457.1 Public Mental Health Crisis Stabilization Units and Short-Term Residential Treatment Programs
Crisis stabilization units and short-term residential treatment units shall comply with the design and construction standards in this section.
Note: Other administrative and programmatic provisions may apply. See Department of Children and Family Services (DCFS) Rule 65E-12, Florida Administrative Code, and Chapter 394, Florida Statutes.
CRISIS STABILIZATION UNIT (CSU). A statesupported mental health service or program and is a short-term alternative to inpatient psychiatric hospitalization and an integrated part of a designated public receiving facility under the authority of Chapter 394, Florida Statutes. A CSU provides brief intensive services for individuals who are presented as acutely mentally ill on a 24-hour-a-day, seven-day-a-week basis, under the licensing authority of the department of Children and Families and the Agency for Health Care Administration. The purpose of a CSU is emergency psychiatric reception, psychiatric examination, to stabilize and redirect people to the most appropriate and least restrictive treatment settings consistent with their needs.
SHORT-TERM RESIDENTIAL TREATMENT PROGRAM (SRT). A state-supported acute care 24-hour-a-day, seven-day-a-week residential alternative service, generally of 90 days or less, and which is an integrated part of a designated public receiving facility and receives state mental health funds under the authority of Chapter 394, Florida Statutes. The purpose of an SRT is to provide less acute intensive short-term treatment to individuals who have previously been admitted to either a hospital or CSU and have been transferred to the SRT as being temporarily in need of a 24-hour-aday structured therapeutic setting in a less restrictive, but longer-stay alternative to hospitalization.
- The building codes described in the Florida Building Code;
- The fire codes contained in Chapter 69A-44, "Minimum Fire Safety Standards for Residential Alcohol and Drug Abuse Treatment and Prevention Programs, Mental Health Residential Treatment Facilities and Crisis Stabilization Units," Florida Administrative Code, as described in NFPA 101, Chapters 18 and 19, Special Definitions, as adopted by the Florida Fire Prevention Code, as applicable to limited health care facilities, which is included by reference in Chapter 59A-3, Florida Administrative Code.
When a CSU is collocated with another program, as provided for in Section 65E-12.106(23), Florida Administrative Code, the following minimum facility requirements shall be met.
Collocation means the operation of CSU and SRT, or CSU and substance abuse detoxification services from a common nurses' station without treatment system integration. It may result in the administration of those services by the same organization and the sharing of common services, such as housekeeping, maintenance and professional services.
- A CSU shall be separated and secured by locked doors, used by persons receiving services, from the SRT and detoxification units.
- Whenever a CSU is collocated with an SRT or substance abuse detoxification unit there shall be no compromise in CSU standards. In all instances, whenever there is a conflict between CSU rules and SRT, alcohol or drug abuse rules, the more restrictive rules shall apply.
All CSUs shall be locked facilities and, to the maximum extent practical, provide a locked perimeter around a living unit and fenced exercise area within which individuals can reside 24 hours-aday in an environment designed to minimize potential for injury. Where this is not possible, operational compensation shall be made as follows:
- Each person receiving services shall be provided a minimum of 175 square feet (16 m2) of usable client space within the CSU. Useable client space is the sum, in gross square feet, of all rooms, interior wall to interior wall, that are part of a CSU and SRT facility. Mechanical and electrical rooms, administrative and staff offices, screening areas, nurses' stations, visitor and reception areas, crawl space and attic space are excluded. Bedrooms shall be spacious and attractive, and activity rooms or space shall be provided.
- CSU facilities shall be locked to provide reasonable control over access to and egress from the unit, recreational area, and emergency reception areas. When individuals are moved to other areas, the pathways shall also be locked or have adequate control provisions to prevent elopement. Such controlled passageways shall include access to the emergency reception area, unit proper, off unit doorways, and recreational areas.
- All unit door locks shall employ a common key for rapid access in emergency situations with quick releasing or single-turn mechanisms.
- The building codes described in the Florida Building Code.
- The fire codes contained in Chapter 69A-44, "Minimum Fire Safety Standards for Residential Alcohol and Drug Abuse Treatment and Prevention Programs, Mental Health Residential Treatment Facilities and Crisis Stabilization Units," Florida Administrative Code, as described in NFPA 101, Chapters 12 and 13, "Special Definitions," as adopted by the Florida Fire Prevention Code, as applicable to limited health care facilities, which is included by reference in Chapter 59A-3, Florida Administrative Code.
- The accessibility requirements of the Florida Building Code, Accessibility.