CS for CS for SB 304                       First Engrossed (ntc)
       
       
       
       
       
       
       
       
       2025304e1
       
    1                        A bill to be entitled                      
    2         An act relating to specific medical diagnoses in child
    3         protective investigations; amending s. 39.301, F.S.;
    4         providing an exception to the requirement that the
    5         Department of Children and Families immediately
    6         forward certain allegations to a law enforcement
    7         agency; requiring a child protective investigator to
    8         inform the subject of an investigation of a certain
    9         duty; conforming a cross-reference; amending s.
   10         39.303, F.S.; requiring Child Protection Teams to
   11         consult with a licensed physician or advanced practice
   12         registered nurse when evaluating certain reports;
   13         conforming provisions to changes made by the act;
   14         amending s. 39.304, F.S.; authorizing, under a certain
   15         circumstance, a parent or legal custodian from whom a
   16         child was removed to request specified examinations of
   17         the child; requiring that certain examinations be paid
   18         for by the parent or legal custodian making the
   19         request or as otherwise covered by insurance or
   20         Medicaid; prohibiting the request of an examination
   21         for a specified purpose; providing an effective date.
   22          
   23  Be It Enacted by the Legislature of the State of Florida:
   24  
   25         Section 1. Paragraph (a) of subsection (2), paragraph (a)
   26  of subsection (5), and paragraph (c) of subsection (14) of
   27  section 39.301, Florida Statutes, are amended to read:
   28         39.301 Initiation of protective investigations.—
   29         (2)(a) The department shall immediately forward allegations
   30  of criminal conduct to the municipal or county law enforcement
   31  agency of the municipality or county in which the alleged
   32  conduct has occurred. However, the department need not
   33  immediately forward allegations of criminal conduct to the
   34  appropriate law enforcement agency if the parent or legal
   35  custodian:
   36         1. Has alleged that the child has a preexisting diagnosis
   37  specified in s. 39.303(4)(b); or
   38         2. Is requesting that the child have an examination under
   39  s. 39.304(1)(c).
   40  
   41  Allegations of criminal conduct that are not immediately
   42  forwarded to the law enforcement agency pursuant to subparagraph
   43  1. or subparagraph 2. must be immediately forwarded to the law
   44  enforcement agency upon completion of the investigation under
   45  this part if criminal conduct is still alleged.
   46         (5)(a) Upon commencing an investigation under this part,
   47  the child protective investigator shall inform any subject of
   48  the investigation of the following:
   49         1. The names of the investigators and identifying
   50  credentials from the department.
   51         2. The purpose of the investigation.
   52         3. The right to obtain his or her own attorney and ways
   53  that the information provided by the subject may be used.
   54         4. The possible outcomes and services of the department’s
   55  response.
   56         5. The right of the parent or legal custodian to be engaged
   57  to the fullest extent possible in determining the nature of the
   58  allegation and the nature of any identified problem and the
   59  remedy.
   60         6. The duty of the parent or legal custodian to report any
   61  change in the residence or location of the child to the
   62  investigator and that the duty to report continues until the
   63  investigation is closed.
   64         7. The duty of the parent or legal custodian to report any
   65  preexisting diagnosis for the child which is specified in s.
   66  39.303(4)(b) and provide any medical records that support that
   67  diagnosis in a timely manner.
   68         (14)
   69         (c) The department, in consultation with the judiciary,
   70  shall adopt by rule:
   71         1. Criteria that are factors requiring that the department
   72  take the child into custody, petition the court as provided in
   73  this chapter, or, if the child is not taken into custody or a
   74  petition is not filed with the court, conduct an administrative
   75  review. Such factors must include, but are not limited to,
   76  noncompliance with a safety plan or the case plan developed by
   77  the department, and the family under this chapter, and prior
   78  abuse reports with findings that involve the child, the child’s
   79  sibling, or the child’s caregiver.
   80         2. Requirements that if after an administrative review the
   81  department determines not to take the child into custody or
   82  petition the court, the department shall document the reason for
   83  its decision in writing and include it in the investigative
   84  file. For all cases that were accepted by the local law
   85  enforcement agency for criminal investigation pursuant to
   86  subsection (2), the department must include in the file written
   87  documentation that the administrative review included input from
   88  law enforcement. In addition, for all cases that must be
   89  referred to Child Protection Teams pursuant to s. 39.303(5) and
   90  (6) s. 39.303(4) and (5), the file must include written
   91  documentation that the administrative review included the
   92  results of the team’s evaluation.
   93         Section 2. Present subsections (4) through (10) of section
   94  39.303, Florida Statutes, are redesignated as subsections (5)
   95  through (11), respectively, a new subsection (4) is added to
   96  that section, and subsection (3) and present subsections (5) and
   97  (6) of that section are amended, to read:
   98         39.303 Child Protection Teams and sexual abuse treatment
   99  programs; services; eligible cases.—
  100         (3) The Department of Health shall use and convene the
  101  Child Protection Teams to supplement the assessment and
  102  protective supervision activities of the family safety and
  103  preservation program of the Department of Children and Families.
  104  This section does not remove or reduce the duty and
  105  responsibility of any person to report pursuant to this chapter
  106  all suspected or actual cases of child abuse, abandonment, or
  107  neglect or sexual abuse of a child. The role of the Child
  108  Protection Teams is to support activities of the program and to
  109  provide services deemed by the Child Protection Teams to be
  110  necessary and appropriate to abused, abandoned, and neglected
  111  children upon referral. The specialized diagnostic assessment,
  112  evaluation, coordination, consultation, and other supportive
  113  services that a Child Protection Team must be capable of
  114  providing include, but are not limited to, the following:
  115         (a) Medical diagnosis and evaluation services, including
  116  provision or interpretation of X rays and laboratory tests, and
  117  related services, as needed, and documentation of related
  118  findings.
  119         (b) Telephone consultation services in emergencies and in
  120  other situations.
  121         (c) Medical evaluation related to abuse, abandonment, or
  122  neglect, as defined by policy or rule of the Department of
  123  Health.
  124         (d) Such psychological and psychiatric diagnosis and
  125  evaluation services for the child or the child’s parent or
  126  parents, legal custodian or custodians, or other caregivers, or
  127  any other individual involved in a child abuse, abandonment, or
  128  neglect case, as the team may determine to be needed.
  129         (e) Expert medical, psychological, and related professional
  130  testimony in court cases.
  131         (f) Case staffings to develop treatment plans for children
  132  whose cases have been referred to the team. A Child Protection
  133  Team may provide consultation with respect to a child who is
  134  alleged or is shown to be abused, abandoned, or neglected, which
  135  consultation shall be provided at the request of a
  136  representative of the family safety and preservation program or
  137  at the request of any other professional involved with a child
  138  or the child’s parent or parents, legal custodian or custodians,
  139  or other caregivers. In every such Child Protection Team case
  140  staffing, consultation, or staff activity involving a child, a
  141  family safety and preservation program representative shall
  142  attend and participate.
  143         (g) Case service coordination and assistance, including the
  144  location of services available from other public and private
  145  agencies in the community.
  146         (h) Such training services for program and other employees
  147  of the Department of Children and Families, employees of the
  148  Department of Health, and other medical professionals as is
  149  deemed appropriate to enable them to develop and maintain their
  150  professional skills and abilities in handling child abuse,
  151  abandonment, and neglect cases. The training service must
  152  include training in the recognition of and appropriate responses
  153  to head trauma and brain injury in a child under 6 years of age
  154  as required by ss. 402.402(2) and 409.988.
  155         (i) Educational and community awareness campaigns on child
  156  abuse, abandonment, and neglect in an effort to enable citizens
  157  more successfully to prevent, identify, and treat child abuse,
  158  abandonment, and neglect in the community.
  159         (j) Child Protection Team assessments that include, as
  160  appropriate, medical evaluations, medical consultations, family
  161  psychosocial interviews, specialized clinical interviews, or
  162  forensic interviews.
  163  
  164  A Child Protection Team that is evaluating a report of medical
  165  neglect and assessing the health care needs of a medically
  166  complex child shall consult with a physician who has experience
  167  in treating children with the same condition.
  168         (4) A Child Protection Team shall consult with a physician
  169  licensed under chapter 458 or chapter 459 or an advanced
  170  practice registered nurse licensed under chapter 464 who has
  171  experience in and routinely provides medical care to pediatric
  172  patients when evaluating a report of:
  173         (a) Medical neglect and assessing the needs of a medically
  174  complex child; or
  175         (b) A child with a reported preexisting diagnosis of any of
  176  the following:
  177         1. Rickets.
  178         2. Ehlers-Danlos syndrome.
  179         3. Osteogenesis imperfecta.
  180         4. Vitamin D deficiency.
  181         5. Any other medical condition known to appear to be caused
  182  by, or known to be misdiagnosed as, abuse.
  183         (6)(5) All abuse and neglect cases transmitted for
  184  investigation to a circuit by the hotline must be simultaneously
  185  transmitted to the Child Protection Team for review. For the
  186  purpose of determining whether a face-to-face medical evaluation
  187  by a Child Protection Team is necessary, all cases transmitted
  188  to the Child Protection Team which meet the criteria in
  189  subsection (5) (4) must be timely reviewed by:
  190         (a) A physician licensed under chapter 458 or chapter 459
  191  who holds board certification in pediatrics and is a member of a
  192  Child Protection Team;
  193         (b) A physician licensed under chapter 458 or chapter 459
  194  who holds board certification in a specialty other than
  195  pediatrics, who may complete the review only when working under
  196  the direction of the Child Protection Team medical director or a
  197  physician licensed under chapter 458 or chapter 459 who holds
  198  board certification in pediatrics and is a member of a Child
  199  Protection Team;
  200         (c) An advanced practice registered nurse licensed under
  201  chapter 464 who has a specialty in pediatrics or family medicine
  202  and is a member of a Child Protection Team;
  203         (d) A physician assistant licensed under chapter 458 or
  204  chapter 459, who may complete the review only when working under
  205  the supervision of the Child Protection Team medical director or
  206  a physician licensed under chapter 458 or chapter 459 who holds
  207  board certification in pediatrics and is a member of a Child
  208  Protection Team; or
  209         (e) A registered nurse licensed under chapter 464, who may
  210  complete the review only when working under the direct
  211  supervision of the Child Protection Team medical director or a
  212  physician licensed under chapter 458 or chapter 459 who holds
  213  board certification in pediatrics and is a member of a Child
  214  Protection Team.
  215         (7)(6) A face-to-face medical evaluation by a Child
  216  Protection Team is not necessary when:
  217         (a) The child was examined for the alleged abuse or neglect
  218  by a physician who is not a member of the Child Protection Team,
  219  and a consultation between the Child Protection Team medical
  220  director or a Child Protection Team board-certified
  221  pediatrician, advanced practice registered nurse, physician
  222  assistant working under the supervision of a Child Protection
  223  Team medical director or a Child Protection Team board-certified
  224  pediatrician, or registered nurse working under the direct
  225  supervision of a Child Protection Team medical director or a
  226  Child Protection Team board-certified pediatrician, and the
  227  examining physician concludes that a further medical evaluation
  228  is unnecessary;
  229         (b) The child protective investigator, with supervisory
  230  approval, has determined, after conducting a child safety
  231  assessment, that there are no indications of injuries as
  232  described in paragraphs (5)(a)-(h) (4)(a)-(h) as reported; or
  233         (c) The Child Protection Team medical director or a Child
  234  Protection Team board-certified pediatrician, as authorized in
  235  subsection (6) (5), determines that a medical evaluation is not
  236  required.
  237  
  238  Notwithstanding paragraphs (a), (b), and (c), a Child Protection
  239  Team medical director or a Child Protection Team pediatrician,
  240  as authorized in subsection (6) (5), may determine that a face
  241  to-face medical evaluation is necessary.
  242         Section 3. Paragraph (c) is added to subsection (1) of
  243  section 39.304, Florida Statutes, to read:
  244         39.304 Photographs, medical examinations, X rays, and
  245  medical treatment of abused, abandoned, or neglected child.—
  246         (1)
  247         (c) If an examination is performed on a child under
  248  paragraph (b), the parent or legal custodian from whom the child
  249  was removed pursuant to s. 39.401 may:
  250         1. If the initial examination was not performed by the
  251  Child Protection Team, request that the child be examined by the
  252  Child Protection Team as soon as practicable;
  253         2. If the initial examination was performed by the Child
  254  Protection Team, for the purpose of obtaining a second opinion
  255  on diagnosis or treatment, request that the child be examined by
  256  a physician licensed under chapter 458 or chapter 459 or an
  257  advanced practice registered nurse licensed under chapter 464 of
  258  his or her choosing who routinely provides medical care to
  259  pediatric patients; or
  260         3. For the purpose of ruling out a differential diagnosis,
  261  request that the child be examined by a physician licensed under
  262  chapter 458 or chapter 459 or an advanced practice registered
  263  nurse licensed under chapter 464 who routinely provides
  264  diagnosis of and medical care to pediatric patients for the
  265  conditions specified in s. 39.303(4)(b).
  266  
  267  An examination requested under subparagraph 2. or subparagraph
  268  3. must be paid for by the parent or legal custodian making such
  269  request or as otherwise covered by insurance or Medicaid. An
  270  examination may not be requested under this paragraph for the
  271  purpose of obtaining a second opinion as to whether a child has
  272  been sexually abused.
  273         Section 4. This act shall take effect July 1, 2025.