (12) FS.

New 2-1-04.

New 2-1-04.