Crisis Stabilization Units
Crisis Stabilization Units (CSUs) provide brief psychiatric intervention, primarily
for low-income individuals with acute psychiatric conditions. Inpatient stays
average 3 to 14 days, resulting in return to the patient's own home or placement
in a long-term mental health facility or other living arrangements.
Facilities must meet licensing requirements by submission of a completed application,
required documentation, and completion of a satisfactory survey. The biennial license
fee is $192.00/bed.
Every Crisis Stabilization Unit must be affiliated with a Baker Act Receiving
Facility prior to being licensed by the Agency for Health Care Administration
(AHCA) as a CSU. Applications for designation as a Baker Act Receiving Facility
may be obtained from the Department of Children & Families (DCF). More information regarding the Baker Act is available on
DCF's Alcohol, Drug Abuse, and Mental Health web site: http://www.dcf.state.fl.us/mentalhealth/laws/index.shtml
Initial/Change of Licensed Operator and Renewal Requirements
To renew a current state license that is due to expire, you must print the licensure application
form below and submit the completed form(s) with the renewal fee prior to the expiration date of
the license. Renewal applications must be received by the Agency at least 60 days prior to
expiration of a license or a late fee will be assessed.
- Completed and signed License Application
Form (349K PDF).
- NOTE: A renewal application will not be accepted if the crisis stabilization
unit license is expired. An initial license application must be filed if your license has expired.
- Health Care Licensing
Application
, Addendum
, Voluntary Board Member
Affidavit, and
Affidavit of Compliance with Background Screening Requirements.
- These forms are recommended for use beginning October 1, 2006, to comply with the reporting
requirements pursuant to Chapter 408, Part II, Florida Statutes. Please provide this information
in addition to the licensing application for the specific provider/facility type.
- If accredited by JCAHO, CARF, COA, or NCQA, provide a copy of the accreditation
award letter showing the beginning and ending dates of accreditation and all
follow up letters.
- Program description: Outline of program & services; resident population
served, age groups admitted, and description of services to minors, if any.
(Optional for JCAHO, CARF, COA, and NCQA accredited facilities.)
- Description of age groups to be admitted: Adults only, adults and children,
or children only. (Optional for JCAHO, CARF, COA, and NCQA accredited facilities.)
- Description of services to children, if children are admitted.
(Optional for JCAHO, CARF, COA, and NCQA accredited facilities.)
- Staffing pattern description, including the names and license or registration number of each licensed or registered person.
(Optional for JCAHO, CARF, COA, and NCQA accredited facilities.)
- Table of organization for all management levels.
(Optional for JCAHO, CARF, COA, and NCQA accredited facilities.)
- Resume of facility manager. (Optional for JCAHO, CARF, COA, and NCQA accredited facilities.)
- Current balance sheet for owner(s) verifying financial information for the facility.
- Statement of operations projecting first six months income, expenses, taxes, credits, etc.
(Not required for renewal applications).
- Certificate of Insurance verifying commercial or general liability insurance coverage (minimum
coverage is $300,000 per incidence and $1 million in aggregate).
- Copy of a current Baker Act Receiving Facility designation certificate.
- Copy of a letter verifying the Department of Children and Families has funding
appropriated to support the beds requested and if funding is recurring or
non-recurring (or provide a copy of the current DCF funding contract).
- AIDS/HIV affidavit assuring required facility staff will be trained.
- Background screening affidavit assuring required facility staff will be screened.
- Satisfactory fire safety inspection report completed in the last 365 days.
- Satisfactory sanitation inspection report completed in the last 365 days.
Capacity Increase or Decrease Requirements
- Completed and signed License Application
Form (349K PDF).
- Program description, if changed from what was filed with the last AHCA application.
(Optional for JCAHO, CARF, COA, and NCQA accredited facilities.)
- Provide a letter from the local Department of Children and Families, Adult Mental Health
Program Manager, verifying funding has been appropriated for the requested capacity (increase or
decrease) and if the funding is continuing or nonrecurring.
- Submit a check for any additional beds requested ($96 per bed). There is no charge for a capacity decrease.
Change of Services Requirements
- Completed and signed License Application
Form (349K PDF).
- Program description: Listing the changes planned in the program and services
provided, and resident population served. (Optional for JCAHO, CARF, COA,
and NCQA accredited facilities.)
- Revised staffing pattern, staff coverage, number of staff and types of staff, etc.
(Optional for JCAHO, CARF, COA, and NCQA accredited facilities.)
Applications/Forms
Background Screening
- Florida Department of Law Enforcement and FBI fingerprinting screening must
be completed by the managing employee (usually the chief executive officer)
and the chief financial officer. Please go to the background
screening section of this web site for additional documentation that must
be submitted with your application.
Statute/Rule Authority
Short Term Residential Treatment Facilities
Short-term Residential Treatment Facilities (SRTs) were created to provide
a step-down service for residents of Crisis Stabilization Units (CSUs) needing
a more extended, but less intensive level of active treatment for psychiatric
conditions. These programs were created to fill a service gap between CSUs and
residential treatment facilities (RTFs). SRTs may only admit adults.
Facilities must meet licensing requirements by submission of a completed application,
required documentation, and completion of a satisfactory survey. The license
fee is $192.00/bed.
Every SRT must be affiliated with a Baker Act Receiving Facility prior to being
licensed by the Agency for Health Care Administration (AHCA) as an SRT. Applications
for designation as a Baker Act Receiving Facility may be obtained from the Department
of Children & Families (DCF). More information regarding the Baker Act is available on
DCF's Alcohol, Drug Abuse, and Mental Health web site: http://www.dcf.state.fl.us/mentalhealth/laws/index.shtml
Initial/Change of Licensed Operator and Renewal Requirements
To renew a current state license that is due to expire, you must print the licensure
application form below and submit the completed form(s) with the renewal fee prior
to the expiration date of the license. Renewal applications must be received by the
Agency at least 60 days prior to expiration of a license or a late fee will be assessed.
- Completed and signed License Application
Form (349K PDF).
- NOTE: A renewal application will not be accepted if the short-term residential treatment facility license is expired. An initial license application must be filed if your license has expired.
- Health Care Licensing
Application
, Addendum
, Voluntary Board Member
Affidavit, and
Affidavit of Compliance with Background Screening Requirements.
- These forms are recommended for use beginning October 1, 2006, to comply with the reporting
requirements pursuant to Chapter 408, Part II, Florida Statutes. Please provide this information
in addition to the licensing application for the specific provider/facility type.
- If accredited by JCAHO, CARF, COA, or NCQA, provide a copy of the accreditation
award letter showing the beginning and ending dates of accreditation and all
follow up letters.
- Program description: Outline of program, services, and resident population
served. (Optional for JCAHO, CARF, COA, and NCQA accredited facilities.)
- Staffing pattern description, including the names and license or registration
number of each licensed or registered person. (Optional for JCAHO, CARF, COA,
and NCQA accredited facilities.)
- Table of organization for all management levels. (Optional for JCAHO, CARF,
COA, and NCQA accredited facilities.)
- Resume of facility manager. (Optional for JCAHO, CARF, COA, and NCQA accredited
facilities.)
- Current balance sheet for owner(s) verifying financial information for the
facility.
- Statement of operations projecting first six months income, expenses, taxes,
credits, etc. (Not required for renewal applications).
- Certificate of Insurance verifying commercial or general liability insurance
coverage (minimum coverage is $300,000 per incidence and $1 million in aggregate).
- Copy of a current Baker Act Receiving Facility designation certificate.
- Copy of a letter verifying the Department of Children and Families has funding
appropriated to support the beds requested and if funding is recurring or
non-recurring (or provide a copy of the current DCF funding contract).
- AIDS/HIV affidavit assuring required facility staff will be trained.
- Background screening affidavit assuring required facility staff will be
screened.
- Satisfactory fire safety inspection report completed in the last 365 days.
- Satisfactory sanitation inspection report completed in the last 365 days.
Capacity Increase or Decrease Requirements
- Completed and signed License Application
Form (349K PDF).
- Program description, if changed from what was filed with the last AHCA application.
(Optional for JCAHO, CARF, COA, and NCQA accredited facilities.)
- Provide a letter from the local Department of Children and Families, Adult Mental Health
Program Manager, verifying funding has been appropriated for the requested capacity (increase or
decrease) and if the funding is continuing or nonrecurring.
- Submit a check for any additional beds requested ($192 per bed). There is no charge for a capacity decrease.
Change of Services Requirements
- Completed and signed License Application
Form (349K PDF).
- Program description: Listing the changes planned in the program and services
provided and resident population served. (Optional for JCAHO, CARF, COA, and
NCQA accredited facilities.)
- Revised staffing pattern, staff coverage, number of staff and types of staff, etc.
(Optional for JCAHO, CARF, COA, and NCQA accredited facilities.)
Applications/Forms
Background Screening
- Florida Department of Law Enforcement and FBI fingerprinting screening must
be completed by the managing employee (usually the chief executive officer)
and the chief financial officer. Please go to the background
screening section of this web site for additional documentation that must
be submitted with your application.
Statute/Rule Authority
Updated March 18, 2008
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