Florida Senate - 2015                                    SB 7078
       By the Committee on Children, Families, and Elder Affairs
       586-03426-15                                          20157078__
    1                        A bill to be entitled                      
    2         An act relating to child welfare; amending s. 39.2015,
    3         F.S.; authorizing critical incident rapid response
    4         teams to review cases of child deaths occurring during
    5         an open investigation; requiring the advisory
    6         committee to meet quarterly and submit quarterly
    7         reports; amending s. 39.3068, F.S.; requiring case
    8         staffing when medical neglect is substantiated;
    9         amending s. 383.402, F.S.; requiring an
   10         epidemiological child abuse death assessment and
   11         prevention system; providing intent for the operation
   12         of and interaction between the state and local death
   13         review committees; limiting members of the state
   14         committee to terms of 2 years, not to exceed three
   15         consecutive terms; requiring the committee to elect a
   16         chairperson and authorizing specified duties of the
   17         chairperson; providing for per diem and reimbursement
   18         of expenses; specifying duties of the state committee;
   19         deleting obsolete provisions; providing for the
   20         convening of county or multicounty local review
   21         committees and support by the county health department
   22         directors; specifying membership and duties of local
   23         review committees; requiring an annual statistical
   24         report; specifying that certain responsibilities of
   25         the Department of Children and Families are to be
   26         administered at the regional level, rather than at the
   27         district level; amending s. 409.986, F.S.; revising
   28         legislative intent to require community-based care
   29         lead agencies to give priority to the use of evidence
   30         based and trauma-informed services; amending s.
   31         409.988; requiring lead agencies to give priority to
   32         the use of evidence-based and trauma-informed
   33         services; providing an effective date.
   35  Be It Enacted by the Legislature of the State of Florida:
   37         Section 1. Subsections (2) and (11) of section 39.2015,
   38  Florida Statutes, are amended to read:
   39         39.2015 Critical incident rapid response team.—
   40         (2) An immediate onsite investigation conducted by a
   41  critical incident rapid response team is required for all child
   42  deaths reported to the department if the child or another child
   43  in his or her family was the subject of a verified report of
   44  suspected abuse or neglect during the previous 12 months. The
   45  secretary may direct an immediate investigation for other cases
   46  involving death or serious injury to a child, including, but not
   47  limited to, a death or serious injury occurring during an open
   48  investigation.
   49         (11) The secretary shall appoint an advisory committee made
   50  up of experts in child protection and child welfare, including
   51  the Statewide Medical Director for Child Protection under the
   52  Department of Health, a representative from the institute
   53  established pursuant to s. 1004.615, an expert in organizational
   54  management, and an attorney with experience in child welfare, to
   55  conduct an independent review of investigative reports from the
   56  critical incident rapid response teams and to make
   57  recommendations to improve policies and practices related to
   58  child protection and child welfare services. The advisory
   59  committee shall meet at least once each quarter and By October 1
   60  of each year, the advisory committee shall submit quarterly
   61  reports a report to the secretary which include includes
   62  findings and recommendations. The secretary shall submit each
   63  the report to the Governor, the President of the Senate, and the
   64  Speaker of the House of Representatives.
   65         Section 2. Subsection (3) of section 39.3068, Florida
   66  Statutes, is amended to read:
   67         39.3068 Reports of medical neglect.—
   68         (3) The child shall be evaluated by the child protection
   69  team as soon as practicable. If After receipt of the report from
   70  the child protection team reports that medical neglect is
   71  substantiated, the department shall convene a case staffing
   72  which shall be attended, at a minimum, by the child protective
   73  investigator; department legal staff; and representatives from
   74  the child protection team that evaluated the child, Children’s
   75  Medical Services, the Agency for Health Care Administration, the
   76  community-based care lead agency, and any providers of services
   77  to the child. However, the Agency for Health Care Administration
   78  is not required to attend the staffing if the child is not
   79  Medicaid eligible. The staffing shall consider, at a minimum,
   80  available services, given the family’s eligibility for services;
   81  services that are effective in addressing conditions leading to
   82  medical neglect allegations; and services that would enable the
   83  child to safely remain at home. Any services that are available
   84  and effective shall be provided.
   85         Section 3. Section 383.402, Florida Statutes, is amended to
   86  read:
   87         383.402 Child abuse death review; State Child Abuse Death
   88  Review Committee; local child abuse death review committees.—
   89         (1) INTENT.—It is the intent of the Legislature to
   90  establish a statewide multidisciplinary, multiagency,
   91  epidemiological child abuse death assessment and prevention
   92  system that consists of state and local review committees. The
   93  state and local review committees shall review the facts and
   94  circumstances of all deaths of children from birth to through
   95  age 18 which occur in this state and are reported to the central
   96  abuse hotline of the Department of Children and Families. The
   97  state and local review committees shall work cooperatively. The
   98  primary function of the state review committee is to provide
   99  direction and leadership for the review system and to analyze
  100  data and recommendations from local review committees to
  101  identify issues and trends and to recommend statewide action.
  102  The primary function of the local review committees is to
  103  conduct individual case reviews of deaths, generate information,
  104  make recommendations, and implement improvements at the local
  105  level. Each case The purpose of the review must use a data
  106  based, epidemiological approach shall be to:
  107         (a) Achieve a greater understanding of the causes and
  108  contributing factors of deaths resulting from child abuse.
  109         (b) Whenever possible, develop a communitywide approach to
  110  address such causes cases and contributing factors.
  111         (c) Identify any gaps, deficiencies, or problems in the
  112  delivery of services to children and their families by public
  113  and private agencies which may be related to deaths that are the
  114  result of child abuse.
  115         (d) Recommend Make and implement recommendations for
  116  changes in law, rules, and policies at the state and local
  117  levels, as well as develop practice standards that support the
  118  safe and healthy development of children and reduce preventable
  119  child abuse deaths.
  120         (e) Implement approved recommendations, to the extent
  121  possible.
  123         (a) Membership.
  124         1. The State Child Abuse Death Review Committee is
  125  established within the Department of Health and shall consist of
  126  a representative of the Department of Health, appointed by the
  127  State Surgeon General, who shall serve as the state committee
  128  coordinator. The head of each of the following agencies or
  129  organizations shall also appoint a representative to the state
  130  committee:
  131         a.1. The Department of Legal Affairs.
  132         b.2. The Department of Children and Families.
  133         c.3. The Department of Law Enforcement.
  134         d.4. The Department of Education.
  135         e.5. The Florida Prosecuting Attorneys Association, Inc.
  136         f.6. The Florida Medical Examiners Commission, whose
  137  representative must be a forensic pathologist.
  138         2.(b) In addition, the State Surgeon General shall appoint
  139  the following members to the state committee, based on
  140  recommendations from the Department of Health and the agencies
  141  listed in subparagraph 1. paragraph (a), and ensuring that the
  142  committee represents the regional, gender, and ethnic diversity
  143  of the state to the greatest extent possible:
  144         a.1. The Department of Health Statewide Child Protection
  145  Team Medical Director for Child Protection.
  146         b.2. A public health nurse.
  147         c.3. A mental health professional who treats children or
  148  adolescents.
  149         d.4. An employee of the Department of Children and Families
  150  who supervises family services counselors and who has at least 5
  151  years of experience in child protective investigations.
  152         e.5. The medical director of a child protection team.
  153         f.6. A member of a child advocacy organization.
  154         g.7. A social worker who has experience in working with
  155  victims and perpetrators of child abuse.
  156         h.8. A person trained as a paraprofessional in patient
  157  resources who is employed in a child abuse prevention program.
  158         i.9. A law enforcement officer who has at least 5 years of
  159  experience in children’s issues.
  160         j.10. A representative of the Florida Coalition Against
  161  Domestic Violence.
  162         k.11. A representative from a private provider of programs
  163  on preventing child abuse and neglect.
  164         l. A substance abuse treatment professional.
  165         3. The members of the state committee shall be appointed to
  166  staggered terms not to exceed 2 years each, as determined by the
  167  State Surgeon General. Members may be appointed to no more than
  168  three consecutive terms. The state committee shall elect a
  169  chairperson from among its members to serve for a 2-year term,
  170  and the chairperson may appoint ad hoc committees as necessary
  171  to carry out the duties of the committee.
  172         4. Members of the state committee shall serve without
  173  compensation but may receive reimbursement for per diem and
  174  travel expenses incurred in the performance of their duties as
  175  provided in s. 112.061 and to the extent that funds are
  176  available.
  177         (b)(3)Duties.The State Child Abuse Death Review Committee
  178  shall:
  179         1.(a) Develop a system for collecting data from local
  180  committees on deaths that are reported to the central abuse
  181  hotline the result of child abuse. The system must include a
  182  protocol for the uniform collection of data statewide, which
  183  must, at a minimum, use the National Child Death Review Case
  184  Reporting System administered by the National Center for the
  185  Review and Prevention of Child Deaths uses existing data
  186  collection systems to the greatest extent possible.
  187         2.(b) Provide training to cooperating agencies,
  188  individuals, and local child abuse death review committees on
  189  the use of the child abuse death data system.
  190         (c) Prepare an annual statistical report on the incidence
  191  and causes of death resulting from reported child abuse in the
  192  state during the prior calendar year. The state committee shall
  193  submit a copy of the report by October 1 of each year to the
  194  Governor, the President of the Senate, and the Speaker of the
  195  House of Representatives. The report must include
  196  recommendations for state and local action, including specific
  197  policy, procedural, regulatory, or statutory changes, and any
  198  other recommended preventive action.
  199         3.(d) Provide training to local child abuse death review
  200  committee members on the dynamics and impact of domestic
  201  violence, substance abuse, or mental health disorders when there
  202  is a co-occurrence of child abuse. Training must shall be
  203  provided by the Florida Coalition Against Domestic Violence, the
  204  Florida Alcohol and Drug Abuse Association, and the Florida
  205  Council for Community Mental Health in each entity’s respective
  206  area of expertise.
  207         4.(e) Develop statewide uniform guidelines, standards, and
  208  protocols, including a protocol for standardized data
  209  collection, and reporting, for local child abuse death review
  210  committees, and provide training and technical assistance to
  211  local committees.
  212         5.(f) Develop statewide uniform guidelines for reviewing
  213  deaths that are the result of child abuse, including guidelines
  214  to be used by law enforcement agencies, prosecutors, medical
  215  examiners, health care practitioners, health care facilities,
  216  and social service agencies.
  217         6.(g) Study the adequacy of laws, rules, training, and
  218  services to determine what changes are needed to decrease the
  219  incidence of child abuse deaths and develop strategies and
  220  recruit partners to implement these changes.
  221         7.(h) Provide consultation on individual cases to local
  222  committees upon request.
  223         8.(i) Educate the public regarding the provisions of
  224  chapter 99-168, Laws of Florida, the incidence and causes of
  225  child abuse death, and ways by which such deaths may be
  226  prevented.
  227         9.(j) Promote continuing education for professionals who
  228  investigate, treat, and prevent child abuse or neglect.
  229         10.(k) Recommend, when appropriate, the review of the death
  230  certificate of a child who died as a result of abuse or neglect.
  231         (4) The members of the state committee shall be appointed
  232  to staggered terms of office which may not exceed 2 years, as
  233  determined by the State Surgeon General. Members are eligible
  234  for 2 reappointments. The state committee shall elect a
  235  chairperson from among its members to serve for a 2-year term,
  236  and the chairperson may appoint ad hoc committees as necessary
  237  to carry out the duties of the committee.
  238         (5) Members of the state committee shall serve without
  239  compensation but are entitled to reimbursement for per diem and
  240  travel expenses incurred in the performance of their duties as
  241  provided in s. 112.061 and to the extent that funds are
  242  available.
  243         (3)(6)LOCAL DEATH REVIEW COMMITTEES.—At the direction of
  244  the State Surgeon General, a county or multicounty death review
  245  committee shall be convened and supported by the county health
  246  department directors the director of each county health
  247  department, or the directors of two or more county health
  248  departments by agreement, may convene and support a county or
  249  multicounty child abuse death review committee in accordance
  250  with the protocols established by the State Child Abuse Death
  251  Review Committee.
  252         (a) Membership.Each local committee must include local
  253  representatives from:
  254         1. The state attorney’s office. a local state attorney, or
  255  his or her designee, and
  256         2. The medical examiner’s office.
  257         3. The local Department of Children and Families child
  258  protective investigations unit.
  259         4. The Department of Health child protection team.
  260         5. The community-based care lead agency.
  261         6. State, county, or local law enforcement agencies.
  262         7. The school district.
  263         8. A mental health treatment provider.
  264         9. A certified domestic violence center.
  265         10. A substance abuse treatment provider.
  266         11. Any other members that are determined by guidelines
  267  developed by the State Child Abuse Death Review Committee.
  269  To the extent possible, individuals from these organizations or
  270  entities who, in a professional capacity, dealt with a child
  271  whose death is verified as caused by abuse or neglect, or with
  272  the family of the child, shall attend any meetings where the
  273  child’s case is reviewed. The members of a local committee shall
  274  be appointed to 2-year terms and may be reappointed. The local
  275  committee shall elect a chairperson from among its members.
  276  Members shall serve without compensation but may receive are
  277  entitled to reimbursement for per diem and travel expenses
  278  incurred in the performance of their duties as provided in s.
  279  112.061 and to the extent that funds are available.
  280         (b)(7)Duties.Each local child abuse death review
  281  committee shall:
  282         1.(a) Assist the state committee in collecting data on
  283  deaths that are the result of child abuse, in accordance with
  284  the protocol established by the state committee. The local
  285  committee shall complete, to the fullest extent possible, the
  286  individual case report in the National Child Death Review Case
  287  Reporting System.
  288         2.(b) Submit written reports as required by at the
  289  direction of the state committee. The reports must include:
  290         a. Nonidentifying information from on individual cases.
  291         b. Identification of any problems with the data system
  292  uncovered through the review process and the committee’s
  293  recommendations for system improvements and needed resources,
  294  training, and information dissemination, where gaps or
  295  deficiencies may exist. and
  296         c. All the steps taken by the local committee and private
  297  and public agencies to implement necessary changes and improve
  298  the coordination of services and reviews.
  299         3.(c) Submit all records requested by the state committee
  300  at the conclusion of its review of a death resulting from child
  301  abuse.
  302         4.(d) Abide by the standards and protocols developed by the
  303  state committee.
  304         5.(e) On a case-by-case basis, request that the state
  305  committee review the data of a particular case.
  306         (4) ANNUAL STATISTICAL REPORT.—The state committee shall
  307  prepare and submit a comprehensive statistical report by October
  308  1 of each year to the Governor, the President of the Senate, and
  309  the Speaker of the House of Representatives which includes data,
  310  trends, analysis, findings, and recommendations for state and
  311  local action regarding deaths from child abuse. Data must be
  312  presented on an individual calendar year basis and in the
  313  context of a multiyear trend. At a minimum, the report must
  314  include:
  315         (a) Descriptive statistics, including demographic
  316  information regarding victims and caregivers, and the causes and
  317  nature of deaths.
  318         (b) A detailed statistical analysis of the incidence and
  319  causes of deaths.
  320         (c) Specific issues identified within current policy,
  321  procedure, rule, or statute and recommendations to address those
  322  issues from both the state and local committees.
  323         (d) Other recommendations to prevent deaths from child
  324  abuse based on an analysis of the data presented in the report.
  325         (5)(8)ACCESS TO AND USE OF RECORDS.—
  326         (a) Notwithstanding any other law, the chairperson of the
  327  State Child Abuse Death Review Committee, or the chairperson of
  328  a local committee, shall be provided with access to any
  329  information or records that pertain to a child whose death is
  330  being reviewed by the committee and that are necessary for the
  331  committee to carry out its duties, including information or
  332  records that pertain to the child’s family, as follows:
  333         1.(a) Patient records in the possession of a public or
  334  private provider of medical, dental, or mental health care,
  335  including, but not limited to, a facility licensed under chapter
  336  393, chapter 394, or chapter 395, or a health care practitioner
  337  as defined in s. 456.001. Providers may charge a fee for copies
  338  not to exceed 50 cents per page for paper records and $1 per
  339  fiche for microfiche records.
  340         2.(b) Information or records of any state agency or
  341  political subdivision which might assist a committee in
  342  reviewing a child’s death, including, but not limited to,
  343  information or records of the Department of Children and
  344  Families, the Department of Health, the Department of Education,
  345  or the Department of Juvenile Justice.
  346         (b)(9) The State Child Abuse Death Review Committee or a
  347  local committee shall have access to all information of a law
  348  enforcement agency which is not the subject of an active
  349  investigation and which pertains to the review of the death of a
  350  child. A committee may not disclose any information that is not
  351  subject to public disclosure by the law enforcement agency, and
  352  active criminal intelligence information or criminal
  353  investigative information, as defined in s. 119.011(3), may not
  354  be made available for review or access under this section.
  355         (c)(10) The state committee and any local committee may
  356  share with each other any relevant information that pertains to
  357  the review of the death of a child.
  358         (d)(11) A member of the state committee or a local
  359  committee may not contact, interview, or obtain information by
  360  request or subpoena directly from a member of a deceased child’s
  361  family as part of a committee’s review of a child abuse death,
  362  except that if a committee member is also a public officer or
  363  state employee, that member may contact, interview, or obtain
  364  information from a member of the deceased child’s family, if
  365  necessary, as part of the committee’s review. A member of the
  366  deceased child’s family may voluntarily provide records or
  367  information to the state committee or a local committee.
  368         (e)(12) The chairperson of the State Child Abuse Death
  369  Review Committee may require the production of records by
  370  requesting a subpoena, through the Department of Legal Affairs,
  371  in any county of the state. Such subpoena is effective
  372  throughout the state and may be served by any sheriff. Failure
  373  to obey the subpoena is punishable as provided by law.
  374         (f)(13) This section does not authorize the members of the
  375  state committee or any local committee to have access to any
  376  grand jury proceedings.
  377         (g)(14) A person who has attended a meeting of the state
  378  committee or a local committee or who has otherwise participated
  379  in activities authorized by this section may not be permitted or
  380  required to testify in any civil, criminal, or administrative
  381  proceeding as to any records or information produced or
  382  presented to a committee during meetings or other activities
  383  authorized by this section. However, this subsection does not
  384  prevent any person who testifies before the committee or who is
  385  a member of the committee from testifying as to matters
  386  otherwise within his or her knowledge. An organization,
  387  institution, committee member, or other person who furnishes
  388  information, data, reports, or records to the state committee or
  389  a local committee is not liable for damages to any person and is
  390  not subject to any other civil, criminal, or administrative
  391  recourse. This subsection does not apply to any person who
  392  admits to committing a crime.
  394         (a) The Department of Health shall administer the funds
  395  appropriated to operate the review committees and may apply for
  396  grants and accept donations.
  397         (b)(16) To the extent that funds are available, the
  398  Department of Health may hire staff or consultants to assist a
  399  review committee in performing its duties. Funds may also be
  400  used to reimburse reasonable expenses of the staff and
  401  consultants for the state committee and the local committees.
  402         (c)(17) For the purpose of carrying out the
  403  responsibilities assigned to the State Child Abuse Death Review
  404  Committee and the local review committees, the State Surgeon
  405  General may substitute an existing entity whose function and
  406  organization includes include the function and organization of
  407  the committees established by this section.
  409  RESPONSIBILITIES.—Each regional managing director district
  410  administrator of the Department of Children and Families must
  411  appoint a child abuse death review coordinator for the region
  412  district. The coordinator must have knowledge and expertise in
  413  the area of child abuse and neglect. The coordinator’s general
  414  responsibilities include:
  415         (a) Coordinating with the local child abuse death review
  416  committee.
  417         (b) Ensuring the appropriate implementation of the child
  418  abuse death review process and all regional district activities
  419  related to the review of child abuse deaths.
  420         (c) Working with the committee to ensure that the reviews
  421  are thorough and that all issues are appropriately addressed.
  422         (d) Maintaining a system of logging child abuse deaths
  423  covered by this procedure and tracking cases during the child
  424  abuse death review process.
  425         (e) Conducting or arranging for a Florida Safe Families
  426  Network Abuse Hotline Information System (FAHIS) record check on
  427  all child abuse deaths covered by this procedure to determine
  428  whether there were any prior reports concerning the child or
  429  concerning any siblings, other children, or adults in the home.
  430         (f) Coordinating child abuse death review activities, as
  431  needed, with individuals in the community and the Department of
  432  Health.
  433         (g) Notifying the regional managing director district
  434  administrator, the Secretary of Children and Families, the
  435  Department of Health Deputy Secretary for Health and Deputy
  436  State Health Officer for Children’s Medical Services, and the
  437  Department of Health Child Abuse Death Review Coordinator of all
  438  child abuse deaths meeting criteria for review as specified in
  439  this section within 1 working day after case closure verifying
  440  the child’s death was due to abuse, neglect, or abandonment.
  441         (h) Ensuring that all critical issues identified by the
  442  local child abuse death review committee are brought to the
  443  attention of the regional managing director district
  444  administrator and the Secretary of Children and Families.
  445         (i) Providing technical assistance to the local child abuse
  446  death review committee during the review of any child abuse
  447  death.
  448         Section 4. Paragraph (a) of subsection (1) of section
  449  409.986, Florida Statutes, is amended to read:
  450         409.986 Legislative findings and intent; child protection
  451  and child welfare outcomes; definitions.—
  453         (a) It is the intent of the Legislature that the Department
  454  of Children and Families provide child protection and child
  455  welfare services to children through contracting with community
  456  based care lead agencies. The community-based lead agencies
  457  shall give priority to the use of services that are evidence
  458  based and trauma-informed. Counties that provide children and
  459  family services with at least 40 licensed residential group care
  460  beds by July 1, 2003, and that provide at least $2 million
  461  annually in county general revenue funds to supplement foster
  462  and family care services shall continue to contract directly
  463  with the state. It is the further intent of the Legislature that
  464  communities have responsibility for and participate in ensuring
  465  safety, permanence, and well-being for all children in the
  466  state.
  467         Section 5. Subsection (3) of section 409.988, Florida
  468  Statutes, is amended to read:
  469         409.988 Lead agency duties; general provisions.—
  470         (3) SERVICES.—A lead agency must provide serve dependent
  471  children with through services that are supported by research or
  472  that are recognized as best practices in the best child welfare
  473  field practices. The agency shall give priority to the use of
  474  services that are evidence-based and trauma-informed and may
  475  also provide other innovative services, including, but not
  476  limited to, family-centered and, cognitive-behavioral, trauma
  477  informed interventions designed to mitigate out-of-home
  478  placements.
  479         Section 6. This act shall take effect July 1, 2015.