Florida Senate - 2022                                    SB 1120
       By Senator Rodriguez
       39-00587A-22                                          20221120__
    1                        A bill to be entitled                      
    2         An act relating to child welfare; amending s. 39.407,
    3         F.S.; authorizing the Department of Children and
    4         Families, under certain circumstances, to place
    5         children in its custody in therapeutic group homes for
    6         residential mental health treatment without prior
    7         court approval; revising definitions; defining the
    8         term “therapeutic group home”; providing that the
    9         department, rather than the Agency for Health Care
   10         Administration, shall appoint qualified evaluators to
   11         conduct suitability assessments of certain children in
   12         the department’s custody; specifying qualifications
   13         for evaluators conducting suitability assessments for
   14         placement in a therapeutic group home; revising
   15         requirements for suitability assessments; specifying
   16         when the department must provide a copy of the
   17         assessment to the guardian ad litem and the court;
   18         revising the department’s and the agency’s rulemaking
   19         authority; providing an effective date.
   21  Be It Enacted by the Legislature of the State of Florida:
   23         Section 1. Subsection (6) of section 39.407, Florida
   24  Statutes, is amended to read:
   25         39.407 Medical, psychiatric, and psychological examination
   26  and treatment of child; physical, mental, or substance abuse
   27  examination of person with or requesting child custody.—
   28         (6) Children who are in the legal custody of the department
   29  may be placed by the department, without prior approval of the
   30  court, in a residential treatment center licensed under s.
   31  394.875, a therapeutic group home, or a hospital licensed under
   32  chapter 395 for residential mental health treatment only
   33  pursuant to this section or may be placed by the court in
   34  accordance with an order of involuntary examination or
   35  involuntary placement entered pursuant to s. 394.463 or s.
   36  394.467. All children placed in a residential treatment program
   37  under this subsection must have a guardian ad litem appointed.
   38         (a) As used in this subsection, the term:
   39         2.1. “Residential treatment” or “residential treatment
   40  program” means a placement for observation, diagnosis, or
   41  treatment of an emotional disturbance in a residential treatment
   42  center licensed under s. 394.875, a therapeutic group home, or a
   43  hospital licensed under chapter 395.
   44         1.2. “Least restrictive alternative” means the treatment
   45  and conditions of treatment that, separately and in combination,
   46  are no more intrusive or restrictive of freedom than reasonably
   47  necessary to achieve a substantial therapeutic benefit or to
   48  protect the child or adolescent or others from physical injury.
   49         3. “Suitable for residential treatment” or “suitability”
   50  means a determination concerning a child or adolescent with an
   51  emotional disturbance as defined in s. 394.492(5) or a serious
   52  emotional disturbance as defined in s. 394.492(6) that each of
   53  the following criteria is met:
   54         a. The child requires residential treatment.
   55         b. The child is in need of a residential treatment program
   56  and is expected to benefit from mental, emotional, or behavioral
   57  health treatment.
   58         c. An appropriate, less restrictive alternative to
   59  residential treatment is unavailable.
   60         4.“Therapeutic group home” means a 24-hour residential
   61  program providing community-based mental health treatment and
   62  mental health support services to children who meet the criteria
   63  in s. 394.492(5) or (6) in a nonsecure, homelike setting that
   64  meets the requirements of a single-family unit or a community
   65  residential home as defined in s. 419.001. Notwithstanding s.
   66  419.001(1)(a), a therapeutic group home may provide a living
   67  environment for up to 16 unrelated residents.
   68         (b) Whenever the department believes that a child in its
   69  legal custody is emotionally disturbed and may need residential
   70  treatment, an examination and suitability assessment must be
   71  conducted by a qualified evaluator who is appointed by the
   72  department Agency for Health Care Administration. This
   73  suitability assessment must be completed before the placement of
   74  the child in a residential treatment program center for
   75  emotionally disturbed children and adolescents or a hospital.
   76         1. The qualified evaluator for placement in a residential
   77  treatment center or a hospital must be a psychiatrist or a
   78  psychologist licensed in this state Florida who has at least 3
   79  years of experience in the diagnosis and treatment of serious
   80  emotional disturbances in children and adolescents and who has
   81  no actual or perceived conflict of interest with any inpatient
   82  facility or residential treatment center or program.
   83         2.The qualified evaluator for placement in a therapeutic
   84  group home must be a psychiatrist licensed under chapter 458, a
   85  psychologist licensed under chapter 490, or a mental health
   86  counselor licensed under chapter 491 who has at least 2 years of
   87  experience in the diagnosis and treatment of serious emotional
   88  or behavioral disturbance in children and adolescents and who
   89  has no actual or perceived conflict of interest with any
   90  residential treatment center or program.
   91         (c) Consistent with the requirements of this section Before
   92  a child is admitted under this subsection, the child shall be
   93  assessed for suitability for residential treatment by a
   94  qualified evaluator who has conducted an a personal examination
   95  and assessment of the child and has made written findings that:
   96         1. The child appears to have an emotional disturbance
   97  serious enough to require treatment in a residential treatment
   98  program and is reasonably likely to benefit from the treatment.
   99         2. The child has been provided with a clinically
  100  appropriate explanation of the nature and purpose of the
  101  treatment.
  102         3. All available modalities of treatment less restrictive
  103  than residential treatment have been considered, and a less
  104  restrictive alternative that would offer comparable benefits to
  105  the child is unavailable.
  107  A copy of the written findings of the evaluation and suitability
  108  assessment must be provided to the department, to the guardian
  109  ad litem, and, if the child is a member of a Medicaid managed
  110  care plan, to the plan that is financially responsible for the
  111  child’s care in residential treatment, all of whom must be
  112  provided with the opportunity to discuss the findings with the
  113  evaluator.
  114         (d) Immediately upon placing a child in a residential
  115  treatment program under this section, the department must notify
  116  the guardian ad litem and the court having jurisdiction over the
  117  child. Within 5 days after the department’s receipt of the
  118  assessment, the department shall and must provide the guardian
  119  ad litem and the court with a copy of the assessment by the
  120  qualified evaluator.
  121         (e) Within 10 days after the admission of a child to a
  122  residential treatment program, the director of the residential
  123  treatment program or the director’s designee must ensure that an
  124  individualized plan of treatment has been prepared by the
  125  program and has been explained to the child, to the department,
  126  and to the guardian ad litem, and submitted to the department.
  127  The child must be involved in the preparation of the plan to the
  128  maximum feasible extent consistent with his or her ability to
  129  understand and participate, and the guardian ad litem and the
  130  child’s foster parents must be involved to the maximum extent
  131  consistent with the child’s treatment needs. The plan must
  132  include a preliminary plan for residential treatment and
  133  aftercare upon completion of residential treatment. The plan
  134  must include specific behavioral and emotional goals against
  135  which the success of the residential treatment may be measured.
  136  A copy of the plan must be provided to the child, to the
  137  guardian ad litem, and to the department.
  138         (f) Within 30 days after admission, the residential
  139  treatment program must review the appropriateness and
  140  suitability of the child’s placement in the program. The
  141  residential treatment program must determine whether the child
  142  is receiving benefit toward the treatment goals and whether the
  143  child could be treated in a less restrictive treatment program.
  144  The residential treatment program shall prepare a written report
  145  of its findings and submit the report to the guardian ad litem
  146  and to the department. The department must submit the report to
  147  the court. The report must include a discharge plan for the
  148  child. The residential treatment program must continue to
  149  evaluate the child’s treatment progress every 30 days thereafter
  150  and must include its findings in a written report submitted to
  151  the department. The department may not reimburse a facility
  152  until the facility has submitted every written report that is
  153  due.
  154         (g)1. The department must submit, at the beginning of each
  155  month, to the court having jurisdiction over the child, a
  156  written report regarding the child’s progress toward achieving
  157  the goals specified in the individualized plan of treatment.
  158         2. The court must conduct a hearing to review the status of
  159  the child’s residential treatment plan no later than 60 days
  160  after the child’s admission to the residential treatment
  161  program. An independent review of the child’s progress toward
  162  achieving the goals and objectives of the treatment plan must be
  163  completed by a qualified evaluator and submitted to the court
  164  before its 60-day review.
  165         3. For any child in residential treatment at the time a
  166  judicial review is held pursuant to s. 39.701, the child’s
  167  continued placement in residential treatment must be a subject
  168  of the judicial review.
  169         4. If at any time the court determines that the child is
  170  not suitable for continued residential treatment, the court
  171  shall order the department to place the child in the least
  172  restrictive setting that is best suited to meet his or her
  173  needs.
  174         (h) After the initial 60-day review, the court must conduct
  175  a review of the child’s residential treatment plan every 90
  176  days.
  177         (i) The department may adopt rules to administer this
  178  subsection must adopt rules for implementing timeframes for the
  179  completion of suitability assessments by qualified evaluators
  180  and a procedure that includes timeframes for completing the 60
  181  day independent review by the qualified evaluators of the
  182  child’s progress toward achieving the goals and objectives of
  183  the treatment plan which review must be submitted to the court.
  184  The Agency for Health Care Administration must adopt rules for
  185  the registration of qualified evaluators, the procedure for
  186  selecting the evaluators to conduct the reviews required under
  187  this section, and a reasonable, cost-efficient fee schedule for
  188  qualified evaluators.
  189         Section 2. This act shall take effect upon becoming a law.