(1) Authorized Levels of Response.
    (a) Protective Action Response, as authorized by the department, shall be the verbal and physical intervention program utilized by direct care staff in state-, county-, or municipally operated and contracted facilities and programs.
    (b) Right Interactions (RI) is the department approved Protective Action Response curriculum.
    (c) Prior authorization for the use of physical intervention techniques and mechanical restraints shall be obtained from the supervisor or acting supervisor unless doing so could result in physical harm to the youth, employee, or another person; property damage; or the youth escaping or absconding from lawful supervision.
    (d) All responses shall be commensurate with the youth’s type of resistance according to the RI Escalation Matrix and this rule.
    (e) Responses shall only be used when reasonably necessary to control youth and only after all reasonable alternatives have been exhausted, including verbal persuasion, warnings, and verbal intervention techniques, or when the alternatives are considered inappropriate due to the rapid escalation of dangerous behavior.
    (f) In the event a youth is armed with a weapon or firearm, all attempts to reasonably diffuse the situation through the application of the RI Escalation Matrix have failed, and staff has determined there is imminent danger of bodily harm or death, facility- and community-based program employees shall, if possible, isolate or contain the youth and request emergency assistance from law enforcement. The Right Interactions Escalation Matrix (TLC 003, April 2023) is incorporated by reference into this rule and is available electronically at http://www.flrules.org/Gateway/reference.asp?No=Ref-15379.
    (g) If the youth is in the process of inflicting grave bodily harm or possible death upon others or self and all attempts to reasonably diffuse the situation have failed, facility- and community-based program staff shall immediately contact law enforcement. Employees are authorized to use reasonable and necessary means to stabilize the situation.
    (h) The use of aerosol or chemical agents, including but not limited to, oleoresin capsicum spray, ammonia capsules, on a youth unless required for medical treatment of the youth by a licensed medical professional is prohibited.
    (i) The use of tasers is prohibited.
    (2) Authorized Techniques.
    (a) Administrators shall submit a new RI Training Plan to the Director of Talent, Leadership, and Culture or designee through the department’s Regional Director or designee, and thereafter notice of any change to this plan shall be submitted as described above within 30 calendar days of the change’s effective date. Newly contracted, county- or municipally operated facilities shall submit their RI Training Plan as described above no less than 30 calendar days prior to becoming operational. The Right Interactions Training Plan (TLC 007, April 2023) is incorporated by reference into this rule and is available electronically at http://www.flrules.org/Gateway/reference.asp?No=Ref-15383.
    (b) RI instructors shall only train employees on the techniques identified on the approved training plan for the facility- or community-based program for which they are training.
    (3) Authorized Mechanical Restraints.
    (a) The department authorizes mechanical restraints designed and manufactured for the specific purpose of secure transport or restraint.
    (b) Authorized mechanical restraints to be used within a facility are as follows: handcuffs, leg cuffs, restraint belt, soft restraints, and waist chains.
    (c) There are two authorized methods to use when handcuffing a youth: hands in front of the youth, and hands behind the youth’s back.
    (d) All secure facilities shall use mechanical restraints to transport youth. All non-secure programs shall use mechanical restraints to transport any youth who has been assessed and determined to be a security risk or risk to self and others and has demonstrated that they cannot be transported by less restrictive methods. Leg cuffs and front handcuffing shall be used to transport such youth.
    (e) Prohibited use of mechanical restraints includes the use of neck restraints, a restraint chair, securing of youth to a fixed object, and securing of a youth’s legs and hands together behind the back.
    (f) No more than two youth may be chained or handcuffed together.
    (g) A youth’s legs and hands may be secured together in the front with the use of waist chains or a restraint belt, in which case the length of the chain securing the youth’s legs and hands together shall not prohibit the youth from standing in a full upright position.
    (h) If handcuffs are used on pregnant youth, they shall be cuffed in front. Leg cuffs, waist chains, soft restraints, and the restraint belt shall not be used on pregnant youth. Restraints may not be used on a youth during labor, delivery, or during postpartum recovery. For purposes of this paragraph, “”postpartum recovery”” shall include the period immediately following delivery, including the recovery period when a youth is in the hospital or infirmary, up to 24 hours after delivery, unless the physician after consultation with the department recommends a longer period of time.
    (i) Except as provided herein, during transports, all violent and escape risk youth shall be handcuffed with their hands in front with the use of a restraint belt or waist chains or the hands shall be cuffed behind the back.
    (4) Supervision of Youth in Mechanical Restraints.
    (a) Youth secured in mechanical restraints for secure transport or in response to resistance shall be supervised in accordance with this section.
    1. At no time shall a youth be left without constant, full, sight and sound supervision by an employee.
    2. The youth shall not be placed in an upper bunk or in any position that does not permit constant, full, sight and sound supervision.
    3. Youth shall not be stripped of their clothing.
    4. Employees responsible for providing constant, full, sight and sound supervision shall be RI certified and have physical possession of the key to unlock the mechanical restraints.
    (b) In addition to items identified in subparagraphs 63H-3.007(4)(a)1.-4., F.A.C. above, while a youth is placed in mechanical restraints as a response to resistance, employees shall:
    1. Employ verbal intervention techniques designed to de-escalate the need for mechanical restraints.
    2. Continually monitor the youth’s type of resistance, aggressiveness, and willingness to comply with instructions to determine whether removal of restraints is safe and advisable.
    3. Conduct breathing and circulation checks at ten-minute intervals. These ten-minute checks shall be documented on the Mechanical Restraints Supervision Log. The Mechanical Restraints Supervision Log (TLC 002, April 2023) is incorporated by reference into this rule and is available electronically at http://www.flrules.org/Gateway/reference.asp?No=Ref-15378.
    4. If a restrained youth continues to exhibit negative, hostile, and/or aggressive behavior so that removal of mechanical restraints is unsafe, the supervisor or acting supervisor shall interview the youth and decide if it is safe to remove the mechanical restraints.
    a. This interview shall occur no more than 30 minutes after the youth is placed in restraints.
    b. If it is decided that it is unsafe to remove the restraints, the supervisor or acting supervisor shall document the decision on the Mechanical Restraints Supervision Log.
    c. If authorization is obtained from the Superintendent, Program Director, Administrator, or designee to continue the use of restraints, another interview shall occur no more than one (1) hour after the youth was placed in restraints.
    d. Each time the decision is made that it is unsafe to remove the restraints, the decision shall be documented as described above.
    (c) Authorization Requirements for Youth in Mechanical Restraints as a Response to Resistance
    1. A youth may remain in mechanical restraints up to 60 minutes with the supervisor’s or acting supervisor’s authorization.
    2. In order to keep the youth in mechanical restraints for 60 to 120 minutes, the supervisor or acting supervisor shall obtain authorization from the Superintendent, Residential Program Director, Administrator, or designee who shall first consult with a licensed medical and/or mental health professional before authorizing additional time. This authorization shall be obtained within the initial 60-minute timeframe and documented on the Mechanical Restraints Supervision Log to include the name of the professional who was consulted, the time contacted, and the amount of time authorized.
    3. In order to keep the youth in mechanical restraints beyond 120 minutes, the same procedures apply as described in Fl. Admin. Code R. 63H-3.007(4)(b) above, for each subsequent 60-minute timeframe.
    4. If at any point during the restraint it is determined that transportation to a medical or mental health treatment center is necessary, the supervisor or acting supervisor shall request verbal authorization from the Superintendent, Program Director, Administrator, or designee to initiate procedures to transport the youth. All authorizations and the time the authorization was received shall be documented on the Mechanical Restraints Supervision Log.
    (5) Documentation and Retention of Records.
    (a) A RI Report shall be completed after an incident involving the use of countermoves, control techniques, takedowns, or the application of mechanical restraints as a response as identified on the RI Escalation Matrix. The Right Interactions Report (TLC 006, April 2023) is incorporated by reference into this rule and is available electronically at http://www.flrules.org/Gateway/reference.asp?No=Ref-15382.
    (b) The employees who were engaged with the youth shall complete the RI Report no later than the end of the employee’s workday.
    (c) When mechanical restraints are used as a result of resistance, the Mechanical Restraints Supervision Log shall be completed.
    (d) The RI Report shall be reviewed by the administrator or designee within 72 hours of the incident, excluding weekends and holidays.
    (e) The Post RI Interview shall be conducted as soon as possible, but no longer than 30 minutes after the incident. The findings of the interview shall be documented on the RI Report.
    (f) If the Post RI Interview indicates the need for a RI Medical Review, the youth shall be referred to the licensed medical health professional (Physician, Physician Assistant, Advanced Registered Nurse Practitioner, Registered Nurse, or Licensed Practical Nurse) on site. If a medical health professional is not on site and telemedicine is not available, then the youth must be sent off site for this evaluation.
    (g) Descriptions of injuries and medical treatment provided shall be filed in the youth’s individual health care record.
    (h) Facilities/programs shall retain a copy of the RI Report for three (3) years following the youth’s release from the department’s custody.
    (6) Medical Requirements for Training.
    (a) If an employee has a medical condition that prohibits performance of one or more physical intervention techniques, the employee shall submit medical documentation from their licensed physician to their supervisor.
    (b) The RI Instructor shall direct any employee that discloses a medical issue or injury during training to the employee’s supervisor for follow-up. The employee shall not engage in any RI training until such time as the employee’s physician states the employee can perform all techniques without restriction.
    (c) Documents from physicians are confidential records and shall be maintained in accordance with state Personnel rules, or if a contracted facility or program, in accordance with the organization’s applicable policy. The medical documentation shall not be submitted to the RI Instructor. The supervisor shall not send any employee to RI training unless the employee is in good medical standing.
    (7) Certification.
    (a) All direct care staff shall become RI certified within 90 calendar days following their date of hire.
    (b) Employees shall be RI certified by successfully completing the RI training designed for facility- or community-based employees, whichever is applicable. Successful completion requires:
    1. Attendance and participation in the 40-hour training specified in the RI curriculum. Employees shall actively participate in the performance of all physical intervention techniques and mechanical restraints being taught during the training session;
    2. A minimum score of 75 percent on the RI examination; and
    3. One hundred percent (100%) satisfactory performance of the techniques specified on the RI Performance Evaluation form. The Right Interactions Performance Evaluation (TLC 005, April 2023) is incorporated by reference into this rule and is available electronically at http://www.flrules.org/Gateway/reference.asp?No=Ref-15381.
    (c) All RI training must be conducted by a certified RI Instructor.
    (d) The instructor to student ratio shall be not exceed 1:8 during the physical techniques portion of a RI training session.
    (e) The 80-hour RI Train-the-Trainer course shall be delivered by at least one Lead Master RI Instructor.
    (8) Cross-Over Training
    (a) A RI-certified facility-based employee who crosses over from a community-based to a facility position, or vice versa, shall successfully complete all objectives of the RI certification curriculum applicable to their new position which are not duplicative of the RI certification objectives previously completed by the employee. Such completion must occur within 90 calendar days following the employee’s cross-over date.
    (b) The RI Instructor shall train and evaluate the employee’s performance on any techniques that the employee has not been trained to perform. This evaluation shall be completed on the RI Performance Evaluation form. If the employee is unable to perform the new techniques, after remediation, the employee shall not be considered RI certified for purpose of their employment in the new facility or community-based program. If this training shall dually serve as the employee’s annual RI Update, all criteria identified in this rule for the annual RI Update shall be successfully completed.
    (9) Rehired Employee Training.
    (a) If an employee is rehired within 12 calendar months of their RI certification or most recent annual RI Update, the employee’s RI certification is current.
    (b) If an employee is rehired after 12 calendar months of separation, they are no longer considered certified and must complete all requirements as outlined in this rule.
    (10) Annual Training Requirement.
    (a) All employees shall complete a minimum of eight (8) hours of RI Update training.
    (b) The training shall include, at a minimum, the following:
    1. A review of this rule section, including curriculum revisions, and other facility or program RI administrative policies and procedures.
    2. Instructions on how and when to properly complete the RI Report.
    3. Practice of all physical intervention techniques checked on the applicable RI Training Plan and, at a minimum, practice in the use of all mechanical restraints authorized by the facility’s RI Training Plan.
    4. Successful completion of the annual in-service training requires 100 percent attendance and participation in the training program. The training hours do not have to be consecutive.
    5. If an employee fails to successfully complete the annual update within 12 months of their last RI training, they will no longer be authorized to use physical or mechanical intervention responses and must attend a minimum of eight (8) hours of remedial training, to include 100 percent satisfactory performance of the techniques specified on the employee’s RI Training Plan using the RI Performance Evaluation.
    6. If an employee fails to successfully complete the annual update within 16 months of their last RI training, the employee is no longer considered RI certified and must attend the 40-hour RI certification course for either community- or facility-based staff but shall not be required to re-take the RI certification exam.
    (11) Testing Requirements.
    (a) If a candidate fails the RI written examination, they are only required to attend the remedial classroom training.
    (b) RI Instructors shall conduct a practical examination utilizing the RI Performance Evaluation. The completed evaluation shall be uploaded into the SkillPro learning management system.
    (c) If an employee failed the RI Performance Evaluation, when remedial training is provided, the RI Instructor candidate or employee is only required to attend the performance-based segment of the training.
    (d) Test candidates shall have no more than three (3) attempts to pass the written exam.
    (e) Test candidates shall adhere to the following schedule for second and third attempts to pass the written exam:
    1. The second attempt shall occur no less than 7 calendar days after, and no more than 45 calendar days after, the first attempt.
    2. The third attempt shall occur no less than 14 calendar days after, and no more than 45 calendar days after, the second attempt.
    (f) For annual in-service training, the RI Performance Evaluation shall be used for the RI Update to document the practice of the techniques identified on the RI Training Plan. The completed evaluation shall be uploaded into the SkillPro learning management system.
    (g) One RI Performance Evaluation form shall be used for each attempt that a facility or program employee makes to pass the performance evaluation. The term “”attempt”” is described below.
    1. ATTEMPT 1: If an employee fails one (1) to three (3) techniques, the RI Instructor shall remediate and re-evaluate the employee on the failed techniques. Upon conclusion of the employee’s performance of the remediated techniques, this shall be the employee’s first attempt at passing the evaluation. If the employee fails to satisfactorily demonstrate the failed techniques after remediation, the employee shall attend remediation on a different date for Attempt 2 and at that time shall be evaluated on the failed techniques. An employee who fails four (4) or more techniques on Attempt 1 shall attend remediation on a different date for Attempt 2 and at that time shall be evaluated on the failed techniques.
    2. ATTEMPT 2: If an employee fails one (1) to three (3) techniques, the RI Instructor shall remediate and re-evaluate the employee on the failed techniques. Upon conclusion of the employee’s performance of the remediated techniques, this shall be the employee’s second attempt at passing the evaluation. If the employee fails to satisfactorily demonstrate the failed techniques after remediation, the employee shall attend remediation on a different date for Attempt 3 and at that time shall be evaluated on the failed techniques. An employee who fails four (4) or more techniques on Attempt 2 shall attend remediation on a different date for Attempt 3 and at that time shall be evaluated on the failed techniques.
    3. ATTEMPT 3: If an employee fails one (1) to three (3) techniques, the RI instructor shall remediate and re-evaluate the employee on the failed techniques. Upon conclusion of the employee’s performance of the remediated techniques, this shall be the employee’s third attempt at passing the evaluation. If the employee fails to satisfactorily demonstrate the failed techniques after remediation, the employee is considered to have failed their third attempt. An employee who fails four (4) or more techniques on Attempt 3 shall not have an opportunity to receive remediation and is considered to have failed their third attempt.
    (h) Employees shall be evaluated using the RI Performance Evaluation form on all physical intervention techniques that are specified on their RI Training Plan.
    (12) Training Instructor Fidelity and Certification Renewal.
    (a) RI Instructors shall conduct 20 hours of RI training annually to maintain certification. Instructors that do not conduct 20 hours of RI training within one calendar year shall have their instructor privileges suspended until such time as they attend remedial training conducted by a Lead Master RI Instructor.
    (b) Instructors shall attend and participate in an eight- (8-) hour in-service training program once every two years as conducted by a Lead Master RI Instructor.
    (c) Instructors shall notify the Office of Talent, Leadership, and Culture via the RI Fidelity email address of all scheduled RI classes at least 72 hours prior to the commencement of the training. This requirement does not apply to impromptu annual update trainings delivered due to the unexpected availability of staff on a given day or shift.
    (d) Instructors shall not be limited in teaching RI to only their facility, program, or unit.
    (e) Any RI Instructor who separates from their employment with the department, county, municipality, or contracted facility, program, or entity with a memorandum of understanding are no longer considered to be a certified RI Instructor.
    (f) If a RI Instructor is rehired by the department or county, municipality, or contracted facility, program, or entity with a memorandum of understanding within 12 months of separation, their RI certification shall be reinstated by successfully completing RI training for facility- or community-based employees pursuant to this rule.
    (g) The facility, provider, or administrator shall notify the Training Entity within 72 hours of a RI Instructor’s separation from the department or contract provider via the RI Fidelity email address.
    (h) At no time shall a RI Instructor be financially compensated for the delivery of the RI curriculum other than the salary they receive from their current employer for work time. RI Instructors shall not be permitted to list themselves as a vendor in the My Florida Marketplace system.
    (i) The Lead Master RI Instructors shall coordinate with Master RI Instructors regarding the monitoring and development of instructor performance in the delivery and application of the RI curriculum. At a minimum, Master RI Instructors shall:
    1. Deliver a minimum of 40 hours of RI training each calendar year, which may include either a RI and/or RI Train-the-Trainer class. The Train-the-Trainer class shall be facilitated by a Lead Master RI Instructor.
    2. Participate in quarterly Master RI Instructor meetings that will be conducted in-person, virtually, or via conference call.
    3. Complete RI fidelities and provide technical assistance when requested.
    (13) RI Fidelity Requirement: All department and contract providers shall adhere to the following procedures when RI incidents resulting in injury or allegations of abuse are reported, for requests for program/facility technical assistance, and for the monitoring of the training and implementation of the RI program.
    (a) Superintendents, program monitors, and Regional Directors shall submit reports of RI incidents resulting in injury requiring outside medical attention, allegations of abuse stemming from the use of RI, or requests for technical assistance to the Training Entity via the RI Fidelity email address. All requests shall include the following:
    1. RI Fidelity Request form. The Right Interactions Fidelity Request (TLC 004, April 2023) is incorporated by reference into this rule and is available electronically at http://www.flrules.org/Gateway/reference.asp?No=Ref-15380.
    2. A copy of the RI Report.
    3. A copy of supporting multimedia (if available).
    (b) Within 24 hours of receipt of the RI Fidelity Request Form, excluding weekends and holidays, a representative of the Office of Talent, Leadership, and Culture will assign the request to a Master RI Instructor.
    (c) Once all documentation is received, depending on the nature and severity of the incident, a minimum of five (5) days will be needed to complete the review.
    1. Upon completion of the review, the Master RI Instructor will submit the completed RI Fidelity Request Form to the requestor or Incident Operation Center.
    2. Documentation of RI Fidelity incidents or requests submitted to the Training Entity will be maintained by the Training Entity.
Rulemaking Authority 985.645 FS. Law Implemented 944.241, 985.645 FS. History—New 3-6-22, Amended 8-3-23.