November 14, 2019
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Senate Bill 2262

Senate Bill sb2262e1

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    CS for CS for SB 2262                    First Engrossed (ntc)



  1                      A bill to be entitled

  2         An act relating to the prescription of

  3         psychotropic medications to dependent minors;

  4         amending s. 743.0645, F.S.; defining the term

  5         "psychotropic medication"; creating the Center

  6         for Juvenile Psychotropic Studies within the

  7         Department of Psychiatry of the College of

  8         Medicine of the University of Florida;

  9         providing the purpose of the center; providing

10         for the appointment of a director; creating an

11         advisory board; providing for board membership;

12         requiring the center to work with the

13         Department of Children and Family Services, the

14         Department of Juvenile Justice, the Agency for

15         Health Care Administration, and the Department

16         of Health; requiring certain data relating to

17         dependent minors for whom psychotropic

18         medications have been prescribed to be made

19         available to the center, as legally allowed;

20         requiring the center to report to legislative

21         leaders by a specified date; providing for

22         future repeal; amending s. 39.401, F.S.;

23         providing that the refusal of a parent, legal

24         guardian, or other person responsible for a

25         child's welfare to administer or consent to the

26         administration of a psychotropic medication

27         does not by itself constitute grounds for

28         taking the child into custody; providing an

29         exception; creating s. 402.3127, F.S.;

30         prohibiting the unauthorized administration of

31         medication by personnel associated with child


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    CS for CS for SB 2262                    First Engrossed (ntc)



 1         care entities; providing an exception for

 2         emergency medical conditions when the child's

 3         parent or legal guardian is unavailable;

 4         defining the term "emergency medical

 5         condition"; providing penalties for violations;

 6         amending s. 1006.062, F.S.; requiring district

 7         school boards to adopt rules prohibiting

 8         district school board personnel from

 9         recommending the use of psychotropic

10         medications for any student; allowing such

11         personnel to recommend that a medical

12         practitioner evaluate a student and to consult

13         with such practitioners; providing an effective

14         date.

15  

16  Be It Enacted by the Legislature of the State of Florida:

17  

18         Section 1.  Section 743.0645, Florida Statutes, is

19  amended to read:

20         743.0645  Other persons who may consent to medical care

21  or treatment of a minor; Center for Juvenile Psychotropic

22  Studies; creation; purpose; advisory board; report.--

23         (1)  As used in this section, the term:

24         (a)  "Blood testing" includes Early Periodic Screening,

25  Diagnosis, and Treatment (EPSDT) testing and other blood

26  testing deemed necessary by documented history or

27  symptomatology but excludes HIV testing and controlled

28  substance testing or any other testing for which separate

29  court order or informed consent as provided by law is

30  required.

31  


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    CS for CS for SB 2262                    First Engrossed (ntc)



 1         (b)  "Medical care and treatment" includes ordinary and

 2  necessary medical and dental examination and treatment,

 3  including blood testing, preventive care including ordinary

 4  immunizations, tuberculin testing, and well-child care, but

 5  does not include surgery, general anesthesia, provision of

 6  psychotropic medications, or other extraordinary procedures

 7  for which a separate court order, power of attorney, or

 8  informed consent as provided by law is required.

 9         (c)  "Person who has the power to consent as otherwise

10  provided by law" includes a natural or adoptive parent, legal

11  custodian, or legal guardian.

12         (d) "Psychotropic medication" means a medicine that may

13  not be dispensed or administered without a prescription which

14  is used for the treatment of medical disorders, and includes

15  hypnotics, antipsychotics, antidepressants, antianxiety

16  agents, sedatives, and mood stabilizers such as lithium,

17  Depakote, and other anticonvulsants used as mood stabilizers

18  and psychomotor stimulants. This paragraph expires July 1,

19  2005.

20         (2)  Any of the following persons, in order of priority

21  listed, may consent to the medical care or treatment of a

22  minor who is not committed to the Department of Children and

23  Family Services or the Department of Juvenile Justice or in

24  their custody under chapter 39, chapter 984, or chapter 985

25  when, after a reasonable attempt, a person who has the power

26  to consent as otherwise provided by law cannot be contacted by

27  the treatment provider and actual notice to the contrary has

28  not been given to the provider by that person:

29         (a)  A person who possesses a power of attorney to

30  provide medical consent for the minor. A power of attorney

31  executed after July 1, 2001, to provide medical consent for a


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    CS for CS for SB 2262                    First Engrossed (ntc)



 1  minor includes the power to consent to medically necessary

 2  surgical and general anesthesia services for the minor unless

 3  such services are excluded by the individual executing the

 4  power of attorney.

 5         (b)  The stepparent.

 6         (c)  The grandparent of the minor.

 7         (d)  An adult brother or sister of the minor.

 8         (e)  An adult aunt or uncle of the minor.

 9  

10  There shall be maintained in the treatment provider's records

11  of the minor documentation that a reasonable attempt was made

12  to contact the person who has the power to consent.

13         (3)  The Department of Children and Family Services or

14  the Department of Juvenile Justice caseworker, juvenile

15  probation officer, or person primarily responsible for the

16  case management of the child, the administrator of any

17  facility licensed by the department under s. 393.067, s.

18  394.875, or s. 409.175, or the administrator of any

19  state-operated or state-contracted delinquency residential

20  treatment facility may consent to the medical care or

21  treatment of any minor committed to it or in its custody under

22  chapter 39, chapter 984, or chapter 985, when the person who

23  has the power to consent as otherwise provided by law cannot

24  be contacted and such person has not expressly objected to

25  such consent.  There shall be maintained in the records of the

26  minor documentation that a reasonable attempt was made to

27  contact the person who has the power to consent as otherwise

28  provided by law.

29         (4)  The medical provider shall notify the parent or

30  other person who has the power to consent as otherwise

31  provided by law as soon as possible after the medical care or


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    CS for CS for SB 2262                    First Engrossed (ntc)



 1  treatment is administered pursuant to consent given under this

 2  section.  The medical records shall reflect the reason consent

 3  as otherwise provided by law was not initially obtained and

 4  shall be open for inspection by the parent or other person who

 5  has the power to consent as otherwise provided by law.

 6         (5)  The person who gives consent; a physician,

 7  dentist, nurse, or other health care professional licensed to

 8  practice in this state; or a hospital or medical facility,

 9  including, but not limited to, county health departments,

10  shall not incur civil liability by reason of the giving of

11  consent, examination, or rendering of treatment, provided that

12  such consent, examination, or treatment was given or rendered

13  as a reasonable prudent person or similar health care

14  professional would give or render it under the same or similar

15  circumstances.

16         (6)  The Center for Juvenile Psychotropic Studies is

17  created within the Department of Psychiatry of the College of

18  Medicine of the University of Florida. The purpose of the

19  center is to collect, track, and assess information regarding

20  minors in state custody held pursuant to chapter 39, chapter

21  984, or chapter 985 who have been or are currently being

22  prescribed psychotropic medications.

23         (a)  In addition to determining the number of children

24  in state custody who are receiving psychotropic medications,

25  the types and dosages of medication being prescribed to those

26  children, and any other data relevant to scientifically

27  assessing the status of minors in state custody who are

28  receiving psychotropic medications, the center shall evaluate:

29         1.  Whether the child received a full and complete

30  medical evaluation and, to the extent that the medication was

31  prescribed for a psychiatric condition and it is possible to


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    CS for CS for SB 2262                    First Engrossed (ntc)



 1  determine from available records, whether or not all other

 2  possible physical causes had been ruled out prior to the

 3  prescribing of psychotropic medication.

 4         2.  What other treatments and services were recommended

 5  for the child in addition to psychotropic medication and

 6  whether or not those services were offered or delivered.

 7         3.  Whether or not informed consent was received from a

 8  parent, legal guardian, or the court prior to initiating

 9  treatment.

10         4.  Whether or not followup monitoring and treatment

11  appropriate to the child's diagnosis and prescribed medication

12  were provided to the child.

13         5.  In cases where court authorization was sought,

14  whether a full and complete child resource record was provided

15  to the court for decisionmaking purposes.

16         6.  Whether or not the prescription for and type of

17  psychotropic medications prescribed for the child were

18  appropriate for the age and diagnosis of the child and

19  consistent with the medical standard of care for the treatment

20  of the child's condition.

21         (b)  The director of the Center for Juvenile

22  Psychotropic Studies shall be appointed by the Dean of the

23  College of Medicine of the University of Florida.

24         (c)  There is created an advisory board that shall

25  periodically and objectively review and advise the center on

26  the academic rigor and research parameters of all actions

27  taken pursuant to this subsection. The board shall consist of

28  the following nine members who have backgrounds in psychiatric

29  health:

30         1.  The Secretary of Children and Family Services or

31  his or her designee;


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    CS for CS for SB 2262                    First Engrossed (ntc)



 1         2.  The Secretary of Juvenile Justice or his or her

 2  designee;

 3         3.  The Secretary of Health Care Administration or his

 4  or her designee;

 5         4.  The Secretary of Health or his or her designee;

 6         5.  One member appointed by the President of the Senate

 7  from the Florida Psychiatric Society who specializes in

 8  treating children and adolescents;

 9         6.  One member appointed by the Speaker of the House of

10  Representatives who is a pediatrician experienced in treating

11  children and adolescents with psychiatric diseases;

12         7.  One member appointed by the President of the

13  University of Florida who is an epidemiologist; and

14         8.  Two members appointed by the Governor, one of whom

15  has experience serving as a guardian ad litem to children and

16  adolescents in the custody of the state who have psychiatric

17  diseases, and one of whom is employed by the Louis de la Parte

18  Florida Mental Health Institute and has experience in the

19  academic study of children and adolescents with psychiatric

20  diseases.

21         (d)  The center shall work in conjunction with the

22  Department of Children and Family Services, the Department of

23  Juvenile Justice, the Agency for Health Care Administration,

24  and the Department of Health, and, to the extent allowed by

25  the privacy requirements of federal and state laws, those

26  agencies shall work with the center and make available to the

27  center data regarding such dependent minors, including, but

28  not limited to:

29         1.  Demographic information, including, but not limited

30  to, age, geographic location, and economic status.

31  


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    CS for CS for SB 2262                    First Engrossed (ntc)



 1         2.  A family history of each dependent minor,

 2  including, but not limited to, the minor's involvement with

 3  the child welfare system or the juvenile justice system, all

 4  applicable social service records, and all applicable court

 5  records.

 6         3.  A medical history of each dependent minor,

 7  including, but not limited to, the minor's medical condition.

 8         4.  All information regarding the medications

 9  prescribed or administered to each minor, including, but not

10  limited to, information contained in each minor's medication

11  administration record.

12         5.  Practice patterns, licensure, and board

13  certification of prescribing physicians.

14         (e)  All oral and written records, information,

15  letters, and reports received, made, or maintained by the

16  center shall be maintained in a manner consistent with all

17  applicable state and federal law.

18         (f)  A privilege against civil liability is granted to

19  any person furnishing medical records in furtherance of the

20  charge of the center, unless such person furnishing medical

21  records acted in bad faith or with malice in providing such

22  information. A person who participates in the center's

23  research activities or provides information to the center with

24  regard to the incompetence, impairment, or unprofessional

25  conduct of any health care provider licensed under chapter

26  458, chapter 459, chapter 460, chapter 461, chapter 462,

27  chapter 463, chapter 464, chapter 465, or chapter 466 may not

28  be held liable in any civil action for furnishing such medical

29  records if such person acts without intentional fraud or

30  malice.

31  


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    CS for CS for SB 2262                    First Engrossed (ntc)



 1         (g)  By January 1, 2005, the center shall report its

 2  findings regarding psychotropic medications prescribed to

 3  dependent minors in state custody to the President of the

 4  Senate, the Speaker of the House of Representatives, and the

 5  appropriate committee chairs of the Senate and the House of

 6  Representatives.

 7         (h)  This subsection expires July 1, 2005.

 8         (7)(6)  The Department of Children and Family Services

 9  and the Department of Juvenile Justice may adopt rules to

10  implement this section.

11         (8)(7)  This section does not affect other statutory

12  provisions of this state that relate to medical consent for

13  minors.

14         Section 2.  Subsection (1) of section 39.401, Florida

15  Statutes, is amended to read:

16         39.401  Taking a child alleged to be dependent into

17  custody; law enforcement officers and authorized agents of the

18  department.--

19         (1)  A child may only be taken into custody:

20         (a)  Pursuant to the provisions of this part, based

21  upon sworn testimony, either before or after a petition is

22  filed; or

23         (b)  By a law enforcement officer, or an authorized

24  agent of the department, if the officer or authorized agent

25  has probable cause to support a finding:

26         1.  That the child has been abused, neglected, or

27  abandoned, or is suffering from or is in imminent danger of

28  illness  or injury as a result of abuse, neglect, or

29  abandonment;

30  

31  


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    CS for CS for SB 2262                    First Engrossed (ntc)



 1         2.  That the parent or legal custodian of the child has

 2  materially violated a condition of placement imposed by the

 3  court; or

 4         3.  That the child has no parent, legal custodian, or

 5  responsible adult relative immediately known and available to

 6  provide supervision and care.

 7  

 8  The refusal of a parent, legal guardian, or other person

 9  responsible for a child's welfare to administer or consent to

10  the administration of any psychotropic medication to the child

11  does not, in and of itself, constitute grounds for the

12  department to take the child into custody, or for any court to

13  order that the child be taken into custody by the department,

14  unless the refusal to administer or consent to the

15  administration of psychotropic medication causes the child to

16  be neglected or abused.

17         Section 3.  Section 402.3127, Florida Statutes, is

18  created to read:

19         402.3127  Unauthorized administration of medication.--

20         (1)  An employee, owner, household member, volunteer,

21  or operator of a child care facility, large family child care

22  home, or family day care home, as defined in s. 402.302,

23  including a child care program operated by a public or

24  nonpublic school deemed to be child care under s. 402.3025,

25  which is required to be licensed or registered, may not,

26  without written authorization from a child's parent or legal

27  guardian, administer any medication to a child attending the

28  child care facility, large family child care home, or family

29  day care home. The written authorization to administer

30  medication must include the child's name, the date or dates

31  for which the authorization is applicable, dosage


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    CS for CS for SB 2262                    First Engrossed (ntc)



 1  instructions, and the signature of the child's parent or legal

 2  guardian.

 3         (2)  In the event of an emergency medical condition

 4  when a child's parent or legal guardian is unavailable, an

 5  employee, owner, household member, volunteer, or operator of a

 6  licensed or unlicensed child care facility, large family child

 7  care home, or family day care home may administer medication

 8  to a child attending the facility or home without the written

 9  authorization required in subsection (1) if the medication is

10  administered according to instructions from a prescribing

11  health care practitioner. The child care facility, large

12  family child care home, or family day care home must

13  immediately notify the child's parent or legal guardian of the

14  emergency medical condition and of the corrective measures

15  taken. If the parent or legal guardian remains unavailable and

16  the child's emergency medical condition persists, the child

17  care facility must immediately notify the child's medical care

18  provider.

19         (3)  As used in this section, the term "emergency

20  medical condition" means circumstances in which a prudent

21  layperson acting reasonably would believe that an emergency

22  medical condition exists.

23         (4)(a)  A person who violates this section commits a

24  felony of the third degree, punishable as provided in s.

25  775.082 or s. 775.083, if the violation results in serious

26  injury to the child.

27         (b)  A person who violates this section commits a

28  misdemeanor of the first degree, punishable as provided in s.

29  775.082 or s. 775.083, if the violation does not result in

30  serious injury to the child.

31  


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    CS for CS for SB 2262                    First Engrossed (ntc)



 1         Section 4.  Subsection (8) is added to section

 2  1006.062, Florida Statutes, to read:

 3         1006.062  Administration of medication and provision of

 4  medical services by district school board personnel.--

 5         (8)  Each district school board shall adopt rules that

 6  prohibit all district school board personnel, except

 7  psychiatrists licensed under chapter 458 or chapter 459, from

 8  recommending the use of psychotropic medications for any

 9  student. This subsection does not prohibit district school

10  board personnel from recommending that a student be evaluated

11  by an appropriate medical practitioner and does not prohibit

12  district school board personnel from consulting with such a

13  practitioner with the consent of the student's parent.

14         Section 5.  This act shall take effect July 1, 2004.

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