Florida Senate - 2015                             CS for SB 7078
       By the Committees on Fiscal Policy; and Children, Families, and
       Elder Affairs
       594-04419-15                                          20157078c1
    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 the state review
   24         committee to submit an annual statistical report to
   25         the Governor and the Legislature; identifying the
   26         required content for the report; specifying that
   27         certain responsibilities of the Department of Children
   28         and Families are to be administered at the regional
   29         level, rather than at the district level; amending s.
   30         409.977, F.S.; authorizing Medicaid managed care
   31         specialty plans to serve specified children; amending
   32         s. 409.986, F.S.; revising legislative intent to
   33         require community-based care lead agencies to give
   34         priority to the use of evidence-based and trauma
   35         informed services; amending s. 409.988; requiring lead
   36         agencies to give priority to the use of evidence-based
   37         and trauma-informed services; amending s. 435.02,
   38         F.S.; redefining a term; providing an effective date.
   40  Be It Enacted by the Legislature of the State of Florida:
   42         Section 1. Subsections (2) and (11) of section 39.2015,
   43  Florida Statutes, are amended to read:
   44         39.2015 Critical incident rapid response team.—
   45         (2) An immediate onsite investigation conducted by a
   46  critical incident rapid response team is required for all child
   47  deaths reported to the department if the child or another child
   48  in his or her family was the subject of a verified report of
   49  suspected abuse or neglect during the previous 12 months. The
   50  secretary may direct an immediate investigation for other cases
   51  involving death or serious injury to a child, including, but not
   52  limited to, a death or serious injury occurring during an open
   53  investigation.
   54         (11) The secretary shall appoint an advisory committee made
   55  up of experts in child protection and child welfare, including
   56  the Statewide Medical Director for Child Protection under the
   57  Department of Health, a representative from the institute
   58  established pursuant to s. 1004.615, an expert in organizational
   59  management, and an attorney with experience in child welfare, to
   60  conduct an independent review of investigative reports from the
   61  critical incident rapid response teams and to make
   62  recommendations to improve policies and practices related to
   63  child protection and child welfare services. The advisory
   64  committee shall meet at least once each quarter and By October 1
   65  of each year, the advisory committee shall submit quarterly
   66  reports a report to the secretary which include includes
   67  findings and recommendations. The secretary shall submit each
   68  the report to the Governor, the President of the Senate, and the
   69  Speaker of the House of Representatives.
   70         Section 2. Subsection (3) of section 39.3068, Florida
   71  Statutes, is amended to read:
   72         39.3068 Reports of medical neglect.—
   73         (3) The child shall be evaluated by the child protection
   74  team as soon as practicable. If After receipt of the report from
   75  the child protection team reports that medical neglect is
   76  substantiated, the department shall convene a case staffing
   77  which shall be attended, at a minimum, by the child protective
   78  investigator; department legal staff; and representatives from
   79  the child protection team that evaluated the child, Children’s
   80  Medical Services, the Agency for Health Care Administration, the
   81  community-based care lead agency, and any providers of services
   82  to the child. However, the Agency for Health Care Administration
   83  is not required to attend the staffing if the child is not
   84  Medicaid eligible. The staffing shall consider, at a minimum,
   85  available services, given the family’s eligibility for services;
   86  services that are effective in addressing conditions leading to
   87  medical neglect allegations; and services that would enable the
   88  child to safely remain at home. Any services that are available
   89  and effective shall be provided.
   90         Section 3. Section 383.402, Florida Statutes, is amended to
   91  read:
   92         383.402 Child abuse death review; State Child Abuse Death
   93  Review Committee; local child abuse death review committees.—
   94         (1) INTENT.—It is the intent of the Legislature to
   95  establish a statewide multidisciplinary, multiagency,
   96  epidemiological child abuse death assessment and prevention
   97  system that consists of state and local review committees. The
   98  state and local review committees shall review the facts and
   99  circumstances of all deaths of children from birth to through
  100  age 18 which occur in this state and are reported to the central
  101  abuse hotline of the Department of Children and Families. The
  102  state and local review committees shall work cooperatively. The
  103  primary function of the state review committee is to provide
  104  direction and leadership for the review system and to analyze
  105  data and recommendations from local review committees to
  106  identify issues and trends and to recommend statewide action.
  107  The primary function of the local review committees is to
  108  conduct individual case reviews of deaths, generate information,
  109  make recommendations, and implement improvements at the local
  110  level. Each case The purpose of the review must use a data
  111  based, epidemiological approach shall be to:
  112         (a) Achieve a greater understanding of the causes and
  113  contributing factors of deaths resulting from child abuse.
  114         (b) Whenever possible, develop a communitywide approach to
  115  address such causes cases and contributing factors.
  116         (c) Identify any gaps, deficiencies, or problems in the
  117  delivery of services to children and their families by public
  118  and private agencies which may be related to deaths that are the
  119  result of child abuse.
  120         (d) Recommend Make and implement recommendations for
  121  changes in law, rules, and policies at the state and local
  122  levels, as well as develop practice standards that support the
  123  safe and healthy development of children and reduce preventable
  124  child abuse deaths.
  125         (e) Implement approved recommendations, to the extent
  126  possible.
  128         (a) Membership.
  129         1. The State Child Abuse Death Review Committee is
  130  established within the Department of Health and shall consist of
  131  a representative of the Department of Health, appointed by the
  132  State Surgeon General, who shall serve as the state committee
  133  coordinator. The head of each of the following agencies or
  134  organizations shall also appoint a representative to the state
  135  committee:
  136         a.1. The Department of Legal Affairs.
  137         b.2. The Department of Children and Families.
  138         c.3. The Department of Law Enforcement.
  139         d.4. The Department of Education.
  140         e.5. The Florida Prosecuting Attorneys Association, Inc.
  141         f.6. The Florida Medical Examiners Commission, whose
  142  representative must be a forensic pathologist.
  143         2.(b) In addition, the State Surgeon General shall appoint
  144  the following members to the state committee, based on
  145  recommendations from the Department of Health and the agencies
  146  listed in subparagraph 1. paragraph (a), and ensuring that the
  147  committee represents the regional, gender, and ethnic diversity
  148  of the state to the greatest extent possible:
  149         a.1. The Department of Health Statewide Child Protection
  150  Team Medical Director for Child Protection.
  151         b.2. A public health nurse.
  152         c.3. A mental health professional who treats children or
  153  adolescents.
  154         d.4. An employee of the Department of Children and Families
  155  who supervises family services counselors and who has at least 5
  156  years of experience in child protective investigations.
  157         e.5. The medical director of a child protection team.
  158         f.6. A member of a child advocacy organization.
  159         g.7. A social worker who has experience in working with
  160  victims and perpetrators of child abuse.
  161         h.8. A person trained as a paraprofessional in patient
  162  resources who is employed in a child abuse prevention program.
  163         i.9. A law enforcement officer who has at least 5 years of
  164  experience in children’s issues.
  165         j.10. A representative of the Florida Coalition Against
  166  Domestic Violence.
  167         k.11. A representative from a private provider of programs
  168  on preventing child abuse and neglect.
  169         l. A substance abuse treatment professional.
  170         3. The members of the state committee shall be appointed to
  171  staggered terms not to exceed 2 years each, as determined by the
  172  State Surgeon General. Members may be appointed to no more than
  173  three consecutive terms. The state committee shall elect a
  174  chairperson from among its members to serve for a 2-year term,
  175  and the chairperson may appoint ad hoc committees as necessary
  176  to carry out the duties of the committee.
  177         4. Members of the state committee shall serve without
  178  compensation but may receive reimbursement for per diem and
  179  travel expenses incurred in the performance of their duties as
  180  provided in s. 112.061 and to the extent that funds are
  181  available.
  182         (b)(3)Duties.The State Child Abuse Death Review Committee
  183  shall:
  184         1.(a) Develop a system for collecting data from local
  185  committees on deaths that are reported to the central abuse
  186  hotline the result of child abuse. The system must include a
  187  protocol for the uniform collection of data statewide, which
  188  must, at a minimum, use the National Child Death Review Case
  189  Reporting System administered by the National Center for the
  190  Review and Prevention of Child Deaths uses existing data
  191  collection systems to the greatest extent possible.
  192         2.(b) Provide training to cooperating agencies,
  193  individuals, and local child abuse death review committees on
  194  the use of the child abuse death data system.
  195         (c) Prepare an annual statistical report on the incidence
  196  and causes of death resulting from reported child abuse in the
  197  state during the prior calendar year. The state committee shall
  198  submit a copy of the report by October 1 of each year to the
  199  Governor, the President of the Senate, and the Speaker of the
  200  House of Representatives. The report must include
  201  recommendations for state and local action, including specific
  202  policy, procedural, regulatory, or statutory changes, and any
  203  other recommended preventive action.
  204         3.(d) Provide training to local child abuse death review
  205  committee members on the dynamics and impact of domestic
  206  violence, substance abuse, or mental health disorders when there
  207  is a co-occurrence of child abuse. Training must shall be
  208  provided by the Florida Coalition Against Domestic Violence, the
  209  Florida Alcohol and Drug Abuse Association, and the Florida
  210  Council for Community Mental Health in each entity’s respective
  211  area of expertise.
  212         4.(e) Develop statewide uniform guidelines, standards, and
  213  protocols, including a protocol for standardized data
  214  collection, and reporting, for local child abuse death review
  215  committees, and provide training and technical assistance to
  216  local committees.
  217         5.(f) Develop statewide uniform guidelines for reviewing
  218  deaths that are the result of child abuse, including guidelines
  219  to be used by law enforcement agencies, prosecutors, medical
  220  examiners, health care practitioners, health care facilities,
  221  and social service agencies.
  222         6.(g) Study the adequacy of laws, rules, training, and
  223  services to determine what changes are needed to decrease the
  224  incidence of child abuse deaths and develop strategies and
  225  recruit partners to implement these changes.
  226         7.(h) Provide consultation on individual cases to local
  227  committees upon request.
  228         8.(i) Educate the public regarding the provisions of
  229  chapter 99-168, Laws of Florida, the incidence and causes of
  230  child abuse death, and ways by which such deaths may be
  231  prevented.
  232         9.(j) Promote continuing education for professionals who
  233  investigate, treat, and prevent child abuse or neglect.
  234         10.(k) Recommend, when appropriate, the review of the death
  235  certificate of a child who died as a result of abuse or neglect.
  236         (4) The members of the state committee shall be appointed
  237  to staggered terms of office which may not exceed 2 years, as
  238  determined by the State Surgeon General. Members are eligible
  239  for 2 reappointments. The state committee shall elect a
  240  chairperson from among its members to serve for a 2-year term,
  241  and the chairperson may appoint ad hoc committees as necessary
  242  to carry out the duties of the committee.
  243         (5) Members of the state committee shall serve without
  244  compensation but are entitled to reimbursement for per diem and
  245  travel expenses incurred in the performance of their duties as
  246  provided in s. 112.061 and to the extent that funds are
  247  available.
  249  direction of the State Surgeon General, a county or multicounty
  250  child abuse death review committee shall be convened and
  251  supported by the county health department directors the director
  252  of each county health department, or the directors of two or
  253  more county health departments by agreement, may convene and
  254  support a county or multicounty child abuse death review
  255  committee in accordance with the protocols established by the
  256  State Child Abuse Death Review Committee.
  257         (a) Membership.Each local child abuse death review
  258  committee must include local representatives from:
  259         1. The state attorney’s office. a local state attorney, or
  260  his or her designee, and
  261         2. The medical examiner’s office.
  262         3. The local Department of Children and Families child
  263  protective investigations unit.
  264         4. The Department of Health child protection team.
  265         5. The community-based care lead agency.
  266         6. State, county, or local law enforcement agencies.
  267         7. The school district.
  268         8. A mental health treatment provider.
  269         9. A certified domestic violence center.
  270         10. A substance abuse treatment provider.
  271         11. Any other members that are determined by guidelines
  272  developed by the State Child Abuse Death Review Committee.
  274  To the extent possible, individuals from these organizations or
  275  entities who, in a professional capacity, dealt with a child
  276  whose death is verified as caused by abuse or neglect, or with
  277  the family of the child, shall attend any meetings where the
  278  child’s case is reviewed. The members of a local committee shall
  279  be appointed to 2-year terms and may be reappointed. The local
  280  committee shall elect a chairperson from among its members.
  281  Members shall serve without compensation but may receive are
  282  entitled to reimbursement for per diem and travel expenses
  283  incurred in the performance of their duties as provided in s.
  284  112.061 and to the extent that funds are available.
  285         (b)(7)Duties.Each local child abuse death review
  286  committee shall:
  287         1.(a) Assist the state committee in collecting data on
  288  deaths that are the result of child abuse, in accordance with
  289  the protocol established by the state committee. The local
  290  committee shall complete, to the fullest extent possible, the
  291  individual case report in the National Child Death Review Case
  292  Reporting System.
  293         2.(b) Submit written reports as required by at the
  294  direction of the state committee. The reports must include:
  295         a. Nonidentifying information from on individual cases.
  296         b. Identification of any problems with the data system
  297  uncovered through the review process and the committee’s
  298  recommendations for system improvements and needed resources,
  299  training, and information dissemination, where gaps or
  300  deficiencies may exist. and
  301         c. All the steps taken by the local committee and private
  302  and public agencies to implement necessary changes and improve
  303  the coordination of services and reviews.
  304         3.(c) Submit all records requested by the state committee
  305  at the conclusion of its review of a death resulting from child
  306  abuse.
  307         4.(d) Abide by the standards and protocols developed by the
  308  state committee.
  309         5.(e) On a case-by-case basis, request that the state
  310  committee review the data of a particular case.
  311         (4) ANNUAL STATISTICAL REPORT.—The state committee shall
  312  prepare and submit a comprehensive statistical report by October
  313  1 of each year to the Governor, the President of the Senate, and
  314  the Speaker of the House of Representatives which includes data,
  315  trends, analysis, findings, and recommendations for state and
  316  local action regarding deaths from child abuse. Data must be
  317  presented on an individual calendar year basis and in the
  318  context of a multiyear trend. At a minimum, the report must
  319  include:
  320         (a) Descriptive statistics, including demographic
  321  information regarding victims and caregivers, and the causes and
  322  nature of deaths.
  323         (b) A detailed statistical analysis of the incidence and
  324  causes of deaths.
  325         (c) Specific issues identified within current policy,
  326  procedure, rule, or statute and recommendations to address those
  327  issues from both the state and local committees.
  328         (d) Other recommendations to prevent deaths from child
  329  abuse based on an analysis of the data presented in the report.
  330         (5)(8)ACCESS TO AND USE OF RECORDS.—
  331         (a) Notwithstanding any other law, the chairperson of the
  332  State Child Abuse Death Review Committee, or the chairperson of
  333  a local committee, shall be provided with access to any
  334  information or records that pertain to a child whose death is
  335  being reviewed by the committee and that are necessary for the
  336  committee to carry out its duties, including information or
  337  records that pertain to the child’s family, as follows:
  338         1.(a) Patient records in the possession of a public or
  339  private provider of medical, dental, or mental health care,
  340  including, but not limited to, a facility licensed under chapter
  341  393, chapter 394, or chapter 395, or a health care practitioner
  342  as defined in s. 456.001. Providers may charge a fee for copies
  343  not to exceed 50 cents per page for paper records and $1 per
  344  fiche for microfiche records.
  345         2.(b) Information or records of any state agency or
  346  political subdivision which might assist a committee in
  347  reviewing a child’s death, including, but not limited to,
  348  information or records of the Department of Children and
  349  Families, the Department of Health, the Department of Education,
  350  or the Department of Juvenile Justice.
  351         (b)(9) The State Child Abuse Death Review Committee or a
  352  local committee shall have access to all information of a law
  353  enforcement agency which is not the subject of an active
  354  investigation and which pertains to the review of the death of a
  355  child. A committee may not disclose any information that is not
  356  subject to public disclosure by the law enforcement agency, and
  357  active criminal intelligence information or criminal
  358  investigative information, as defined in s. 119.011(3), may not
  359  be made available for review or access under this section.
  360         (c)(10) The state committee and any local committee may
  361  share with each other any relevant information that pertains to
  362  the review of the death of a child.
  363         (d)(11) A member of the state committee or a local
  364  committee may not contact, interview, or obtain information by
  365  request or subpoena directly from a member of a deceased child’s
  366  family as part of a committee’s review of a child abuse death,
  367  except that if a committee member is also a public officer or
  368  state employee, that member may contact, interview, or obtain
  369  information from a member of the deceased child’s family, if
  370  necessary, as part of the committee’s review. A member of the
  371  deceased child’s family may voluntarily provide records or
  372  information to the state committee or a local committee.
  373         (e)(12) The chairperson of the State Child Abuse Death
  374  Review Committee may require the production of records by
  375  requesting a subpoena, through the Department of Legal Affairs,
  376  in any county of the state. Such subpoena is effective
  377  throughout the state and may be served by any sheriff. Failure
  378  to obey the subpoena is punishable as provided by law.
  379         (f)(13) This section does not authorize the members of the
  380  state committee or any local committee to have access to any
  381  grand jury proceedings.
  382         (g)(14) A person who has attended a meeting of the state
  383  committee or a local committee or who has otherwise participated
  384  in activities authorized by this section may not be permitted or
  385  required to testify in any civil, criminal, or administrative
  386  proceeding as to any records or information produced or
  387  presented to a committee during meetings or other activities
  388  authorized by this section. However, this subsection does not
  389  prevent any person who testifies before the committee or who is
  390  a member of the committee from testifying as to matters
  391  otherwise within his or her knowledge. An organization,
  392  institution, committee member, or other person who furnishes
  393  information, data, reports, or records to the state committee or
  394  a local committee is not liable for damages to any person and is
  395  not subject to any other civil, criminal, or administrative
  396  recourse. This subsection does not apply to any person who
  397  admits to committing a crime.
  399         (a) The Department of Health shall administer the funds
  400  appropriated to operate the review committees and may apply for
  401  grants and accept donations.
  402         (b)(16) To the extent that funds are available, the
  403  Department of Health may hire staff or consultants to assist a
  404  review committee in performing its duties. Funds may also be
  405  used to reimburse reasonable expenses of the staff and
  406  consultants for the state committee and the local committees.
  407         (c)(17) For the purpose of carrying out the
  408  responsibilities assigned to the State Child Abuse Death Review
  409  Committee and the local review committees, the State Surgeon
  410  General may substitute an existing entity whose function and
  411  organization includes include the function and organization of
  412  the committees established by this section.
  414  RESPONSIBILITIES.—Each regional managing director district
  415  administrator of the Department of Children and Families must
  416  appoint a child abuse death review coordinator for the region
  417  district. The coordinator must have knowledge and expertise in
  418  the area of child abuse and neglect. The coordinator’s general
  419  responsibilities include:
  420         (a) Coordinating with the local child abuse death review
  421  committee.
  422         (b) Ensuring the appropriate implementation of the child
  423  abuse death review process and all regional district activities
  424  related to the review of child abuse deaths.
  425         (c) Working with the committee to ensure that the reviews
  426  are thorough and that all issues are appropriately addressed.
  427         (d) Maintaining a system of logging child abuse deaths
  428  covered by this procedure and tracking cases during the child
  429  abuse death review process.
  430         (e) Conducting or arranging for a Florida Safe Families
  431  Network Abuse Hotline Information System (FAHIS) record check on
  432  all child abuse deaths covered by this procedure to determine
  433  whether there were any prior reports concerning the child or
  434  concerning any siblings, other children, or adults in the home.
  435         (f) Coordinating child abuse death review activities, as
  436  needed, with individuals in the community and the Department of
  437  Health.
  438         (g) Notifying the regional managing director district
  439  administrator, the Secretary of Children and Families, the
  440  Department of Health Deputy Secretary for Health and Deputy
  441  State Health Officer for Children’s Medical Services, and the
  442  Department of Health Child Abuse Death Review Coordinator of all
  443  child abuse deaths meeting criteria for review as specified in
  444  this section within 1 working day after case closure verifying
  445  the child’s death was due to abuse, neglect, or abandonment.
  446         (h) Ensuring that all critical issues identified by the
  447  local child abuse death review committee are brought to the
  448  attention of the regional managing director district
  449  administrator and the Secretary of Children and Families.
  450         (i) Providing technical assistance to the local child abuse
  451  death review committee during the review of any child abuse
  452  death.
  453         Section 4. Subsection (5) is added to section 409.977,
  454  Florida Statutes, to read:
  455         409.977 Enrollment.—
  456         (5) Specialty plans serving children in the care and
  457  custody of the department may serve such children as long as
  458  they remain in care, including those remaining in extended
  459  foster care pursuant to s. 39.6251, or are in subsidized
  460  adoption and continue to be eligible for Medicaid pursuant to s.
  461  409.903.
  462         Section 5. Paragraph (a) of subsection (1) of section
  463  409.986, Florida Statutes, is amended to read:
  464         409.986 Legislative findings and intent; child protection
  465  and child welfare outcomes; definitions.—
  467         (a) It is the intent of the Legislature that the Department
  468  of Children and Families provide child protection and child
  469  welfare services to children through contracting with community
  470  based care lead agencies. The community-based lead agencies
  471  shall give priority to the use of services that are evidence
  472  based and trauma-informed. Counties that provide children and
  473  family services with at least 40 licensed residential group care
  474  beds by July 1, 2003, and that provide at least $2 million
  475  annually in county general revenue funds to supplement foster
  476  and family care services shall continue to contract directly
  477  with the state. It is the further intent of the Legislature that
  478  communities have responsibility for and participate in ensuring
  479  safety, permanence, and well-being for all children in the
  480  state.
  481         Section 6. Subsection (3) of section 409.988, Florida
  482  Statutes, is amended to read:
  483         409.988 Lead agency duties; general provisions.—
  484         (3) SERVICES.—A lead agency must provide serve dependent
  485  children with through services that are supported by research or
  486  that are recognized as best practices in the best child welfare
  487  field practices. The agency shall give priority to the use of
  488  services that are evidence-based and trauma-informed and may
  489  also provide other innovative services, including, but not
  490  limited to, family-centered and, cognitive-behavioral, trauma
  491  informed interventions designed to mitigate out-of-home
  492  placements.
  493         Section 7. Subsection (5) of section 435.02, Florida
  494  Statutes, is amended to read:
  495         435.02 Definitions.—For the purposes of this chapter, the
  496  term:
  497         (5) “Specified agency” means the Department of Health, the
  498  Department of Children and Families, the Division of Vocational
  499  Rehabilitation within the Department of Education, the Agency
  500  for Health Care Administration, the Department of Elderly
  501  Affairs, the Department of Juvenile Justice, and the Agency for
  502  Persons with Disabilities, and local licensing agencies approved
  503  pursuant to s. 402.307, when these agencies are conducting state
  504  and national criminal history background screening on persons
  505  who work with children or persons who are elderly or disabled.
  506         Section 8. This act shall take effect July 1, 2015.