November 29, 2020
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       CS for CS for CS for SB 724                     Second Engrossed
       
       
       
       
       
       
       
       
       2010724e2
       
    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, 39.001, 39.01,
   50         39.0121, 39.301, 39.302, 39.303, 39.806, 39.828,
   51         49.011, 381.0072, 394.493, 394.4985, 394.67, 394.73,
   52         394.74, 394.75, 394.76, 394.82, 394.9084, 397.821,
   53         402.49, 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. Paragraph (o) is added to subsection (1) of
  325  section 39.001, Florida Statutes, to read:
  326         39.001 Purposes and intent; personnel standards and
  327  screening.—
  328         (1) PURPOSES OF CHAPTER.—The purposes of this chapter are:
  329         (o) To provide all children and families with a fully
  330  integrated, comprehensive approach to handling all cases that
  331  involve children and families and a resolution of family
  332  disputes in a fair, timely efficient and cost-effective manner.
  333  It is the intent of the Legislature that the courts of this
  334  state embrace methods of resolving disputes that do not cause
  335  additional emotional harm to the children and families who are
  336  required to interact with the judicial system. It is the intent
  337  of the Legislature to support the development of a unified
  338  family court in a revenue neutral manner and to support the
  339  efforts of the state courts system to improve the resolution of
  340  disputes involving children and families through a fully
  341  integrated, comprehensive approach that includes coordinated
  342  case management; the concept of “one family, one judge”;
  343  collaboration with the community for referral to needed
  344  services; and methods of alternative dispute resolution. The
  345  Legislature supports the goal that the legal system focus on the
  346  needs of children who are involved in the litigation, refer
  347  families to resources that will make families’ relationships
  348  stronger, coordinate families’ cases to provide consistent
  349  results, and strive to leave families in better condition than
  350  when the families entered the system.
  351         Section 6. Subsections (18) through (76) of section 39.01,
  352  Florida Statutes, are renumbered as subsections (19) through
  353  (75), respectively, subsection (10) is amended, present
  354  subsection (26) is repealed, and present subsection (27) of that
  355  section is renumbered as subsection (18) and amended, to read:
  356         39.01 Definitions.—When used in this chapter, unless the
  357  context otherwise requires:
  358         (10) “Caregiver” means the parent, legal custodian,
  359  permanent guardian, adult household member, or other person
  360  responsible for a child’s welfare as defined in subsection (46)
  361  (47).
  362         (26) “District” means any one of the 15 service districts
  363  of the department established pursuant to s. 20.19.
  364         (18)(27) “Circuit District administrator” means the chief
  365  operating officer of each circuit service district of the
  366  department as defined in s. 20.19(5) and, where appropriate,
  367  includes any district administrator whose service district falls
  368  within the boundaries of a judicial circuit.
  369         Section 7. Subsection (10) of section 39.0121, Florida
  370  Statutes, is amended to read:
  371         39.0121 Specific rulemaking authority.—Pursuant to the
  372  requirements of s. 120.536, the department is specifically
  373  authorized to adopt, amend, and repeal administrative rules
  374  which implement or interpret law or policy, or describe the
  375  procedure and practice requirements necessary to implement this
  376  chapter, including, but not limited to, the following:
  377         (10) The Family Builders Program, the Intensive Crisis
  378  Counseling Program, and any other early intervention programs
  379  and kinship care assistance programs.
  380         Section 8. Paragraph (a) of subsection (15) of section
  381  39.301, Florida Statutes, is amended to read:
  382         39.301 Initiation of protective investigations.—
  383         (15)(a) If the department or its agent determines that a
  384  child requires immediate or long-term protection through:
  385         1. Medical or other health care; or
  386         2. Homemaker care, day care, protective supervision, or
  387  other services to stabilize the home environment, including
  388  intensive family preservation services through the Family
  389  Builders Program or the Intensive Crisis Counseling Program, or
  390  both,
  391  
  392  such services shall first be offered for voluntary acceptance
  393  unless there are high-risk factors that may impact the ability
  394  of the parents or legal custodians to exercise judgment. Such
  395  factors may include the parents’ or legal custodians’ young age
  396  or history of substance abuse or domestic violence.
  397         Section 9. Subsection (1) of section 39.302, Florida
  398  Statutes, is amended to read:
  399         39.302 Protective investigations of institutional child
  400  abuse, abandonment, or neglect.—
  401         (1) The department shall conduct a child protective
  402  investigation of each report of institutional child abuse,
  403  abandonment, or neglect. Upon receipt of a report that alleges
  404  that an employee or agent of the department, or any other entity
  405  or person covered by s. 39.01(32)(33) or (46)(47), acting in an
  406  official capacity, has committed an act of child abuse,
  407  abandonment, or neglect, the department shall initiate a child
  408  protective investigation within the timeframe established under
  409  s. 39.201(5) and orally notify the appropriate state attorney,
  410  law enforcement agency, and licensing agency, which shall
  411  immediately conduct a joint investigation, unless independent
  412  investigations are more feasible. When conducting investigations
  413  onsite or having face-to-face interviews with the child,
  414  investigation visits shall be unannounced unless it is
  415  determined by the department or its agent that unannounced
  416  visits threaten the safety of the child. If a facility is exempt
  417  from licensing, the department shall inform the owner or
  418  operator of the facility of the report. Each agency conducting a
  419  joint investigation is entitled to full access to the
  420  information gathered by the department in the course of the
  421  investigation. A protective investigation must include an onsite
  422  visit of the child’s place of residence. The department shall
  423  make a full written report to the state attorney within 3
  424  working days after making the oral report. A criminal
  425  investigation shall be coordinated, whenever possible, with the
  426  child protective investigation of the department. Any interested
  427  person who has information regarding the offenses described in
  428  this subsection may forward a statement to the state attorney as
  429  to whether prosecution is warranted and appropriate. Within 15
  430  days after the completion of the investigation, the state
  431  attorney shall report the findings to the department and shall
  432  include in the report a determination of whether or not
  433  prosecution is justified and appropriate in view of the
  434  circumstances of the specific case.
  435         Section 10. Section 39.303, Florida Statutes, is amended to
  436  read:
  437         39.303 Child protection teams; services; eligible cases.
  438  The Children’s Medical Services Program in the Department of
  439  Health shall develop, maintain, and coordinate the services of
  440  one or more multidisciplinary child protection teams in each of
  441  the circuits service districts of the Department of Children and
  442  Families Family Services. Such teams may be composed of
  443  appropriate representatives of school districts and appropriate
  444  health, mental health, social service, legal service, and law
  445  enforcement agencies. The Legislature finds that optimal
  446  coordination of child protection teams and sexual abuse
  447  treatment programs requires collaboration between the Department
  448  of Health and the Department of Children and Families Family
  449  Services. The two departments shall maintain an interagency
  450  agreement that establishes protocols for oversight and
  451  operations of child protection teams and sexual abuse treatment
  452  programs. The State Surgeon General and the Deputy Secretary for
  453  Children’s Medical Services, in consultation with the Secretary
  454  of Children and Families Family Services, shall maintain the
  455  responsibility for the screening, employment, and, if necessary,
  456  the termination of child protection team medical directors, at
  457  headquarters and in the circuits 15 districts. Child protection
  458  team medical directors shall be responsible for oversight of the
  459  teams in the circuits districts.
  460         (1) The Department of Health shall utilize and convene the
  461  teams to supplement the assessment and protective supervision
  462  activities of the family safety and preservation program of the
  463  Department of Children and Families Family Services. Nothing in
  464  this section shall be construed to remove or reduce the duty and
  465  responsibility of any person to report pursuant to this chapter
  466  all suspected or actual cases of child abuse, abandonment, or
  467  neglect or sexual abuse of a child. The role of the teams shall
  468  be to support activities of the program and to provide services
  469  deemed by the teams to be necessary and appropriate to abused,
  470  abandoned, and neglected children upon referral. The specialized
  471  diagnostic assessment, evaluation, coordination, consultation,
  472  and other supportive services that a child protection team shall
  473  be capable of providing include, but are not limited to, the
  474  following:
  475         (a) Medical diagnosis and evaluation services, including
  476  provision or interpretation of X rays and laboratory tests, and
  477  related services, as needed, and documentation of findings
  478  relative thereto.
  479         (b) Telephone consultation services in emergencies and in
  480  other situations.
  481         (c) Medical evaluation related to abuse, abandonment, or
  482  neglect, as defined by policy or rule of the Department of
  483  Health.
  484         (d) Such psychological and psychiatric diagnosis and
  485  evaluation services for the child or the child’s parent or
  486  parents, legal custodian or custodians, or other caregivers, or
  487  any other individual involved in a child abuse, abandonment, or
  488  neglect case, as the team may determine to be needed.
  489         (e) Expert medical, psychological, and related professional
  490  testimony in court cases.
  491         (f) Case staffings to develop treatment plans for children
  492  whose cases have been referred to the team. A child protection
  493  team may provide consultation with respect to a child who is
  494  alleged or is shown to be abused, abandoned, or neglected, which
  495  consultation shall be provided at the request of a
  496  representative of the family safety and preservation program or
  497  at the request of any other professional involved with a child
  498  or the child’s parent or parents, legal custodian or custodians,
  499  or other caregivers. In every such child protection team case
  500  staffing, consultation, or staff activity involving a child, a
  501  family safety and preservation program representative shall
  502  attend and participate.
  503         (g) Case service coordination and assistance, including the
  504  location of services available from other public and private
  505  agencies in the community.
  506         (h) Such training services for program and other employees
  507  of the Department of Children and Families Family Services,
  508  employees of the Department of Health, and other medical
  509  professionals as is deemed appropriate to enable them to develop
  510  and maintain their professional skills and abilities in handling
  511  child abuse, abandonment, and neglect cases.
  512         (i) Educational and community awareness campaigns on child
  513  abuse, abandonment, and neglect in an effort to enable citizens
  514  more successfully to prevent, identify, and treat child abuse,
  515  abandonment, and neglect in the community.
  516         (j) Child protection team assessments that include, as
  517  appropriate, medical evaluations, medical consultations, family
  518  psychosocial interviews, specialized clinical interviews, or
  519  forensic interviews.
  520  
  521  All medical personnel participating on a child protection team
  522  must successfully complete the required child protection team
  523  training curriculum as set forth in protocols determined by the
  524  Deputy Secretary for Children’s Medical Services and the
  525  Statewide Medical Director for Child Protection.
  526         (2) The child abuse, abandonment, and neglect reports that
  527  must be referred by the department to child protection teams of
  528  the Department of Health for an assessment and other appropriate
  529  available support services as set forth in subsection (1) must
  530  include cases involving:
  531         (a) Injuries to the head, bruises to the neck or head,
  532  burns, or fractures in a child of any age.
  533         (b) Bruises anywhere on a child 5 years of age or under.
  534         (c) Any report alleging sexual abuse of a child.
  535         (d) Any sexually transmitted disease in a prepubescent
  536  child.
  537         (e) Reported malnutrition of a child and failure of a child
  538  to thrive.
  539         (f) Reported medical neglect of a child.
  540         (g) Any family in which one or more children have been
  541  pronounced dead on arrival at a hospital or other health care
  542  facility, or have been injured and later died, as a result of
  543  suspected abuse, abandonment, or neglect, when any sibling or
  544  other child remains in the home.
  545         (h) Symptoms of serious emotional problems in a child when
  546  emotional or other abuse, abandonment, or neglect is suspected.
  547         (3) All abuse and neglect cases transmitted for
  548  investigation to a circuit district by the hotline must be
  549  simultaneously transmitted to the Department of Health child
  550  protection team for review. For the purpose of determining
  551  whether face-to-face medical evaluation by a child protection
  552  team is necessary, all cases transmitted to the child protection
  553  team which meet the criteria in subsection (2) must be timely
  554  reviewed by:
  555         (a) A physician licensed under chapter 458 or chapter 459
  556  who holds board certification in pediatrics and is a member of a
  557  child protection team;
  558         (b) A physician licensed under chapter 458 or chapter 459
  559  who holds board certification in a specialty other than
  560  pediatrics, who may complete the review only when working under
  561  the direction of a physician licensed under chapter 458 or
  562  chapter 459 who holds board certification in pediatrics and is a
  563  member of a child protection team;
  564         (c) An advanced registered nurse practitioner licensed
  565  under chapter 464 who has a specialty speciality in pediatrics
  566  or family medicine and is a member of a child protection team;
  567         (d) A physician assistant licensed under chapter 458 or
  568  chapter 459, who may complete the review only when working under
  569  the supervision of a physician licensed under chapter 458 or
  570  chapter 459 who holds board certification in pediatrics and is a
  571  member of a child protection team; or
  572         (e) A registered nurse licensed under chapter 464, who may
  573  complete the review only when working under the direct
  574  supervision of a physician licensed under chapter 458 or chapter
  575  459 who holds certification in pediatrics and is a member of a
  576  child protection team.
  577         (4) A face-to-face medical evaluation by a child protection
  578  team is not necessary when:
  579         (a) The child was examined for the alleged abuse or neglect
  580  by a physician who is not a member of the child protection team,
  581  and a consultation between the child protection team board
  582  certified pediatrician, advanced registered nurse practitioner,
  583  physician assistant working under the supervision of a child
  584  protection team board-certified pediatrician, or registered
  585  nurse working under the direct supervision of a child protection
  586  team board-certified pediatrician, and the examining physician
  587  concludes that a further medical evaluation is unnecessary;
  588         (b) The child protective investigator, with supervisory
  589  approval, has determined, after conducting a child safety
  590  assessment, that there are no indications of injuries as
  591  described in paragraphs (2)(a)-(h) as reported; or
  592         (c) The child protection team board-certified pediatrician,
  593  as authorized in subsection (3), determines that a medical
  594  evaluation is not required.
  595  
  596  Notwithstanding paragraphs (a), (b), and (c), a child protection
  597  team pediatrician, as authorized in subsection (3), may
  598  determine that a face-to-face medical evaluation is necessary.
  599         (5) In all instances in which a child protection team is
  600  providing certain services to abused, abandoned, or neglected
  601  children, other offices and units of the Department of Health,
  602  and offices and units of the Department of Children and Families
  603  Family Services, shall avoid duplicating the provision of those
  604  services.
  605         (6) The Department of Health child protection team quality
  606  assurance program and the Department of Children and Families’
  607  Family Services’ Family Safety Program Office quality assurance
  608  program shall collaborate to ensure referrals and responses to
  609  child abuse, abandonment, and neglect reports are appropriate.
  610  Each quality assurance program shall include a review of records
  611  in which there are no findings of abuse, abandonment, or
  612  neglect, and the findings of these reviews shall be included in
  613  each department’s quality assurance reports.
  614         Section 11. Paragraph (k) of subsection (1) of section
  615  39.806, Florida Statutes, is amended to read:
  616         39.806 Grounds for termination of parental rights.—
  617         (1) Grounds for the termination of parental rights may be
  618  established under any of the following circumstances:
  619         (k) A test administered at birth that indicated that the
  620  child’s blood, urine, or meconium contained any amount of
  621  alcohol or a controlled substance or metabolites of such
  622  substances, the presence of which was not the result of medical
  623  treatment administered to the mother or the newborn infant, and
  624  the biological mother of the child is the biological mother of
  625  at least one other child who was adjudicated dependent after a
  626  finding of harm to the child’s health or welfare due to exposure
  627  to a controlled substance or alcohol as defined in s.
  628  39.01(31)(32)(g), after which the biological mother had the
  629  opportunity to participate in substance abuse treatment.
  630         Section 12. Paragraph (a) of subsection (1) of section
  631  39.828, Florida Statutes, is amended to read:
  632         39.828 Grounds for appointment of a guardian advocate.—
  633         (1) The court shall appoint the person named in the
  634  petition as a guardian advocate with all the powers and duties
  635  specified in s. 39.829 for an initial term of 1 year upon a
  636  finding that:
  637         (a) The child named in the petition is or was a drug
  638  dependent newborn as described in s. 39.01(31)(32)(g);
  639         (b) The parent or parents of the child have voluntarily
  640  relinquished temporary custody of the child to a relative or
  641  other responsible adult;
  642         (c) The person named in the petition to be appointed the
  643  guardian advocate is capable of carrying out the duties as
  644  provided in s. 39.829; and
  645         (d) A petition to adjudicate the child dependent under this
  646  chapter has not been filed.
  647         Section 13. Subsection (13) of section 49.011, Florida
  648  Statutes, is amended to read:
  649         49.011 Service of process by publication; cases in which
  650  allowed.—Service of process by publication may be made in any
  651  court on any party identified in s. 49.021 in any action or
  652  proceeding:
  653         (13) For termination of parental rights pursuant to part
  654  VIII IX of chapter 39 or chapter 63.
  655         Section 14. Paragraph (a) of subsection (3) of section
  656  381.0072, Florida Statutes, is amended to read:
  657         381.0072 Food service protection.—It shall be the duty of
  658  the Department of Health to adopt and enforce sanitation rules
  659  consistent with law to ensure the protection of the public from
  660  food-borne illness. These rules shall provide the standards and
  661  requirements for the storage, preparation, serving, or display
  662  of food in food service establishments as defined in this
  663  section and which are not permitted or licensed under chapter
  664  500 or chapter 509.
  665         (3) LICENSES REQUIRED.—
  666         (a) Licenses; annual renewals.—Each food service
  667  establishment regulated under this section shall obtain a
  668  license from the department annually. Food service establishment
  669  licenses shall expire annually and are not transferable from one
  670  place or individual to another. However, those facilities
  671  licensed by the department’s Office of Licensure and
  672  Certification, the Child Care Licensure Services Program Office,
  673  or the Agency for Persons with Disabilities are exempt from this
  674  subsection. It shall be a misdemeanor of the second degree,
  675  punishable as provided in s. 381.0061, s. 775.082, or s.
  676  775.083, for such an establishment to operate without this
  677  license. The department may refuse a license, or a renewal
  678  thereof, to any establishment that is not constructed or
  679  maintained in accordance with law and with the rules of the
  680  department. Annual application for renewal is not required.
  681         Section 15. Subsection (3) of section 394.47865, Florida
  682  Statutes, is amended to read:
  683         394.47865 South Florida State Hospital; privatization.—
  684         (3)(a) Current South Florida State Hospital employees who
  685  are affected by the privatization shall be given first
  686  preference for continued employment by the contractor. The
  687  department shall make reasonable efforts to find suitable job
  688  placements for employees who wish to remain within the state
  689  Career Service System.
  690         (b) Any savings that result from the privatization of South
  691  Florida State Hospital shall be directed to the department’s
  692  service districts 9, 10, and 11 for the delivery of community
  693  mental health services.
  694         Section 16. Subsection (2) of section 394.493, Florida
  695  Statutes, is amended to read:
  696         394.493 Target populations for child and adolescent mental
  697  health services funded through the department.—
  698         (2) Each mental health provider under contract with the
  699  department to provide mental health services to the target
  700  population shall collect fees from the parent or legal guardian
  701  of the child or adolescent receiving services. The fees shall be
  702  based on a sliding fee scale for families whose net family
  703  income is at or above 150 percent of the Federal Poverty Income
  704  Guidelines. The department shall adopt, by rule, a sliding fee
  705  scale for statewide implementation. Fees collected from families
  706  shall be retained in the circuit service district and used for
  707  expanding child and adolescent mental health treatment services.
  708         Section 17. Section 394.4985, Florida Statutes, is amended
  709  to read:
  710         394.4985 Circuitwide Districtwide information and referral
  711  network; implementation.—
  712         (1) Each circuit service district of the Department of
  713  Children and Families Family Services shall develop a detailed
  714  implementation plan for a circuitwide districtwide comprehensive
  715  child and adolescent mental health information and referral
  716  network to be operational by July 1, 1999. The plan must include
  717  an operating budget that demonstrates cost efficiencies and
  718  identifies funding sources for the circuit district information
  719  and referral network. The plan must be submitted by the
  720  department to the Legislature by October 1, 1998. The circuit
  721  district shall use existing circuit district information and
  722  referral providers if, in the development of the plan, it is
  723  concluded that these providers would deliver information and
  724  referral services in a more efficient and effective manner when
  725  compared to other alternatives. The circuit district information
  726  and referral network must include:
  727         (a) A resource file that contains information about the
  728  child and adolescent mental health services as described in s.
  729  394.495, including, but not limited to:
  730         1. Type of program;
  731         2. Hours of service;
  732         3. Ages of persons served;
  733         4. Program description;
  734         5. Eligibility requirements; and
  735         6. Fees.
  736         (b) Information about private providers and professionals
  737  in the community which serve children and adolescents with an
  738  emotional disturbance.
  739         (c) A system to document requests for services that are
  740  received through the network referral process, including, but
  741  not limited to:
  742         1. Number of calls by type of service requested;
  743         2. Ages of the children and adolescents for whom services
  744  are requested; and
  745         3. Type of referral made by the network.
  746         (d) The ability to share client information with the
  747  appropriate community agencies.
  748         (e) The submission of an annual report to the department,
  749  the Agency for Health Care Administration, and appropriate local
  750  government entities, which contains information about the
  751  sources and frequency of requests for information, types and
  752  frequency of services requested, and types and frequency of
  753  referrals made.
  754         (2) In planning the information and referral network, the
  755  circuit district shall consider the establishment of a 24-hour
  756  toll-free telephone number, staffed at all times, for parents
  757  and other persons to call for information that concerns child
  758  and adolescent mental health services and a community public
  759  service campaign to inform the public about information and
  760  referral services.
  761         Section 18. Subsections (2) through (6) of section 394.67,
  762  Florida Statutes, are renumbered as subsections (4) and (8),
  763  respectively, and present subsections (7) and (8) are renumbered
  764  as subsections (2) and (3), respectively, and amended to read:
  765         394.67 Definitions.—As used in this part, the term:
  766         (2)(7) “Circuit District administrator” means the person
  767  appointed by the Secretary of Children and Families Family
  768  Services for the purpose of administering a department circuit
  769  service district as set forth in s. 20.19.
  770         (3)(8) “Circuit District plan” or “plan” means the combined
  771  circuit district substance abuse and mental health plan approved
  772  by the circuit district administrator and governing bodies in
  773  accordance with this part.
  774         Section 19. Section 394.73, Florida Statutes, is amended to
  775  read:
  776         394.73 Joint alcohol, drug abuse, and mental health service
  777  programs in two or more counties.—
  778         (1) Subject to rules established by the department, any
  779  county within a circuit service district shall have the same
  780  power to contract for alcohol, drug abuse, and mental health
  781  services as the department has under existing statutes.
  782         (2) In order to carry out the intent of this part and to
  783  provide alcohol, drug abuse, and mental health services in
  784  accordance with the circuit district plan, the counties within a
  785  circuit service district may enter into agreements with each
  786  other for the establishment of joint service programs. The
  787  agreements may provide for the joint provision or operation of
  788  services and facilities or for the provision or operation of
  789  services and facilities by one participating county under
  790  contract with other participating counties.
  791         (3) When a circuit service district comprises two or more
  792  counties or portions thereof, it is the obligation of the
  793  planning council to submit to the governing bodies, prior to the
  794  budget submission date of each governing body, an estimate of
  795  the proportionate share of costs of alcohol, drug abuse, and
  796  mental health services proposed to be borne by each such
  797  governing body.
  798         (4) Any county desiring to withdraw from a joint program
  799  may submit to the circuit district administrator a resolution
  800  requesting withdrawal therefrom together with a plan for the
  801  equitable adjustment and division of the assets, property,
  802  debts, and obligations, if any, of the joint program.
  803         Section 20. Paragraph (a) of subsection (3) of section
  804  394.74, Florida Statutes, is amended to read:
  805         394.74 Contracts for provision of local substance abuse and
  806  mental health programs.—
  807         (3) Contracts shall include, but are not limited to:
  808         (a) A provision that, within the limits of available
  809  resources, substance abuse and mental health crisis services, as
  810  defined in s. 394.67(5)(3), shall be available to any individual
  811  residing or employed within the service area, regardless of
  812  ability to pay for such services, current or past health
  813  condition, or any other factor;
  814         Section 21. Subsection (10) of section 394.75, Florida
  815  Statutes, is amended to read:
  816         394.75 State and circuit district substance abuse and
  817  mental health plans.—
  818         (10) The circuit district administrator shall ensure that
  819  the circuit district plan:
  820         (a) Conforms to the priorities in the state plan, the
  821  requirements of this part, and the standards adopted under this
  822  part;
  823         (b) Ensures that the most effective and economical use will
  824  be made of available public and private substance abuse and
  825  mental health resources in the circuit service district; and
  826         (c) Has adequate provisions made for review and evaluation
  827  of the services provided in the circuit service district.
  828         Section 22. Subsection (2) of section 394.76, Florida
  829  Statutes, is amended to read:
  830         394.76 Financing of circuit district programs and
  831  services.—If the local match funding level is not provided in
  832  the General Appropriations Act or the substantive bill
  833  implementing the General Appropriations Act, such funding level
  834  shall be provided as follows:
  835         (2) If in any fiscal year the approved state appropriation
  836  is insufficient to finance the programs and services specified
  837  by this part, the department shall have the authority to
  838  determine the amount of state funds available to each circuit
  839  service district for such purposes in accordance with the
  840  priorities in both the state and circuit district plans. The
  841  circuit district administrator shall consult with the planning
  842  council to ensure that the summary operating budget conforms to
  843  the approved plan.
  844         Section 23. Subsection (5) of section 394.78, Florida
  845  Statutes, is amended to read:
  846         394.78 Operation and administration; personnel standards;
  847  procedures for audit and monitoring of service providers;
  848  resolution of disputes.—
  849         (5) In unresolved disputes regarding this part or rules
  850  established pursuant to this part, providers and district health
  851  and human services boards shall adhere to formal procedures
  852  specified under s. 20.19(8)(n).
  853         Section 24. Subsections (3) and (4) of section 394.82,
  854  Florida Statutes, are amended to read:
  855         394.82 Funding of expanded services.—
  856         (3) Each fiscal year, any funding increases for crisis
  857  services or community mental health services that are included
  858  in the General Appropriations Act shall be appropriated in a
  859  lump-sum category as defined in s. 216.011(1)(aa). In accordance
  860  with s. 216.181(6)(a), the Executive Office of the Governor
  861  shall require the Department of Children and Families Family
  862  Services to submit a spending plan for the use of funds
  863  appropriated for this purpose. The spending plan must include a
  864  schedule for phasing in the new community mental health services
  865  in each circuit service district of the department and must
  866  describe how the new services will be integrated and coordinated
  867  with all current community-based health and human services.
  868         (4) By January 1, 2004, the crisis services defined in s.
  869  394.67(5)(3) shall be implemented, as appropriate, in the
  870  state’s public community mental health system to serve children
  871  and adults who are experiencing an acute mental or emotional
  872  crisis, as defined in s. 394.67(17). By January 1, 2006, the
  873  mental health services defined in s. 394.67(15) shall be
  874  implemented, as appropriate, in the state’s public community
  875  mental health system to serve adults and older adults who have a
  876  severe and persistent mental illness and to serve children who
  877  have a serious emotional disturbance or mental illness, as
  878  defined in s. 394.492(6).
  879         Section 25. Subsection (1) of section 394.9084, Florida
  880  Statutes, is amended to read:
  881         394.9084 Florida Self-Directed Care program.—
  882         (1) The Department of Children and Families Family
  883  Services, in cooperation with the Agency for Health Care
  884  Administration, may provide a client-directed and choice-based
  885  Florida Self-Directed Care program in all department circuits
  886  service districts, in addition to the pilot projects established
  887  in district 4 and district 8, to provide mental health treatment
  888  and support services to adults who have a serious mental
  889  illness. The department may also develop and implement a client
  890  directed and choice-based pilot project in one circuit district
  891  to provide mental health treatment and support services for
  892  children with a serious emotional disturbance who live at home.
  893  If established, any staff who work with children must be
  894  screened under s. 435.04. The department shall implement a
  895  payment mechanism in which each client controls the money that
  896  is available for that client’s mental health treatment and
  897  support services. The department shall establish interagency
  898  cooperative agreements and work with the agency, the Division of
  899  Vocational Rehabilitation, and the Social Security
  900  Administration to implement and administer the Florida Self
  901  Directed Care program.
  902         Section 26. Subsection (1) of section 397.821, Florida
  903  Statutes, is amended to read:
  904         397.821 Juvenile substance abuse impairment prevention and
  905  early intervention councils.—
  906         (1) Each judicial circuit as set forth in s. 26.021 may
  907  establish a juvenile substance abuse impairment prevention and
  908  early intervention council composed of at least 12 members,
  909  including representatives from law enforcement, the department,
  910  school districts, state attorney and public defender offices,
  911  the circuit court, the religious community, substance abuse
  912  impairment professionals, child advocates from the community,
  913  business leaders, parents, and high school students. However,
  914  those circuits which already have in operation a council of
  915  similar composition may designate the existing body as the
  916  juvenile substance abuse impairment prevention and early
  917  intervention council for the purposes of this section. Each
  918  council shall establish bylaws providing for the length of term
  919  of its members, but the term may not exceed 4 years. The circuit
  920  substate entity administrator, as defined in s. 20.19, and the
  921  chief judge of the circuit court shall each appoint six members
  922  of the council. The circuit substate entity administrator shall
  923  appoint a representative from the department, a school district
  924  representative, a substance abuse impairment treatment
  925  professional, a child advocate, a parent, and a high school
  926  student. The chief judge of the circuit court shall appoint a
  927  business leader and representatives from the state attorney’s
  928  office, the public defender’s office, the religious community,
  929  the circuit court, and law enforcement agencies.
  930         Section 27. Subsection (1) of section 402.313, Florida
  931  Statutes, is amended to read:
  932         402.313 Family day care homes.—
  933         (1) Family day care homes shall be licensed under this act
  934  if they are presently being licensed under an existing county
  935  licensing ordinance, if they are participating in the subsidized
  936  child care program, or if the board of county commissioners
  937  passes a resolution that family day care homes be licensed. If
  938  no county authority exists for the licensing of a family day
  939  care home and the county passes a resolution requiring
  940  licensure, the department shall have the authority to license
  941  family day care homes under contract with the county for the
  942  purchase-of-service system in the subsidized child care program.
  943         (a) If not subject to license, family day care homes shall
  944  register annually with the department, providing the following
  945  information:
  946         1. The name and address of the home.
  947         2. The name of the operator.
  948         3. The number of children served.
  949         4. Proof of a written plan to provide at least one other
  950  competent adult to be available to substitute for the operator
  951  in an emergency. This plan shall include the name, address, and
  952  telephone number of the designated substitute.
  953         5. Proof of screening and background checks.
  954         6. Proof of successful completion of the 30-hour training
  955  course, as evidenced by passage of a competency examination,
  956  which shall include:
  957         a. State and local rules and regulations that govern child
  958  care.
  959         b. Health, safety, and nutrition.
  960         c. Identifying and reporting child abuse and neglect.
  961         d. Child development, including typical and atypical
  962  language development; and cognitive, motor, social, and self
  963  help skills development.
  964         e. Observation of developmental behaviors, including using
  965  a checklist or other similar observation tools and techniques to
  966  determine a child’s developmental level.
  967         f. Specialized areas, including early literacy and language
  968  development of children from birth to 5 years of age, as
  969  determined by the department, for owner-operators of family day
  970  care homes.
  971         7. Proof that immunization records are kept current.
  972         8. Proof of completion of the required continuing education
  973  units or clock hours.
  974         (b) A family day care home not participating in the
  975  subsidized child care program may volunteer to be licensed under
  976  the provisions of this act.
  977         (c) The department may provide technical assistance to
  978  counties and family day care home providers to enable counties
  979  and family day care providers to achieve compliance with family
  980  day care homes standards.
  981         Section 28. Subsection (2) of section 402.315, Florida
  982  Statutes, is amended to read:
  983         402.315 Funding; license fees.—
  984         (2) The county department shall bear the costs of the
  985  licensing of family day care homes when contracting with the
  986  department pursuant to s. 402.313(1) child care facilities when
  987  contracted to do so by a county or when directly responsible for
  988  licensing in a county which fails to meet or exceed state
  989  minimum standards.
  990         Section 29. Subsections (2), (3), and (7) of section
  991  402.40, Florida Statutes, are amended to read:
  992         402.40 Child welfare training.—
  993         (2) DEFINITIONS.—As used in this section, the term:
  994         (a) “Child welfare certification” means a professional
  995  credential awarded by the department or by a credentialing
  996  entity recognized by the department to individuals demonstrating
  997  core competency in any child welfare services practice area.
  998         (b) “Child welfare services” means any intake, protective
  999  investigations, preprotective services, protective services,
 1000  foster care, shelter and group care, and adoption and related
 1001  services program, including supportive services, supervision,
 1002  and legal services, provided to children who are alleged to have
 1003  been abused, abandoned, or neglected, or who are at risk of
 1004  becoming, are alleged to be, or have been found dependent
 1005  pursuant to chapter 39.
 1006         (c)“Core competency” means the knowledge, skills, and
 1007  abilities necessary to carry out work responsibilities.
 1008         (d)(b) “Person providing child welfare services” means a
 1009  person who has a responsibility for supervisory, legal, direct
 1010  care or support related work in the provision of child welfare
 1011  services pursuant to chapter 39.
 1012         (3) CHILD WELFARE TRAINING PROGRAM.—The department shall
 1013  establish a program for training pursuant to the provisions of
 1014  this section, and all persons providing child welfare services
 1015  shall be required to demonstrate core competency by earning and
 1016  maintaining a department or third-party-awarded child welfare
 1017  certification and participate in and successfully complete the
 1018  program of training pertinent to their areas of responsibility.
 1019         (7) CERTIFICATION AND TRAINER QUALIFICATIONS.—The
 1020  department shall, in collaboration with the professionals and
 1021  providers described in subsection (5), develop minimum standards
 1022  for a certification process that ensures that participants have
 1023  successfully attained the knowledge, skills, and abilities
 1024  necessary to competently carry out their work responsibilities.
 1025  The department shall recognize third-party certification for
 1026  child welfare services staff which satisfies the core
 1027  competencies and meets the certification requirements
 1028  established in this section and shall develop minimum standards
 1029  for trainer qualifications which must be required of training
 1030  academies in the offering of the training curricula. Any person
 1031  providing child welfare services shall be required to master the
 1032  core competencies and hold an active child welfare certification
 1033  components of the curriculum that is are particular to that
 1034  person’s work responsibilities.
 1035         Section 30. Subsection (2) of section 402.49, Florida
 1036  Statutes, is amended to read:
 1037         402.49 Mediation process established.—
 1038         (2)(a) The department shall appoint at least one mediation
 1039  panel in each of the department’s circuits service districts.
 1040  Each panel shall have at least three and not more than five
 1041  members and shall include a representative from the department,
 1042  a representative of an agency that provides similar services to
 1043  those provided by the agency that is a party to the dispute, and
 1044  additional members who are mutually acceptable to the department
 1045  and the agency that is a party to the dispute. Such additional
 1046  members may include laypersons who are involved in advocacy
 1047  organizations, members of boards of directors of agencies
 1048  similar to the agency that is a party to the dispute, members of
 1049  families of department clients, members of department planning
 1050  councils in the area of services that are the subject of the
 1051  dispute, and interested and informed members of the local
 1052  community.
 1053         (b) If the parties to the conflict agree, a mediation panel
 1054  may hear a complaint that is filed outside of the panel’s
 1055  circuit service district.
 1056         Section 31. Subsection (3) of section 409.152, Florida
 1057  Statutes, is amended to read:
 1058         409.152 Service integration and family preservation.—
 1059         (3) Each circuit service district of the department shall
 1060  develop a family preservation service integration plan that
 1061  identifies various programs that can be organized at the point
 1062  of service delivery into a logical and cohesive family-centered
 1063  services constellation. The plan shall include:
 1064         (a) Goals and objectives for integrating services for
 1065  families and avoiding barriers to service integration,
 1066  procedures for centralized intake and assessment, a
 1067  comprehensive service plan for each family, and an evaluation
 1068  method of program outcome.
 1069         (b) Recommendations for proposed changes to fiscal and
 1070  substantive policies, regulations, and laws at local, circuit
 1071  district, and state delivery levels, including budget and
 1072  personnel policies; purchasing flexibility and workforce
 1073  incentives; discretionary resources; and incentives to reduce
 1074  dependency on government programs and services.
 1075         (c) Strategies for creating partnerships with the
 1076  community, clients, and consumers of services which establish,
 1077  maintain, and preserve family units.
 1078         Section 32. Paragraph (e) of subsection (1) and subsection
 1079  (8) of section 409.1671, Florida Statutes, are amended, and
 1080  paragraph (m) is added to subsection (1) of that section, to
 1081  read:
 1082         409.1671 Foster care and related services; outsourcing.—
 1083         (1)
 1084         (e) As used in this section, the term “eligible lead
 1085  community-based provider” means a single agency with which the
 1086  department contracts shall contract for the provision of child
 1087  protective services in a community that is no smaller than a
 1088  county. The secretary of the department may authorize more than
 1089  one eligible lead community-based provider within a single
 1090  county if it when to do so will result in more effective
 1091  delivery of foster care and related services. To compete for an
 1092  outsourcing project, such agency must have:
 1093         1. The ability to coordinate, integrate, and manage all
 1094  child protective services in the designated community in
 1095  cooperation with child protective investigations.
 1096         2. The ability to ensure continuity of care from entry to
 1097  exit for all children referred from the protective investigation
 1098  and court systems.
 1099         3. The ability to provide directly, or contract for through
 1100  a local network of providers, for all necessary child protective
 1101  services. Such agencies should directly provide no more than 35
 1102  percent of all child protective services provided.
 1103         4. The willingness to be accountable accept accountability
 1104  for meeting the outcomes and performance standards related to
 1105  child protective services established by the Legislature and the
 1106  Federal Government.
 1107         5. The capability and the willingness to serve all children
 1108  referred to it from the protective investigation and court
 1109  systems, regardless of the level of funding allocated to the
 1110  community by the state if, provided all related funding is
 1111  transferred.
 1112         6. The willingness to ensure that each individual who
 1113  provides child protective services completes the training
 1114  required of child protective service workers by the Department
 1115  of Children and Family Services.
 1116         7. The ability to maintain eligibility to receive all
 1117  federal child welfare funds, including Title IV-E and IV-A
 1118  funds, currently being used by the Department of Children and
 1119  Family Services.
 1120         8. Written agreements with Healthy Families Florida lead
 1121  entities in their community, pursuant to s. 409.153, to promote
 1122  cooperative planning for the provision of prevention and
 1123  intervention services.
 1124         9. A board of directors, of which at least 51 percent of
 1125  the membership is comprised of persons residing in this state.
 1126  Of the state residents, at least 51 percent must also reside
 1127  within the service area of the eligible lead community-based
 1128  provider.
 1129         (m) In order to ensure an efficient and effective
 1130  community-based care system, the department shall annually
 1131  evaluate each lead agency’s success in developing an effective
 1132  network of local providers, improving the coordination and
 1133  delivery of services to children, and investing appropriated
 1134  funds into the community for direct services to children and
 1135  families.
 1136         (8) Notwithstanding the provisions of s. 215.425, all
 1137  documented federal funds earned for the current fiscal year by
 1138  the department and community-based agencies which exceed the
 1139  amount appropriated by the Legislature shall be distributed to
 1140  all entities that contributed to the excess earnings based on a
 1141  schedule and methodology developed by the department and
 1142  approved by the Executive Office of the Governor. Distribution
 1143  shall be pro rata based on total earnings and shall be made only
 1144  to those entities that contributed to excess earnings. Excess
 1145  earnings of community-based agencies shall be used only in the
 1146  circuit service district in which they were earned. Additional
 1147  state funds appropriated by the Legislature for community-based
 1148  agencies or made available pursuant to the budgetary amendment
 1149  process described in s. 216.177 shall be transferred to the
 1150  community-based agencies. The department shall amend a
 1151  community-based agency’s contract to permit expenditure of the
 1152  funds.
 1153         Section 33. Section 409.1685, Florida Statutes, is amended
 1154  to read:
 1155         409.1685 Children in foster care; annual report to
 1156  Legislature.—The Department of Children and Family Services
 1157  shall submit a written report to the substantive committees of
 1158  the Legislature concerning the status of children in foster care
 1159  and concerning the judicial review mandated by part IX X of
 1160  chapter 39. This report shall be submitted by March 1 of each
 1161  year and shall include the following information for the prior
 1162  calendar year:
 1163         (1) The number of 6-month and annual judicial reviews
 1164  completed during that period.
 1165         (2) The number of children in foster care returned to a
 1166  parent, guardian, or relative as a result of a 6-month or annual
 1167  judicial review hearing during that period.
 1168         (3) The number of termination of parental rights
 1169  proceedings instituted during that period including which shall
 1170  include:
 1171         (a) The number of termination of parental rights
 1172  proceedings initiated pursuant to former s. 39.703; and
 1173         (b) The total number of terminations of parental rights
 1174  ordered.
 1175         (4) The number of foster care children placed for adoption
 1176  during that period.
 1177         Section 34. Paragraph (a) of subsection (4) of section
 1178  409.1755, Florida Statutes, is amended to read:
 1179         409.1755 One Church, One Child of Florida Corporation Act;
 1180  creation; duties.—
 1181         (4) BOARD OF DIRECTORS.—
 1182         (a) The One Church, One Child of Florida Corporation shall
 1183  operate subject to the supervision and approval of a board of
 1184  directors consisting of 21 23 members, with one two directors
 1185  representing each circuit service district of the Department of
 1186  Children and Families Family Services and one director who shall
 1187  be an at-large member.
 1188         Section 35. Paragraph (a) of subsection (1) and subsection
 1189  (2) of section 410.0245, Florida Statutes, are amended to read:
 1190         410.0245 Study of service needs; report; multiyear plan.—
 1191         (1)(a) The Adult Protection Services Program Office of the
 1192  Department of Children and Families Family Services shall
 1193  contract for a study of the service needs of the 18-to-59-year
 1194  old disabled adult population served or waiting to be served by
 1195  the community care for disabled adults program. The Division of
 1196  Vocational Rehabilitation of the Department of Education and
 1197  other appropriate state agencies shall provide information to
 1198  the Department of Children and Families Family Services when
 1199  requested for the purposes of this study.
 1200         (2) Based on the findings of the study, the Adult
 1201  Protection Services Program of the Department of Children and
 1202  Families Family Services shall develop a multiyear plan which
 1203  shall provide for the needs of disabled adults in this state and
 1204  shall provide strategies for statewide coordination of all
 1205  services for disabled adults. The multiyear plan shall include
 1206  an inventory of existing services and an analysis of costs
 1207  associated with existing and projected services. The multiyear
 1208  plan shall be presented to the Governor, the President of the
 1209  Senate, and the Speaker of the House of Representatives every 3
 1210  years on or before March 1, beginning in 1992. On or before
 1211  March 1 of each intervening year, the department shall submit an
 1212  analysis of the status of the implementation of each element of
 1213  the multiyear plan, any continued unmet need, and the
 1214  relationship between that need and the department’s budget
 1215  request for that year.
 1216         Section 36. Subsections (1) and (2) of section 410.603,
 1217  Florida Statutes, are renumbered as subsections (2) and (3),
 1218  respectively, and present subsection (3) of that section is
 1219  renumbered as subsection (1) and amended to read:
 1220         410.603 Definitions relating to Community Care for Disabled
 1221  Adults Act.—As used in ss. 410.601-410.606:
 1222         (1)(3) “Circuit District” means a specified geographic
 1223  service area that conforms to the judicial circuits established
 1224  in s. 26.021, as defined in s. 20.19, in which the programs of
 1225  the department are administered and services are delivered.
 1226         Section 37. Subsection (2) of section 410.604, Florida
 1227  Statutes, is amended to read:
 1228         410.604 Community care for disabled adults program; powers
 1229  and duties of the department.—
 1230         (2) Any person who meets the definition of a disabled adult
 1231  pursuant to s. 410.603(3)(2) is eligible to receive the services
 1232  of the community care for disabled adults program. However, the
 1233  community care for disabled adults program shall operate within
 1234  the funds appropriated by the Legislature. Priority shall be
 1235  given to disabled adults who are not eligible for comparable
 1236  services in programs of or funded by the department or the
 1237  Division of Vocational Rehabilitation of the Department of
 1238  Education; who are determined to be at risk of
 1239  institutionalization; and whose income is at or below the
 1240  existing institutional care program eligibility standard.
 1241         Section 38. Section 411.224, Florida Statutes, is amended
 1242  to read:
 1243         411.224 Family support planning process.—The Legislature
 1244  establishes a family support planning process to be used by the
 1245  Department of Children and Families Family Services as the
 1246  service planning process for targeted individuals, children, and
 1247  families under its purview.
 1248         (1) The Department of Education shall take all appropriate
 1249  and necessary steps to encourage and facilitate the
 1250  implementation of the family support planning process for
 1251  individuals, children, and families within its purview.
 1252         (2) To the extent possible within existing resources, the
 1253  following populations must be included in the family support
 1254  planning process:
 1255         (a) Children from birth to age 5 who are served by the
 1256  clinic and programs of the Division of Children’s Medical
 1257  Services of the Department of Health.
 1258         (b) Children participating in the developmental evaluation
 1259  and intervention program of the Division of Children’s Medical
 1260  Services of the Department of Health.
 1261         (c) Children from age 3 through age 5 who are served by the
 1262  Agency for Persons with Disabilities.
 1263         (d) Children from birth through age 5 who are served by the
 1264  Mental Health Program Office of the Department of Children and
 1265  Families Family Services.
 1266         (e) Participants who are served by the Children’s Early
 1267  Investment Program established in s. 411.232.
 1268         (f) Healthy Start participants in need of ongoing service
 1269  coordination.
 1270         (g) Children from birth through age 5 who are served by the
 1271  voluntary family services, protective supervision, foster care,
 1272  or adoption and related services programs of the Child Care
 1273  Licensure Services Program Office of the Department of Children
 1274  and Families Family Services, and who are eligible for ongoing
 1275  services from one or more other programs or agencies that
 1276  participate in family support planning; however, children served
 1277  by the voluntary family services program, where the planned
 1278  length of intervention is 30 days or less, are excluded from
 1279  this population.
 1280         (3) When individuals included in the target population are
 1281  served by Head Start, local education agencies, or other
 1282  prevention and early intervention programs, providers must be
 1283  notified and efforts made to facilitate the concerned agency’s
 1284  participation in family support planning.
 1285         (4) Local education agencies are encouraged to use a family
 1286  support planning process for children from birth through 5 years
 1287  of age who are served by the prekindergarten program for
 1288  children with disabilities, in lieu of the Individual Education
 1289  Plan.
 1290         (5) There must be only a single-family support plan to
 1291  address the problems of the various family members unless the
 1292  family requests that an individual family support plan be
 1293  developed for different members of that family. The family
 1294  support plan must replace individual habilitation plans for
 1295  children from 3 through 5 years old who are served by the Agency
 1296  for Persons with Disabilities.
 1297         (6) The family support plan at a minimum must include the
 1298  following information:
 1299         (a) The family’s statement of family concerns, priorities,
 1300  and resources.
 1301         (b) Information related to the health, educational,
 1302  economic and social needs, and overall development of the
 1303  individual and the family.
 1304         (c) The outcomes that the plan is intended to achieve.
 1305         (d) Identification of the resources and services to achieve
 1306  each outcome projected in the plan. These resources and services
 1307  are to be provided based on availability and funding.
 1308         (7) A family support plan meeting must be held with the
 1309  family to initially develop the family support plan and annually
 1310  thereafter to update the plan as necessary. The family includes
 1311  anyone who has an integral role in the life of the individual or
 1312  child as identified by the individual or family. The family
 1313  support plan must be reviewed periodically during the year, at
 1314  least at 6-month intervals, to modify and update the plan as
 1315  needed. Such periodic reviews do not require a family support
 1316  plan team meeting but may be accomplished through other means
 1317  such as a case file review and telephone conference with the
 1318  family.
 1319         (8) The initial family support plan must be developed
 1320  within a 90-day period. If exceptional circumstances make it
 1321  impossible to complete the evaluation activities and to hold the
 1322  initial family support plan team meeting within a reasonable
 1323  time period, these circumstances must be documented, and the
 1324  individual or family must be notified of the reason for the
 1325  delay. With the agreement of the family and the provider,
 1326  services for which either the individual or the family is
 1327  eligible may be initiated before the completion of the
 1328  evaluation activities and the family support plan.
 1329         (9) The Department of Children and Families Family
 1330  Services, the Department of Health, and the Department of
 1331  Education, to the extent that funds are available, must offer
 1332  technical assistance to communities to facilitate the
 1333  implementation of the family support plan.
 1334         (10) The Department of Children and Families Family
 1335  Services, the Department of Health, and the Department of
 1336  Education shall adopt rules necessary to implement this act.
 1337         Section 39. Section 414.24, Florida Statutes, is amended to
 1338  read:
 1339         414.24 Integrated welfare reform and child welfare
 1340  services.—The department shall develop integrated service
 1341  delivery strategies to better meet the needs of families subject
 1342  to work activity requirements who are involved in the child
 1343  welfare system or are at high risk of involvement in the child
 1344  welfare system. To the extent that resources are available, the
 1345  department and the Department of Labor and Employment Security
 1346  shall provide funds to one or more circuits service districts to
 1347  promote development of integrated, nonduplicative case
 1348  management within the department, the Department of Labor and
 1349  Employment Security, other participating government agencies,
 1350  and community partners. Alternative delivery systems shall be
 1351  encouraged which include well-defined, pertinent outcome
 1352  measures. Other factors to be considered shall include
 1353  innovation regarding training, enhancement of existing
 1354  resources, and increased private sector and business sector
 1355  participation.
 1356         Section 40. Subsection (8) of section 415.1113, Florida
 1357  Statutes, is amended to read:
 1358         415.1113 Administrative fines for false report of abuse,
 1359  neglect, or exploitation of a vulnerable adult.—
 1360         (8) All amounts collected under this section must be
 1361  deposited into the Operations and Maintenance Trust Fund within
 1362  the Adult Protection Services Program of the department.
 1363         Section 41. Subsections (1) through (3) of section 420.621,
 1364  Florida Statutes, are renumbered as subsections (2) through (4),
 1365  respectively, and present subsection (4) of that section is
 1366  renumbered as subsection (1) and amended to read:
 1367         420.621 Definitions.—As used in ss. 420.621-420.628, the
 1368  term:
 1369         (1)(4) “Circuit District” means a specified geographic
 1370  service area that conforms to the judicial circuits established
 1371  in s. 26.021 service district of the department, as set forth in
 1372  s. 20.19.
 1373         Section 42. Subsection (1) of section 420.622, Florida
 1374  Statutes, is amended to read:
 1375         420.622 State Office on Homelessness; Council on
 1376  Homelessness.—
 1377         (1) The State Office on Homelessness is created within the
 1378  Department of Children and Families Family Services to provide
 1379  interagency, council, and other related coordination on issues
 1380  relating to homelessness. An executive director of the office
 1381  shall be appointed by the Governor.
 1382         Section 43. Subsection (4) of section 420.623, Florida
 1383  Statutes, is amended to read:
 1384         420.623 Local coalitions for the homeless.—
 1385         (4) ANNUAL REPORTS.—The department shall submit to the
 1386  Governor, the Speaker of the House of Representatives, and the
 1387  President of the Senate, by June 30, an annual report consisting
 1388  of a compilation of data collected by local coalitions, progress
 1389  made in the development and implementation of local homeless
 1390  assistance continuums of care plans in each circuit district,
 1391  local spending plans, programs and resources available at the
 1392  local level, and recommendations for programs and funding.
 1393         Section 44. Subsections (4) through (8) of section 420.625,
 1394  Florida Statutes, are amended to read:
 1395         420.625 Grant-in-aid program.—
 1396         (4) APPLICATION PROCEDURE.—Local agencies shall submit an
 1397  application for grant-in-aid funds to the circuit district
 1398  administrator for review. During the first year of
 1399  implementation, circuit district administrators shall begin to
 1400  accept applications for circuit district funds no later than
 1401  October 1, 1988, and by August 1 of each year thereafter for
 1402  which funding for this section is provided. Circuit District
 1403  funds shall be made available to local agencies no more than 30
 1404  days after the deadline date for applications for each funding
 1405  cycle.
 1406         (5) SPENDING PLANS.—The department shall develop guidelines
 1407  for the development of spending plans and for the evaluation and
 1408  approval by circuit district administrators of spending plans,
 1409  based upon such factors as:
 1410         (a) The demonstrated level of need for the program.
 1411         (b) The demonstrated ability of the local agency or
 1412  agencies seeking assistance to deliver the services and to
 1413  assure that identified needs will be met.
 1414         (c) The ability of the local agency or agencies seeking
 1415  assistance to deliver a wide range of services as enumerated in
 1416  subsection (3).
 1417         (d) The adequacy and reasonableness of proposed budgets and
 1418  planned expenditures, and the demonstrated capacity of the local
 1419  agency or agencies to administer the funds sought.
 1420         (e) A statement from the local coalition for the homeless
 1421  as to the steps to be taken to assure coordination and
 1422  integration of services in the circuit district to avoid
 1423  unnecessary duplication and costs.
 1424         (f) Assurances by the local coalition for the homeless that
 1425  alternative funding strategies for meeting needs through the
 1426  reallocation of existing resources, utilization of volunteers,
 1427  and local government or private agency funding have been
 1428  explored.
 1429         (g) The existence of an evaluation component designed to
 1430  measure program outcomes and determine the overall effectiveness
 1431  of the local programs for the homeless for which funding is
 1432  sought.
 1433         (6) ALLOCATION OF GRANT FUNDS TO CIRCUITS DISTRICTS.—State
 1434  grant-in-aid funds for local initiatives for the homeless shall
 1435  be allocated by the department to, and administered by,
 1436  department circuits districts. Allocations shall be based upon
 1437  sufficient documentation of:
 1438         (a) The magnitude of the problem of homelessness in the
 1439  circuit district, and the demonstrated level of unmet need for
 1440  services in the circuit district for those who are homeless or
 1441  are about to become homeless.
 1442         (b) A strong local commitment to seriously address the
 1443  problem of homelessness as evidenced by coordinated programs
 1444  involving preventive, emergency, and transitional services and
 1445  by the existence of active local organizations committed to
 1446  serving those who have become, or are about to become, homeless.
 1447         (c) Agreement by local government and private agencies
 1448  currently serving the homeless not to reduce current
 1449  expenditures for services presently provided to those who are
 1450  homeless or are about to become homeless if grant assistance is
 1451  provided pursuant to this section.
 1452         (d) Geographic distribution of circuit district programs to
 1453  ensure that such programs serve both rural and urban areas, as
 1454  needed.
 1455         (7) DISTRIBUTION TO LOCAL AGENCIES.—Circuit District funds
 1456  so allocated shall be available for distribution by the circuit
 1457  district administrator to local agencies to fund programs such
 1458  as those set forth in subsection (3), based upon the
 1459  recommendations of the local coalitions in accordance with
 1460  spending plans developed by the coalitions and approved by the
 1461  circuit district administrator. Not more than 10 percent of the
 1462  total state funds awarded under a spending plan may be used by
 1463  the local coalition for staffing and administration.
 1464         (8) LOCAL MATCHING FUNDS.—Entities contracting to provide
 1465  services through financial assistance obtained under this
 1466  section shall provide a minimum of 25 percent of the funding
 1467  necessary for the support of project operations. In-kind
 1468  contributions, whether materials, commodities, transportation,
 1469  office space, other types of facilities, or personal services,
 1470  and contributions of money or services from homeless persons may
 1471  be evaluated and counted as part or all of this required local
 1472  funding, in the discretion of the circuit district
 1473  administrator.
 1474         Section 45. Subsection (2) of section 429.35, Florida
 1475  Statutes, is amended to read:
 1476         429.35 Maintenance of records; reports.—
 1477         (2) Within 60 days after the date of the biennial
 1478  inspection visit required under s. 408.811 or within 30 days
 1479  after the date of any interim visit, the agency shall forward
 1480  the results of the inspection to the local ombudsman council in
 1481  whose planning and service area, as defined in part II of
 1482  chapter 400, the facility is located; to at least one public
 1483  library or, in the absence of a public library, the county seat
 1484  in the county in which the inspected assisted living facility is
 1485  located; and, when appropriate, to the circuit district Adult
 1486  Protection Services and Mental Health Program Offices.
 1487         Section 46. Paragraph (d) of subsection (3) of section
 1488  1002.67, Florida Statutes, is amended to read:
 1489         1002.67 Performance standards; curricula and
 1490  accountability.—
 1491         (3)
 1492         (d) Each early learning coalition, the Agency for Workforce
 1493  Innovation, and the department shall coordinate with the Child
 1494  Care Licensure Services Program Office of the Department of
 1495  Children and Families Family Services to minimize interagency
 1496  duplication of activities for monitoring private prekindergarten
 1497  providers for compliance with requirements of the Voluntary
 1498  Prekindergarten Education Program under this part, the school
 1499  readiness programs under s. 411.01, and the licensing of
 1500  providers under ss. 402.301-402.319.
 1501         Section 47. Sections 39.311, 39.312, 39.313, 39.314,
 1502  39.315, 39.316, 39.317, 39.318, 394.9083, and 402.35, Florida
 1503  Statutes, are repealed.
 1504         Section 48. Subsection (3) of section 39.407, Florida
 1505  Statutes, is amended to read:
 1506         39.407 Medical, psychiatric, and psychological examination
 1507  and treatment of child; physical, mental, or substance abuse
 1508  examination of person with or requesting child custody.—
 1509         (3)(a) All children placed in out-of-home care shall be
 1510  provided with a comprehensive behavioral health assessment. The
 1511  child protective investigator or dependency case manager shall
 1512  submit a referral for such assessment within 7 days after the
 1513  child is placed in out-of-home care.
 1514         (b) Any child who has been in out-of-home care for more
 1515  than 1 year, or who did not receive a comprehensive behavioral
 1516  health assessment when placed into out-of-home care, is eligible
 1517  to receive a comprehensive behavioral health assessment. Such
 1518  assessments evaluate behaviors that give rise to the concern
 1519  that the child has unmet mental health needs. Any party to the
 1520  dependency proceeding, or the court on its own motion, may
 1521  request that an assessment be performed.
 1522         (c) The child protective investigator or dependency case
 1523  manager is responsible for ensuring that all recommendations in
 1524  the comprehensive behavioral health assessment are incorporated
 1525  into the child’s case plan and that the recommended services are
 1526  provided in a timely manner. If, at a case planning conference,
 1527  a determination is made that a specific recommendation should
 1528  not be included in a child’s case plan, a written explanation
 1529  must be provided to the court as to why the recommendation is
 1530  not being followed.
 1531         (d) This subsection does not to prevent a child from
 1532  receiving any other form of psychological assessment if needed.
 1533         (e) If it is determined that a child is in need of mental
 1534  health services, the comprehensive behavioral health assessment
 1535  must be provided to the physician involved in developing the
 1536  child’s mental health treatment plan, pursuant to s. 39.4071(9).
 1537         (3)(a)1. Except as otherwise provided in subparagraph (b)1.
 1538  or paragraph (e), before the department provides psychotropic
 1539  medications to a child in its custody, the prescribing physician
 1540  shall attempt to obtain express and informed consent, as defined
 1541  in s. 394.455(9) and as described in s. 394.459(3)(a), from the
 1542  child’s parent or legal guardian. The department must take steps
 1543  necessary to facilitate the inclusion of the parent in the
 1544  child’s consultation with the physician. However, if the
 1545  parental rights of the parent have been terminated, the parent’s
 1546  location or identity is unknown or cannot reasonably be
 1547  ascertained, or the parent declines to give express and informed
 1548  consent, the department may, after consultation with the
 1549  prescribing physician, seek court authorization to provide the
 1550  psychotropic medications to the child. Unless parental rights
 1551  have been terminated and if it is possible to do so, the
 1552  department shall continue to involve the parent in the
 1553  decisionmaking process regarding the provision of psychotropic
 1554  medications. If, at any time, a parent whose parental rights
 1555  have not been terminated provides express and informed consent
 1556  to the provision of a psychotropic medication, the requirements
 1557  of this section that the department seek court authorization do
 1558  not apply to that medication until such time as the parent no
 1559  longer consents.
 1560         2. Any time the department seeks a medical evaluation to
 1561  determine the need to initiate or continue a psychotropic
 1562  medication for a child, the department must provide to the
 1563  evaluating physician all pertinent medical information known to
 1564  the department concerning that child.
 1565         (b)1. If a child who is removed from the home under s.
 1566  39.401 is receiving prescribed psychotropic medication at the
 1567  time of removal and parental authorization to continue providing
 1568  the medication cannot be obtained, the department may take
 1569  possession of the remaining medication and may continue to
 1570  provide the medication as prescribed until the shelter hearing,
 1571  if it is determined that the medication is a current
 1572  prescription for that child and the medication is in its
 1573  original container.
 1574         2. If the department continues to provide the psychotropic
 1575  medication to a child when parental authorization cannot be
 1576  obtained, the department shall notify the parent or legal
 1577  guardian as soon as possible that the medication is being
 1578  provided to the child as provided in subparagraph 1. The child’s
 1579  official departmental record must include the reason parental
 1580  authorization was not initially obtained and an explanation of
 1581  why the medication is necessary for the child’s well-being.
 1582         3.If the department is advised by a physician licensed
 1583  under chapter 458 or chapter 459 that the child should continue
 1584  the psychotropic medication and parental authorization has not
 1585  been obtained, the department shall request court authorization
 1586  at the shelter hearing to continue to provide the psychotropic
 1587  medication and shall provide to the court any information in its
 1588  possession in support of the request. Any authorization granted
 1589  at the shelter hearing may extend only until the arraignment
 1590  hearing on the petition for adjudication of dependency or 28
 1591  days following the date of removal, whichever occurs sooner.
 1592         4. Before filing the dependency petition, the department
 1593  shall ensure that the child is evaluated by a physician licensed
 1594  under chapter 458 or chapter 459 to determine whether it is
 1595  appropriate to continue the psychotropic medication. If, as a
 1596  result of the evaluation, the department seeks court
 1597  authorization to continue the psychotropic medication, a motion
 1598  for such continued authorization shall be filed at the same time
 1599  as the dependency petition, within 21 days after the shelter
 1600  hearing.
 1601         (c) Except as provided in paragraphs (b) and (e), the
 1602  department must file a motion seeking the court’s authorization
 1603  to initially provide or continue to provide psychotropic
 1604  medication to a child in its legal custody. The motion must be
 1605  supported by a written report prepared by the department which
 1606  describes the efforts made to enable the prescribing physician
 1607  to obtain express and informed consent for providing the
 1608  medication to the child and other treatments considered or
 1609  recommended for the child. In addition, the motion must be
 1610  supported by the prescribing physician’s signed medical report
 1611  providing:
 1612         1. The name of the child, the name and range of the dosage
 1613  of the psychotropic medication, and that there is a need to
 1614  prescribe psychotropic medication to the child based upon a
 1615  diagnosed condition for which such medication is being
 1616  prescribed.
 1617         2. A statement indicating that the physician has reviewed
 1618  all medical information concerning the child which has been
 1619  provided.
 1620         3. A statement indicating that the psychotropic medication,
 1621  at its prescribed dosage, is appropriate for treating the
 1622  child’s diagnosed medical condition, as well as the behaviors
 1623  and symptoms the medication, at its prescribed dosage, is
 1624  expected to address.
 1625         4. An explanation of the nature and purpose of the
 1626  treatment; the recognized side effects, risks, and
 1627  contraindications of the medication; drug-interaction
 1628  precautions; the possible effects of stopping the medication;
 1629  and how the treatment will be monitored, followed by a statement
 1630  indicating that this explanation was provided to the child if
 1631  age appropriate and to the child’s caregiver.
 1632         5. Documentation addressing whether the psychotropic
 1633  medication will replace or supplement any other currently
 1634  prescribed medications or treatments; the length of time the
 1635  child is expected to be taking the medication; and any
 1636  additional medical, mental health, behavioral, counseling, or
 1637  other services that the prescribing physician recommends.
 1638         (d)1. The department must notify all parties of the
 1639  proposed action taken under paragraph (c) in writing or by
 1640  whatever other method best ensures that all parties receive
 1641  notification of the proposed action within 48 hours after the
 1642  motion is filed. If any party objects to the department’s
 1643  motion, that party shall file the objection within 2 working
 1644  days after being notified of the department’s motion. If any
 1645  party files an objection to the authorization of the proposed
 1646  psychotropic medication, the court shall hold a hearing as soon
 1647  as possible before authorizing the department to initially
 1648  provide or to continue providing psychotropic medication to a
 1649  child in the legal custody of the department. At such hearing
 1650  and notwithstanding s. 90.803, the medical report described in
 1651  paragraph (c) is admissible in evidence. The prescribing
 1652  physician need not attend the hearing or testify unless the
 1653  court specifically orders such attendance or testimony, or a
 1654  party subpoenas the physician to attend the hearing or provide
 1655  testimony. If, after considering any testimony received, the
 1656  court finds that the department’s motion and the physician’s
 1657  medical report meet the requirements of this subsection and that
 1658  it is in the child’s best interests, the court may order that
 1659  the department provide or continue to provide the psychotropic
 1660  medication to the child without additional testimony or
 1661  evidence. At any hearing held under this paragraph, the court
 1662  shall further inquire of the department as to whether additional
 1663  medical, mental health, behavioral, counseling, or other
 1664  services are being provided to the child by the department which
 1665  the prescribing physician considers to be necessary or
 1666  beneficial in treating the child’s medical condition and which
 1667  the physician recommends or expects to provide to the child in
 1668  concert with the medication. The court may order additional
 1669  medical consultation, including consultation with the MedConsult
 1670  line at the University of Florida, if available, or require the
 1671  department to obtain a second opinion within a reasonable
 1672  timeframe as established by the court, not to exceed 21 calendar
 1673  days, after such order based upon consideration of the best
 1674  interests of the child. The department must make a referral for
 1675  an appointment for a second opinion with a physician within 1
 1676  working day. The court may not order the discontinuation of
 1677  prescribed psychotropic medication if such order is contrary to
 1678  the decision of the prescribing physician unless the court first
 1679  obtains an opinion from a licensed psychiatrist, if available,
 1680  or, if not available, a physician licensed under chapter 458 or
 1681  chapter 459, stating that more likely than not, discontinuing
 1682  the medication would not cause significant harm to the child.
 1683  If, however, the prescribing psychiatrist specializes in mental
 1684  health care for children and adolescents, the court may not
 1685  order the discontinuation of prescribed psychotropic medication
 1686  unless the required opinion is also from a psychiatrist who
 1687  specializes in mental health care for children and adolescents.
 1688  The court may also order the discontinuation of prescribed
 1689  psychotropic medication if a child’s treating physician,
 1690  licensed under chapter 458 or chapter 459, states that
 1691  continuing the prescribed psychotropic medication would cause
 1692  significant harm to the child due to a diagnosed nonpsychiatric
 1693  medical condition.
 1694         2. The burden of proof at any hearing held under this
 1695  paragraph shall be by a preponderance of the evidence.
 1696         (e)1. If the child’s prescribing physician certifies in the
 1697  signed medical report required in paragraph (c) that delay in
 1698  providing a prescribed psychotropic medication would more likely
 1699  than not cause significant harm to the child, the medication may
 1700  be provided in advance of the issuance of a court order. In such
 1701  event, the medical report must provide the specific reasons why
 1702  the child may experience significant harm and the nature and the
 1703  extent of the potential harm. The department must submit a
 1704  motion seeking continuation of the medication and the
 1705  physician’s medical report to the court, the child’s guardian ad
 1706  litem, and all other parties within 3 working days after the
 1707  department commences providing the medication to the child. The
 1708  department shall seek the order at the next regularly scheduled
 1709  court hearing required under this chapter, or within 30 days
 1710  after the date of the prescription, whichever occurs sooner. If
 1711  any party objects to the department’s motion, the court shall
 1712  hold a hearing within 7 days.
 1713         2. Psychotropic medications may be administered in advance
 1714  of a court order in hospitals, crisis stabilization units, and
 1715  in statewide inpatient psychiatric programs. Within 3 working
 1716  days after the medication is begun, the department must seek
 1717  court authorization as described in paragraph (c).
 1718         (f)1. The department shall fully inform the court of the
 1719  child’s medical and behavioral status as part of the social
 1720  services report prepared for each judicial review hearing held
 1721  for a child for whom psychotropic medication has been prescribed
 1722  or provided under this subsection. As a part of the information
 1723  provided to the court, the department shall furnish copies of
 1724  all pertinent medical records concerning the child which have
 1725  been generated since the previous hearing. On its own motion or
 1726  on good cause shown by any party, including any guardian ad
 1727  litem, attorney, or attorney ad litem who has been appointed to
 1728  represent the child or the child’s interests, the court may
 1729  review the status more frequently than required in this
 1730  subsection.
 1731         2. The court may, in the best interests of the child, order
 1732  the department to obtain a medical opinion addressing whether
 1733  the continued use of the medication under the circumstances is
 1734  safe and medically appropriate.
 1735         (g) The department shall adopt rules to ensure that
 1736  children receive timely access to clinically appropriate
 1737  psychotropic medications. These rules must include, but need not
 1738  be limited to, the process for determining which adjunctive
 1739  services are needed, the uniform process for facilitating the
 1740  prescribing physician’s ability to obtain the express and
 1741  informed consent of a child’s parent or guardian, the procedures
 1742  for obtaining court authorization for the provision of a
 1743  psychotropic medication, the frequency of medical monitoring and
 1744  reporting on the status of the child to the court, how the
 1745  child’s parents will be involved in the treatment-planning
 1746  process if their parental rights have not been terminated, and
 1747  how caretakers are to be provided information contained in the
 1748  physician’s signed medical report. The rules must also include
 1749  uniform forms to be used in requesting court authorization for
 1750  the use of a psychotropic medication and provide for the
 1751  integration of each child’s treatment plan and case plan. The
 1752  department must begin the formal rulemaking process within 90
 1753  days after the effective date of this act.
 1754         Section 49. Section 39.4071, Florida Statutes, is created
 1755  to read:
 1756         39.4071 Use of psychotropic medication for children in out
 1757  of-home placement.—
 1758         (1) LEGISLATIVE FINDINGS AND INTENT.—
 1759         (a) The Legislature finds that children in out-of-home
 1760  placements often have multiple risk factors that predispose them
 1761  to emotional and behavioral disorders and that they receive
 1762  mental health services at higher rates and are more likely to be
 1763  given psychotropic medications than children from comparable
 1764  backgrounds.
 1765         (b) The Legislature also finds that the use of psychotropic
 1766  medications for the treatment of children in out-of-home
 1767  placements who have emotional and behavioral disturbances has
 1768  increased over recent years. While the increased use of
 1769  psychotropic medications is paralleled by an increase in the
 1770  rate of the coadministration of two or more psychotropic
 1771  medications, data on the safety and efficacy of many of the
 1772  psychotropic medications used in children and research
 1773  supporting the coadministration of two or more psychotropic
 1774  medications in this population is limited.
 1775         (c) The Legislature further finds that significant
 1776  challenges are encountered in providing quality mental health
 1777  care to children in out-of-home placements. Not uncommonly,
 1778  children in out-of-home placements are subjected to multiple
 1779  placements and many service providers, with communication
 1780  between providers often poor, resulting in fragmented medical
 1781  and mental health care. The dependable, ongoing therapeutic and
 1782  caregiving relationships these children need are hampered by the
 1783  high turnover among child welfare caseworkers and care
 1784  providers. Furthermore, children in out-of-home placements,
 1785  unlike children from intact families, often have no consistent
 1786  interested party who is available to coordinate treatment and
 1787  monitoring plans or to provide longitudinal oversight of care.
 1788         (d) The Legislature recognizes the important role the
 1789  Guardian ad Litem Program has played in Florida’s dependency
 1790  system for the past 30 years serving the state’s most vulnerable
 1791  children through the use of trained volunteers, case
 1792  coordinators, child advocates and attorneys. The program’s
 1793  singular focus is on the child and its mission is to advocate
 1794  for the best interest of the child. It is often the guardian ad
 1795  litem who is the constant in a child’s life, maintaining
 1796  consistent contact with the child, the child’s caseworkers, and
 1797  others involved with the child, including family, doctors,
 1798  teachers, and service providers. Studies have shown that a child
 1799  assigned a guardian ad litem will, on average, experience fewer
 1800  placement changes than a child without a guardian ad litem. It
 1801  is therefore the intent of the Legislature that children in out
 1802  of-home placements who may benefit from psychotropic medications
 1803  receive those medications safely as part of a comprehensive
 1804  mental health treatment plan requiring the appointment of a
 1805  guardian ad litem whose responsibility is to monitor the plan
 1806  for compliance and suitability as to the child’s best interest.
 1807         (2) DEFINITIONS.—As used in this section, the term:
 1808         (a) “Behavior analysis” means services rendered by a
 1809  provider who is certified by the Behavior Analysis Certification
 1810  Board in accordance with chapter 393.
 1811         (b) “Obtaining assent” means a process by which a provider
 1812  of medical services helps a child achieve a developmentally
 1813  appropriate awareness of the nature of his or her condition,
 1814  informs the child of what can be expected through tests and
 1815  treatment, makes a clinical assessment of the child’s
 1816  understanding of the situation and the factors influencing how
 1817  he or she is responding, and solicits an expression of the
 1818  child’s willingness to adhere to the proposed care. The mere
 1819  absence of an objection by the child may not be construed as
 1820  assent.
 1821         (c) “Comprehensive behavioral health assessment” means an
 1822  in-depth and detailed assessment of the child’s emotional,
 1823  social, behavioral, and developmental functioning within the
 1824  family home, school, and community. A comprehensive behavioral
 1825  health assessment includes direct observation of the child in
 1826  the home, school, and community, as well as in the clinical
 1827  setting, and adheres to the requirements in the Florida Medicaid
 1828  Community Behavioral Health Services Coverage and Limitations
 1829  Handbook.
 1830         (d) “Express and informed consent” means a process by which
 1831  a provider of medical services obtains voluntary consent from a
 1832  parent whose rights have not been terminated or a legal guardian
 1833  of the child who has received full, accurate, and sufficient
 1834  information and an explanation about the child’s medical
 1835  condition, medication, and treatment in order to enable the
 1836  parent or guardian to make a knowledgeable decision without any
 1837  element of fraud, deceit, duress, or other form of coercion.
 1838         (e) “Mental health treatment plan” means a plan that lists
 1839  the particular mental health needs of the child and the services
 1840  that will be provided to address those needs. If the plan
 1841  includes prescribing psychotropic medication to a child in out
 1842  of-home placement, the plan must also include the information
 1843  required under subsection (9).
 1844         (f)“Psychotropic medication” means a prescription
 1845  medication that is used for the treatment of mental disorders
 1846  and includes, without limitation, hypnotics, antipsychotics,
 1847  antidepressants, antianxiety agents, sedatives, stimulants, and
 1848  mood stabilizers.
 1849         (3) APPOINTMENT OF GUARDIAN AD LITEM.—
 1850         (a) If not already appointed, a guardian ad litem shall be
 1851  appointed by the court at the earliest possible time to
 1852  represent the best interests of a child in out-of-home placement
 1853  who is prescribed a psychotropic medication or is being
 1854  evaluated for the initiation of psychotropic medication.
 1855  Pursuant to s. 39.820, the appointed guardian ad litem is a
 1856  party to any judicial proceeding as a representative of the
 1857  child and serves until discharged by the court.
 1858         (b) Pursuant to this section, the guardian ad litem shall
 1859  participate in the development of the mental health treatment
 1860  plan, monitor whether all requirements of the mental health
 1861  treatment plan are being provided to the child, including
 1862  counseling, behavior analysis, or other services, medications,
 1863  and treatment modalities; and notice the court of the child’s
 1864  objections, if any, to the mental health treatment plan. The
 1865  guardian ad litem shall prepare and submit to the court a
 1866  written report every 45 days or as directed by the court,
 1867  advising the court and the parties as to the status of the care,
 1868  health, and medical treatment of the child pursuant to the
 1869  mental health treatment plan and any change in the status of the
 1870  child. The guardian ad litem must immediately notify parties as
 1871  soon as a medical emergency of the child becomes known. The
 1872  guardian ad litem shall ensure that the prescribing physician
 1873  has been provided with all pertinent medical information
 1874  concerning the child.
 1875         (c) The department and the community-based care lead agency
 1876  shall notify the court and the guardian ad litem, and, if
 1877  applicable, the child’s attorney, in writing within 24 hours
 1878  after any change in the status of the child, including, but not
 1879  limited to, a change in placement, a change in school, a change
 1880  in medical condition or medication, or a change in prescribing
 1881  physician, other service providers, counseling, or treatment
 1882  scheduling.
 1883         (4) PSYCHIATRIC EVALUATION OF CHILD.—Whenever the
 1884  department believes that a child in its legal custody may need
 1885  psychiatric treatment, an evaluation must be conducted by a
 1886  physician licensed under chapter 458 or chapter 459.
 1887         (5) EXPRESS AND INFORMED CONSENT AND ASSENT.—If, at the
 1888  time of removal from his or her home, a child is being provided,
 1889  or at any time is being evaluated for the initiation of,
 1890  prescribed psychotropic medication under this section, express
 1891  and informed consent and assent shall be sought by the
 1892  prescribing physician.
 1893         (a) The prescribing physician shall obtain assent from the
 1894  child, unless the prescribing physician determines that it is
 1895  not appropriate. In making this assessment, the prescribing
 1896  physician shall consider the capacity of the child to make an
 1897  independent decision based on his or her age, maturity, and
 1898  psychological and emotional state. If the physician determines
 1899  that it is not appropriate, the physician must document the
 1900  decision in the mental health treatment plan. If the physician
 1901  determines it is appropriate and the child refuses to give
 1902  assent, the physician must document the child’s refusal in the
 1903  mental health treatment plan.
 1904         1. Assent from a child shall be sought in a manner that is
 1905  understandable to the child using a developmentally appropriate
 1906  assent form. The child shall be provided with sufficient
 1907  information, such as the nature and purpose of the medication,
 1908  how it will be administered, the probable risks and benefits,
 1909  alternative treatments and the risks and benefits thereof, and
 1910  the risks and benefits of refusing or discontinuing the
 1911  medication, and when it may be appropriately discontinued.
 1912  Assent may be oral or written and must be documented by the
 1913  prescribing physician.
 1914         2. Oral assent is appropriate for a child who is younger
 1915  than 7 years of age. Assent from a child who is 7 to 13 years of
 1916  age may be sought orally or in a simple form that is written at
 1917  the second-grade or third-grade reading level. A child who is 14
 1918  years of age or older may understand the language presented in
 1919  the consent form for parents or legal guardians. If so, the
 1920  child may sign the consent form along with the parent or legal
 1921  guardian. Forms for parents and older children shall be written
 1922  at the sixth grade to eighth-grade reading level.
 1923         3. In each case where assent is obtained, a copy of the
 1924  assent documents must be provided to the parent or legal
 1925  guardian and the guardian ad litem, with the original assent
 1926  documents becoming a part of the child’s mental health treatment
 1927  plan and filed with the court.
 1928         (b) Express and informed consent for the administration of
 1929  psychotropic medication may be given only by a parent whose
 1930  rights have not been terminated or a legal guardian of the child
 1931  who has received full, accurate, and sufficient information and
 1932  an explanation about the child’s medical condition, medication,
 1933  and treatment in order to enable the parent or guardian to make
 1934  a knowledgeable decision. A sufficient explanation includes, but
 1935  need not be limited to, the following information, which must be
 1936  provided and explained in plain language by the prescribing
 1937  physician to the parent or legal guardian: the child’s
 1938  diagnosis, the symptoms to be addressed by the medication, the
 1939  name of the medication and its dosage ranges, the reason for
 1940  prescribing it, and its purpose or intended results; benefits,
 1941  side effects, risks, and contraindications, including effects of
 1942  not starting or stopping the medication; method for
 1943  administering the medication and how it will monitored;
 1944  potential drug interactions; alternative treatments to
 1945  psychotropic medication; a plan to reduce or eliminate ongoing
 1946  medication when medically appropriate; the counseling,
 1947  behavioral analysis, or other services used to complement the
 1948  use of medication, if applicable; and that the parent or legal
 1949  guardian may revoke the consent at any time.
 1950         1. Express and informed consent may be oral or written and
 1951  must be documented by the prescribing physician. If the
 1952  department or the physician is unable to obtain consent from the
 1953  parent or legal guardian, the reasons must be documented.
 1954         2. If express and informed consent is obtained, a copy of
 1955  the consent documents must be provided to the parent or legal
 1956  guardian and the guardian ad litem, with the original consent
 1957  documents becoming a part of the child’s mental health treatment
 1958  plan and filed with the court.
 1959         (c) The informed consent of any parent whose whereabouts
 1960  are unknown for 60 days, who is adjudicated incapacitated, who
 1961  does not have regular and frequent contact with the child, who
 1962  later revokes assent, or whose parental rights are terminated
 1963  after giving consent, is invalid. If the informed consent of a
 1964  parent becomes invalid, the department may seek informed consent
 1965  from any other parent or legal guardian. If the informed consent
 1966  provided by a parent whose parental rights have been terminated
 1967  is invalid and no other parent or legal guardian gives informed
 1968  consent, the department shall file a motion for the
 1969  administration of psychotropic medication along with the motion
 1970  for final judgment of termination of parental rights.
 1971         (d) If consent is revoked or becomes invalid the department
 1972  shall immediately notify all parties and, if applicable, the
 1973  child’s attorney. Medication shall be continued until such time
 1974  as the court rules on the motion.
 1975         (e) A medication may not be discontinued without explicit
 1976  instruction from a physician as to how to safely discontinue the
 1977  medication.
 1978         (6) ADMINISTRATION OF PSYCHOTROPIC MEDICATION TO A CHILD IN
 1979  SHELTER CARE OR IN FOSTER CARE WHEN INFORMED CONSENT HAS NOT
 1980  BEEN OBTAINED.—
 1981         (a) Motion for court authorization for administration of
 1982  psychotropic medications.
 1983         1. If a physician who has evaluated the child prescribes
 1984  psychotropic medication as part of the mental health treatment
 1985  plan and the child’s parents or legal guardians have not
 1986  provided express and informed consent as provided by law or such
 1987  consent is invalid as set forth in paragraph (5)(c), the
 1988  department or its agent shall file a motion with the court
 1989  within 3 working days to authorize the administration of the
 1990  psychotropic medication before the administration of the
 1991  medication, except as provided in subsection (7). In each case
 1992  in which a motion is required, the motion must include:
 1993         a. A written report by the department describing the
 1994  efforts made to enable the prescribing physician to obtain
 1995  express and informed consent and describing other treatments
 1996  attempted, considered, and recommended for the child; and
 1997         b. The prescribing physician’s completed and signed mental
 1998  health treatment plan.
 1999         2. The department must file a copy of the motion with the
 2000  court and, within 48 hours after filing the motion, notify all
 2001  parties in writing, or by whatever other method best ensures
 2002  that all parties receive notification, of its proposed
 2003  administration of psychotropic medication to the child.
 2004         3. If any party objects to the proposed administration of
 2005  the psychotropic medication to the child, that party must file
 2006  its objection within 2 working days after being notified of the
 2007  department’s motion. A party may request an extension of time to
 2008  object for good cause shown if such extension would be in the
 2009  best interests of the child. Any extension must be for a
 2010  specific number of days not to exceed the time absolutely
 2011  necessary.
 2012         4. Lack of assent from the child is deemed a timely
 2013  objection from the child.
 2014         (b) Court action on motion for administration of
 2015  psychotropic medication.
 2016         1. If no party timely files an objection to the
 2017  department’s motion and the motion is legally sufficient, the
 2018  court may enter its order authorizing the proposed
 2019  administration of the psychotropic medication without a hearing.
 2020  Based on its determination of the best interests of the child,
 2021  the court may order additional medical consultation, including
 2022  consultation with the MedConsult line at the University of
 2023  Florida, if available, or require the department to obtain a
 2024  second opinion within a reasonable time established by the
 2025  court, not to exceed 21 calendar days. If the court orders an
 2026  additional medical consultation or second medical opinion, the
 2027  department shall file a written report including the results of
 2028  this additional consultation or a copy of the second medical
 2029  opinion with the court within the time required by the court,
 2030  and serve a copy of the report on all parties.
 2031         2.If any party timely files its objection to the proposed
 2032  administration of the psychotropic medication, the court shall
 2033  hold a hearing as soon as possible on the department’s motion.
 2034         a. The signed mental health treatment plan of the
 2035  prescribing physician is admissible in evidence at the hearing.
 2036         b. The court shall ask the department whether additional
 2037  medical, mental health, behavior analysis, counseling, or other
 2038  services are being provided to the child which the prescribing
 2039  physician considers to be necessary or beneficial in treating
 2040  the child’s medical condition and which the physician recommends
 2041  or expects to be provided to the child along with the
 2042  medication.
 2043         3. The court may order additional medical consultation or a
 2044  second medical opinion, as provided in this paragraph.
 2045         4. After considering the department’s motion and any
 2046  testimony received, the court may enter its order authorizing
 2047  the department to provide or continue to provide the proposed
 2048  psychotropic medication. The court must find a compelling
 2049  governmental interest that the proposed psychotropic medication
 2050  is in the child’s best interest. In so determining the court
 2051  shall, at a minimum, consider the following factors:
 2052         a. The severity and likelihood of risks associated with the
 2053  treatment.
 2054         b. The magnitude and likelihood of benefits expected from
 2055  the treatment.
 2056         c. The child’s prognosis without the proposed psychotropic
 2057  medication.
 2058         d. The availability and effectiveness of alternative
 2059  treatments.
 2060         e. The wishes of the child concerning treatment
 2061  alternatives.
 2062         f. The recommendation of the parents or legal guardian.
 2063         g. The recommendation of the guardian ad litem.
 2064         (7) ADMINISTRATION OF PSYCHOTROPIC MEDICATION TO A CHILD IN
 2065  OUT-OF-HOME CARE BEFORE COURT AUTHORIZATION HAS BEEN OBTAINED.
 2066  The department may provide continued administration of
 2067  psychotropic medication to a child before authorization by the
 2068  court has been obtained only as provided in this subsection.
 2069         (a) If a child is removed from the home and taken into
 2070  custody under s. 39.401, the department may continue to
 2071  administer a current prescription of psychotropic medication;
 2072  however, the department shall request court authorization for
 2073  the continued administration of the medication at the shelter
 2074  hearing. This request shall be included in the shelter petition.
 2075         1. The department shall provide all information in its
 2076  possession to the court in support of its request at the shelter
 2077  hearing. The court may authorize the continued administration of
 2078  the psychotropic medication only until the arraignment hearing
 2079  on the petition for adjudication, or for 28 days following the
 2080  date of the child’s removal, whichever occurs first.
 2081         2. If the department believes, based on the required
 2082  physician’s evaluation, that it is appropriate to continue the
 2083  psychotropic medication beyond the time authorized by the court
 2084  at the shelter hearing, the department shall file a motion
 2085  seeking continued court authorization at the same time that it
 2086  files the dependency petition, but within 21 days after the
 2087  shelter hearing.
 2088         (b) If the department believes, based on the certification
 2089  of the prescribing physician, that delay in providing the
 2090  prescribed psychotropic medication would, more likely than not,
 2091  cause significant harm to the child, the department shall
 2092  administer the medication immediately. The department must
 2093  submit a motion to the court seeking continuation of the
 2094  medication within 3 working days after the department begins
 2095  providing the medication to the child.
 2096         1. The motion seeking authorization for the continued
 2097  administration of the psychotropic medication must include all
 2098  information required in this section. The required medical
 2099  report must also include the specific reasons why the child may
 2100  experience significant harm, and the nature and the extent of
 2101  the potential harm, resulting from a delay in authorizing the
 2102  prescribed medication.
 2103         2. The department shall serve the motion on all parties
 2104  within 3 working days after the department begins providing the
 2105  medication to the child.
 2106         3. The court shall hear the department’s motion at the next
 2107  regularly scheduled court hearing required by law, or within 30
 2108  days after the date of the prescription, whichever occurs first.
 2109  However, if any party files an objection to the motion, the
 2110  court must hold a hearing within 7 days.
 2111         (c) The department may authorize, in advance of a court
 2112  order, the administration of psychotropic medications to a child
 2113  in its custody in a hospital, crisis stabilization unit or
 2114  receiving facility, therapeutic group home, or statewide
 2115  inpatient psychiatric program. If the department does so, it
 2116  must file a motion to seek court authorization for the continued
 2117  administration of the medication within 3 working days as
 2118  required in this section.
 2119         (d) If a child receives a one-time dose of a psychotropic
 2120  medication during a crisis, the department shall provide
 2121  immediate notice to all parties and to the court of each such
 2122  emergency use.
 2123         (8) DISCONTINUATION OR ALTERATION OF MEDICATION;
 2124  DESTRUCTION OF MEDICATION.—A party may not alter the provision
 2125  of prescribed psychotropic medication in any way except upon
 2126  order of the court or advice of a physician.
 2127         (a) On the motion of any party or its own motion, the court
 2128  may order the discontinuation of a medication already
 2129  prescribed. Such discontinuation must be performed in
 2130  consultation with a physician in such a manner as to minimize
 2131  risk to the child.
 2132         (b) The child’s repeated refusal to take or continue to
 2133  take a medication shall be treated as a motion to discontinue
 2134  the medication and shall be set for hearing as soon as possible
 2135  but within 7 days after knowledge of such repeated refusal.
 2136         (c) Upon any discontinuation of a medication, the
 2137  department shall document the date and reason for the
 2138  discontinuation and notify all parties. The guardian ad litem
 2139  must be notified within 24 hours as previously provided herein.
 2140         (d) The department shall ensure the destruction of any
 2141  medication no longer being taken by the prescribed child.
 2142         (9) DEVELOPMENT OF MENTAL HEALTH TREATMENT PLAN.—Upon the
 2143  determination that a child needs mental health services, a
 2144  mental health treatment plan must be developed which lists the
 2145  particular mental health needs of the child and the services
 2146  that will be provided to address those needs. If possible, the
 2147  plan shall be developed in a face-to-face conference with the
 2148  child, the child’s parents, case manager, physician, therapist,
 2149  legal guardian, guardian ad litem, and any other interested
 2150  party. The mental health treatment plan shall be incorporated
 2151  into the case plan as tasks for the department and may be
 2152  amended under s. 39.6013.
 2153         (a) If the mental health treatment plan involves the
 2154  provision of psychotropic medication, the plan must include:
 2155         1. The name of the child, a statement indicating that there
 2156  is a need to prescribe psychotropic medication based upon a
 2157  diagnosed condition for which there is an evidence base for the
 2158  medication that is being prescribed, a statement indicating the
 2159  compelling governmental interest in prescribing the psychotropic
 2160  medication, and the name and range of the dosage of the
 2161  psychotropic medication.
 2162         2. A statement indicating that the physician has reviewed
 2163  all medical information concerning the child which has been
 2164  provided by the department or community-based care lead agency
 2165  and briefly listing all information received.
 2166         3. A medication profile, including all medications the
 2167  child is prescribed or will be prescribed, any previously
 2168  prescribed medications if known, and whether those medications
 2169  are being added, continued, or discontinued upon implementation
 2170  of the mental health treatment plan.
 2171         4. A statement indicating that the psychotropic medication,
 2172  at its prescribed dosage, is appropriate for treating the
 2173  child’s diagnosed medical condition, as well as the behaviors
 2174  and symptoms that the medication, at its prescribed dosage, is
 2175  expected to address.
 2176         5. An explanation of the nature and purpose of the
 2177  treatment; the recognized side effects, risks, and
 2178  contraindications of the medication, including procedures for
 2179  reporting adverse effects; drug-interaction precautions; the
 2180  possible effects of stopping or not initiating the medication;
 2181  and how the treatment will be monitored, followed by a statement
 2182  indicating that this explanation was provided to the child if
 2183  developmentally appropriate and to the child’s caregiver.
 2184         6. Documentation addressing whether the psychotropic
 2185  medication will replace or supplement any other currently
 2186  prescribed medications or treatments; the length of time the
 2187  child is expected to be taking the medication; a plan for the
 2188  discontinuation of any medication if medically appropriate; and
 2189  any additional medical, mental health, behavioral, counseling,
 2190  or other services that the prescribing physician recommends as
 2191  part of a comprehensive treatment plan.
 2192         7. A document describing those observable behaviors
 2193  warranting psychotropic treatment, the means for obtaining
 2194  reliable frequency data on these same observable behaviors, and
 2195  the reporting of this data with sufficient frequency to support
 2196  medication decisions.
 2197         (b) The department shall develop and administer procedures
 2198  to require the caregiver and prescribing physician to report any
 2199  adverse side effects of the medication to the department or its
 2200  designee and the guardian ad litem. Any adverse side effects
 2201  must be documented in the mental health treatment plan and
 2202  medical records for the child.
 2203         (10) REVIEW FOR ADMINISTRATION OF PSYCHOTROPIC MEDICATION
 2204  FOR CHILDREN FROM BIRTH THROUGH 10 YEARS OF AGE IN OUT-OF-HOME
 2205  CARE.—
 2206         (a) Absent a finding of a compelling state interest, a
 2207  psychotropic medication may not be authorized by the court for
 2208  any child from birth through 10 years of age who is in out-of
 2209  home placement. Based on a finding of a compelling state
 2210  interest but before a psychotropic medication is authorized by
 2211  the court for such child, a review of the administration must be
 2212  obtained from a child psychiatrist who is licensed under chapter
 2213  458 or chapter 459. The results of this review must be provided
 2214  to the child and the parent or legal guardian before final
 2215  express and informed consent is given.
 2216         (b)In advance of a court order, the department may
 2217  authorize the administration of psychotropic medications to a
 2218  child from birth through 10 years of age in its custody in the
 2219  following levels of residential care:
 2220         1. Hospital;
 2221         2. Crisis stabilization unit or receiving facility;
 2222         3. Therapeutic group home; or
 2223         4. Statewide inpatient psychiatric program.
 2224  
 2225  These levels of care demonstrate the requirement of a compelling
 2226  state interest through the extensive admission criteria being
 2227  met. If the department does so, it must file a motion to seek
 2228  court authorization for the continued administration of the
 2229  medication within 3 working days.
 2230         (c) If a child receives a one-time dose of a psychotropic
 2231  medication during a crisis, the department shall provide
 2232  immediate notice to all parties and to the court of each such
 2233  emergency use.
 2234         (11) CLINICAL TRIALS.—A child in the custody of the
 2235  department may not participate in a clinical trial that is
 2236  designed to develop new psychotropic medications or evaluate
 2237  their application to children.
 2238         (12) JUDICIAL REVIEW HEARINGS.—The department shall fully
 2239  inform the court of the child’s medical and behavioral status as
 2240  part of the social services report prepared for each judicial
 2241  review hearing held for a child for whom psychotropic medication
 2242  has been prescribed or provided under this subsection. As a part
 2243  of the information provided, the department shall furnish copies
 2244  of all pertinent medical records concerning the child which have
 2245  been generated since the previous hearing. On its own motion or
 2246  on good cause shown by any party, including any guardian ad
 2247  litem, attorney, or attorney ad litem who has been appointed to
 2248  represent the child or the child’s interests, the court may
 2249  review the status more frequently than required under this
 2250  subsection.
 2251         (13) ADOPTION OF RULES.—The department may adopt rules to
 2252  ensure that children receive timely access to mental health
 2253  services, including, but not limited to, clinically appropriate
 2254  psychotropic medications. These rules must include, but need not
 2255  be limited to, the process for determining which adjunctive
 2256  services are needed, the uniform process for facilitating the
 2257  prescribing physician’s ability to obtain the express and
 2258  informed consent of a child’s parent or legal guardian, the
 2259  procedures for obtaining court authorization for the provision
 2260  of a psychotropic medication, the frequency of medical
 2261  monitoring and reporting on the status of the child to the
 2262  court, how the child’s parents will be involved in the
 2263  treatment-planning process if their parental rights have not
 2264  been terminated, and how caretakers are to be provided
 2265  information contained in the physician’s signed mental health
 2266  treatment plan. The rules must also include uniform forms or
 2267  standardized information to be used on a statewide basis in
 2268  requesting court authorization for the use of a psychotropic
 2269  medication and provide for the integration of each child’s
 2270  mental health treatment plan and case plan. The department must
 2271  begin the formal rulemaking process within 90 days after July 1,
 2272  2010.
 2273         Section 50. Paragraph (b) of subsection (1) of section
 2274  743.0645, Florida Statutes, is amended to read:
 2275         743.0645 Other persons who may consent to medical care or
 2276  treatment of a minor.—
 2277         (1) As used in this section, the term:
 2278         (b) “Medical care and treatment” includes ordinary and
 2279  necessary medical and dental examination and treatment,
 2280  including blood testing, preventive care including ordinary
 2281  immunizations, tuberculin testing, and well-child care, but does
 2282  not include surgery, general anesthesia, provision of
 2283  psychotropic medications, or other extraordinary procedures for
 2284  which a separate court order, power of attorney, or informed
 2285  consent as provided by law is required, except as provided in s.
 2286  39.4071 s. 39.407(3).
 2287         Section 51. The Division of Statutory Revision of the Joint
 2288  Legislative Management Committee is directed to prepare a
 2289  reviser’s bill for introduction at a subsequent session of the
 2290  Legislature to change the term “Department of Children and
 2291  Family Services” to “Department of Children and Families,” the
 2292  term “Secretary of Children and Family Services” to “Secretary
 2293  of Children and Families,” and the term “district administrator”
 2294  to “circuit administrator,” as that term relates to the
 2295  responsibilities of the Department of Children and Families,
 2296  wherever that term appears in the Florida Statutes.
 2297         Section 52. The Agency for Persons with Disabilities is
 2298  directed to prepare a plan that will enable it to perform all of
 2299  its own administrative and operational functions separate from
 2300  the Department of Children and Family Services by July 1, 2015.
 2301  The plan must identify resource requirements and a timeframe for
 2302  completing the transfer of responsibilities from the Department
 2303  of Children and Family Services, including submittal of a
 2304  detailed justification for each position the agency estimates it
 2305  would need to become administratively self-sufficient; an
 2306  analysis of each function to determine if the Department of
 2307  Children and Family Services could provide the service more
 2308  efficiently on a reimbursed cost basis through an interagency
 2309  agreement; and an estimate of the costs and benefits to be
 2310  derived through the separation. The Department of Children and
 2311  Family Services is directed to cooperate with the agency in
 2312  preparing the plan. The plan shall be presented to the Speaker
 2313  of the House of Representatives, the President of the Senate,
 2314  and the appropriate substantive committees by January 15, 2011.
 2315         Section 53. The Department of Children and Families,
 2316  through its Office of General Counsel and in consultation with
 2317  its contracted legal services providers and lead agency
 2318  administrators, shall define the types of legal services
 2319  associated with dependency proceedings. These legal services
 2320  include, but are not limited to, service of process, court
 2321  reporter and transcription services, expert witnesses, and legal
 2322  publication. The department shall delineate the specific costs
 2323  each lead agency will pay for those defined legal services, and
 2324  by contract amendment, modify lead agency funding amounts to
 2325  shift funding and responsibility for those costs to the
 2326  department through its Office of General Counsel.
 2327         Section 54. The Children and Youth Cabinet created pursuant
 2328  to s. 402.56, Florida Statutes, is directed to submit a plan to
 2329  the Legislature by January 15, 2011, for addressing the
 2330  inappropriate and excessive prescribing of psychotropic
 2331  medication for children who are in the custody of the Department
 2332  of Children and Family Services, who are clients of the Agency
 2333  for Persons with Disabilities, and who are otherwise on
 2334  Medicaid.
 2335         (1) At a minimum, the plan must include:
 2336         (a) The identification of all agencies and entities, public
 2337  and private, which are responsible for monitoring the care of
 2338  children who are being prescribed psychotropic medication;
 2339         (b) The development of a plan for interagency cooperation
 2340  in identifying and reporting prescribers; and
 2341         (c) An analysis of the prescribing practices of Medicaid
 2342  providers for these populations of children.
 2343         (2) The Children and Youth Cabinet shall also include
 2344  suggestions for any legislative changes necessary to implement
 2345  the plan.
 2346         Section 55. This act shall take effect July 1, 2010.

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