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