November 29, 2020
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       CS for CS for CS for SB 724                      First Engrossed
       
       
       
       
       
       
       
       
       2010724e1
       
    1  
    2                        A bill to be entitled                      
    3         An act relating to a review of the Department of
    4         Children and Family Services under the Florida
    5         Government Accountability Act; reenacting and amending
    6         s. 20.19, F.S., relating to the establishment of the
    7         department; changing the name of the Department of
    8         Children and Family Services to the Department of
    9         Children and Families; revising provisions relating to
   10         the establishment and structure of, and services
   11         provided by, the department; providing for operating
   12         units called circuits that conform to the geographic
   13         boundaries of judicial circuits; providing for the
   14         establishment of and requirements for membership and
   15         participation in community alliances and community
   16         partnerships; amending s. 20.04, F.S.; authorizing the
   17         department to establish circuits or regions headed by
   18         circuit administrators or region directors and
   19         deleting a requirement for statutory enactment for
   20         additional divisions or offices in the department;
   21         amending s. 20.43, F.S.; revising provisions relating
   22         to service area boundaries; amending s. 394.47865,
   23         F.S.; deleting obsolete provisions relating to the
   24         privatization of South Florida State Hospital;
   25         amending s. 394.78, F.S.; deleting an obsolete
   26         provision relating to dispute resolution; amending s.
   27         402.313, F.S.; revising licensure requirements for
   28         family day care homes; amending s. 402.315, F.S.;
   29         requiring the county, rather than the department, to
   30         bear the costs of licensing family day care homes,
   31         under certain circumstances; amending s. 402.40, F.S.;
   32         defining the terms “child welfare certification” and
   33         “core competency”; requiring that professionals
   34         providing child welfare services demonstrate core
   35         competency; requiring that the department recognize
   36         certain certifications; requiring that certain persons
   37         hold active certification; amending s. 409.1671, F.S.;
   38         revising provisions relating to lead agencies;
   39         requiring the department to annually evaluate each
   40         agency; conforming provision to changes made by the
   41         act; amending s. 409.1755, F.S.; decreasing the
   42         membership of the One Church, One Child of Florida
   43         Corporation, to conform to changes made by the act;
   44         amending s. 420.621, F.S.; revising the definition of
   45         the term “district” to conform to changes made by the
   46         act; amending s. 420.622, F.S.; deleting a requirement
   47         for the Governor to appoint the executive director of
   48         the State Office of Homelessness; conforming a
   49         provision; amending ss. 20.195, 39.01, 39.0121,
   50         39.301, 39.302, 39.303, 39.806, 39.828, 49.011,
   51         381.0072, 394.493, 394.4985, 394.67, 394.73, 394.74,
   52         394.75, 394.76, 394.82, 394.9084, 397.821, 402.49,
   53         409.152, 409.1685, 410.0245, 410.603, 410.604,
   54         411.224, 414.24, 415.1113, 420.623, 420.625, 429.35,
   55         and 1002.67, F.S.; revising provisions to conform to
   56         changes made by the act; correcting cross-references;
   57         repealing ss. 39.311, 39.312, 39.313, 39.314, 39.315,
   58         39.316, 39.317, and 39.318, F.S., relating to the
   59         Family Builders Program; repealing s. 394.9083, F.S.,
   60         relating to the Behavioral Health Services Integration
   61         Workgroup; repealing s. 402.35, F.S., which provides
   62         for department employees to be governed by Department
   63         of Management rules; amending s. 39.407, F.S.;
   64         requiring the provision of a comprehensive mental
   65         health treatment plan; specifying eligibility;
   66         prescribing duties for the Department of Children and
   67         Family Services; deleting provisions relating to the
   68         provision of psychotropic medications to children in
   69         out-of-home care; creating s. 39.4071, F.S.; providing
   70         legislative findings and intent; providing
   71         definitions; requiring that a guardian ad litem be
   72         appointed by the court to represent a child in the
   73         custody of the Department of Children and Family
   74         Services who is prescribed a psychotropic medication;
   75         prescribing the duties of the guardian ad litem;
   76         requiring that the department or lead agency notify
   77         the guardian ad litem of any change in the status of
   78         the child; providing for psychiatric evaluation of the
   79         child; requiring that express and informed consent and
   80         assent be obtained from a child or the child’s parent
   81         or guardian; providing requirements for a prescribing
   82         physician in obtaining consent and assent; providing
   83         for the invalidation of a parent’s informed consent;
   84         requiring the department to seek informed consent from
   85         the legal guardian in certain circumstances; requiring
   86         the department to file a motion for the administration
   87         of psychotropic medication with the final judgment of
   88         termination of parental rights under certain
   89         circumstances; requiring that a court authorize the
   90         administration of psychotropic medication to a child
   91         who is in shelter care or in foster care and for whom
   92         informed consent from the parents or a legal guardian
   93         has not been obtained; providing requirements for the
   94         motion to the court; requiring that any party
   95         objecting to the administration of psychotropic
   96         medication file its objection within a specified
   97         period; authorizing the court to obtain a second
   98         opinion regarding the proposed administration;
   99         requiring that the court hold a hearing if any party
  100         objects to the proposed administration; specifying
  101         circumstances under which the department may provide
  102         psychotropic medication to a child before court
  103         authorization is obtained; requiring that the
  104         department seek court authorization for continued
  105         administration of the medication; providing for an
  106         expedited hearing on such motion under certain
  107         circumstances; requiring the department to provide
  108         notice to all parties and the court for each emergency
  109         use of psychotropic medication under certain
  110         conditions; providing for discontinuation, alteration,
  111         and destruction of medication; requiring that a mental
  112         health treatment plan be developed for each child or
  113         youth who needs mental health services; requiring
  114         certain information to be included in a mental health
  115         treatment plan; requiring the department to develop
  116         and administer procedures to require the caregiver and
  117         prescribing physician to report any adverse side
  118         effects; requiring documentation of the adverse side
  119         effects; prohibiting the prescription of psychotropic
  120         medication to certain children who are in out-of-home
  121         care absent certain conditions; requiring review by a
  122         licensed child psychiatrist before psychotropic
  123         medication is administered to certain children who are
  124         in out-of-home care under certain conditions;
  125         prohibiting authorization for a child in the custody
  126         of the department to participate in any clinical trial
  127         designed to evaluate the use of psychotropic
  128         medication in children; amending s. 743.0645, F.S.;
  129         conforming a cross-reference; directing the Division
  130         of Statutory Revision to prepare a reviser’s bill;
  131         requiring the Agency for Persons with Disabilities to
  132         prepare a plan to perform its own administrative and
  133         operational functions separate from the department;
  134         directing the department to define legal services
  135         associated with dependency proceeding and modify lead
  136         agency funding; directing the Children and Youth
  137         Cabinet to submit a plan to the Legislature addressing
  138         the inappropriate and excessive prescribing of
  139         psychotropic medication for certain children;
  140         providing an effective date.
  141  
  142  Be It Enacted by the Legislature of the State of Florida:
  143  
  144         Section 1. Section 20.19, Florida Statutes, is reenacted
  145  and amended to read:
  146         (Substantial rewording of section. See
  147         s. 20.19, F.S., for present text.)
  148         20.19 Department of Children and Families.—There is created
  149  a Department of Children and Families.
  150         (1)MISSION AND PLAN.—
  151         (a)The mission of the Department of Children and Families
  152  is to work in partnership with local communities to ensure the
  153  safety, well-being, and self-sufficiency of the people served.
  154         (b)The department shall develop a strategic plan for
  155  fulfilling its mission and establish a set of measurable goals,
  156  objectives, performance standards, and quality assurance
  157  requirements to ensure that the department is accountable to the
  158  people of Florida.
  159         (c)To the extent allowed by law and within specific
  160  appropriations, the department shall deliver services by
  161  contract through private providers.
  162         (2) SECRETARY OF CHILDREN AND FAMILIES.—
  163         (a) The head of the department is the Secretary of Children
  164  and Families. The Governor shall appoint the secretary, who is
  165  subject to confirmation by the Senate. The secretary serves at
  166  the pleasure of the Governor.
  167         (b) The secretary is responsible for planning,
  168  coordinating, and managing the delivery of all services that are
  169  the responsibility of the department.
  170         (c) The secretary shall appoint a deputy secretary who
  171  shall act in the absence of the secretary. The deputy secretary
  172  is directly responsible to the secretary, performs such duties
  173  as are assigned by the secretary, and serves at the pleasure of
  174  the secretary.
  175         (d) The secretary shall appoint an Assistant Secretary for
  176  Substance Abuse and Mental Health and may establish assistant
  177  secretary positions as necessary to administer the requirements
  178  of this section. All persons appointed to such positions shall
  179  serve at the pleasure of the secretary. The department shall
  180  integrate substance abuse and mental health programs into the
  181  overall structure and priorities of the department.
  182         (3) SERVICES PROVIDED.—
  183         (a) The department shall establish the following program
  184  offices, each of which shall be headed by a program director who
  185  shall be appointed by and serve at the pleasure of the
  186  secretary:
  187         1. Adult protection.
  188         2. Child care licensure.
  189         3. Domestic violence.
  190         4. Economic self-sufficiency.
  191         5. Family safety.
  192         6. Mental health.
  193         7. Refugee services.
  194         8. Substance abuse.
  195         9. Homelessness.
  196         (b) The secretary may appoint additional directors as
  197  necessary for the effective management of the program services
  198  provided by the department.
  199         (4) OPERATING UNITS.—
  200         (a) The department shall plan and administer its program
  201  services through operating units called “circuits” that conform
  202  to the geographic boundaries of the judicial circuits
  203  established in s. 26.021. The department may also establish one
  204  or more regions consisting of one or more circuits. A region
  205  shall provide administrative, management, and infrastructure
  206  support to the circuits operating within the region. The region
  207  shall consolidate support functions to provide the most
  208  efficient use of resources to support the circuits operating
  209  within the region.
  210         (b) The secretary may appoint a circuit administrator for
  211  each circuit and a region director for each region who shall
  212  serve at the pleasure of the secretary and shall perform such
  213  duties as are assigned by the secretary.
  214         (5) COMMUNITY ALLIANCES AND PARTNERSHIPS; ADVISORY GROUPS.
  215  The department may, or at the request of a county government
  216  shall, establish in each circuit one or more community alliances
  217  or community partnerships. The purpose of a community alliance
  218  or community partnership is to provide a focal point for
  219  community participation and the governance of community-based
  220  services. The membership of a community alliance or community
  221  partnership shall represent the diversity of a community and
  222  consist of stakeholders, community leaders, client
  223  representatives, and entities that fund human services. The
  224  secretary may also establish advisory groups at the state level
  225  as necessary to ensure and enhance communication and provide
  226  liaison with stakeholders, community leaders, and client
  227  representatives.
  228         (a) The duties of a community alliance or community
  229  partnership may include, but are not limited to:
  230         1. Participating in joint planning for the effective use of
  231  resources in the community, including resources appropriated to
  232  the department, and any funds that local funding sources choose
  233  to provide.
  234         2. Performing a needs assessment and establishing community
  235  priorities for service delivery.
  236         3. Determining community outcome goals to supplement state
  237  required outcomes.
  238         4. Serving as a catalyst for community resource
  239  development.
  240         5. Providing for community education and advocacy on issues
  241  related to service delivery.
  242         6. Promoting prevention and early intervention services.
  243         (b) If one or more community alliances or community
  244  partnerships are established in a circuit, the department shall
  245  ensure, to the greatest extent possible, that the formation of
  246  each alliance or partnership builds on the strengths of the
  247  existing community human services infrastructure.
  248         (c) Members of community alliances, community partnerships,
  249  and advisory groups shall serve without compensation, but are
  250  entitled to reimbursement for per diem and travel expenses in
  251  accordance with s. 112.061. The department may also authorize
  252  payment for preapproved child care expenses or lost wages for
  253  members who are consumers of services provided by the
  254  department.
  255         (d) Members of community alliances, community partnerships,
  256  and advisory groups are subject to part III of chapter 112, the
  257  Code of Ethics for Public Officers and Employees.
  258         (e) Actions taken by community alliances, community
  259  partnerships, and advisory groups must be consistent with
  260  department policy and state and federal laws, rules, and
  261  regulations.
  262         (f) Each member of a community alliance or community
  263  partnership must submit annually to the inspector general of the
  264  department a disclosure statement of any interest in services
  265  provided by the department. Any member who has an interest in a
  266  matter under consideration by the community alliance, community
  267  partnership, or advisory group must abstain from voting on that
  268  matter.
  269         (g) All meetings of community alliances, community
  270  partnerships, and advisory groups are open to the public
  271  pursuant to s. 286.011 and are subject to the public-records
  272  provisions of s. 119.07(1).
  273         (6) CONSULTATION WITH COUNTIES ON MANDATED PROGRAMS.—It is
  274  the intent of the Legislature that when county governments are
  275  required by law to participate in the funding of programs
  276  serviced by the department, the department shall consult with
  277  designated representatives of county governments in developing
  278  policies and service delivery plans for those programs.
  279         Section 2. Subsection (4) and paragraph (b) of subsection
  280  (7) of section 20.04, Florida Statutes, are amended to read:
  281         20.04 Structure of executive branch.—The executive branch
  282  of state government is structured as follows:
  283         (4) Within the Department of Children and Families Family
  284  Services there are organizational units called “program
  285  offices,” headed by program directors, and operating units
  286  called “circuits,” headed by circuit administrators. In
  287  addition, there may be “regions,” headed by region directors.
  288         (7)
  289         (b) Within the limitations of this subsection, the head of
  290  the department may recommend the establishment of additional
  291  divisions, bureaus, sections, and subsections of the department
  292  to promote efficient and effective operation of the department.
  293  However, additional divisions, or offices in the Department of
  294  Children and Family Services, the Department of Corrections, and
  295  the Department of Transportation, may be established only by
  296  specific statutory enactment. New bureaus, sections, and
  297  subsections of departments may be initiated by a department and
  298  established as recommended by the Department of Management
  299  Services and approved by the Executive Office of the Governor,
  300  or may be established by specific statutory enactment.
  301         Section 3. Paragraph (a) of subsection (4) of section
  302  20.195, Florida Statutes, is amended to read:
  303         20.195 Department of Children and Family Services; trust
  304  funds.—The following trust funds shall be administered by the
  305  Department of Children and Family Services:
  306         (4) Domestic Violence Trust Fund.
  307         (a) Funds to be credited to and uses of the trust fund
  308  shall be administered in accordance with the provisions of s.
  309  28.101, part XII XIII of chapter 39, and chapter 741.
  310         Section 4. Subsection (5) of section 20.43, Florida
  311  Statutes, is amended to read:
  312         20.43 Department of Health.—There is created a Department
  313  of Health.
  314         (5) The department shall plan and administer its public
  315  health programs through its county health departments and may,
  316  for administrative purposes and efficient service delivery,
  317  establish up to 15 service areas to carry out such duties as may
  318  be prescribed by the State Surgeon General. The boundaries of
  319  the service areas shall be the same as, or combinations of, the
  320  service districts of the Department of Children and Family
  321  Services established in s. 20.19 and, to the extent practicable,
  322  shall take into consideration the boundaries of the jobs and
  323  education regional boards.
  324         Section 5. Subsections (18) through (76) of section 39.01,
  325  Florida Statutes, are renumbered as subsections (19) through
  326  (75), respectively, subsection (10) is amended, present
  327  subsection (26) is repealed, and present subsection (27) of that
  328  section is renumbered as subsection (18) and amended, to read:
  329         39.01 Definitions.—When used in this chapter, unless the
  330  context otherwise requires:
  331         (10) “Caregiver” means the parent, legal custodian,
  332  permanent guardian, adult household member, or other person
  333  responsible for a child’s welfare as defined in subsection (46)
  334  (47).
  335         (26) “District” means any one of the 15 service districts
  336  of the department established pursuant to s. 20.19.
  337         (18)(27) “Circuit District administrator” means the chief
  338  operating officer of each circuit service district of the
  339  department as defined in s. 20.19(5) and, where appropriate,
  340  includes any district administrator whose service district falls
  341  within the boundaries of a judicial circuit.
  342         Section 6. Subsection (10) of section 39.0121, Florida
  343  Statutes, is amended to read:
  344         39.0121 Specific rulemaking authority.—Pursuant to the
  345  requirements of s. 120.536, the department is specifically
  346  authorized to adopt, amend, and repeal administrative rules
  347  which implement or interpret law or policy, or describe the
  348  procedure and practice requirements necessary to implement this
  349  chapter, including, but not limited to, the following:
  350         (10) The Family Builders Program, the Intensive Crisis
  351  Counseling Program, and any other early intervention programs
  352  and kinship care assistance programs.
  353         Section 7. Paragraph (a) of subsection (15) of section
  354  39.301, Florida Statutes, is amended to read:
  355         39.301 Initiation of protective investigations.—
  356         (15)(a) If the department or its agent determines that a
  357  child requires immediate or long-term protection through:
  358         1. Medical or other health care; or
  359         2. Homemaker care, day care, protective supervision, or
  360  other services to stabilize the home environment, including
  361  intensive family preservation services through the Family
  362  Builders Program or the Intensive Crisis Counseling Program, or
  363  both,
  364  
  365  such services shall first be offered for voluntary acceptance
  366  unless there are high-risk factors that may impact the ability
  367  of the parents or legal custodians to exercise judgment. Such
  368  factors may include the parents’ or legal custodians’ young age
  369  or history of substance abuse or domestic violence.
  370         Section 8. Subsection (1) of section 39.302, Florida
  371  Statutes, is amended to read:
  372         39.302 Protective investigations of institutional child
  373  abuse, abandonment, or neglect.—
  374         (1) The department shall conduct a child protective
  375  investigation of each report of institutional child abuse,
  376  abandonment, or neglect. Upon receipt of a report that alleges
  377  that an employee or agent of the department, or any other entity
  378  or person covered by s. 39.01(32)(33) or (46)(47), acting in an
  379  official capacity, has committed an act of child abuse,
  380  abandonment, or neglect, the department shall initiate a child
  381  protective investigation within the timeframe established under
  382  s. 39.201(5) and orally notify the appropriate state attorney,
  383  law enforcement agency, and licensing agency, which shall
  384  immediately conduct a joint investigation, unless independent
  385  investigations are more feasible. When conducting investigations
  386  onsite or having face-to-face interviews with the child,
  387  investigation visits shall be unannounced unless it is
  388  determined by the department or its agent that unannounced
  389  visits threaten the safety of the child. If a facility is exempt
  390  from licensing, the department shall inform the owner or
  391  operator of the facility of the report. Each agency conducting a
  392  joint investigation is entitled to full access to the
  393  information gathered by the department in the course of the
  394  investigation. A protective investigation must include an onsite
  395  visit of the child’s place of residence. The department shall
  396  make a full written report to the state attorney within 3
  397  working days after making the oral report. A criminal
  398  investigation shall be coordinated, whenever possible, with the
  399  child protective investigation of the department. Any interested
  400  person who has information regarding the offenses described in
  401  this subsection may forward a statement to the state attorney as
  402  to whether prosecution is warranted and appropriate. Within 15
  403  days after the completion of the investigation, the state
  404  attorney shall report the findings to the department and shall
  405  include in the report a determination of whether or not
  406  prosecution is justified and appropriate in view of the
  407  circumstances of the specific case.
  408         Section 9. Section 39.303, Florida Statutes, is amended to
  409  read:
  410         39.303 Child protection teams; services; eligible cases.
  411  The Children’s Medical Services Program in the Department of
  412  Health shall develop, maintain, and coordinate the services of
  413  one or more multidisciplinary child protection teams in each of
  414  the circuits service districts of the Department of Children and
  415  Families Family Services. Such teams may be composed of
  416  appropriate representatives of school districts and appropriate
  417  health, mental health, social service, legal service, and law
  418  enforcement agencies. The Legislature finds that optimal
  419  coordination of child protection teams and sexual abuse
  420  treatment programs requires collaboration between the Department
  421  of Health and the Department of Children and Families Family
  422  Services. The two departments shall maintain an interagency
  423  agreement that establishes protocols for oversight and
  424  operations of child protection teams and sexual abuse treatment
  425  programs. The State Surgeon General and the Deputy Secretary for
  426  Children’s Medical Services, in consultation with the Secretary
  427  of Children and Families Family Services, shall maintain the
  428  responsibility for the screening, employment, and, if necessary,
  429  the termination of child protection team medical directors, at
  430  headquarters and in the circuits 15 districts. Child protection
  431  team medical directors shall be responsible for oversight of the
  432  teams in the circuits districts.
  433         (1) The Department of Health shall utilize and convene the
  434  teams to supplement the assessment and protective supervision
  435  activities of the family safety and preservation program of the
  436  Department of Children and Families Family Services. Nothing in
  437  this section shall be construed to remove or reduce the duty and
  438  responsibility of any person to report pursuant to this chapter
  439  all suspected or actual cases of child abuse, abandonment, or
  440  neglect or sexual abuse of a child. The role of the teams shall
  441  be to support activities of the program and to provide services
  442  deemed by the teams to be necessary and appropriate to abused,
  443  abandoned, and neglected children upon referral. The specialized
  444  diagnostic assessment, evaluation, coordination, consultation,
  445  and other supportive services that a child protection team shall
  446  be capable of providing include, but are not limited to, the
  447  following:
  448         (a) Medical diagnosis and evaluation services, including
  449  provision or interpretation of X rays and laboratory tests, and
  450  related services, as needed, and documentation of findings
  451  relative thereto.
  452         (b) Telephone consultation services in emergencies and in
  453  other situations.
  454         (c) Medical evaluation related to abuse, abandonment, or
  455  neglect, as defined by policy or rule of the Department of
  456  Health.
  457         (d) Such psychological and psychiatric diagnosis and
  458  evaluation services for the child or the child’s parent or
  459  parents, legal custodian or custodians, or other caregivers, or
  460  any other individual involved in a child abuse, abandonment, or
  461  neglect case, as the team may determine to be needed.
  462         (e) Expert medical, psychological, and related professional
  463  testimony in court cases.
  464         (f) Case staffings to develop treatment plans for children
  465  whose cases have been referred to the team. A child protection
  466  team may provide consultation with respect to a child who is
  467  alleged or is shown to be abused, abandoned, or neglected, which
  468  consultation shall be provided at the request of a
  469  representative of the family safety and preservation program or
  470  at the request of any other professional involved with a child
  471  or the child’s parent or parents, legal custodian or custodians,
  472  or other caregivers. In every such child protection team case
  473  staffing, consultation, or staff activity involving a child, a
  474  family safety and preservation program representative shall
  475  attend and participate.
  476         (g) Case service coordination and assistance, including the
  477  location of services available from other public and private
  478  agencies in the community.
  479         (h) Such training services for program and other employees
  480  of the Department of Children and Families Family Services,
  481  employees of the Department of Health, and other medical
  482  professionals as is deemed appropriate to enable them to develop
  483  and maintain their professional skills and abilities in handling
  484  child abuse, abandonment, and neglect cases.
  485         (i) Educational and community awareness campaigns on child
  486  abuse, abandonment, and neglect in an effort to enable citizens
  487  more successfully to prevent, identify, and treat child abuse,
  488  abandonment, and neglect in the community.
  489         (j) Child protection team assessments that include, as
  490  appropriate, medical evaluations, medical consultations, family
  491  psychosocial interviews, specialized clinical interviews, or
  492  forensic interviews.
  493  
  494  All medical personnel participating on a child protection team
  495  must successfully complete the required child protection team
  496  training curriculum as set forth in protocols determined by the
  497  Deputy Secretary for Children’s Medical Services and the
  498  Statewide Medical Director for Child Protection.
  499         (2) The child abuse, abandonment, and neglect reports that
  500  must be referred by the department to child protection teams of
  501  the Department of Health for an assessment and other appropriate
  502  available support services as set forth in subsection (1) must
  503  include cases involving:
  504         (a) Injuries to the head, bruises to the neck or head,
  505  burns, or fractures in a child of any age.
  506         (b) Bruises anywhere on a child 5 years of age or under.
  507         (c) Any report alleging sexual abuse of a child.
  508         (d) Any sexually transmitted disease in a prepubescent
  509  child.
  510         (e) Reported malnutrition of a child and failure of a child
  511  to thrive.
  512         (f) Reported medical neglect of a child.
  513         (g) Any family in which one or more children have been
  514  pronounced dead on arrival at a hospital or other health care
  515  facility, or have been injured and later died, as a result of
  516  suspected abuse, abandonment, or neglect, when any sibling or
  517  other child remains in the home.
  518         (h) Symptoms of serious emotional problems in a child when
  519  emotional or other abuse, abandonment, or neglect is suspected.
  520         (3) All abuse and neglect cases transmitted for
  521  investigation to a circuit district by the hotline must be
  522  simultaneously transmitted to the Department of Health child
  523  protection team for review. For the purpose of determining
  524  whether face-to-face medical evaluation by a child protection
  525  team is necessary, all cases transmitted to the child protection
  526  team which meet the criteria in subsection (2) must be timely
  527  reviewed by:
  528         (a) A physician licensed under chapter 458 or chapter 459
  529  who holds board certification in pediatrics and is a member of a
  530  child protection team;
  531         (b) A physician licensed under chapter 458 or chapter 459
  532  who holds board certification in a specialty other than
  533  pediatrics, who may complete the review only when working under
  534  the direction of a physician licensed under chapter 458 or
  535  chapter 459 who holds board certification in pediatrics and is a
  536  member of a child protection team;
  537         (c) An advanced registered nurse practitioner licensed
  538  under chapter 464 who has a specialty speciality in pediatrics
  539  or family medicine and is a member of a child protection team;
  540         (d) A physician assistant licensed under chapter 458 or
  541  chapter 459, who may complete the review only when working under
  542  the supervision of a physician licensed under chapter 458 or
  543  chapter 459 who holds board certification in pediatrics and is a
  544  member of a child protection team; or
  545         (e) A registered nurse licensed under chapter 464, who may
  546  complete the review only when working under the direct
  547  supervision of a physician licensed under chapter 458 or chapter
  548  459 who holds certification in pediatrics and is a member of a
  549  child protection team.
  550         (4) A face-to-face medical evaluation by a child protection
  551  team is not necessary when:
  552         (a) The child was examined for the alleged abuse or neglect
  553  by a physician who is not a member of the child protection team,
  554  and a consultation between the child protection team board
  555  certified pediatrician, advanced registered nurse practitioner,
  556  physician assistant working under the supervision of a child
  557  protection team board-certified pediatrician, or registered
  558  nurse working under the direct supervision of a child protection
  559  team board-certified pediatrician, and the examining physician
  560  concludes that a further medical evaluation is unnecessary;
  561         (b) The child protective investigator, with supervisory
  562  approval, has determined, after conducting a child safety
  563  assessment, that there are no indications of injuries as
  564  described in paragraphs (2)(a)-(h) as reported; or
  565         (c) The child protection team board-certified pediatrician,
  566  as authorized in subsection (3), determines that a medical
  567  evaluation is not required.
  568  
  569  Notwithstanding paragraphs (a), (b), and (c), a child protection
  570  team pediatrician, as authorized in subsection (3), may
  571  determine that a face-to-face medical evaluation is necessary.
  572         (5) In all instances in which a child protection team is
  573  providing certain services to abused, abandoned, or neglected
  574  children, other offices and units of the Department of Health,
  575  and offices and units of the Department of Children and Families
  576  Family Services, shall avoid duplicating the provision of those
  577  services.
  578         (6) The Department of Health child protection team quality
  579  assurance program and the Department of Children and Families’
  580  Family Services’ Family Safety Program Office quality assurance
  581  program shall collaborate to ensure referrals and responses to
  582  child abuse, abandonment, and neglect reports are appropriate.
  583  Each quality assurance program shall include a review of records
  584  in which there are no findings of abuse, abandonment, or
  585  neglect, and the findings of these reviews shall be included in
  586  each department’s quality assurance reports.
  587         Section 10. Paragraph (k) of subsection (1) of section
  588  39.806, Florida Statutes, is amended to read:
  589         39.806 Grounds for termination of parental rights.—
  590         (1) Grounds for the termination of parental rights may be
  591  established under any of the following circumstances:
  592         (k) A test administered at birth that indicated that the
  593  child’s blood, urine, or meconium contained any amount of
  594  alcohol or a controlled substance or metabolites of such
  595  substances, the presence of which was not the result of medical
  596  treatment administered to the mother or the newborn infant, and
  597  the biological mother of the child is the biological mother of
  598  at least one other child who was adjudicated dependent after a
  599  finding of harm to the child’s health or welfare due to exposure
  600  to a controlled substance or alcohol as defined in s.
  601  39.01(31)(32)(g), after which the biological mother had the
  602  opportunity to participate in substance abuse treatment.
  603         Section 11. Paragraph (a) of subsection (1) of section
  604  39.828, Florida Statutes, is amended to read:
  605         39.828 Grounds for appointment of a guardian advocate.—
  606         (1) The court shall appoint the person named in the
  607  petition as a guardian advocate with all the powers and duties
  608  specified in s. 39.829 for an initial term of 1 year upon a
  609  finding that:
  610         (a) The child named in the petition is or was a drug
  611  dependent newborn as described in s. 39.01(31)(32)(g);
  612         (b) The parent or parents of the child have voluntarily
  613  relinquished temporary custody of the child to a relative or
  614  other responsible adult;
  615         (c) The person named in the petition to be appointed the
  616  guardian advocate is capable of carrying out the duties as
  617  provided in s. 39.829; and
  618         (d) A petition to adjudicate the child dependent under this
  619  chapter has not been filed.
  620         Section 12. Subsection (13) of section 49.011, Florida
  621  Statutes, is amended to read:
  622         49.011 Service of process by publication; cases in which
  623  allowed.—Service of process by publication may be made in any
  624  court on any party identified in s. 49.021 in any action or
  625  proceeding:
  626         (13) For termination of parental rights pursuant to part
  627  VIII IX of chapter 39 or chapter 63.
  628         Section 13. Paragraph (a) of subsection (3) of section
  629  381.0072, Florida Statutes, is amended to read:
  630         381.0072 Food service protection.—It shall be the duty of
  631  the Department of Health to adopt and enforce sanitation rules
  632  consistent with law to ensure the protection of the public from
  633  food-borne illness. These rules shall provide the standards and
  634  requirements for the storage, preparation, serving, or display
  635  of food in food service establishments as defined in this
  636  section and which are not permitted or licensed under chapter
  637  500 or chapter 509.
  638         (3) LICENSES REQUIRED.—
  639         (a) Licenses; annual renewals.—Each food service
  640  establishment regulated under this section shall obtain a
  641  license from the department annually. Food service establishment
  642  licenses shall expire annually and are not transferable from one
  643  place or individual to another. However, those facilities
  644  licensed by the department’s Office of Licensure and
  645  Certification, the Child Care Licensure Services Program Office,
  646  or the Agency for Persons with Disabilities are exempt from this
  647  subsection. It shall be a misdemeanor of the second degree,
  648  punishable as provided in s. 381.0061, s. 775.082, or s.
  649  775.083, for such an establishment to operate without this
  650  license. The department may refuse a license, or a renewal
  651  thereof, to any establishment that is not constructed or
  652  maintained in accordance with law and with the rules of the
  653  department. Annual application for renewal is not required.
  654         Section 14. Subsection (3) of section 394.47865, Florida
  655  Statutes, is amended to read:
  656         394.47865 South Florida State Hospital; privatization.—
  657         (3)(a) Current South Florida State Hospital employees who
  658  are affected by the privatization shall be given first
  659  preference for continued employment by the contractor. The
  660  department shall make reasonable efforts to find suitable job
  661  placements for employees who wish to remain within the state
  662  Career Service System.
  663         (b) Any savings that result from the privatization of South
  664  Florida State Hospital shall be directed to the department’s
  665  service districts 9, 10, and 11 for the delivery of community
  666  mental health services.
  667         Section 15. Subsection (2) of section 394.493, Florida
  668  Statutes, is amended to read:
  669         394.493 Target populations for child and adolescent mental
  670  health services funded through the department.—
  671         (2) Each mental health provider under contract with the
  672  department to provide mental health services to the target
  673  population shall collect fees from the parent or legal guardian
  674  of the child or adolescent receiving services. The fees shall be
  675  based on a sliding fee scale for families whose net family
  676  income is at or above 150 percent of the Federal Poverty Income
  677  Guidelines. The department shall adopt, by rule, a sliding fee
  678  scale for statewide implementation. Fees collected from families
  679  shall be retained in the circuit service district and used for
  680  expanding child and adolescent mental health treatment services.
  681         Section 16. Section 394.4985, Florida Statutes, is amended
  682  to read:
  683         394.4985 Circuitwide Districtwide information and referral
  684  network; implementation.—
  685         (1) Each circuit service district of the Department of
  686  Children and Families Family Services shall develop a detailed
  687  implementation plan for a circuitwide districtwide comprehensive
  688  child and adolescent mental health information and referral
  689  network to be operational by July 1, 1999. The plan must include
  690  an operating budget that demonstrates cost efficiencies and
  691  identifies funding sources for the circuit district information
  692  and referral network. The plan must be submitted by the
  693  department to the Legislature by October 1, 1998. The circuit
  694  district shall use existing circuit district information and
  695  referral providers if, in the development of the plan, it is
  696  concluded that these providers would deliver information and
  697  referral services in a more efficient and effective manner when
  698  compared to other alternatives. The circuit district information
  699  and referral network must include:
  700         (a) A resource file that contains information about the
  701  child and adolescent mental health services as described in s.
  702  394.495, including, but not limited to:
  703         1. Type of program;
  704         2. Hours of service;
  705         3. Ages of persons served;
  706         4. Program description;
  707         5. Eligibility requirements; and
  708         6. Fees.
  709         (b) Information about private providers and professionals
  710  in the community which serve children and adolescents with an
  711  emotional disturbance.
  712         (c) A system to document requests for services that are
  713  received through the network referral process, including, but
  714  not limited to:
  715         1. Number of calls by type of service requested;
  716         2. Ages of the children and adolescents for whom services
  717  are requested; and
  718         3. Type of referral made by the network.
  719         (d) The ability to share client information with the
  720  appropriate community agencies.
  721         (e) The submission of an annual report to the department,
  722  the Agency for Health Care Administration, and appropriate local
  723  government entities, which contains information about the
  724  sources and frequency of requests for information, types and
  725  frequency of services requested, and types and frequency of
  726  referrals made.
  727         (2) In planning the information and referral network, the
  728  circuit district shall consider the establishment of a 24-hour
  729  toll-free telephone number, staffed at all times, for parents
  730  and other persons to call for information that concerns child
  731  and adolescent mental health services and a community public
  732  service campaign to inform the public about information and
  733  referral services.
  734         Section 17. Subsections (2) through (6) of section 394.67,
  735  Florida Statutes, are renumbered as subsections (4) and (8),
  736  respectively, and present subsections (7) and (8) are renumbered
  737  as subsections (2) and (3), respectively, and amended to read:
  738         394.67 Definitions.—As used in this part, the term:
  739         (2)(7) “Circuit District administrator” means the person
  740  appointed by the Secretary of Children and Families Family
  741  Services for the purpose of administering a department circuit
  742  service district as set forth in s. 20.19.
  743         (3)(8) “Circuit District plan” or “plan” means the combined
  744  circuit district substance abuse and mental health plan approved
  745  by the circuit district administrator and governing bodies in
  746  accordance with this part.
  747         Section 18. Section 394.73, Florida Statutes, is amended to
  748  read:
  749         394.73 Joint alcohol, drug abuse, and mental health service
  750  programs in two or more counties.—
  751         (1) Subject to rules established by the department, any
  752  county within a circuit service district shall have the same
  753  power to contract for alcohol, drug abuse, and mental health
  754  services as the department has under existing statutes.
  755         (2) In order to carry out the intent of this part and to
  756  provide alcohol, drug abuse, and mental health services in
  757  accordance with the circuit district plan, the counties within a
  758  circuit service district may enter into agreements with each
  759  other for the establishment of joint service programs. The
  760  agreements may provide for the joint provision or operation of
  761  services and facilities or for the provision or operation of
  762  services and facilities by one participating county under
  763  contract with other participating counties.
  764         (3) When a circuit service district comprises two or more
  765  counties or portions thereof, it is the obligation of the
  766  planning council to submit to the governing bodies, prior to the
  767  budget submission date of each governing body, an estimate of
  768  the proportionate share of costs of alcohol, drug abuse, and
  769  mental health services proposed to be borne by each such
  770  governing body.
  771         (4) Any county desiring to withdraw from a joint program
  772  may submit to the circuit district administrator a resolution
  773  requesting withdrawal therefrom together with a plan for the
  774  equitable adjustment and division of the assets, property,
  775  debts, and obligations, if any, of the joint program.
  776         Section 19. Paragraph (a) of subsection (3) of section
  777  394.74, Florida Statutes, is amended to read:
  778         394.74 Contracts for provision of local substance abuse and
  779  mental health programs.—
  780         (3) Contracts shall include, but are not limited to:
  781         (a) A provision that, within the limits of available
  782  resources, substance abuse and mental health crisis services, as
  783  defined in s. 394.67(5)(3), shall be available to any individual
  784  residing or employed within the service area, regardless of
  785  ability to pay for such services, current or past health
  786  condition, or any other factor;
  787         Section 20. Subsection (10) of section 394.75, Florida
  788  Statutes, is amended to read:
  789         394.75 State and circuit district substance abuse and
  790  mental health plans.—
  791         (10) The circuit district administrator shall ensure that
  792  the circuit district plan:
  793         (a) Conforms to the priorities in the state plan, the
  794  requirements of this part, and the standards adopted under this
  795  part;
  796         (b) Ensures that the most effective and economical use will
  797  be made of available public and private substance abuse and
  798  mental health resources in the circuit service district; and
  799         (c) Has adequate provisions made for review and evaluation
  800  of the services provided in the circuit service district.
  801         Section 21. Subsection (2) of section 394.76, Florida
  802  Statutes, is amended to read:
  803         394.76 Financing of circuit district programs and
  804  services.—If the local match funding level is not provided in
  805  the General Appropriations Act or the substantive bill
  806  implementing the General Appropriations Act, such funding level
  807  shall be provided as follows:
  808         (2) If in any fiscal year the approved state appropriation
  809  is insufficient to finance the programs and services specified
  810  by this part, the department shall have the authority to
  811  determine the amount of state funds available to each circuit
  812  service district for such purposes in accordance with the
  813  priorities in both the state and circuit district plans. The
  814  circuit district administrator shall consult with the planning
  815  council to ensure that the summary operating budget conforms to
  816  the approved plan.
  817         Section 22. Subsection (5) of section 394.78, Florida
  818  Statutes, is amended to read:
  819         394.78 Operation and administration; personnel standards;
  820  procedures for audit and monitoring of service providers;
  821  resolution of disputes.—
  822         (5) In unresolved disputes regarding this part or rules
  823  established pursuant to this part, providers and district health
  824  and human services boards shall adhere to formal procedures
  825  specified under s. 20.19(8)(n).
  826         Section 23. Subsections (3) and (4) of section 394.82,
  827  Florida Statutes, are amended to read:
  828         394.82 Funding of expanded services.—
  829         (3) Each fiscal year, any funding increases for crisis
  830  services or community mental health services that are included
  831  in the General Appropriations Act shall be appropriated in a
  832  lump-sum category as defined in s. 216.011(1)(aa). In accordance
  833  with s. 216.181(6)(a), the Executive Office of the Governor
  834  shall require the Department of Children and Families Family
  835  Services to submit a spending plan for the use of funds
  836  appropriated for this purpose. The spending plan must include a
  837  schedule for phasing in the new community mental health services
  838  in each circuit service district of the department and must
  839  describe how the new services will be integrated and coordinated
  840  with all current community-based health and human services.
  841         (4) By January 1, 2004, the crisis services defined in s.
  842  394.67(5)(3) shall be implemented, as appropriate, in the
  843  state’s public community mental health system to serve children
  844  and adults who are experiencing an acute mental or emotional
  845  crisis, as defined in s. 394.67(17). By January 1, 2006, the
  846  mental health services defined in s. 394.67(15) shall be
  847  implemented, as appropriate, in the state’s public community
  848  mental health system to serve adults and older adults who have a
  849  severe and persistent mental illness and to serve children who
  850  have a serious emotional disturbance or mental illness, as
  851  defined in s. 394.492(6).
  852         Section 24. Subsection (1) of section 394.9084, Florida
  853  Statutes, is amended to read:
  854         394.9084 Florida Self-Directed Care program.—
  855         (1) The Department of Children and Families Family
  856  Services, in cooperation with the Agency for Health Care
  857  Administration, may provide a client-directed and choice-based
  858  Florida Self-Directed Care program in all department circuits
  859  service districts, in addition to the pilot projects established
  860  in district 4 and district 8, to provide mental health treatment
  861  and support services to adults who have a serious mental
  862  illness. The department may also develop and implement a client
  863  directed and choice-based pilot project in one circuit district
  864  to provide mental health treatment and support services for
  865  children with a serious emotional disturbance who live at home.
  866  If established, any staff who work with children must be
  867  screened under s. 435.04. The department shall implement a
  868  payment mechanism in which each client controls the money that
  869  is available for that client’s mental health treatment and
  870  support services. The department shall establish interagency
  871  cooperative agreements and work with the agency, the Division of
  872  Vocational Rehabilitation, and the Social Security
  873  Administration to implement and administer the Florida Self
  874  Directed Care program.
  875         Section 25. Subsection (1) of section 397.821, Florida
  876  Statutes, is amended to read:
  877         397.821 Juvenile substance abuse impairment prevention and
  878  early intervention councils.—
  879         (1) Each judicial circuit as set forth in s. 26.021 may
  880  establish a juvenile substance abuse impairment prevention and
  881  early intervention council composed of at least 12 members,
  882  including representatives from law enforcement, the department,
  883  school districts, state attorney and public defender offices,
  884  the circuit court, the religious community, substance abuse
  885  impairment professionals, child advocates from the community,
  886  business leaders, parents, and high school students. However,
  887  those circuits which already have in operation a council of
  888  similar composition may designate the existing body as the
  889  juvenile substance abuse impairment prevention and early
  890  intervention council for the purposes of this section. Each
  891  council shall establish bylaws providing for the length of term
  892  of its members, but the term may not exceed 4 years. The circuit
  893  substate entity administrator, as defined in s. 20.19, and the
  894  chief judge of the circuit court shall each appoint six members
  895  of the council. The circuit substate entity administrator shall
  896  appoint a representative from the department, a school district
  897  representative, a substance abuse impairment treatment
  898  professional, a child advocate, a parent, and a high school
  899  student. The chief judge of the circuit court shall appoint a
  900  business leader and representatives from the state attorney’s
  901  office, the public defender’s office, the religious community,
  902  the circuit court, and law enforcement agencies.
  903         Section 26. Subsection (1) of section 402.313, Florida
  904  Statutes, is amended to read:
  905         402.313 Family day care homes.—
  906         (1) Family day care homes shall be licensed under this act
  907  if they are presently being licensed under an existing county
  908  licensing ordinance, if they are participating in the subsidized
  909  child care program, or if the board of county commissioners
  910  passes a resolution that family day care homes be licensed. If
  911  no county authority exists for the licensing of a family day
  912  care home and the county passes a resolution requiring
  913  licensure, the department shall have the authority to license
  914  family day care homes under contract with the county for the
  915  purchase-of-service system in the subsidized child care program.
  916         (a) If not subject to license, family day care homes shall
  917  register annually with the department, providing the following
  918  information:
  919         1. The name and address of the home.
  920         2. The name of the operator.
  921         3. The number of children served.
  922         4. Proof of a written plan to provide at least one other
  923  competent adult to be available to substitute for the operator
  924  in an emergency. This plan shall include the name, address, and
  925  telephone number of the designated substitute.
  926         5. Proof of screening and background checks.
  927         6. Proof of successful completion of the 30-hour training
  928  course, as evidenced by passage of a competency examination,
  929  which shall include:
  930         a. State and local rules and regulations that govern child
  931  care.
  932         b. Health, safety, and nutrition.
  933         c. Identifying and reporting child abuse and neglect.
  934         d. Child development, including typical and atypical
  935  language development; and cognitive, motor, social, and self
  936  help skills development.
  937         e. Observation of developmental behaviors, including using
  938  a checklist or other similar observation tools and techniques to
  939  determine a child’s developmental level.
  940         f. Specialized areas, including early literacy and language
  941  development of children from birth to 5 years of age, as
  942  determined by the department, for owner-operators of family day
  943  care homes.
  944         7. Proof that immunization records are kept current.
  945         8. Proof of completion of the required continuing education
  946  units or clock hours.
  947         (b) A family day care home not participating in the
  948  subsidized child care program may volunteer to be licensed under
  949  the provisions of this act.
  950         (c) The department may provide technical assistance to
  951  counties and family day care home providers to enable counties
  952  and family day care providers to achieve compliance with family
  953  day care homes standards.
  954         Section 27. Subsection (2) of section 402.315, Florida
  955  Statutes, is amended to read:
  956         402.315 Funding; license fees.—
  957         (2) The county department shall bear the costs of the
  958  licensing of family day care homes when contracting with the
  959  department pursuant to s. 402.313(1) child care facilities when
  960  contracted to do so by a county or when directly responsible for
  961  licensing in a county which fails to meet or exceed state
  962  minimum standards.
  963         Section 28. Subsections (2), (3), and (7) of section
  964  402.40, Florida Statutes, are amended to read:
  965         402.40 Child welfare training.—
  966         (2) DEFINITIONS.—As used in this section, the term:
  967         (a) “Child welfare certification” means a professional
  968  credential awarded by the department or by a credentialing
  969  entity recognized by the department to individuals demonstrating
  970  core competency in any child welfare services practice area.
  971         (b) “Child welfare services” means any intake, protective
  972  investigations, preprotective services, protective services,
  973  foster care, shelter and group care, and adoption and related
  974  services program, including supportive services, supervision,
  975  and legal services, provided to children who are alleged to have
  976  been abused, abandoned, or neglected, or who are at risk of
  977  becoming, are alleged to be, or have been found dependent
  978  pursuant to chapter 39.
  979         (c)“Core competency” means the knowledge, skills, and
  980  abilities necessary to carry out work responsibilities.
  981         (d)(b) “Person providing child welfare services” means a
  982  person who has a responsibility for supervisory, legal, direct
  983  care or support related work in the provision of child welfare
  984  services pursuant to chapter 39.
  985         (3) CHILD WELFARE TRAINING PROGRAM.—The department shall
  986  establish a program for training pursuant to the provisions of
  987  this section, and all persons providing child welfare services
  988  shall be required to demonstrate core competency by earning and
  989  maintaining a department or third-party-awarded child welfare
  990  certification and participate in and successfully complete the
  991  program of training pertinent to their areas of responsibility.
  992         (7) CERTIFICATION AND TRAINER QUALIFICATIONS.—The
  993  department shall, in collaboration with the professionals and
  994  providers described in subsection (5), develop minimum standards
  995  for a certification process that ensures that participants have
  996  successfully attained the knowledge, skills, and abilities
  997  necessary to competently carry out their work responsibilities.
  998  The department shall recognize third-party certification for
  999  child welfare services staff which satisfies the core
 1000  competencies and meets the certification requirements
 1001  established in this section and shall develop minimum standards
 1002  for trainer qualifications which must be required of training
 1003  academies in the offering of the training curricula. Any person
 1004  providing child welfare services shall be required to master the
 1005  core competencies and hold an active child welfare certification
 1006  components of the curriculum that is are particular to that
 1007  person’s work responsibilities.
 1008         Section 29. Subsection (2) of section 402.49, Florida
 1009  Statutes, is amended to read:
 1010         402.49 Mediation process established.—
 1011         (2)(a) The department shall appoint at least one mediation
 1012  panel in each of the department’s circuits service districts.
 1013  Each panel shall have at least three and not more than five
 1014  members and shall include a representative from the department,
 1015  a representative of an agency that provides similar services to
 1016  those provided by the agency that is a party to the dispute, and
 1017  additional members who are mutually acceptable to the department
 1018  and the agency that is a party to the dispute. Such additional
 1019  members may include laypersons who are involved in advocacy
 1020  organizations, members of boards of directors of agencies
 1021  similar to the agency that is a party to the dispute, members of
 1022  families of department clients, members of department planning
 1023  councils in the area of services that are the subject of the
 1024  dispute, and interested and informed members of the local
 1025  community.
 1026         (b) If the parties to the conflict agree, a mediation panel
 1027  may hear a complaint that is filed outside of the panel’s
 1028  circuit service district.
 1029         Section 30. Subsection (3) of section 409.152, Florida
 1030  Statutes, is amended to read:
 1031         409.152 Service integration and family preservation.—
 1032         (3) Each circuit service district of the department shall
 1033  develop a family preservation service integration plan that
 1034  identifies various programs that can be organized at the point
 1035  of service delivery into a logical and cohesive family-centered
 1036  services constellation. The plan shall include:
 1037         (a) Goals and objectives for integrating services for
 1038  families and avoiding barriers to service integration,
 1039  procedures for centralized intake and assessment, a
 1040  comprehensive service plan for each family, and an evaluation
 1041  method of program outcome.
 1042         (b) Recommendations for proposed changes to fiscal and
 1043  substantive policies, regulations, and laws at local, circuit
 1044  district, and state delivery levels, including budget and
 1045  personnel policies; purchasing flexibility and workforce
 1046  incentives; discretionary resources; and incentives to reduce
 1047  dependency on government programs and services.
 1048         (c) Strategies for creating partnerships with the
 1049  community, clients, and consumers of services which establish,
 1050  maintain, and preserve family units.
 1051         Section 31. Paragraph (e) of subsection (1) and subsection
 1052  (8) of section 409.1671, Florida Statutes, are amended, and
 1053  paragraph (m) is added to subsection (1) of that section, to
 1054  read:
 1055         409.1671 Foster care and related services; outsourcing.—
 1056         (1)
 1057         (e) As used in this section, the term “eligible lead
 1058  community-based provider” means a single agency with which the
 1059  department contracts shall contract for the provision of child
 1060  protective services in a community that is no smaller than a
 1061  county. The secretary of the department may authorize more than
 1062  one eligible lead community-based provider within a single
 1063  county if it when to do so will result in more effective
 1064  delivery of foster care and related services. To compete for an
 1065  outsourcing project, such agency must have:
 1066         1. The ability to coordinate, integrate, and manage all
 1067  child protective services in the designated community in
 1068  cooperation with child protective investigations.
 1069         2. The ability to ensure continuity of care from entry to
 1070  exit for all children referred from the protective investigation
 1071  and court systems.
 1072         3. The ability to provide directly, or contract for through
 1073  a local network of providers, for all necessary child protective
 1074  services. Such agencies should directly provide no more than 35
 1075  percent of all child protective services provided.
 1076         4. The willingness to be accountable accept accountability
 1077  for meeting the outcomes and performance standards related to
 1078  child protective services established by the Legislature and the
 1079  Federal Government.
 1080         5. The capability and the willingness to serve all children
 1081  referred to it from the protective investigation and court
 1082  systems, regardless of the level of funding allocated to the
 1083  community by the state if, provided all related funding is
 1084  transferred.
 1085         6. The willingness to ensure that each individual who
 1086  provides child protective services completes the training
 1087  required of child protective service workers by the Department
 1088  of Children and Family Services.
 1089         7. The ability to maintain eligibility to receive all
 1090  federal child welfare funds, including Title IV-E and IV-A
 1091  funds, currently being used by the Department of Children and
 1092  Family Services.
 1093         8. Written agreements with Healthy Families Florida lead
 1094  entities in their community, pursuant to s. 409.153, to promote
 1095  cooperative planning for the provision of prevention and
 1096  intervention services.
 1097         9. A board of directors, of which at least 51 percent of
 1098  the membership is comprised of persons residing in this state.
 1099  Of the state residents, at least 51 percent must also reside
 1100  within the service area of the eligible lead community-based
 1101  provider.
 1102         (m) In order to ensure an efficient and effective
 1103  community-based care system, the department shall annually
 1104  evaluate each lead agency’s success in developing an effective
 1105  network of local providers, improving the coordination and
 1106  delivery of services to children, and investing appropriated
 1107  funds into the community for direct services to children and
 1108  families.
 1109         (8) Notwithstanding the provisions of s. 215.425, all
 1110  documented federal funds earned for the current fiscal year by
 1111  the department and community-based agencies which exceed the
 1112  amount appropriated by the Legislature shall be distributed to
 1113  all entities that contributed to the excess earnings based on a
 1114  schedule and methodology developed by the department and
 1115  approved by the Executive Office of the Governor. Distribution
 1116  shall be pro rata based on total earnings and shall be made only
 1117  to those entities that contributed to excess earnings. Excess
 1118  earnings of community-based agencies shall be used only in the
 1119  circuit service district in which they were earned. Additional
 1120  state funds appropriated by the Legislature for community-based
 1121  agencies or made available pursuant to the budgetary amendment
 1122  process described in s. 216.177 shall be transferred to the
 1123  community-based agencies. The department shall amend a
 1124  community-based agency’s contract to permit expenditure of the
 1125  funds.
 1126         Section 32. Section 409.1685, Florida Statutes, is amended
 1127  to read:
 1128         409.1685 Children in foster care; annual report to
 1129  Legislature.—The Department of Children and Family Services
 1130  shall submit a written report to the substantive committees of
 1131  the Legislature concerning the status of children in foster care
 1132  and concerning the judicial review mandated by part IX X of
 1133  chapter 39. This report shall be submitted by March 1 of each
 1134  year and shall include the following information for the prior
 1135  calendar year:
 1136         (1) The number of 6-month and annual judicial reviews
 1137  completed during that period.
 1138         (2) The number of children in foster care returned to a
 1139  parent, guardian, or relative as a result of a 6-month or annual
 1140  judicial review hearing during that period.
 1141         (3) The number of termination of parental rights
 1142  proceedings instituted during that period including which shall
 1143  include:
 1144         (a) The number of termination of parental rights
 1145  proceedings initiated pursuant to former s. 39.703; and
 1146         (b) The total number of terminations of parental rights
 1147  ordered.
 1148         (4) The number of foster care children placed for adoption
 1149  during that period.
 1150         Section 33. Paragraph (a) of subsection (4) of section
 1151  409.1755, Florida Statutes, is amended to read:
 1152         409.1755 One Church, One Child of Florida Corporation Act;
 1153  creation; duties.—
 1154         (4) BOARD OF DIRECTORS.—
 1155         (a) The One Church, One Child of Florida Corporation shall
 1156  operate subject to the supervision and approval of a board of
 1157  directors consisting of 21 23 members, with one two directors
 1158  representing each circuit service district of the Department of
 1159  Children and Families Family Services and one director who shall
 1160  be an at-large member.
 1161         Section 34. Paragraph (a) of subsection (1) and subsection
 1162  (2) of section 410.0245, Florida Statutes, are amended to read:
 1163         410.0245 Study of service needs; report; multiyear plan.—
 1164         (1)(a) The Adult Protection Services Program Office of the
 1165  Department of Children and Families Family Services shall
 1166  contract for a study of the service needs of the 18-to-59-year
 1167  old disabled adult population served or waiting to be served by
 1168  the community care for disabled adults program. The Division of
 1169  Vocational Rehabilitation of the Department of Education and
 1170  other appropriate state agencies shall provide information to
 1171  the Department of Children and Families Family Services when
 1172  requested for the purposes of this study.
 1173         (2) Based on the findings of the study, the Adult
 1174  Protection Services Program of the Department of Children and
 1175  Families Family Services shall develop a multiyear plan which
 1176  shall provide for the needs of disabled adults in this state and
 1177  shall provide strategies for statewide coordination of all
 1178  services for disabled adults. The multiyear plan shall include
 1179  an inventory of existing services and an analysis of costs
 1180  associated with existing and projected services. The multiyear
 1181  plan shall be presented to the Governor, the President of the
 1182  Senate, and the Speaker of the House of Representatives every 3
 1183  years on or before March 1, beginning in 1992. On or before
 1184  March 1 of each intervening year, the department shall submit an
 1185  analysis of the status of the implementation of each element of
 1186  the multiyear plan, any continued unmet need, and the
 1187  relationship between that need and the department’s budget
 1188  request for that year.
 1189         Section 35. Subsections (1) and (2) of section 410.603,
 1190  Florida Statutes, are renumbered as subsections (2) and (3),
 1191  respectively, and present subsection (3) of that section is
 1192  renumbered as subsection (1) and amended to read:
 1193         410.603 Definitions relating to Community Care for Disabled
 1194  Adults Act.—As used in ss. 410.601-410.606:
 1195         (1)(3) “Circuit District” means a specified geographic
 1196  service area that conforms to the judicial circuits established
 1197  in s. 26.021, as defined in s. 20.19, in which the programs of
 1198  the department are administered and services are delivered.
 1199         Section 36. Subsection (2) of section 410.604, Florida
 1200  Statutes, is amended to read:
 1201         410.604 Community care for disabled adults program; powers
 1202  and duties of the department.—
 1203         (2) Any person who meets the definition of a disabled adult
 1204  pursuant to s. 410.603(3)(2) is eligible to receive the services
 1205  of the community care for disabled adults program. However, the
 1206  community care for disabled adults program shall operate within
 1207  the funds appropriated by the Legislature. Priority shall be
 1208  given to disabled adults who are not eligible for comparable
 1209  services in programs of or funded by the department or the
 1210  Division of Vocational Rehabilitation of the Department of
 1211  Education; who are determined to be at risk of
 1212  institutionalization; and whose income is at or below the
 1213  existing institutional care program eligibility standard.
 1214         Section 37. Section 411.224, Florida Statutes, is amended
 1215  to read:
 1216         411.224 Family support planning process.—The Legislature
 1217  establishes a family support planning process to be used by the
 1218  Department of Children and Families Family Services as the
 1219  service planning process for targeted individuals, children, and
 1220  families under its purview.
 1221         (1) The Department of Education shall take all appropriate
 1222  and necessary steps to encourage and facilitate the
 1223  implementation of the family support planning process for
 1224  individuals, children, and families within its purview.
 1225         (2) To the extent possible within existing resources, the
 1226  following populations must be included in the family support
 1227  planning process:
 1228         (a) Children from birth to age 5 who are served by the
 1229  clinic and programs of the Division of Children’s Medical
 1230  Services of the Department of Health.
 1231         (b) Children participating in the developmental evaluation
 1232  and intervention program of the Division of Children’s Medical
 1233  Services of the Department of Health.
 1234         (c) Children from age 3 through age 5 who are served by the
 1235  Agency for Persons with Disabilities.
 1236         (d) Children from birth through age 5 who are served by the
 1237  Mental Health Program Office of the Department of Children and
 1238  Families Family Services.
 1239         (e) Participants who are served by the Children’s Early
 1240  Investment Program established in s. 411.232.
 1241         (f) Healthy Start participants in need of ongoing service
 1242  coordination.
 1243         (g) Children from birth through age 5 who are served by the
 1244  voluntary family services, protective supervision, foster care,
 1245  or adoption and related services programs of the Child Care
 1246  Licensure Services Program Office of the Department of Children
 1247  and Families Family Services, and who are eligible for ongoing
 1248  services from one or more other programs or agencies that
 1249  participate in family support planning; however, children served
 1250  by the voluntary family services program, where the planned
 1251  length of intervention is 30 days or less, are excluded from
 1252  this population.
 1253         (3) When individuals included in the target population are
 1254  served by Head Start, local education agencies, or other
 1255  prevention and early intervention programs, providers must be
 1256  notified and efforts made to facilitate the concerned agency’s
 1257  participation in family support planning.
 1258         (4) Local education agencies are encouraged to use a family
 1259  support planning process for children from birth through 5 years
 1260  of age who are served by the prekindergarten program for
 1261  children with disabilities, in lieu of the Individual Education
 1262  Plan.
 1263         (5) There must be only a single-family support plan to
 1264  address the problems of the various family members unless the
 1265  family requests that an individual family support plan be
 1266  developed for different members of that family. The family
 1267  support plan must replace individual habilitation plans for
 1268  children from 3 through 5 years old who are served by the Agency
 1269  for Persons with Disabilities.
 1270         (6) The family support plan at a minimum must include the
 1271  following information:
 1272         (a) The family’s statement of family concerns, priorities,
 1273  and resources.
 1274         (b) Information related to the health, educational,
 1275  economic and social needs, and overall development of the
 1276  individual and the family.
 1277         (c) The outcomes that the plan is intended to achieve.
 1278         (d) Identification of the resources and services to achieve
 1279  each outcome projected in the plan. These resources and services
 1280  are to be provided based on availability and funding.
 1281         (7) A family support plan meeting must be held with the
 1282  family to initially develop the family support plan and annually
 1283  thereafter to update the plan as necessary. The family includes
 1284  anyone who has an integral role in the life of the individual or
 1285  child as identified by the individual or family. The family
 1286  support plan must be reviewed periodically during the year, at
 1287  least at 6-month intervals, to modify and update the plan as
 1288  needed. Such periodic reviews do not require a family support
 1289  plan team meeting but may be accomplished through other means
 1290  such as a case file review and telephone conference with the
 1291  family.
 1292         (8) The initial family support plan must be developed
 1293  within a 90-day period. If exceptional circumstances make it
 1294  impossible to complete the evaluation activities and to hold the
 1295  initial family support plan team meeting within a reasonable
 1296  time period, these circumstances must be documented, and the
 1297  individual or family must be notified of the reason for the
 1298  delay. With the agreement of the family and the provider,
 1299  services for which either the individual or the family is
 1300  eligible may be initiated before the completion of the
 1301  evaluation activities and the family support plan.
 1302         (9) The Department of Children and Families Family
 1303  Services, the Department of Health, and the Department of
 1304  Education, to the extent that funds are available, must offer
 1305  technical assistance to communities to facilitate the
 1306  implementation of the family support plan.
 1307         (10) The Department of Children and Families Family
 1308  Services, the Department of Health, and the Department of
 1309  Education shall adopt rules necessary to implement this act.
 1310         Section 38. Section 414.24, Florida Statutes, is amended to
 1311  read:
 1312         414.24 Integrated welfare reform and child welfare
 1313  services.—The department shall develop integrated service
 1314  delivery strategies to better meet the needs of families subject
 1315  to work activity requirements who are involved in the child
 1316  welfare system or are at high risk of involvement in the child
 1317  welfare system. To the extent that resources are available, the
 1318  department and the Department of Labor and Employment Security
 1319  shall provide funds to one or more circuits service districts to
 1320  promote development of integrated, nonduplicative case
 1321  management within the department, the Department of Labor and
 1322  Employment Security, other participating government agencies,
 1323  and community partners. Alternative delivery systems shall be
 1324  encouraged which include well-defined, pertinent outcome
 1325  measures. Other factors to be considered shall include
 1326  innovation regarding training, enhancement of existing
 1327  resources, and increased private sector and business sector
 1328  participation.
 1329         Section 39. Subsection (8) of section 415.1113, Florida
 1330  Statutes, is amended to read:
 1331         415.1113 Administrative fines for false report of abuse,
 1332  neglect, or exploitation of a vulnerable adult.—
 1333         (8) All amounts collected under this section must be
 1334  deposited into the Operations and Maintenance Trust Fund within
 1335  the Adult Protection Services Program of the department.
 1336         Section 40. Subsections (1) through (3) of section 420.621,
 1337  Florida Statutes, are renumbered as subsections (2) through (4),
 1338  respectively, and present subsection (4) of that section is
 1339  renumbered as subsection (1) and amended to read:
 1340         420.621 Definitions.—As used in ss. 420.621-420.628, the
 1341  term:
 1342         (1)(4) “Circuit District” means a specified geographic
 1343  service area that conforms to the judicial circuits established
 1344  in s. 26.021 service district of the department, as set forth in
 1345  s. 20.19.
 1346         Section 41. Subsection (1) of section 420.622, Florida
 1347  Statutes, is amended to read:
 1348         420.622 State Office on Homelessness; Council on
 1349  Homelessness.—
 1350         (1) The State Office on Homelessness is created within the
 1351  Department of Children and Families Family Services to provide
 1352  interagency, council, and other related coordination on issues
 1353  relating to homelessness. An executive director of the office
 1354  shall be appointed by the Governor.
 1355         Section 42. Subsection (4) of section 420.623, Florida
 1356  Statutes, is amended to read:
 1357         420.623 Local coalitions for the homeless.—
 1358         (4) ANNUAL REPORTS.—The department shall submit to the
 1359  Governor, the Speaker of the House of Representatives, and the
 1360  President of the Senate, by June 30, an annual report consisting
 1361  of a compilation of data collected by local coalitions, progress
 1362  made in the development and implementation of local homeless
 1363  assistance continuums of care plans in each circuit district,
 1364  local spending plans, programs and resources available at the
 1365  local level, and recommendations for programs and funding.
 1366         Section 43. Subsections (4) through (8) of section 420.625,
 1367  Florida Statutes, are amended to read:
 1368         420.625 Grant-in-aid program.—
 1369         (4) APPLICATION PROCEDURE.—Local agencies shall submit an
 1370  application for grant-in-aid funds to the circuit district
 1371  administrator for review. During the first year of
 1372  implementation, circuit district administrators shall begin to
 1373  accept applications for circuit district funds no later than
 1374  October 1, 1988, and by August 1 of each year thereafter for
 1375  which funding for this section is provided. Circuit District
 1376  funds shall be made available to local agencies no more than 30
 1377  days after the deadline date for applications for each funding
 1378  cycle.
 1379         (5) SPENDING PLANS.—The department shall develop guidelines
 1380  for the development of spending plans and for the evaluation and
 1381  approval by circuit district administrators of spending plans,
 1382  based upon such factors as:
 1383         (a) The demonstrated level of need for the program.
 1384         (b) The demonstrated ability of the local agency or
 1385  agencies seeking assistance to deliver the services and to
 1386  assure that identified needs will be met.
 1387         (c) The ability of the local agency or agencies seeking
 1388  assistance to deliver a wide range of services as enumerated in
 1389  subsection (3).
 1390         (d) The adequacy and reasonableness of proposed budgets and
 1391  planned expenditures, and the demonstrated capacity of the local
 1392  agency or agencies to administer the funds sought.
 1393         (e) A statement from the local coalition for the homeless
 1394  as to the steps to be taken to assure coordination and
 1395  integration of services in the circuit district to avoid
 1396  unnecessary duplication and costs.
 1397         (f) Assurances by the local coalition for the homeless that
 1398  alternative funding strategies for meeting needs through the
 1399  reallocation of existing resources, utilization of volunteers,
 1400  and local government or private agency funding have been
 1401  explored.
 1402         (g) The existence of an evaluation component designed to
 1403  measure program outcomes and determine the overall effectiveness
 1404  of the local programs for the homeless for which funding is
 1405  sought.
 1406         (6) ALLOCATION OF GRANT FUNDS TO CIRCUITS DISTRICTS.—State
 1407  grant-in-aid funds for local initiatives for the homeless shall
 1408  be allocated by the department to, and administered by,
 1409  department circuits districts. Allocations shall be based upon
 1410  sufficient documentation of:
 1411         (a) The magnitude of the problem of homelessness in the
 1412  circuit district, and the demonstrated level of unmet need for
 1413  services in the circuit district for those who are homeless or
 1414  are about to become homeless.
 1415         (b) A strong local commitment to seriously address the
 1416  problem of homelessness as evidenced by coordinated programs
 1417  involving preventive, emergency, and transitional services and
 1418  by the existence of active local organizations committed to
 1419  serving those who have become, or are about to become, homeless.
 1420         (c) Agreement by local government and private agencies
 1421  currently serving the homeless not to reduce current
 1422  expenditures for services presently provided to those who are
 1423  homeless or are about to become homeless if grant assistance is
 1424  provided pursuant to this section.
 1425         (d) Geographic distribution of circuit district programs to
 1426  ensure that such programs serve both rural and urban areas, as
 1427  needed.
 1428         (7) DISTRIBUTION TO LOCAL AGENCIES.—Circuit District funds
 1429  so allocated shall be available for distribution by the circuit
 1430  district administrator to local agencies to fund programs such
 1431  as those set forth in subsection (3), based upon the
 1432  recommendations of the local coalitions in accordance with
 1433  spending plans developed by the coalitions and approved by the
 1434  circuit district administrator. Not more than 10 percent of the
 1435  total state funds awarded under a spending plan may be used by
 1436  the local coalition for staffing and administration.
 1437         (8) LOCAL MATCHING FUNDS.—Entities contracting to provide
 1438  services through financial assistance obtained under this
 1439  section shall provide a minimum of 25 percent of the funding
 1440  necessary for the support of project operations. In-kind
 1441  contributions, whether materials, commodities, transportation,
 1442  office space, other types of facilities, or personal services,
 1443  and contributions of money or services from homeless persons may
 1444  be evaluated and counted as part or all of this required local
 1445  funding, in the discretion of the circuit district
 1446  administrator.
 1447         Section 44. Subsection (2) of section 429.35, Florida
 1448  Statutes, is amended to read:
 1449         429.35 Maintenance of records; reports.—
 1450         (2) Within 60 days after the date of the biennial
 1451  inspection visit required under s. 408.811 or within 30 days
 1452  after the date of any interim visit, the agency shall forward
 1453  the results of the inspection to the local ombudsman council in
 1454  whose planning and service area, as defined in part II of
 1455  chapter 400, the facility is located; to at least one public
 1456  library or, in the absence of a public library, the county seat
 1457  in the county in which the inspected assisted living facility is
 1458  located; and, when appropriate, to the circuit district Adult
 1459  Protection Services and Mental Health Program Offices.
 1460         Section 45. Paragraph (d) of subsection (3) of section
 1461  1002.67, Florida Statutes, is amended to read:
 1462         1002.67 Performance standards; curricula and
 1463  accountability.—
 1464         (3)
 1465         (d) Each early learning coalition, the Agency for Workforce
 1466  Innovation, and the department shall coordinate with the Child
 1467  Care Licensure Services Program Office of the Department of
 1468  Children and Families Family Services to minimize interagency
 1469  duplication of activities for monitoring private prekindergarten
 1470  providers for compliance with requirements of the Voluntary
 1471  Prekindergarten Education Program under this part, the school
 1472  readiness programs under s. 411.01, and the licensing of
 1473  providers under ss. 402.301-402.319.
 1474         Section 46. Sections 39.311, 39.312, 39.313, 39.314,
 1475  39.315, 39.316, 39.317, 39.318, 394.9083, and 402.35, Florida
 1476  Statutes, are repealed.
 1477         Section 47. Subsection (3) of section 39.407, Florida
 1478  Statutes, is amended to read:
 1479         39.407 Medical, psychiatric, and psychological examination
 1480  and treatment of child; physical, mental, or substance abuse
 1481  examination of person with or requesting child custody.—
 1482         (3)(a) All children placed in out-of-home care shall be
 1483  provided with a comprehensive behavioral health assessment. The
 1484  child protective investigator or dependency case manager shall
 1485  submit a referral for such assessment within 7 days after the
 1486  child is placed in out-of-home care.
 1487         (b) Any child who has been in out-of-home care for more
 1488  than 1 year, or who did not receive a comprehensive behavioral
 1489  health assessment when placed into out-of-home care, is eligible
 1490  to receive a comprehensive behavioral health assessment. Such
 1491  assessments evaluate behaviors that give rise to the concern
 1492  that the child has unmet mental health needs. Any party to the
 1493  dependency proceeding, or the court on its own motion, may
 1494  request that an assessment be performed.
 1495         (c) The child protective investigator or dependency case
 1496  manager is responsible for ensuring that all recommendations in
 1497  the comprehensive behavioral health assessment are incorporated
 1498  into the child’s case plan and that the recommended services are
 1499  provided in a timely manner. If, at a case planning conference,
 1500  a determination is made that a specific recommendation should
 1501  not be included in a child’s case plan, a written explanation
 1502  must be provided to the court as to why the recommendation is
 1503  not being followed.
 1504         (d) This subsection does not to prevent a child from
 1505  receiving any other form of psychological assessment if needed.
 1506         (e) If it is determined that a child is in need of mental
 1507  health services, the comprehensive behavioral health assessment
 1508  must be provided to the physician involved in developing the
 1509  child’s mental health treatment plan, pursuant to s. 39.4071(9).
 1510         (3)(a)1. Except as otherwise provided in subparagraph (b)1.
 1511  or paragraph (e), before the department provides psychotropic
 1512  medications to a child in its custody, the prescribing physician
 1513  shall attempt to obtain express and informed consent, as defined
 1514  in s. 394.455(9) and as described in s. 394.459(3)(a), from the
 1515  child’s parent or legal guardian. The department must take steps
 1516  necessary to facilitate the inclusion of the parent in the
 1517  child’s consultation with the physician. However, if the
 1518  parental rights of the parent have been terminated, the parent’s
 1519  location or identity is unknown or cannot reasonably be
 1520  ascertained, or the parent declines to give express and informed
 1521  consent, the department may, after consultation with the
 1522  prescribing physician, seek court authorization to provide the
 1523  psychotropic medications to the child. Unless parental rights
 1524  have been terminated and if it is possible to do so, the
 1525  department shall continue to involve the parent in the
 1526  decisionmaking process regarding the provision of psychotropic
 1527  medications. If, at any time, a parent whose parental rights
 1528  have not been terminated provides express and informed consent
 1529  to the provision of a psychotropic medication, the requirements
 1530  of this section that the department seek court authorization do
 1531  not apply to that medication until such time as the parent no
 1532  longer consents.
 1533         2. Any time the department seeks a medical evaluation to
 1534  determine the need to initiate or continue a psychotropic
 1535  medication for a child, the department must provide to the
 1536  evaluating physician all pertinent medical information known to
 1537  the department concerning that child.
 1538         (b)1. If a child who is removed from the home under s.
 1539  39.401 is receiving prescribed psychotropic medication at the
 1540  time of removal and parental authorization to continue providing
 1541  the medication cannot be obtained, the department may take
 1542  possession of the remaining medication and may continue to
 1543  provide the medication as prescribed until the shelter hearing,
 1544  if it is determined that the medication is a current
 1545  prescription for that child and the medication is in its
 1546  original container.
 1547         2. If the department continues to provide the psychotropic
 1548  medication to a child when parental authorization cannot be
 1549  obtained, the department shall notify the parent or legal
 1550  guardian as soon as possible that the medication is being
 1551  provided to the child as provided in subparagraph 1. The child’s
 1552  official departmental record must include the reason parental
 1553  authorization was not initially obtained and an explanation of
 1554  why the medication is necessary for the child’s well-being.
 1555         3.If the department is advised by a physician licensed
 1556  under chapter 458 or chapter 459 that the child should continue
 1557  the psychotropic medication and parental authorization has not
 1558  been obtained, the department shall request court authorization
 1559  at the shelter hearing to continue to provide the psychotropic
 1560  medication and shall provide to the court any information in its
 1561  possession in support of the request. Any authorization granted
 1562  at the shelter hearing may extend only until the arraignment
 1563  hearing on the petition for adjudication of dependency or 28
 1564  days following the date of removal, whichever occurs sooner.
 1565         4. Before filing the dependency petition, the department
 1566  shall ensure that the child is evaluated by a physician licensed
 1567  under chapter 458 or chapter 459 to determine whether it is
 1568  appropriate to continue the psychotropic medication. If, as a
 1569  result of the evaluation, the department seeks court
 1570  authorization to continue the psychotropic medication, a motion
 1571  for such continued authorization shall be filed at the same time
 1572  as the dependency petition, within 21 days after the shelter
 1573  hearing.
 1574         (c) Except as provided in paragraphs (b) and (e), the
 1575  department must file a motion seeking the court’s authorization
 1576  to initially provide or continue to provide psychotropic
 1577  medication to a child in its legal custody. The motion must be
 1578  supported by a written report prepared by the department which
 1579  describes the efforts made to enable the prescribing physician
 1580  to obtain express and informed consent for providing the
 1581  medication to the child and other treatments considered or
 1582  recommended for the child. In addition, the motion must be
 1583  supported by the prescribing physician’s signed medical report
 1584  providing:
 1585         1. The name of the child, the name and range of the dosage
 1586  of the psychotropic medication, and that there is a need to
 1587  prescribe psychotropic medication to the child based upon a
 1588  diagnosed condition for which such medication is being
 1589  prescribed.
 1590         2. A statement indicating that the physician has reviewed
 1591  all medical information concerning the child which has been
 1592  provided.
 1593         3. A statement indicating that the psychotropic medication,
 1594  at its prescribed dosage, is appropriate for treating the
 1595  child’s diagnosed medical condition, as well as the behaviors
 1596  and symptoms the medication, at its prescribed dosage, is
 1597  expected to address.
 1598         4. An explanation of the nature and purpose of the
 1599  treatment; the recognized side effects, risks, and
 1600  contraindications of the medication; drug-interaction
 1601  precautions; the possible effects of stopping the medication;
 1602  and how the treatment will be monitored, followed by a statement
 1603  indicating that this explanation was provided to the child if
 1604  age appropriate and to the child’s caregiver.
 1605         5. Documentation addressing whether the psychotropic
 1606  medication will replace or supplement any other currently
 1607  prescribed medications or treatments; the length of time the
 1608  child is expected to be taking the medication; and any
 1609  additional medical, mental health, behavioral, counseling, or
 1610  other services that the prescribing physician recommends.
 1611         (d)1. The department must notify all parties of the
 1612  proposed action taken under paragraph (c) in writing or by
 1613  whatever other method best ensures that all parties receive
 1614  notification of the proposed action within 48 hours after the
 1615  motion is filed. If any party objects to the department’s
 1616  motion, that party shall file the objection within 2 working
 1617  days after being notified of the department’s motion. If any
 1618  party files an objection to the authorization of the proposed
 1619  psychotropic medication, the court shall hold a hearing as soon
 1620  as possible before authorizing the department to initially
 1621  provide or to continue providing psychotropic medication to a
 1622  child in the legal custody of the department. At such hearing
 1623  and notwithstanding s. 90.803, the medical report described in
 1624  paragraph (c) is admissible in evidence. The prescribing
 1625  physician need not attend the hearing or testify unless the
 1626  court specifically orders such attendance or testimony, or a
 1627  party subpoenas the physician to attend the hearing or provide
 1628  testimony. If, after considering any testimony received, the
 1629  court finds that the department’s motion and the physician’s
 1630  medical report meet the requirements of this subsection and that
 1631  it is in the child’s best interests, the court may order that
 1632  the department provide or continue to provide the psychotropic
 1633  medication to the child without additional testimony or
 1634  evidence. At any hearing held under this paragraph, the court
 1635  shall further inquire of the department as to whether additional
 1636  medical, mental health, behavioral, counseling, or other
 1637  services are being provided to the child by the department which
 1638  the prescribing physician considers to be necessary or
 1639  beneficial in treating the child’s medical condition and which
 1640  the physician recommends or expects to provide to the child in
 1641  concert with the medication. The court may order additional
 1642  medical consultation, including consultation with the MedConsult
 1643  line at the University of Florida, if available, or require the
 1644  department to obtain a second opinion within a reasonable
 1645  timeframe as established by the court, not to exceed 21 calendar
 1646  days, after such order based upon consideration of the best
 1647  interests of the child. The department must make a referral for
 1648  an appointment for a second opinion with a physician within 1
 1649  working day. The court may not order the discontinuation of
 1650  prescribed psychotropic medication if such order is contrary to
 1651  the decision of the prescribing physician unless the court first
 1652  obtains an opinion from a licensed psychiatrist, if available,
 1653  or, if not available, a physician licensed under chapter 458 or
 1654  chapter 459, stating that more likely than not, discontinuing
 1655  the medication would not cause significant harm to the child.
 1656  If, however, the prescribing psychiatrist specializes in mental
 1657  health care for children and adolescents, the court may not
 1658  order the discontinuation of prescribed psychotropic medication
 1659  unless the required opinion is also from a psychiatrist who
 1660  specializes in mental health care for children and adolescents.
 1661  The court may also order the discontinuation of prescribed
 1662  psychotropic medication if a child’s treating physician,
 1663  licensed under chapter 458 or chapter 459, states that
 1664  continuing the prescribed psychotropic medication would cause
 1665  significant harm to the child due to a diagnosed nonpsychiatric
 1666  medical condition.
 1667         2. The burden of proof at any hearing held under this
 1668  paragraph shall be by a preponderance of the evidence.
 1669         (e)1. If the child’s prescribing physician certifies in the
 1670  signed medical report required in paragraph (c) that delay in
 1671  providing a prescribed psychotropic medication would more likely
 1672  than not cause significant harm to the child, the medication may
 1673  be provided in advance of the issuance of a court order. In such
 1674  event, the medical report must provide the specific reasons why
 1675  the child may experience significant harm and the nature and the
 1676  extent of the potential harm. The department must submit a
 1677  motion seeking continuation of the medication and the
 1678  physician’s medical report to the court, the child’s guardian ad
 1679  litem, and all other parties within 3 working days after the
 1680  department commences providing the medication to the child. The
 1681  department shall seek the order at the next regularly scheduled
 1682  court hearing required under this chapter, or within 30 days
 1683  after the date of the prescription, whichever occurs sooner. If
 1684  any party objects to the department’s motion, the court shall
 1685  hold a hearing within 7 days.
 1686         2. Psychotropic medications may be administered in advance
 1687  of a court order in hospitals, crisis stabilization units, and
 1688  in statewide inpatient psychiatric programs. Within 3 working
 1689  days after the medication is begun, the department must seek
 1690  court authorization as described in paragraph (c).
 1691         (f)1. The department shall fully inform the court of the
 1692  child’s medical and behavioral status as part of the social
 1693  services report prepared for each judicial review hearing held
 1694  for a child for whom psychotropic medication has been prescribed
 1695  or provided under this subsection. As a part of the information
 1696  provided to the court, the department shall furnish copies of
 1697  all pertinent medical records concerning the child which have
 1698  been generated since the previous hearing. On its own motion or
 1699  on good cause shown by any party, including any guardian ad
 1700  litem, attorney, or attorney ad litem who has been appointed to
 1701  represent the child or the child’s interests, the court may
 1702  review the status more frequently than required in this
 1703  subsection.
 1704         2. The court may, in the best interests of the child, order
 1705  the department to obtain a medical opinion addressing whether
 1706  the continued use of the medication under the circumstances is
 1707  safe and medically appropriate.
 1708         (g) The department shall adopt rules to ensure that
 1709  children receive timely access to clinically appropriate
 1710  psychotropic medications. These rules must include, but need not
 1711  be limited to, the process for determining which adjunctive
 1712  services are needed, the uniform process for facilitating the
 1713  prescribing physician’s ability to obtain the express and
 1714  informed consent of a child’s parent or guardian, the procedures
 1715  for obtaining court authorization for the provision of a
 1716  psychotropic medication, the frequency of medical monitoring and
 1717  reporting on the status of the child to the court, how the
 1718  child’s parents will be involved in the treatment-planning
 1719  process if their parental rights have not been terminated, and
 1720  how caretakers are to be provided information contained in the
 1721  physician’s signed medical report. The rules must also include
 1722  uniform forms to be used in requesting court authorization for
 1723  the use of a psychotropic medication and provide for the
 1724  integration of each child’s treatment plan and case plan. The
 1725  department must begin the formal rulemaking process within 90
 1726  days after the effective date of this act.
 1727         Section 48. Section 39.4071, Florida Statutes, is created
 1728  to read:
 1729         39.4071 Use of psychotropic medication for children in out
 1730  of-home placement.—
 1731         (1) LEGISLATIVE FINDINGS AND INTENT.—
 1732         (a) The Legislature finds that children in out-of-home
 1733  placements often have multiple risk factors that predispose them
 1734  to emotional and behavioral disorders and that they receive
 1735  mental health services at higher rates and are more likely to be
 1736  given psychotropic medications than children from comparable
 1737  backgrounds.
 1738         (b) The Legislature also finds that the use of psychotropic
 1739  medications for the treatment of children in out-of-home
 1740  placements who have emotional and behavioral disturbances has
 1741  increased over recent years. While the increased use of
 1742  psychotropic medications is paralleled by an increase in the
 1743  rate of the coadministration of two or more psychotropic
 1744  medications, data on the safety and efficacy of many of the
 1745  psychotropic medications used in children and research
 1746  supporting the coadministration of two or more psychotropic
 1747  medications in this population is limited.
 1748         (c) The Legislature further finds that significant
 1749  challenges are encountered in providing quality mental health
 1750  care to children in out-of-home placements. Not uncommonly,
 1751  children in out-of-home placements are subjected to multiple
 1752  placements and many service providers, with communication
 1753  between providers often poor, resulting in fragmented medical
 1754  and mental health care. The dependable, ongoing therapeutic and
 1755  caregiving relationships these children need are hampered by the
 1756  high turnover among child welfare caseworkers and care
 1757  providers. Furthermore, children in out-of-home placements,
 1758  unlike children from intact families, often have no consistent
 1759  interested party who is available to coordinate treatment and
 1760  monitoring plans or to provide longitudinal oversight of care.
 1761         (d) The Legislature recognizes the important role the
 1762  Guardian ad Litem Program has played in Florida’s dependency
 1763  system for the past 30 years serving the state’s most vulnerable
 1764  children through the use of trained volunteers, case
 1765  coordinators, child advocates and attorneys. The program’s
 1766  singular focus is on the child and its mission is to advocate
 1767  for the best interest of the child. It is often the guardian ad
 1768  litem who is the constant in a child’s life, maintaining
 1769  consistent contact with the child, the child’s caseworkers, and
 1770  others involved with the child, including family, doctors,
 1771  teachers, and service providers. Studies have shown that a child
 1772  assigned a guardian ad litem will, on average, experience fewer
 1773  placement changes than a child without a guardian ad litem. It
 1774  is therefore the intent of the Legislature that children in out
 1775  of-home placements who may benefit from psychotropic medications
 1776  receive those medications safely as part of a comprehensive
 1777  mental health treatment plan requiring the appointment of a
 1778  guardian ad litem whose responsibility is to monitor the plan
 1779  for compliance and suitability as to the child’s best interest.
 1780         (2) DEFINITIONS.—As used in this section, the term:
 1781         (a) “Behavior analysis” means services rendered by a
 1782  provider who is certified by the Behavior Analysis Certification
 1783  Board in accordance with chapter 393.
 1784         (b) “Obtaining assent” means a process by which a provider
 1785  of medical services helps a child achieve a developmentally
 1786  appropriate awareness of the nature of his or her condition,
 1787  informs the child of what can be expected through tests and
 1788  treatment, makes a clinical assessment of the child’s
 1789  understanding of the situation and the factors influencing how
 1790  he or she is responding, and solicits an expression of the
 1791  child’s willingness to adhere to the proposed care. The mere
 1792  absence of an objection by the child may not be construed as
 1793  assent.
 1794         (c) “Comprehensive behavioral health assessment” means an
 1795  in-depth and detailed assessment of the child’s emotional,
 1796  social, behavioral, and developmental functioning within the
 1797  family home, school, and community. A comprehensive behavioral
 1798  health assessment includes direct observation of the child in
 1799  the home, school, and community, as well as in the clinical
 1800  setting, and adheres to the requirements in the Florida Medicaid
 1801  Community Behavioral Health Services Coverage and Limitations
 1802  Handbook.
 1803         (d) “Express and informed consent” means a process by which
 1804  a provider of medical services obtains voluntary consent from a
 1805  parent whose rights have not been terminated or a legal guardian
 1806  of the child who has received full, accurate, and sufficient
 1807  information and an explanation about the child’s medical
 1808  condition, medication, and treatment in order to enable the
 1809  parent or guardian to make a knowledgeable decision without any
 1810  element of fraud, deceit, duress, or other form of coercion.
 1811         (e) “Mental health treatment plan” means a plan that lists
 1812  the particular mental health needs of the child and the services
 1813  that will be provided to address those needs. If the plan
 1814  includes prescribing psychotropic medication to a child in out
 1815  of-home placement, the plan must also include the information
 1816  required under subsection (9).
 1817         (f)“Psychotropic medication” means a prescription
 1818  medication that is used for the treatment of mental disorders
 1819  and includes, without limitation, hypnotics, antipsychotics,
 1820  antidepressants, antianxiety agents, sedatives, stimulants, and
 1821  mood stabilizers.
 1822         (3) APPOINTMENT OF GUARDIAN AD LITEM.—
 1823         (a) If not already appointed, a guardian ad litem shall be
 1824  appointed by the court at the earliest possible time to
 1825  represent the best interests of a child in out-of-home placement
 1826  who is prescribed a psychotropic medication or is being
 1827  evaluated for the initiation of psychotropic medication.
 1828  Pursuant to s. 39.820, the appointed guardian ad litem is a
 1829  party to any judicial proceeding as a representative of the
 1830  child and serves until discharged by the court.
 1831         (b) Pursuant to this section, the guardian ad litem shall
 1832  participate in the development of the mental health treatment
 1833  plan, monitor whether all requirements of the mental health
 1834  treatment plan are being provided to the child, including
 1835  counseling, behavior analysis, or other services, medications,
 1836  and treatment modalities; and notice the court of the child’s
 1837  objections, if any, to the mental health treatment plan. The
 1838  guardian ad litem shall prepare and submit to the court a
 1839  written report every 45 days or as directed by the court,
 1840  advising the court and the parties as to the status of the care,
 1841  health, and medical treatment of the child pursuant to the
 1842  mental health treatment plan and any change in the status of the
 1843  child. The guardian ad litem must immediately notify parties as
 1844  soon as a medical emergency of the child becomes known. The
 1845  guardian ad litem shall ensure that the prescribing physician
 1846  has been provided with all pertinent medical information
 1847  concerning the child.
 1848         (c) The department and the community-based care lead agency
 1849  shall notify the court and the guardian ad litem, and, if
 1850  applicable, the child’s attorney, in writing within 24 hours
 1851  after any change in the status of the child, including, but not
 1852  limited to, a change in placement, a change in school, a change
 1853  in medical condition or medication, or a change in prescribing
 1854  physician, other service providers, counseling, or treatment
 1855  scheduling.
 1856         (4) PSYCHIATRIC EVALUATION OF CHILD.—Whenever the
 1857  department believes that a child in its legal custody may need
 1858  psychiatric treatment, an evaluation must be conducted by a
 1859  physician licensed under chapter 458 or chapter 459.
 1860         (5) EXPRESS AND INFORMED CONSENT AND ASSENT.—If, at the
 1861  time of removal from his or her home, a child is being provided,
 1862  or at any time is being evaluated for the initiation of,
 1863  prescribed psychotropic medication under this section, express
 1864  and informed consent and assent shall be sought by the
 1865  prescribing physician.
 1866         (a) The prescribing physician shall obtain assent from the
 1867  child, unless the prescribing physician determines that it is
 1868  not appropriate. In making this assessment, the prescribing
 1869  physician shall consider the capacity of the child to make an
 1870  independent decision based on his or her age, maturity, and
 1871  psychological and emotional state. If the physician determines
 1872  that it is not appropriate, the physician must document the
 1873  decision in the mental health treatment plan. If the physician
 1874  determines it is appropriate and the child refuses to give
 1875  assent, the physician must document the child’s refusal in the
 1876  mental health treatment plan.
 1877         1. Assent from a child shall be sought in a manner that is
 1878  understandable to the child using a developmentally appropriate
 1879  assent form. The child shall be provided with sufficient
 1880  information, such as the nature and purpose of the medication,
 1881  how it will be administered, the probable risks and benefits,
 1882  alternative treatments and the risks and benefits thereof, and
 1883  the risks and benefits of refusing or discontinuing the
 1884  medication, and when it may be appropriately discontinued.
 1885  Assent may be oral or written and must be documented by the
 1886  prescribing physician.
 1887         2. Oral assent is appropriate for a child who is younger
 1888  than 7 years of age. Assent from a child who is 7 to 13 years of
 1889  age may be sought orally or in a simple form that is written at
 1890  the second-grade or third-grade reading level. A child who is 14
 1891  years of age or older may understand the language presented in
 1892  the consent form for parents or legal guardians. If so, the
 1893  child may sign the consent form along with the parent or legal
 1894  guardian. Forms for parents and older children shall be written
 1895  at the sixth grade to eighth-grade reading level.
 1896         3. In each case where assent is obtained, a copy of the
 1897  assent documents must be provided to the parent or legal
 1898  guardian and the guardian ad litem, with the original assent
 1899  documents becoming a part of the child’s mental health treatment
 1900  plan and filed with the court.
 1901         (b) Express and informed consent for the administration of
 1902  psychotropic medication may be given only by a parent whose
 1903  rights have not been terminated or a legal guardian of the child
 1904  who has received full, accurate, and sufficient information and
 1905  an explanation about the child’s medical condition, medication,
 1906  and treatment in order to enable the parent or guardian to make
 1907  a knowledgeable decision. A sufficient explanation includes, but
 1908  need not be limited to, the following information, which must be
 1909  provided and explained in plain language by the prescribing
 1910  physician to the parent or legal guardian: the child’s
 1911  diagnosis, the symptoms to be addressed by the medication, the
 1912  name of the medication and its dosage ranges, the reason for
 1913  prescribing it, and its purpose or intended results; benefits,
 1914  side effects, risks, and contraindications, including effects of
 1915  not starting or stopping the medication; method for
 1916  administering the medication and how it will monitored;
 1917  potential drug interactions; alternative treatments to
 1918  psychotropic medication; a plan to reduce or eliminate ongoing
 1919  medication when medically appropriate; the counseling,
 1920  behavioral analysis, or other services used to complement the
 1921  use of medication, if applicable; and that the parent or legal
 1922  guardian may revoke the consent at any time.
 1923         1. Express and informed consent may be oral or written and
 1924  must be documented by the prescribing physician. If the
 1925  department or the physician is unable to obtain consent from the
 1926  parent or legal guardian, the reasons must be documented.
 1927         2. If express and informed consent is obtained, a copy of
 1928  the consent documents must be provided to the parent or legal
 1929  guardian and the guardian ad litem, with the original consent
 1930  documents becoming a part of the child’s mental health treatment
 1931  plan and filed with the court.
 1932         (c) The informed consent of any parent whose whereabouts
 1933  are unknown for 60 days, who is adjudicated incapacitated, who
 1934  does not have regular and frequent contact with the child, who
 1935  later revokes assent, or whose parental rights are terminated
 1936  after giving consent, is invalid. If the informed consent of a
 1937  parent becomes invalid, the department may seek informed consent
 1938  from any other parent or legal guardian. If the informed consent
 1939  provided by a parent whose parental rights have been terminated
 1940  is invalid and no other parent or legal guardian gives informed
 1941  consent, the department shall file a motion for the
 1942  administration of psychotropic medication along with the motion
 1943  for final judgment of termination of parental rights.
 1944         (d) If consent is revoked or becomes invalid the department
 1945  shall immediately notify all parties and, if applicable, the
 1946  child’s attorney. Medication shall be continued until such time
 1947  as the court rules on the motion.
 1948         (e) A medication may not be discontinued without explicit
 1949  instruction from a physician as to how to safely discontinue the
 1950  medication.
 1951         (6) ADMINISTRATION OF PSYCHOTROPIC MEDICATION TO A CHILD IN
 1952  SHELTER CARE OR IN FOSTER CARE WHEN INFORMED CONSENT HAS NOT
 1953  BEEN OBTAINED.—
 1954         (a) Motion for court authorization for administration of
 1955  psychotropic medications.
 1956         1. If a physician who has evaluated the child prescribes
 1957  psychotropic medication as part of the mental health treatment
 1958  plan and the child’s parents or legal guardians have not
 1959  provided express and informed consent as provided by law or such
 1960  consent is invalid as set forth in paragraph (5)(c), the
 1961  department or its agent shall file a motion with the court
 1962  within 3 working days to authorize the administration of the
 1963  psychotropic medication before the administration of the
 1964  medication, except as provided in subsection (7). In each case
 1965  in which a motion is required, the motion must include:
 1966         a. A written report by the department describing the
 1967  efforts made to enable the prescribing physician to obtain
 1968  express and informed consent and describing other treatments
 1969  attempted, considered, and recommended for the child; and
 1970         b. The prescribing physician’s completed and signed mental
 1971  health treatment plan.
 1972         2. The department must file a copy of the motion with the
 1973  court and, within 48 hours after filing the motion, notify all
 1974  parties in writing, or by whatever other method best ensures
 1975  that all parties receive notification, of its proposed
 1976  administration of psychotropic medication to the child.
 1977         3. If any party objects to the proposed administration of
 1978  the psychotropic medication to the child, that party must file
 1979  its objection within 2 working days after being notified of the
 1980  department’s motion. A party may request an extension of time to
 1981  object for good cause shown if such extension would be in the
 1982  best interests of the child. Any extension must be for a
 1983  specific number of days not to exceed the time absolutely
 1984  necessary.
 1985         4. Lack of assent from the child is deemed a timely
 1986  objection from the child.
 1987         (b) Court action on motion for administration of
 1988  psychotropic medication.
 1989         1. If no party timely files an objection to the
 1990  department’s motion and the motion is legally sufficient, the
 1991  court may enter its order authorizing the proposed
 1992  administration of the psychotropic medication without a hearing.
 1993  Based on its determination of the best interests of the child,
 1994  the court may order additional medical consultation, including
 1995  consultation with the MedConsult line at the University of
 1996  Florida, if available, or require the department to obtain a
 1997  second opinion within a reasonable time established by the
 1998  court, not to exceed 21 calendar days. If the court orders an
 1999  additional medical consultation or second medical opinion, the
 2000  department shall file a written report including the results of
 2001  this additional consultation or a copy of the second medical
 2002  opinion with the court within the time required by the court,
 2003  and serve a copy of the report on all parties.
 2004         2.If any party timely files its objection to the proposed
 2005  administration of the psychotropic medication, the court shall
 2006  hold a hearing as soon as possible on the department’s motion.
 2007         a. The signed mental health treatment plan of the
 2008  prescribing physician is admissible in evidence at the hearing.
 2009         b. The court shall ask the department whether additional
 2010  medical, mental health, behavior analysis, counseling, or other
 2011  services are being provided to the child which the prescribing
 2012  physician considers to be necessary or beneficial in treating
 2013  the child’s medical condition and which the physician recommends
 2014  or expects to be provided to the child along with the
 2015  medication.
 2016         3. The court may order additional medical consultation or a
 2017  second medical opinion, as provided in this paragraph.
 2018         4. After considering the department’s motion and any
 2019  testimony received, the court may enter its order authorizing
 2020  the department to provide or continue to provide the proposed
 2021  psychotropic medication. The court must find a compelling
 2022  governmental interest that the proposed psychotropic medication
 2023  is in the child’s best interest. In so determining the court
 2024  shall, at a minimum, consider the following factors:
 2025         a. The severity and likelihood of risks associated with the
 2026  treatment.
 2027         b. The magnitude and likelihood of benefits expected from
 2028  the treatment.
 2029         c. The child’s prognosis without the proposed psychotropic
 2030  medication.
 2031         d. The availability and effectiveness of alternative
 2032  treatments.
 2033         e. The wishes of the child concerning treatment
 2034  alternatives.
 2035         f. The recommendation of the parents or legal guardian.
 2036         g. The recommendation of the guardian ad litem.
 2037         (7) ADMINISTRATION OF PSYCHOTROPIC MEDICATION TO A CHILD IN
 2038  OUT-OF-HOME CARE BEFORE COURT AUTHORIZATION HAS BEEN OBTAINED.
 2039  The department may provide continued administration of
 2040  psychotropic medication to a child before authorization by the
 2041  court has been obtained only as provided in this subsection.
 2042         (a) If a child is removed from the home and taken into
 2043  custody under s. 39.401, the department may continue to
 2044  administer a current prescription of psychotropic medication;
 2045  however, the department shall request court authorization for
 2046  the continued administration of the medication at the shelter
 2047  hearing. This request shall be included in the shelter petition.
 2048         1. The department shall provide all information in its
 2049  possession to the court in support of its request at the shelter
 2050  hearing. The court may authorize the continued administration of
 2051  the psychotropic medication only until the arraignment hearing
 2052  on the petition for adjudication, or for 28 days following the
 2053  date of the child’s removal, whichever occurs first.
 2054         2. If the department believes, based on the required
 2055  physician’s evaluation, that it is appropriate to continue the
 2056  psychotropic medication beyond the time authorized by the court
 2057  at the shelter hearing, the department shall file a motion
 2058  seeking continued court authorization at the same time that it
 2059  files the dependency petition, but within 21 days after the
 2060  shelter hearing.
 2061         (b) If the department believes, based on the certification
 2062  of the prescribing physician, that delay in providing the
 2063  prescribed psychotropic medication would, more likely than not,
 2064  cause significant harm to the child, the department shall
 2065  administer the medication immediately. The department must
 2066  submit a motion to the court seeking continuation of the
 2067  medication within 3 working days after the department begins
 2068  providing the medication to the child.
 2069         1. The motion seeking authorization for the continued
 2070  administration of the psychotropic medication must include all
 2071  information required in this section. The required medical
 2072  report must also include the specific reasons why the child may
 2073  experience significant harm, and the nature and the extent of
 2074  the potential harm, resulting from a delay in authorizing the
 2075  prescribed medication.
 2076         2. The department shall serve the motion on all parties
 2077  within 3 working days after the department begins providing the
 2078  medication to the child.
 2079         3. The court shall hear the department’s motion at the next
 2080  regularly scheduled court hearing required by law, or within 30
 2081  days after the date of the prescription, whichever occurs first.
 2082  However, if any party files an objection to the motion, the
 2083  court must hold a hearing within 7 days.
 2084         (c) The department may authorize, in advance of a court
 2085  order, the administration of psychotropic medications to a child
 2086  in its custody in a hospital, crisis stabilization unit or
 2087  receiving facility, therapeutic group home, or statewide
 2088  inpatient psychiatric program. If the department does so, it
 2089  must file a motion to seek court authorization for the continued
 2090  administration of the medication within 3 working days as
 2091  required in this section.
 2092         (d) If a child receives a one-time dose of a psychotropic
 2093  medication during a crisis, the department shall provide
 2094  immediate notice to all parties and to the court of each such
 2095  emergency use.
 2096         (8) DISCONTINUATION OR ALTERATION OF MEDICATION;
 2097  DESTRUCTION OF MEDICATION.—A party may not alter the provision
 2098  of prescribed psychotropic medication in any way except upon
 2099  order of the court or advice of a physician.
 2100         (a) On the motion of any party or its own motion, the court
 2101  may order the discontinuation of a medication already
 2102  prescribed. Such discontinuation must be performed in
 2103  consultation with a physician in such a manner as to minimize
 2104  risk to the child.
 2105         (b) The child’s repeated refusal to take or continue to
 2106  take a medication shall be treated as a motion to discontinue
 2107  the medication and shall be set for hearing as soon as possible
 2108  but within 7 days after knowledge of such repeated refusal.
 2109         (c) Upon any discontinuation of a medication, the
 2110  department shall document the date and reason for the
 2111  discontinuation and notify all parties. The guardian ad litem
 2112  must be notified within 24 hours as previously provided herein.
 2113         (d) The department shall ensure the destruction of any
 2114  medication no longer being taken by the prescribed child.
 2115         (9) DEVELOPMENT OF MENTAL HEALTH TREATMENT PLAN.—Upon the
 2116  determination that a child needs mental health services, a
 2117  mental health treatment plan must be developed which lists the
 2118  particular mental health needs of the child and the services
 2119  that will be provided to address those needs. If possible, the
 2120  plan shall be developed in a face-to-face conference with the
 2121  child, the child’s parents, case manager, physician, therapist,
 2122  legal guardian, guardian ad litem, and any other interested
 2123  party. The mental health treatment plan shall be incorporated
 2124  into the case plan as tasks for the department and may be
 2125  amended under s. 39.6013.
 2126         (a) If the mental health treatment plan involves the
 2127  provision of psychotropic medication, the plan must include:
 2128         1. The name of the child, a statement indicating that there
 2129  is a need to prescribe psychotropic medication based upon a
 2130  diagnosed condition for which there is an evidence base for the
 2131  medication that is being prescribed, a statement indicating the
 2132  compelling governmental interest in prescribing the psychotropic
 2133  medication, and the name and range of the dosage of the
 2134  psychotropic medication.
 2135         2. A statement indicating that the physician has reviewed
 2136  all medical information concerning the child which has been
 2137  provided by the department or community-based care lead agency
 2138  and briefly listing all information received.
 2139         3. A medication profile, including all medications the
 2140  child is prescribed or will be prescribed, any previously
 2141  prescribed medications if known, and whether those medications
 2142  are being added, continued, or discontinued upon implementation
 2143  of the mental health treatment plan.
 2144         4. A statement indicating that the psychotropic medication,
 2145  at its prescribed dosage, is appropriate for treating the
 2146  child’s diagnosed medical condition, as well as the behaviors
 2147  and symptoms that the medication, at its prescribed dosage, is
 2148  expected to address.
 2149         5. An explanation of the nature and purpose of the
 2150  treatment; the recognized side effects, risks, and
 2151  contraindications of the medication, including procedures for
 2152  reporting adverse effects; drug-interaction precautions; the
 2153  possible effects of stopping or not initiating the medication;
 2154  and how the treatment will be monitored, followed by a statement
 2155  indicating that this explanation was provided to the child if
 2156  developmentally appropriate and to the child’s caregiver.
 2157         6. Documentation addressing whether the psychotropic
 2158  medication will replace or supplement any other currently
 2159  prescribed medications or treatments; the length of time the
 2160  child is expected to be taking the medication; a plan for the
 2161  discontinuation of any medication if medically appropriate; and
 2162  any additional medical, mental health, behavioral, counseling,
 2163  or other services that the prescribing physician recommends as
 2164  part of a comprehensive treatment plan.
 2165         7. A document describing those observable behaviors
 2166  warranting psychotropic treatment, the means for obtaining
 2167  reliable frequency data on these same observable behaviors, and
 2168  the reporting of this data with sufficient frequency to support
 2169  medication decisions.
 2170         (b) The department shall develop and administer procedures
 2171  to require the caregiver and prescribing physician to report any
 2172  adverse side effects of the medication to the department or its
 2173  designee and the guardian ad litem. Any adverse side effects
 2174  must be documented in the mental health treatment plan and
 2175  medical records for the child.
 2176         (10) REVIEW FOR ADMINISTRATION OF PSYCHOTROPIC MEDICATION
 2177  FOR CHILDREN FROM BIRTH THROUGH 10 YEARS OF AGE IN OUT-OF-HOME
 2178  CARE.—
 2179         (a) Absent a finding of a compelling state interest, a
 2180  psychotropic medication may not be authorized by the court for
 2181  any child from birth through 10 years of age who is in out-of
 2182  home placement. Based on a finding of a compelling state
 2183  interest but before a psychotropic medication is authorized by
 2184  the court for such child, a review of the administration must be
 2185  obtained from a child psychiatrist who is licensed under chapter
 2186  458 or chapter 459. The results of this review must be provided
 2187  to the child and the parent or legal guardian before final
 2188  express and informed consent is given.
 2189         (b)In advance of a court order, the department may
 2190  authorize the administration of psychotropic medications to a
 2191  child from birth through 10 years of age in its custody in the
 2192  following levels of residential care:
 2193         1. Hospital;
 2194         2. Crisis stabilization unit or receiving facility;
 2195         3. Therapeutic group home; or
 2196         4. Statewide inpatient psychiatric program.
 2197  
 2198  These levels of care demonstrate the requirement of a compelling
 2199  state interest through the extensive admission criteria being
 2200  met. If the department does so, it must file a motion to seek
 2201  court authorization for the continued administration of the
 2202  medication within 3 working days.
 2203         (c) If a child receives a one-time dose of a psychotropic
 2204  medication during a crisis, the department shall provide
 2205  immediate notice to all parties and to the court of each such
 2206  emergency use.
 2207         (11) CLINICAL TRIALS.—A child in the custody of the
 2208  department may not participate in a clinical trial that is
 2209  designed to develop new psychotropic medications or evaluate
 2210  their application to children.
 2211         (12) JUDICIAL REVIEW HEARINGS.—The department shall fully
 2212  inform the court of the child’s medical and behavioral status as
 2213  part of the social services report prepared for each judicial
 2214  review hearing held for a child for whom psychotropic medication
 2215  has been prescribed or provided under this subsection. As a part
 2216  of the information provided, the department shall furnish copies
 2217  of all pertinent medical records concerning the child which have
 2218  been generated since the previous hearing. On its own motion or
 2219  on good cause shown by any party, including any guardian ad
 2220  litem, attorney, or attorney ad litem who has been appointed to
 2221  represent the child or the child’s interests, the court may
 2222  review the status more frequently than required under this
 2223  subsection.
 2224         (13) ADOPTION OF RULES.—The department may adopt rules to
 2225  ensure that children receive timely access to mental health
 2226  services, including, but not limited to, clinically appropriate
 2227  psychotropic medications. These rules must include, but need not
 2228  be limited to, the process for determining which adjunctive
 2229  services are needed, the uniform process for facilitating the
 2230  prescribing physician’s ability to obtain the express and
 2231  informed consent of a child’s parent or legal guardian, the
 2232  procedures for obtaining court authorization for the provision
 2233  of a psychotropic medication, the frequency of medical
 2234  monitoring and reporting on the status of the child to the
 2235  court, how the child’s parents will be involved in the
 2236  treatment-planning process if their parental rights have not
 2237  been terminated, and how caretakers are to be provided
 2238  information contained in the physician’s signed mental health
 2239  treatment plan. The rules must also include uniform forms or
 2240  standardized information to be used on a statewide basis in
 2241  requesting court authorization for the use of a psychotropic
 2242  medication and provide for the integration of each child’s
 2243  mental health treatment plan and case plan. The department must
 2244  begin the formal rulemaking process within 90 days after July 1,
 2245  2010.
 2246         Section 49. Paragraph (b) of subsection (1) of section
 2247  743.0645, Florida Statutes, is amended to read:
 2248         743.0645 Other persons who may consent to medical care or
 2249  treatment of a minor.—
 2250         (1) As used in this section, the term:
 2251         (b) “Medical care and treatment” includes ordinary and
 2252  necessary medical and dental examination and treatment,
 2253  including blood testing, preventive care including ordinary
 2254  immunizations, tuberculin testing, and well-child care, but does
 2255  not include surgery, general anesthesia, provision of
 2256  psychotropic medications, or other extraordinary procedures for
 2257  which a separate court order, power of attorney, or informed
 2258  consent as provided by law is required, except as provided in s.
 2259  39.4071 s. 39.407(3).
 2260         Section 50. The Division of Statutory Revision of the Joint
 2261  Legislative Management Committee is directed to prepare a
 2262  reviser’s bill for introduction at a subsequent session of the
 2263  Legislature to change the term “Department of Children and
 2264  Family Services” to “Department of Children and Families,” the
 2265  term “Secretary of Children and Family Services” to “Secretary
 2266  of Children and Families,” and the term “district administrator”
 2267  to “circuit administrator,” as that term relates to the
 2268  responsibilities of the Department of Children and Families,
 2269  wherever that term appears in the Florida Statutes.
 2270         Section 51. The Agency for Persons with Disabilities is
 2271  directed to prepare a plan that will enable it to perform all of
 2272  its own administrative and operational functions separate from
 2273  the Department of Children and Family Services by July 1, 2015.
 2274  The plan must identify resource requirements and a timeframe for
 2275  completing the transfer of responsibilities from the Department
 2276  of Children and Family Services, including submittal of a
 2277  detailed justification for each position the agency estimates it
 2278  would need to become administratively self-sufficient; an
 2279  analysis of each function to determine if the Department of
 2280  Children and Family Services could provide the service more
 2281  efficiently on a reimbursed cost basis through an interagency
 2282  agreement; and an estimate of the costs and benefits to be
 2283  derived through the separation. The Department of Children and
 2284  Family Services is directed to cooperate with the agency in
 2285  preparing the plan. The plan shall be presented to the Speaker
 2286  of the House of Representatives, the President of the Senate,
 2287  and the appropriate substantive committees by January 15, 2011.
 2288         Section 52. The Department of Children and Families,
 2289  through its Office of General Counsel and in consultation with
 2290  its contracted legal services providers and lead agency
 2291  administrators, shall define the types of legal services
 2292  associated with dependency proceedings. These legal services
 2293  include, but are not limited to, service of process, court
 2294  reporter and transcription services, expert witnesses, and legal
 2295  publication. The department shall delineate the specific costs
 2296  each lead agency will pay for those defined legal services, and
 2297  by contract amendment, modify lead agency funding amounts to
 2298  shift funding and responsibility for those costs to the
 2299  department through its Office of General Counsel.
 2300         Section 53. The Children and Youth Cabinet created pursuant
 2301  to s. 402.56, Florida Statutes, is directed to submit a plan to
 2302  the Legislature by January 15, 2011, for addressing the
 2303  inappropriate and excessive prescribing of psychotropic
 2304  medication for children who are in the custody of the Department
 2305  of Children and Family Services, who are clients of the Agency
 2306  for Persons with Disabilities, and who are otherwise on
 2307  Medicaid.
 2308         (1) At a minimum, the plan must include:
 2309         (a) The identification of all agencies and entities, public
 2310  and private, which are responsible for monitoring the care of
 2311  children who are being prescribed psychotropic medication;
 2312         (b) The development of a plan for interagency cooperation
 2313  in identifying and reporting prescribers; and
 2314         (c) An analysis of the prescribing practices of Medicaid
 2315  providers for these populations of children.
 2316         (2) The Children and Youth Cabinet shall also include
 2317  suggestions for any legislative changes necessary to implement
 2318  the plan.
 2319         Section 54. This act shall take effect July 1, 2010.

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