Fla. Admin. Code r. 65E-5.604

65E-5.604 Minimum Standards for 988 Florida Lifeline Call Centers

This rule establishes minimum operating standards for 988 Florida Lifeline call centers, which provide telephone-based crisis counseling, suicide intervention, and referral to community behavioral health services. Call centers must obtain accreditation from an approved body, maintain liability insurance, implement written policies on suicide safety, follow-up, and warm transfers, and ensure 24/7 crisis counseling availability. Staff must complete required trainings, centers must coordinate with mobile response teams and designated receiving facilities, and all operations must comply with HIPAA and state incident reporting requirements.

65E-5.604 Minimum Standards for 988 Florida Lifeline Call Centers.
(1) Definitions as used in this rule section:
(a) “988 Florida Lifeline” means the network of 988 suicide and crisis lifeline call centers within Florida that connect individuals experiencing emotional distress to trained crisis counselors who provide de-escalation, crisis intervention, and connection to community-based behavioral health services. 
(b) “Automatic call distribution (ACD) queuing technologies” means a specialized phone system that can distribute incoming calls based on pre-defined call routing rules, which is the algorithm used by the technology that determines where a call is routed.
(c) “Dual-tone-multi-frequency (DTMF) functionality” means that a device or a system can send and receive audio tones to communicate with other devices over telephone lines, allowing for the transmission of digits and signals through sound signals of two different frequencies at the same time.
(d) “National Lifeline Administrator” means the organization that provides federal oversight for the national 988 suicide and crisis lifeline network.
(e) “Public Safety Answering Points (PSAP)” means a physical or virtual entity where 9-1-1 calls are delivered by the 9-1-1 service provider.
(2) 988 Florida Lifeline call centers must adhere to the following standards:
(a) 988 Florida Lifeline call centers must obtain and maintain accreditation through one of the following:
1. American Association of Suicidology (AAS);
2. International Council for Helplines (formerly CONTACT USA);
3. Alliance of Information and Referral Systems (AIRS);
4. The Joint Commission;
5. Commission on Accreditation of Rehabilitation Facilities (CARF);
6. Council on Accreditation (COA); or
7. Utilization Review Accreditation Commission (URAC)
(b) Have liability insurance that covers directors, officers, staff, and volunteers who respond to crisis calls in the amount of at least $1,000,000 per occurrence and $3,000,000 aggregate, unless otherwise approved by the Department and the National Lifeline Administrator.
(c) 988 Florida Lifeline call centers must pass National Lifeline Administrator tests of their telephone system to ensure compatibility with the Lifeline’s routing system. Centers using ACD queuing technologies must have DTMF functionality.
(d) Have a written policy that addresses the handling of frequent contacts including:
1. Procedures for responding to frequent contacts;
2. Tracking familiar contacts; and
3. Establishing an action plan. 
(e) Have a written follow-up policy that addresses:
1. Eligibility requirements;
2. Consent criteria;
3. Modalities for follow-up;
4. Timeline for completing follow-up contacts;
5. Required number of outreach attempts; and
6. Required structure of a follow-up call.
(f) Have a written suicide safety policy that specifically addresses actions to be undertaken by crisis counselors in working with those at risk of suicide, including:
1. Assessment and intervention;
2. Supervisory support and training; and
3. Community engagement and collaboration with emergency service providers.
(g) Have a written policy for providing warm transfers, referrals, and resources that address:
1. Connecting contacts to the Veterans Crisis Line, the Spanish subnetwork, or the local PSAP; and
2. Referral procedures for contacts received outside the Center’s primary coverage area.
(h) Provide the following services 24 hours per day, seven days per week to all individuals contacting the 988 Florida Lifeline:
1. Active engagement and supportive crisis counseling.
2. Safety assessments, evaluations, and development of individualized safety or crisis plans.
3. Alternatives to crisis service interventions, such as mobile response teams (MRTs).
4. Connection to community-based resources, including mental health and substance use treatment services.
(i) Facilitate coordination through formal written agreements with MRTs, designated receiving facilities, and other community partners to enhance crisis response.
(j) Collaborate with local PSAPs to implement an interoperability plan, ensuring rapid access to the appropriate level of care for all contacts and addressing:
1. Information sharing;
2. Call transfer protocol;
3. Operational analytics; and
4. Training considerations.
(k) Maintain and update monthly a database of behavioral health resources and service providers to support referrals and warm hand-offs.
(l) Collaborate with the Department and other community partners to develop consistent public messaging about the 988 Florida Lifeline.
(m) Ensure that all crisis counselors complete the following minimum required trainings prior to answering 988 Florida Lifeline calls:
1. 988 Lifeline Core Trainings provided by the National Lifeline Administrator.
2. Training on the use of emergency services that address:
a. The Center’s Suicide Safety Policy.
b. General procedures and technical processes for contacting PSAP personnel and requesting law enforcement or emergency medical services (EMS).
c. General procedures and technical processes for receiving and handling any warm transfers of mental health calls from 9-1-1.
d. Detailed overview of local PSAPs, including identification of PSAPs that handle specific public safety needs, such as State Patrol, Sheriff, police, EMS, and any other relevant parties within their region.
(n) Adhere fully to the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Florida Electronic Health Records Exchange Act, in accordance with s. 408.051, F.S., ensuring confidentiality and the protection of personal health information.
(o) Report all critical incidents to the Department’s electronic Incident Reporting and Analysis System (IRAS).
Rulemaking Authority 394.9088(2) FS. Law Implemented 394.9088 FS. History – New 2-18-26.