Senate Bill sb0112c1

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    Florida Senate - 2003                            CS for SB 112

    By the Committee on Children and Families; and Senator
    Campbell




    300-799A-03

  1                      A bill to be entitled

  2         An act relating to dependent children; amending

  3         s. 39.01, F.S.; defining the term "child

  4         resource record"; amending ss. 39.0015, 39.302,

  5         F.S.; conforming cross-references; amending s.

  6         39.407, F.S.; specifying conditions under which

  7         the Department of Children and Family Services

  8         may consent to the dispensing of psychotropic

  9         medication to a child in its legal custody

10         prior to a court order; providing requirements

11         for a petition to the court for authority to

12         dispense psychotropic medication to such a

13         child; providing for prior review of the

14         child's medical history and evidence

15         demonstrating that the treatment is appropriate

16         for the child's condition; providing for the

17         burden of proof; providing for further medical

18         consultation, including second opinions, under

19         certain circumstances; providing conditions for

20         discontinuation of prescribed psychotropic

21         medication or for the provision of other

22         services; providing for periodic court review

23         of the child's progress; directing the

24         department to adopt rules; amending s.

25         743.0645, F.S.; providing an exception to the

26         limitations on the dispensing of psychotropic

27         medications; providing an effective date.

28  

29  Be It Enacted by the Legislature of the State of Florida:

30  

31  

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    Florida Senate - 2003                            CS for SB 112
    300-799A-03




 1         Section 1.  Paragraph (b) of subsection (3) of section

 2  39.0015, Florida Statutes, is amended to read:

 3         39.0015  Child abuse prevention training in the

 4  district school system.--

 5         (3)  DEFINITIONS.--As used in this section:

 6         (b)  "Child abuse" means those acts as defined in ss.

 7  39.01(1), (2), (31), (44), (46), (53), and (64) (30), (43),

 8  (45), (52), and (63), 827.04, and 984.03(1), (2), and (37).

 9         Section 2.  Present subsections (14) through (72) of

10  section 39.01, Florida Statutes, are renumbered as subsections

11  (15) through (73), respectively, and a new subsection (14) is

12  added to that section, to read:

13         39.01  Definitions.--When used in this chapter, unless

14  the context otherwise requires:

15         (14)  "Child resource record" means a standardized

16  folder that contains copies of the basic legal, demographic,

17  and known medical information pertaining to a specific child,

18  as well as any documents necessary for the child to be

19  provided medical treatment.

20         Section 3.  Subsection (1) of section 39.302, Florida

21  Statutes, is amended to read:

22         39.302 Protective investigations of institutional child

23  abuse, abandonment, or neglect.--

24         (1) The department shall conduct a child protective

25  investigation of each report of institutional child abuse,

26  abandonment, or neglect. Upon receipt of a report which

27  alleges that an employee or agent of the department, or any

28  other entity or person covered by s. 39.01(31) or (48)(47),

29  acting in an official capacity, has committed an act of child

30  abuse, abandonment, or neglect, the department shall

31  immediately initiate a child protective investigation and

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    Florida Senate - 2003                            CS for SB 112
    300-799A-03




 1  orally notify the appropriate state attorney, law enforcement

 2  agency, and licensing agency. These agencies shall immediately

 3  conduct a joint investigation, unless independent

 4  investigations are more feasible. When conducting

 5  investigations onsite or having face-to-face interviews with

 6  the child, such investigation visits shall be unannounced

 7  unless it is determined by the department or its agent that

 8  such unannounced visits would threaten the safety of the

 9  child. When a facility is exempt from licensing, the

10  department shall inform the owner or operator of the facility

11  of the report. Each agency conducting a joint investigation

12  shall be entitled to full access to the information gathered

13  by the department in the course of the investigation. A

14  protective investigation must include an onsite visit of the

15  child's place of residence. In all cases, the department shall

16  make a full written report to the state attorney within 3

17  working days after making the oral report. A criminal

18  investigation shall be coordinated, whenever possible, with

19  the child protective investigation of the department. Any

20  interested person who has information regarding the offenses

21  described in this subsection may forward a statement to the

22  state attorney as to whether prosecution is warranted and

23  appropriate. Within 15 days after the completion of the

24  investigation, the state attorney shall report the findings to

25  the department and shall include in such report a

26  determination of whether or not prosecution is justified and

27  appropriate in view of the circumstances of the specific case.

28         Section 4.  Subsections (3) through (14) of section

29  39.407, Florida Statutes, are renumbered as subsections (4)

30  through (15), respectively, and a new subsection (3) is added

31  to that section, to read:

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    Florida Senate - 2003                            CS for SB 112
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 1         39.407  Medical, psychiatric, and psychological

 2  examination and treatment of child; physical or mental

 3  examination of parent or person requesting custody of child.--

 4         (3)(a)  If a child in the legal custody of the

 5  department was taking prescribed psychotropic medications at

 6  the time the child was removed from the home, the department

 7  may take possession of the remaining medications when the

 8  department takes the child and may provide consent for the

 9  dispensing of those medications on a temporary basis until the

10  next regularly scheduled court hearing required under this

11  chapter, other than the shelter hearing, if such hearing

12  occurs within 60 days after the time the child was removed.

13         (b)  A motion seeking court authority to dispense

14  psychotropic medication to a child in the legal custody of the

15  department must be supported by the prescribing physician's

16  signed medical report indicating:

17         1.  The name of the child and the name and range of the

18  dosage of the psychotropic medication and indicating that

19  there is a need to prescribe psychotropic medication to the

20  child based upon a diagnosed condition for which such

21  medication is indicated and that there is a plan of treatment

22  that addresses treatment alternatives that are or are not

23  available or desirable.

24         2.  That the psychotropic medication at its prescribed

25  dosage is appropriate for the treatment of the child's

26  diagnosed medical condition, as well as the behaviors and

27  symptoms the medication at its prescribed dosage level is

28  expected to address.

29         3.  That the prescribing physician has provided to the

30  child, if age-appropriate, the department, and any person

31  responsible for the child in his or her residential setting a

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    Florida Senate - 2003                            CS for SB 112
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 1  clinically appropriate explanation of the nature and purpose

 2  of the treatment; the recognized side effects, risks, and

 3  contraindications of the medication; and drug interaction

 4  precautions.

 5         4.  Whether the psychotropic medication will replace or

 6  supplement any other currently prescribed medications or

 7  treatments; the length of time the child is expected to be

 8  taking the medication; and any additional medical, counseling,

 9  or other services that the prescribing physician believes are

10  necessary or would be beneficial for the treatment of the

11  child's medical condition and that the physician expects or

12  advises to be provided to the child in concert with the

13  medication.

14  

15  The department has the burden of compliance with and proof of

16  the provisions of this paragraph.

17         (c)  At a hearing to determine whether to initially

18  allow dispensing of psychotropic medication to a child in the

19  legal custody of the department, or at a hearing for

20  continuation of such medication, the medical report described

21  in paragraph (b) is admissible in evidence. The prescribing

22  physician is not required to attend the hearing or testify

23  unless the court specifically orders such attendance or

24  testimony. If the medical report, the child resource record,

25  and other evidence are in accord with the requirements of this

26  subsection, the court may order the dispensing or continuation

27  of psychotropic medication without further testimony or

28  evidence. The court shall further inquire of the department as

29  to whether the additional medical, counseling, or other

30  services that the prescribing physician believes are necessary

31  or would be beneficial for the treatment of the child's

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    Florida Senate - 2003                            CS for SB 112
    300-799A-03




 1  medical condition and that the physician expects or advises to

 2  be provided to the child in concert with the medication are

 3  being provided to the child by the department. The court may

 4  require further medical consultation, including obtaining a

 5  second opinion, based upon considerations of the best

 6  interests of the child, and the court may not order the

 7  discontinuation of prescribed psychotropic medication contrary

 8  to the decision of the prescribing physician without first

 9  obtaining a second opinion from a licensed psychiatrist, if

10  available, or, if not available, a physician licensed under

11  chapter 458 or chapter 459 that the psychotropic medication

12  should be discontinued.

13         (d)  The court shall review the child resource record

14  and the status of the child's progress on psychotropic

15  medication at least every 6 months, which may be accomplished

16  during timely scheduled judicial review hearings pursuant to

17  s. 39.701. On its own motion or on good cause shown by any

18  party, including any guardian ad litem, attorney, or attorney

19  ad litem who has been appointed to represent the child or his

20  or her interests, the court may review the status more

21  frequently than required in this paragraph.

22         (e)  If at any time the court determines that the

23  statutory requirements for continued use of the psychotropic

24  medication are not being met, the court may, in the best

25  interests of the child, order the department to either produce

26  evidence of compliance with the requirements of this section

27  or obtain a medical opinion that continued use of the

28  medication under the circumstances is safe and medically

29  appropriate. If at any time the court determines that the

30  additional medical, counseling, or other services that the

31  prescribing physician believes are necessary or would be

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    Florida Senate - 2003                            CS for SB 112
    300-799A-03




 1  beneficial for the treatment of the child's medical condition

 2  and that the physician expects or advises to be provided to

 3  the child in concert with the medication are not being

 4  provided, the court may, in the best interests of the child,

 5  order the department to either produce evidence of compliance

 6  with the requirement of providing those services or obtain a

 7  medical opinion that such services are not medically

 8  appropriate.

 9         (f)  The department shall adopt rules to ensure that

10  children receive timely access to clinically appropriate

11  psychotropic medications. These rules must, at a minimum,

12  describe a uniform process for obtaining informed consent and

13  procedures for obtaining court authorization, including

14  adoption of uniform forms to be used in requesting court

15  authorization for use of psychotropic medication.

16         Section 5.  Paragraph (b) of subsection (1) of section

17  743.0645, Florida Statutes, is amended to read:

18         743.0645  Other persons who may consent to medical care

19  or treatment of a minor.--

20         (1)  As used in this section, the term:

21         (b)  "Medical care and treatment" includes ordinary and

22  necessary medical and dental examination and treatment,

23  including blood testing, preventive care including ordinary

24  immunizations, tuberculin testing, and well-child care, but

25  does not include surgery, general anesthesia, provision of

26  psychotropic medications, or other extraordinary procedures

27  for which a separate court order, power of attorney, or

28  informed consent as provided by law is required, except as

29  provided in s. 39.407(3)(a).

30         Section 6.  This act shall take effect July 1, 2003.

31  

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    Florida Senate - 2003                            CS for SB 112
    300-799A-03




 1          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
 2                         Senate Bill 112

 3                                 

 4  
    Eliminates the definition of "medical passport;"
 5  
    Creates a definition for "child resource record;"
 6  
    Deletes provisions authorizing the dispensing of psychotropic
 7  medications in advance of a court order;

 8  Authorizes the medical report to specify the range of dosages
    allowed for the psychotropic medications rather than requiring
 9  a specific dosage of the medication;

10  Deletes the requirement for an affidavit when a signed medical
    report is unavailable;
11  
    Specifies that the physician from whom the court obtains a
12  second opinion must be a licensed psychiatrist whenever
    available;
13  
    Requires the Department of Children and Family Services to
14  write rules regarding uniform procedures for obtaining
    informed consent and requesting authorizations from the courts
15  and for the identification of a standardized format for the
    content of medical reports to be submitted to the court; and
16  
    Amends s. 743.0645, F.S., providing an exception to the
17  limitations on the dispensing of psychotropic medications.

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