Florida Administrative Code

(1) Licensed nurses are required to practice within the Florida Nurse Practice Act and the applicable Florida Board of Nursing Chapter 464, F.S. (2) All detention and residential facilities shall have onsite nursing coverage to be provided by Registered Nurses (RNs) or, at a mini…

(1) Aspects of medical care may be delegated to non-licensed staff that have been appropriately trained and experienced to perform those specific tasks of care. Competency to safely perform these tasks shall be verified by the Registered Nurse who has delegated the tasks to the n…

(1) Protocols shall adhere to community standards of practice and identify and support the need for maintaining youth privacy during examination and handling of health information. Clinical encounters shall be conducted in private. Escorting, non-health care staff/officers, shall…

(1) The facility Superintendent or Program Director shall be responsible for ensuring that service agreements are in place with health care providers that are routinely and/or frequently utilized by the program. Ancillary service contracts or written agreements may be executed wi…

(1) The facility Superintendent, Program Director or designee are responsible for verification of credentials prior to contract execution and at the time of a change in medical provider prior to admittance to the facility/center for all health care providers. (2) A copy of the fo…

(1) For students or interns in health care profession and licensure training programs, the same training requirements for licensure verification apply to the preceptor/supervising instructor from the academic institution. (2) All student observation experiences must be pursuant t…

(1) All facilities and programs shall implement a method of identifying and solving potential and actual problems in health care delivery to committed youth. (2) Meetings shall be held and documented no less than quarterly, whereby all disciplines that provide or oversee the prov…

(1) Each facility shall screen every youth upon admission to determine if the youth has an acute injury, illness, chronic medical condition, physical impairment (e.g., speech, hearing, visual), mental disability, or developmental disability that requires medical or mental health …

(1) During the admission and screening process, immediate emergency medical assessment and/or transfer by Emergency Medical Services (EMS) to the nearest hospital is required if a youth presents with an incapacitating medical illness or condition. In all situations, the staff sha…

(1) In situations where a youth does not require immediate emergency transfer, the Designated Health Authority or designee must be notified of all youth admitted with a medical condition, illness, or injury documented at the time of screening. This notification may be by telephon…

(1) All facilities shall implement routine screening for all youth for tuberculosis, upon admission, as well as environmental controls in the case of a youth with active Tuberculosis, in accordance with the Florida Department of Health recommendations. (2) After the initial scree…

(1) Each facility shall implement a Medical Alert system. The Medical Alert system is required for non-licensed staff to use in making safety and security decisions as they relate to youth behavior and monitoring needs. (2) Non-licensed staff shall also identify youth for inclusi…

(1) All facilities shall conduct an orientation for youth to the health care delivery services upon admission, or at the next available opportunity after admission. (2) The healthcare orientation shall be provided by a nurse, or at a minimum, by a non-licensed staff knowledgeable…

(1) The HRH (HS 014) shall be completed no later than seven (7) calendar days following the date of admission. The HRH (HS 014, March 2024) is incorporated into this rule and is available electronically at http://www.flrules.org/Gateway/reference.asp?No=Ref-17500. (2) The HRH sha…

(1) The Comprehensive Physical Assessment (HS 007) shall be completed no later than seven (7) calendar days following the date of admission. For youth with a Comprehensive Physical Assessment completed prior to admission, see subsection 63M-2.0048(9), F.A.C. (2) The DHA/designee …

The following are the requirements for the authorization of health care services to youth in the physical custody of the department. (1) The Authority for Evaluation and Treatment (AET) is the means by which the department obtains the consent of the parent, guardian, or assigned …

(1) Because a signed AET is essential to providing routine health services to youth, an effort must be made to obtain a signed AET as early as possible during the youth's intake and stay. (2) Department staff shall obtain routine consent for health services, either through a sign…

(1) Additional consent is required in special circumstances through the Parental Notification of Health Related Care: General (HS 020, January 2014) and is incorporated into this rule and is available electronically at http://www.flrules.org/Gateway/reference.asp?No=Ref-03808. In…

(1) Sick Call shall be conducted only by a licensed nurse or higher licensure level. (2) Sick Call shall be regularly scheduled in each facility and conducted by a licensed health care provider within 24 hours of placing the sick call request. (3) All youth with a complaint, illn…

(1) A periodic evaluation and plan of care by a Physician, PA or APRN shall be conducted for youth in a facility who: (a) Have at least one chronic medical condition, or (b) Have a communicable disease, or (c) Are prescribed medications for at least three (3) consecutive months. …

(1) Medical issues that require immediate attention shall be determined by the DHA or physician designee. (2) Any complaint of severe pain, including dental pain, shall be treated as an emergency with immediate referral to the onsite nursing staff, APRN, PA or Physician. (3) Non-…

(1) The Designated Health Authority or physician designee, PA or APRN shall be responsible for the management of appropriate girls' medical and age-related health care and services in addition to routine medical care and services. (2) Girls' medical care shall include all of the …

(1) All Detention and Residential Program facilities are required to obtain and maintain the appropriate Board of Pharmacy permits/licenses as per chapter 64B16-28, F.A.C. Each facility is responsible for complying with all federal and state laws, rules and regulations governing …

(1) Facility and/or Program staff must continue all currently prescribed and verified medications to youth prior to entering the department's custody. (2) A duly licensed Physician, PA or APRN must make all changes in medication regimens subsequent to an appropriate assessment. U…

(1) Medication Acceptance (to be utilized when youth is being transported): For youth being transported through the Statewide Transportation and Relocation System there shall be, at a minimum, a 7-day supply of medications for transport to accompany the youth. A medication pack c…

(1) All medications shall be identified and secured in the locked area designated for storage of medications. (2) All medications received from youth and parent/guardian shall be labeled with the youth's identifying information, and then secured in a designated area for medicatio…

(1) Sharps shall have a perpetual inventory, be securely stored and inventory checked weekly. A week is defined as a seven-day period beginning on Sunday and ending on Saturday. (2) The Designated Health Authority and the facility superintendent or program director shall be notif…

Medication inventory shall include, at a minimum, the following components: (1) A perpetual inventory with clear descriptions shall be maintained for all stock and over the counter medications with documented weekly checks by a licensed health care staff. A week is defined as a s…

(1) The Designated Health Authority or physician designee shall be responsible for verifying the proper destruction and disposal of medications in accordance with chapter 64F-12, F.A.C. (2) Each facility must perform the following: (a) Inventory Accountability; (b) Monitoring pha…

(1) All prescription and OTC medications shall be administered by licensed nursing staff when they are on duty. (2) Medication delivery, including the security and control of the medications shall be the sole responsibility of the licensed nursing staff during the administration …

(1) Pursuant to chapter 64B9-14, F.A.C. (Delegation to Unlicensed Assistive Personnel), a Registered Nurse may delegate non-licensed trained staff (the Unlicensed Assistive Personnel) to serve as assistant to the Registered Nurse or Licensed Practical Nurse with the youth's self-…

(1) A youth's refusal to take a dosage of a prescribed medication shall be documented in the Individual Health Care Record, in addition to "R" for Refusal (as indicated on the MAR form). (2) The staff shall initial the MAR indicating refusal of medication. The youth shall sign th…

(1) The licensed nurse or non-licensed staff assisting with medication delivery shall verify whether a youth has swallowed his/her medications. (2) Licensed health care professional staff shall notify the DHA/Psychiatrist when a youth is found to be "cheeking" or not swallowing h…

(1) Non-licensed staff shall not administer parenteral medications, or routinely administer any medication that is injected subcutaneously, intradermally, intramuscularly or intravenously. (2) A non-licensed staff person may administer a percutaneous injection of a pre-packaged m…

(1) The Designated Health Authority or physician designee, PA or APRN, or psychiatrist is responsible for ordering the appropriate laboratory testing, including serum drug testing, for medications prescribed prior to a youth entering a DJJ facility. (2) Licensed health care profe…

(1) All youth shall be monitored routinely for adverse drug events, and potential adverse drug events, including medication errors. (2) Nursing and facility staff shall be notified of potential adverse drug effects and drug interactions through the Medical Alert system. (3) Licen…

(1) All youth with a diagnosed chronic medical condition who are prescribed medications shall receive instructions and education related to those chronic medical conditions and prescribed medications. (2) Education for a youth by an onsite licensed health care professional shall …

(1) All facilities shall address medical risks and complications associated with elevated heat index, exercise tolerance, and cold exposure. (2) Facility staff shall instruct youth who are in distress during any type of activity to immediately stop the activity. The staff must no…

(1) All facilities shall conduct surveillance, screening and management of specific illnesses or potential infectious conditions. (2) Each facility must develop and administer a comprehensive program of education and prevention regarding blood borne pathogens. (3) An Exposure Con…

(1) All facilities shall establish needle stick post-exposure intervention and treatment. (2) If an exposure meets criteria for post-exposure treatment, the post-exposure chemoprophylaxis (PEP) must be offered and initiated immediately after the exposure. (3) For a youth or staff…

(1) All youth determined at risk for HIV infection shall be offered counseling, testing, and referral for medical treatment as indicated. (2) The facility shall provide or facilitate HIV counseling and testing according to Chapter 65D-2, F.A.C. and pursuant to section 381.004, F.…

(1) All facilities shall conduct evaluation, identification, treatment, and containment of pediculosis (lice) or mites (scabies), including product-specific treatment and environmental control practices. (2) Treatment protocols and facility procedures shall be developed and appro…

(1) Each facility's DHA or designee shall be responsible for infection control requirements in accordance with the CDC for the identification, evaluation, treatment and containment of Methicillin-Resistant Staphylococcus Aureus (MRSA). (2) Youth with open skin infections shall be…

(1) Any infectious disease outbreak shall be investigated and reported to the local County Health Department. The index case (youth) shall be interviewed as a part of the investigation. (2) The Designated Health Authority or Designee, PA or APRN shall verify that information abou…

(1) All Individual Health Care Records shall remain confidential. (2) The Individual Health Care Record consists of two sections: (a) Section 1: Core Health Profile; and, (b) Section 2: Interdisciplinary Health Record. The Interdisciplinary Health Record contains the additional s…

The Core Health Profile shall include the following forms and be organized in the order in which the forms are listed below: (1) Personal and Health-Related Information (HS 023, January 2024), which is incorporated into this rule and is available electronically at http://www.flru…

This section of the IHCR shall include the forms listed below and organized in this order: (1) Practitioner's Orders; (2) Chronological Progress Notes includes but not limited to: all health encounters (sick call, episodic and emergency care, report of health care by non-health c…

(1) The Individual Health Care Records shall be stored separately from other files that contain non-health-related records and notes. The storage area must be locked and inaccessible to youth. (2) Only licensed health care professionals or facility/provider/departmental staff del…

(1) Health education programs shall pertain to health issues of adolescents. These topics shall include, at a minimum, the following, and shall be completed prior to or in conjunction with the HRH or review of the HRH: (a) Seat belt usage; (b) Alcohol and drug related problems; (…

(1) The assigned JPO, facility nursing staff, and the facility case manager shall work together to ensure that all medical information requiring parental follow-up is communicated to the responsible parent/guardian/assigned custodian prior to the youth's exit from the facility. (…