1. (1) Each behavioral qualified residential treatment program (BQRTP) providing services for youth who have serious emotional or behavioral disorders or disturbances must meet the licensing requirements set forth in rules 65C-46.001 through 65C-46.014, F.A.C., in addition to the program standards in this rule.
2. (2) File Requirements. Each BQRTP shall obtain a copy of all of the child’s assessments completed as outlined in 65C-28.021, F.A.C., and place it in the child’s file. Each BQRTP serving non-dependency youth shall obtain a copy of an independent assessment confirming the child meets criteria to receive services in a BQRTP.
3. (3) Each BQRTP shall work in conjunction with the qualified individual, as defined in Rule 65C-28.021, F.A.C., conducting all assessments.

4. (4) Training.

   1. (a) Each BQRTP shall ensure all direct care staff complete pre-service training requirements in Rule 65C-46.011(9)(c), F.A.C., and receive an additional 24 hours of specialized training specific to the treatment of serious emotional or behavioral disorders or disturbances. Topics shall include the following:

      1. Emotional disturbances in children and common behavioral problems exhibited;

      2. Behavior management, theory, and skills;

      3. Discipline, limit-setting, logical consequences, problem-solving, and relationship building skills;

      4. Crisis intervention and emergency procedures;

      5. Behaviors and emotional issues of children who have been sexually abused, are sexually reactive, or have developmental disabilities;

      6. Working with biological or adoptive families;

      7. Motivational Interviewing; and

      8. Understanding the impact of trauma.

   2. (b) Of the 40 hours of annual in-service training required in rule 65C-46.011(9)(d), F.A.C., eight (8) hours shall focus on the treatment of serious emotional or behavioral disorders or disturbances.

5. (5) Staffing.

   1. (a) Each BQRTP shall have staff experienced in addressing maladaptive behaviors, registered or licensed nursing staff, and other licensed clinical staff who are:

      1. On-site as outlined in the BQRTP’s trauma-informed treatment model;

      2. Available 24-hours a day, seven (7) days a week for response; and

      3. May be contracted providers.

   2. (b) Each BQRTP may utilize a shift care staffing model or house parent model.

6. (6) Accreditation. Each BQRTP must be accredited by one of the following organizations:

   1. (a) Commission on Accreditation of Rehabilitation Facilities (CARF);
   2. (b) The Joint Commission;
   3. (c) Council on Accreditation (COA); or
   4. (d) Any other not-for-profit accrediting agency approved by the Department.

7. (7) Admission.

   1. (a) Each BQRTP shall develop an admission plan that outlines the intake procedures and

      identifies exclusionary criteria.

   2. (b) Children requiring services and treatment for acute emotional or behavioral disorders or disturbances outlined in s. 394.492(5) and (6), F.S., should be referred to a residential treatment center licensed under 65E-9, F.A.C.

8. (8) Basic Service Requirements.

   1. (a) Each BQRTP shall develop a policy outlining the program’s trauma-informed treatment model that addresses the clinical needs of children with emotional or behavioral disorders or disturbances and is able to implement the treatment identified for the child. The policy shall address the staffing requirements needed to implement the trauma-informed model.

   2. (b) Each BQRTP must provide time-limited, high-quality, supportive services for youth including:

      1. Substance abuse and mental health screening and treatment, if applicable;

      2. Family/group/individual therapy;

      3. Behavioral management;

      4. Psychiatric services;

      5. Support groups;

      6. Specialized intervention services;

      7. Social & rehabilitative services; and

      8. Psycho-educational services.

   3. (c) Each BQRTP shall develop a policy outlining the requirement to facilitate participation of family members in the child’s treatment program including:

      1. Inclusion in family therapy;

      2. Outreach to family members, including siblings;

      3. Documenting how family members are integrated into the treatment process for the child, including post-discharge; and

      4. Documenting how sibling connections are maintained.

   4. (d) Each BQRTP shall ensure that emotional safety and recovery are assessed, and precautions are taken in regard to the safety of other children in the same setting.
9. (9) Each BQRTP is responsible for the development of treatment plans as outlined in Rule 65C-46.012(13), F.A.C. Any BQRTP enrolled as a Medicaid provider, must complete treatment plans in accordance with Medicaid policy requirements.

10. (10) Discharge and Aftercare Plans.

    1. (a) The provider shall have, and use on an ongoing basis, a written procedure on discharge planning and aftercare supports that specifies the availability of services and the persons responsible for implementation of the aftercare supports.
    2. (b) Each BQRTP shall provide discharge planning and family-based aftercare support for at least six (6) months post-discharge.
    3. (c) Discharge planning shall include input from the child, the child’s parent or guardian, foster parents, caregiver, Department, and guardian ad litem, and a copy shall be provided to the child welfare professional.
    4. (d) The child’s diagnosis(es) shall be considered during discharge planning and development.
    5. (e) Aftercare support plans shall be developed at least one month prior to discharge.
    6. (f) Aftercare support shall be developed to meet the needs of a child with intent for the child to reside in the most appropriate, least restrictive setting.
    7. (g) Aftercare Support Eligibility for Dependency Youth. Aftercare support must be offered to all children placed in a BQRTP setting. Aftercare support is not required for youth who discharge to another BQRTP setting or higher level of care to include residential treatment programs, also known as Statewide Inpatient Psychiatric Program (SIPP), or a therapeutic group home which are defined in s. 39.407(6), F.S.

    8. (h) Aftercare Supports. Each BQRTP shall provide the following aftercare supports:

       1. Community service coordination for the youth and their family/caregiver;

       2. Ensure all service referrals are linked and barriers to access services are eliminated;

       3. Provide a minimum of two (2) contacts per month, with at least one face to face contact, with the youth and family/caregiver;

       4. Provide written progress reports every 30 calendar days to the youth’s child welfare professional, if in foster care.

    9. (i) When a youth is discharged to a placement setting outside a 50-mile radius of the provider, the BQRTP must coordinate aftercare support with the community-based care lead agency having jurisdiction of the youth. The community-based care lead agency shall resume responsibility for the aftercare support services provided to the dependency youth.
    10. (j) Each BQRTP may contract/sub-contract with a community provider qualified to provide aftercare services.

Rulemaking Authority 409.175(5) FS. Law Implemented 409.175 FS. History–New 1-28-24.