HB 0261 2003
1	CHAMBER ACTION
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6	The Committee on Future of Florida's Families recommends the
7	following:
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9	Committee Substitute
10	Remove the entire bill and insert:
11	A bill to be entitled
12	An act relating to dependent children; amending s. 39.01,
13	F.S.; defining the term "child resource record"; amending
14	ss. 39.0015, 39.205, 39.302, 39.828, and 419.001, F.S.;
15	conforming cross references; amending s. 39.407, F.S.;
16	specifying conditions under which the Department of
17	Children and Family Services may consent to the dispensing
18	of psychotropic medication to a child in its legal custody
19	prior to a court order; providing requirements for a
20	petition to the court for authority to dispense
21	psychotropic medication to such a child; providing for
22	prior review of the child's medical history and evidence
23	demonstrating that the treatment is appropriate for the
24	child's condition; providing for the burden of proof;
25	providing for further medical consultation, including
26	second opinions, under certain circumstances; providing
27	conditions for discontinuation of prescribed psychotropic
28	medication or for the provision of other services;
29	providing for periodic court review of the child's
30	progress; directing the department to adopt rules;
31	amending s. 743.0645, F.S.; providing an exception to the
32	limitations on the dispensing of psychotropic medications;
33	providing an effective date.
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35	Be It Enacted by the Legislature of the State of Florida:
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37	Section 1. Paragraph (b) of subsection (3) of section
38	39.0015, Florida Statutes, is amended to read:
39	39.0015 Child abuse prevention training in the district
40	school system.--
41	(3) DEFINITIONS.--As used in this section:
42	(b) "Child abuse" means those acts as defined in ss.
43	39.01(1), (2), (31), (44), (46), (53), and (64)(30), (43),
44	(45), (52), and (63), 827.04, and 984.03(1), (2), and (37).
45	Section 2. Subsection (10) of section 39.01, Florida
46	Statutes, is amended, subsections (14) through (72) are
47	renumbered as subsections (15) through (73), respectively, and a
48	new subsection (14) is added to said section, to read:
49	39.01 Definitions.--When used in this chapter, unless the
50	context otherwise requires:
51	(10) "Caregiver" means the parent, legal custodian, adult
52	household member, or other person responsible for a child's
53	welfare as defined in subsection (48)(47).
54	(14) "Child resource record" means a standardized folder
55	that contains copies of the basic legal, demographic, and known
56	medical information pertaining to a specific child, as well as
57	any documents necessary for the child to be provided medical
58	treatment.
59	Section 3. Subsection (5) of section 39.205, Florida
60	Statutes, is amended to read:
61	39.205 Penalties relating to reporting of child abuse,
62	abandonment, or neglect.--
63	(5) If the department or its authorized agent has
64	determined after its investigation that a report is false, the
65	department shall, with the consent of the alleged perpetrator,
66	refer the report to the local law enforcement agency having
67	jurisdiction for an investigation to determine whether
68	sufficient evidence exists to refer the case for prosecution for
69	filing a false report as defined in s. 39.01(28)(27). During the
70	pendency of the investigation by the local law enforcement
71	agency, the department must notify the local law enforcement
72	agency of, and the local law enforcement agency must respond to,
73	all subsequent reports concerning children in that same family
74	in accordance with s. 39.301. If the law enforcement agency
75	believes that there are indicators of abuse, abandonment, or
76	neglect, it must immediately notify the department, which must
77	assure the safety of the children. If the law enforcement agency
78	finds sufficient evidence for prosecution for filing a false
79	report, it must refer the case to the appropriate state attorney
80	for prosecution.
81	Section 4. Subsection (1) of section 39.302, Florida
82	Statutes, is amended to read:
83	39.302 Protective investigations of institutional child
84	abuse, abandonment, or neglect.--
85	(1) The department shall conduct a child protective
86	investigation of each report of institutional child abuse,
87	abandonment, or neglect. Upon receipt of a report which alleges
88	that an employee or agent of the department, or any other entity
89	or person covered by s. 39.01(32)(31) or (48)(47), acting in an
90	official capacity, has committed an act of child abuse,
91	abandonment, or neglect, the department shall immediately
92	initiate a child protective investigation and orally notify the
93	appropriate state attorney, law enforcement agency, and
94	licensing agency. These agencies shall immediately conduct a
95	joint investigation, unless independent investigations are more
96	feasible. When conducting investigations onsite or having face-
97	to-face interviews with the child, such investigation visits
98	shall be unannounced unless it is determined by the department
99	or its agent that such unannounced visits would threaten the
100	safety of the child. When a facility is exempt from licensing,
101	the department shall inform the owner or operator of the
102	facility of the report. Each agency conducting a joint
103	investigation shall be entitled to full access to the
104	information gathered by the department in the course of the
105	investigation. A protective investigation must include an onsite
106	visit of the child's place of residence. In all cases, the
107	department shall make a full written report to the state
108	attorney within 3 working days after making the oral report. A
109	criminal investigation shall be coordinated, whenever possible,
110	with the child protective investigation of the department. Any
111	interested person who has information regarding the offenses
112	described in this subsection may forward a statement to the
113	state attorney as to whether prosecution is warranted and
114	appropriate. Within 15 days after the completion of the
115	investigation, the state attorney shall report the findings to
116	the department and shall include in such report a determination
117	of whether or not prosecution is justified and appropriate in
118	view of the circumstances of the specific case.
119	Section 5. Subsections (3) through (14) of section 39.407,
120	Florida Statutes, are renumbered as subsections (4) through
121	(15), respectively, a new subsection (3) is added to said
122	section, and present subsection (4) of said section is amended,
123	to read:
124	39.407 Medical, psychiatric, and psychological examination
125	and treatment of child; physical or mental examination of parent
126	or person requesting custody of child.--
127	(3)(a) If a child in the legal custody of the department
128	was taking prescribed psychotropic medication at the time the
129	child was removed from the home, the department may take
130	possession of the remaining medication when the department takes
131	the child and may provide consent for the dispensing of that
132	medication on a temporary basis until the next regularly
133	scheduled court hearing required under this chapter, other than
134	the shelter hearing, if such hearing occurs within 60 days after
135	the time the child was removed.
136	(b) Psychotropic medications may be dispensed in advance
137	of issuance of a court order if the prescribing physician
138	indicates in writing that delay in dispensing the medication
139	could be detrimental to the child. The order required under this
140	subsection shall be sought by the department at the next
141	regularly scheduled court hearing required under this chapter,
142	or within 60 days after the date of the prescription, whichever
143	is sooner.
144	(c) Psychotropic medications may be dispensed in an acute
145	care setting.
146	(d) A motion seeking court authority to dispense
147	psychotropic medication to a child in the legal custody of the
148	department must be supported by the prescribing physician's
149	signed medical report indicating:
150	1. The name of the child and the name and range of the
151	dosage of the psychotropic medication and indicating that there
152	is a need to prescribe psychotropic medication to the child
153	based upon a diagnosed condition for which such medication is
154	indicated and that there is a plan of treatment that addresses
155	treatment alternatives that are or are not available or
156	desirable.
157	2. That the psychotropic medication at its prescribed
158	dosage is appropriate for the treatment of the child's diagnosed
159	medical condition, as well as the behaviors and symptoms the
160	medication at its prescribed dosage level is expected to
161	address.
162	3. That the prescribing physician has provided to the
163	child, if age-appropriate, the department, and any person
164	responsible for the child in his or her residential setting a
165	clinically appropriate explanation of the nature and purpose of
166	the treatment; the recognized side effects, risks, and
167	contraindications of the medication; and drug interaction
168	precautions.
169	4. Whether the psychotropic medication will replace or
170	supplement any other currently prescribed medications or
171	treatments; the length of time the child is expected to be
172	taking the medication; and any additional medical, counseling,
173	or other services that the prescribing physician believes are
174	necessary or would be beneficial for the treatment of the
175	child's medical condition and that the physician expects or
176	advises to be provided to the child in concert with the
177	medication.
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179	The department has the burden of compliance with and proof of
180	compliance with the provisions of this paragraph.
181	(e) At a hearing to determine whether to initially allow
182	dispensing of psychotropic medication to a child in the legal
183	custody of the department, or at a hearing for continuation of
184	such medication, the medical report described in paragraph (d)
185	is admissible in evidence. The prescribing physician is not
186	required to attend the hearing or testify unless the court
187	specifically orders such attendance or testimony. If the medical
188	report, the child resource record, and other evidence are in
189	accord with the requirements of this subsection, the court may
190	order the dispensing or continuation of psychotropic medication
191	without further testimony or evidence. The court shall further
192	inquire of the department as to whether additional medical,
193	counseling, or other services that the prescribing physician
194	believes are necessary or would be beneficial for the treatment
195	of the child's medical condition, and that the physician expects
196	or advises to be provided to the child in concert with the
197	medication, are being provided to the child by the department.
198	The court may require further medical consultation, including
199	obtaining a second opinion, based upon considerations of the
200	best interests of the child, and the court may not order the
201	discontinuation of prescribed psychotropic medication contrary
202	to the decision of the prescribing physician without first
203	obtaining a second opinion from a licensed psychiatrist, if
204	available, or, if not available, a physician licensed under
205	chapter 458 or chapter 459 that the psychotropic medication
206	should be discontinued.
207	(f) The court shall review the child resource record and
208	the status of the child's progress on psychotropic medication at
209	least every 6 months, which may be accomplished during timely
210	scheduled judicial review hearings pursuant to s. 39.701. On its
211	own motion or on good cause shown by any party, including any
212	guardian ad litem, attorney, or attorney ad litem who has been
213	appointed to represent the child or his or her interests, the
214	court may review the status more frequently than required in
215	this paragraph.
216	(g) If at any time the court determines that the statutory
217	requirements for continued use of the psychotropic medication
218	are not being met, the court may, in the best interests of the
219	child, order the department to either produce evidence of
220	compliance with the requirements of this section or obtain a
221	medical opinion that continued use of the medication under the
222	circumstances is safe and medically appropriate. If at any time
223	the court determines that the additional medical, counseling, or
224	other services that the prescribing physician believes are
225	necessary or would be beneficial for the treatment of the
226	child's medical condition and that the physician expects or
227	advises to be provided to the child in concert with the
228	medication are not being provided, the court may, in the best
229	interests of the child, order the department to either produce
230	evidence of compliance with the requirement of providing those
231	services or obtain a medical opinion that such services are not
232	medically appropriate.
233	(h) The department shall adopt rules to ensure that
234	children receive timely access to clinically appropriate
235	psychotropic medications. These rules must, at a minimum,
236	describe a uniform process for obtaining informed consent and
237	procedures for obtaining court authorization, including adoption
238	of uniform forms to be used in requesting court authorization
239	for use of psychotropic medication.
240	(5)(4)A judge may order a child in an out-of-home
241	placement to be treated by a licensed health care professional
242	based on evidence that the child should receive treatment. The
243	judge may also order such child to receive mental health or
244	developmental disabilities services from a psychiatrist,
245	psychologist, or other appropriate service provider. Except as
246	provided in subsection (6)(5), if it is necessary to place the
247	child in a residential facility for such services, the
248	procedures and criteria established in s. 394.467 or chapter 393
249	shall be used, whichever is applicable. A child may be provided
250	developmental disabilities or mental health services in
251	emergency situations, pursuant to the procedures and criteria
252	contained in s. 394.463(1) or chapter 393, whichever is
253	applicable.
254	Section 6. Paragraph (a) of subsection (1) of section
255	39.828, Florida Statutes, is amended to read:
256	39.828 Grounds for appointment of a guardian advocate.--
257	(1) The court shall appoint the person named in the
258	petition as a guardian advocate with all the powers and duties
259	specified in s. 39.829 for an initial term of 1 year upon a
260	finding that:
261	(a) The child named in the petition is or was a drug
262	dependent newborn as described in s. 39.01(31)(30)(g);
263	Section 7. Paragraph (d) of subsection (1) of section
264	419.001, Florida Statutes, is amended to read:
265	419.001 Site selection of community residential homes.--
266	(1) For the purposes of this section, the following
267	definitions shall apply:
268	(d) "Resident" means any of the following: a frail elder
269	as defined in s. 400.618; a physically disabled or handicapped
270	person as defined in s. 760.22(7)(a); a developmentally disabled
271	person as defined in s. 393.063(12); a nondangerous mentally ill
272	person as defined in s. 394.455(18); or a child as defined in s.
273	39.01(15)(14), s. 984.03(9) or (12), or s. 985.03(8).
274	Section 8. Paragraph (b) of subsection (1) of section
275	743.0645, Florida Statutes, is amended to read:
276	743.0645 Other persons who may consent to medical care or
277	treatment of a minor.--
278	(1) As used in this section, the term:
279	(b) "Medical care and treatment" includes ordinary and
280	necessary medical and dental examination and treatment,
281	including blood testing, preventive care including ordinary
282	immunizations, tuberculin testing, and well-child care, but does
283	not include surgery, general anesthesia, provision of
284	psychotropic medications, or other extraordinary procedures for
285	which a separate court order, power of attorney, or informed
286	consent as provided by law is required, except as provided in s.
287	39.407(3)(a).
288	Section 9. This act shall take effect July 1, 2003.