Florida Senate - 2017                        COMMITTEE AMENDMENT
       Bill No. SB 1454
       
       
       
       
       
       
                                Ì720470zÎ720470                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  03/28/2017           .                                
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       The Committee on Children, Families, and Elder Affairs (Broxson)
       recommended the following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Section 39.303, Florida Statutes, is amended to
    6  read:
    7         39.303 Child protection teams and sexual abuse treatment
    8  programs; services; eligible cases.—
    9         (1) The Children’s Medical Services Program in the
   10  Department of Health shall develop, maintain, and coordinate the
   11  services of one or more multidisciplinary child protection teams
   12  in each of the service circuits districts of the Department of
   13  Children and Families. Such teams may be composed of appropriate
   14  representatives of school districts and appropriate health,
   15  mental health, social service, legal service, and law
   16  enforcement agencies. The Department of Health and the
   17  Department of Children and Families shall maintain an
   18  interagency agreement that establishes protocols for oversight
   19  and operations of child protection teams and sexual abuse
   20  treatment programs. The State Surgeon General and the Deputy
   21  Secretary for Children’s Medical Services, in consultation with
   22  the Secretary of Children and Families and the Statewide Medical
   23  Director for Child Protection, shall maintain the responsibility
   24  for the screening, employment, and, if necessary, the
   25  termination of child protection team medical directors, at
   26  headquarters and in the 15 circuits districts.
   27         (2)(a) The Statewide Medical Director for Child Protection
   28  must be a physician licensed under chapter 458 or chapter 459
   29  who is a board-certified pediatrician with a subspecialty
   30  certification in child abuse from the American Board of
   31  Pediatrics.
   32         (b) Each child protection team district medical director
   33  must be a physician licensed under chapter 458 or chapter 459
   34  who is a board-certified physician in pediatrics or family
   35  medicine pediatrician and, within 2 4 years after the date of
   36  his or her employment as a child protection team district
   37  medical director, obtains either obtain a subspecialty
   38  certification in child abuse from the American Board of
   39  Pediatrics or within 2 years meet the minimum requirements
   40  established by a third-party credentialing entity recognizing a
   41  demonstrated specialized competence in child abuse pediatrics
   42  pursuant to paragraph (d). Each child protection team district
   43  medical director employed on July 1, 2015, must, by July 1, 2019
   44  within 4 years, either obtain a subspecialty certification in
   45  child abuse from the American Board of Pediatrics or meet the
   46  minimum requirements established by a third-party credentialing
   47  entity recognizing a demonstrated specialized competence in
   48  child abuse pediatrics pursuant to paragraph (d). Child
   49  protection team medical directors shall be responsible for
   50  oversight of the teams in the circuits districts.
   51         (c) All medical personnel participating on a child
   52  protection team must successfully complete the required child
   53  protection team training curriculum as set forth in protocols
   54  determined by the Deputy Secretary for Children’s Medical
   55  Services and the Statewide Medical Director for Child
   56  Protection.
   57         (d) Contingent on appropriations, the Department of Health
   58  shall approve one or more third-party credentialing entities for
   59  the purpose of developing and administering a professional
   60  credentialing program for child protection team district medical
   61  directors. Within 90 days after receiving documentation from a
   62  third-party credentialing entity, the department shall approve a
   63  third-party credentialing entity that demonstrates compliance
   64  with the following minimum standards:
   65         1. Establishment of child abuse pediatrics core
   66  competencies, certification standards, testing instruments, and
   67  recertification standards according to national psychometric
   68  standards.
   69         2. Establishment of a process to administer the
   70  certification application, award, and maintenance processes
   71  according to national psychometric standards.
   72         3. Demonstrated ability to administer a professional code
   73  of ethics and disciplinary process that applies to all certified
   74  persons.
   75         4. Establishment of, and ability to maintain, a publicly
   76  accessible Internet-based database that contains information on
   77  each person who applies for and is awarded certification, such
   78  as the person’s first and last name, certification status, and
   79  ethical or disciplinary history.
   80         5. Demonstrated ability to administer biennial continuing
   81  education and certification renewal requirements.
   82         6. Demonstrated ability to administer an education provider
   83  program to approve qualified training entities and to provide
   84  precertification training to applicants and continuing education
   85  opportunities to certified professionals.
   86         (3) The Department of Health shall use and convene the
   87  child protection teams to supplement the assessment and
   88  protective supervision activities of the family safety and
   89  preservation program of the Department of Children and Families.
   90  This section does not remove or reduce the duty and
   91  responsibility of any person to report pursuant to this chapter
   92  all suspected or actual cases of child abuse, abandonment, or
   93  neglect or sexual abuse of a child. The role of the child
   94  protection teams is shall be to support activities of the
   95  program and to provide services deemed by the child protection
   96  teams to be necessary and appropriate to abused, abandoned, and
   97  neglected children upon referral. The specialized diagnostic
   98  assessment, evaluation, coordination, consultation, and other
   99  supportive services that a child protection team must shall be
  100  capable of providing include, but are not limited to, the
  101  following:
  102         (a) Medical diagnosis and evaluation services, including
  103  provision or interpretation of X rays and laboratory tests, and
  104  related services, as needed, and documentation of related
  105  findings.
  106         (b) Telephone consultation services in emergencies and in
  107  other situations.
  108         (c) Medical evaluation related to abuse, abandonment, or
  109  neglect, as defined by policy or rule of the Department of
  110  Health.
  111         (d) Such psychological and psychiatric diagnosis and
  112  evaluation services for the child or the child’s parent or
  113  parents, legal custodian or custodians, or other caregivers, or
  114  any other individual involved in a child abuse, abandonment, or
  115  neglect case, as the team may determine to be needed.
  116         (e) Expert medical, psychological, and related professional
  117  testimony in court cases.
  118         (f) Case staffings to develop treatment plans for children
  119  whose cases have been referred to the team. A child protection
  120  team may provide consultation with respect to a child who is
  121  alleged or is shown to be abused, abandoned, or neglected, which
  122  consultation shall be provided at the request of a
  123  representative of the family safety and preservation program or
  124  at the request of any other professional involved with a child
  125  or the child’s parent or parents, legal custodian or custodians,
  126  or other caregivers. In every such child protection team case
  127  staffing, consultation, or staff activity involving a child, a
  128  family safety and preservation program representative shall
  129  attend and participate.
  130         (g) Case service coordination and assistance, including the
  131  location of services available from other public and private
  132  agencies in the community.
  133         (h) Such training services for program and other employees
  134  of the Department of Children and Families, employees of the
  135  Department of Health, and other medical professionals as is
  136  deemed appropriate to enable them to develop and maintain their
  137  professional skills and abilities in handling child abuse,
  138  abandonment, and neglect cases.
  139         (i) Educational and community awareness campaigns on child
  140  abuse, abandonment, and neglect in an effort to enable citizens
  141  more successfully to prevent, identify, and treat child abuse,
  142  abandonment, and neglect in the community.
  143         (j) Child protection team assessments that include, as
  144  appropriate, medical evaluations, medical consultations, family
  145  psychosocial interviews, specialized clinical interviews, or
  146  forensic interviews.
  147  
  148  A child protection team that is evaluating a report of medical
  149  neglect and assessing the health care needs of a medically
  150  complex child shall consult with a physician who has experience
  151  in treating children with the same condition.
  152         (4) The child abuse, abandonment, and neglect reports that
  153  must be referred by the department to child protection teams of
  154  the Department of Health for an assessment and other appropriate
  155  available support services as set forth in subsection (3) must
  156  include cases involving:
  157         (a) Injuries to the head, bruises to the neck or head,
  158  burns, or fractures in a child of any age.
  159         (b) Bruises anywhere on a child 5 years of age or under.
  160         (c) Any report alleging sexual abuse of a child.
  161         (d) Any sexually transmitted disease in a prepubescent
  162  child.
  163         (e) Reported malnutrition of a child and failure of a child
  164  to thrive.
  165         (f) Reported medical neglect of a child.
  166         (g) Any family in which one or more children have been
  167  pronounced dead on arrival at a hospital or other health care
  168  facility, or have been injured and later died, as a result of
  169  suspected abuse, abandonment, or neglect, when any sibling or
  170  other child remains in the home.
  171         (h) Symptoms of serious emotional problems in a child when
  172  emotional or other abuse, abandonment, or neglect is suspected.
  173         (5) All abuse and neglect cases transmitted for
  174  investigation to a circuit district by the hotline must be
  175  simultaneously transmitted to the Department of Health child
  176  protection team for review. For the purpose of determining
  177  whether a face-to-face medical evaluation by a child protection
  178  team is necessary, all cases transmitted to the child protection
  179  team which meet the criteria in subsection (4) must be timely
  180  reviewed by:
  181         (a) A physician licensed under chapter 458 or chapter 459
  182  who holds board certification in pediatrics and is a member of a
  183  child protection team;
  184         (b) A physician licensed under chapter 458 or chapter 459
  185  who holds board certification in a specialty other than
  186  pediatrics, who may complete the review only when working under
  187  the direction of the child protection team medical director or a
  188  physician licensed under chapter 458 or chapter 459 who holds
  189  board certification in pediatrics and is a member of a child
  190  protection team;
  191         (c) An advanced registered nurse practitioner licensed
  192  under chapter 464 who has a specialty in pediatrics or family
  193  medicine and is a member of a child protection team;
  194         (d) A physician assistant licensed under chapter 458 or
  195  chapter 459, who may complete the review only when working under
  196  the supervision of the child protection team medical director or
  197  a physician licensed under chapter 458 or chapter 459 who holds
  198  board certification in pediatrics and is a member of a child
  199  protection team; or
  200         (e) A registered nurse licensed under chapter 464, who may
  201  complete the review only when working under the direct
  202  supervision of the child protection team medical director or a
  203  physician licensed under chapter 458 or chapter 459 who holds
  204  board certification in pediatrics and is a member of a child
  205  protection team.
  206         (6) A face-to-face medical evaluation by a child protection
  207  team is not necessary when:
  208         (a) The child was examined for the alleged abuse or neglect
  209  by a physician who is not a member of the child protection team,
  210  and a consultation between the child protection team medical
  211  director or a child protection team board-certified
  212  pediatrician, advanced registered nurse practitioner, physician
  213  assistant working under the supervision of a child protection
  214  team medical director or a child protection team board-certified
  215  pediatrician, or registered nurse working under the direct
  216  supervision of a child protection team medical director or a
  217  child protection team board-certified pediatrician, and the
  218  examining physician concludes that a further medical evaluation
  219  is unnecessary;
  220         (b) The child protective investigator, with supervisory
  221  approval, has determined, after conducting a child safety
  222  assessment, that there are no indications of injuries as
  223  described in paragraphs (4)(a)-(h) as reported; or
  224         (c) The child protection team medical director or a child
  225  protection team board-certified pediatrician, as authorized in
  226  subsection (5), determines that a medical evaluation is not
  227  required.
  228  
  229  Notwithstanding paragraphs (a), (b), and (c), a child protection
  230  team medical director or a child protection team pediatrician,
  231  as authorized in subsection (5), may determine that a face-to
  232  face medical evaluation is necessary.
  233         (7) In all instances in which a child protection team is
  234  providing certain services to abused, abandoned, or neglected
  235  children, other offices and units of the Department of Health,
  236  and offices and units of the Department of Children and
  237  Families, shall avoid duplicating the provision of those
  238  services.
  239         (8) The Department of Health child protection team quality
  240  assurance program and the Family Safety Program Office of the
  241  Department of Children and Families shall collaborate to ensure
  242  referrals and responses to child abuse, abandonment, and neglect
  243  reports are appropriate. Each quality assurance program shall
  244  include a review of records in which there are no findings of
  245  abuse, abandonment, or neglect, and the findings of these
  246  reviews shall be included in each department’s quality assurance
  247  reports.
  248         (9)(a) Children’s Medical Services shall convene a task
  249  force to develop a standardized protocol for forensic
  250  interviewing of children suspected of having been abused. The
  251  Department of Health shall provide staff to the task force as
  252  necessary. The task force must include:
  253         1. A representative from the Florida Prosecuting Attorneys
  254  Association.
  255         2. A representative from the Florida Psychological
  256  Association.
  257         3. The Statewide Medical Director for Child Protection.
  258         4. A representative from the Florida Public Defender
  259  Association.
  260         5. The executive director of the Statewide Guardian Ad
  261  Litem Office.
  262         6. A representative from a community-based care lead
  263  agency.
  264         7. A representative from Children’s Medical Services.
  265         8. A representative from the Florida Sheriffs Association.
  266         9. A representative from the Florida Chapter of the
  267  American Academy of Pediatrics.
  268         10. A representative from the Florida Network of Children’s
  269  Advocacy Centers.
  270         11. Other representatives designated by Children’s Medical
  271  Services.
  272         (b) Children’s Medical Services must provide the
  273  standardized protocol to the President of the Senate and the
  274  Speaker of the House of Representatives by July 1, 2018.
  275         (c) Members of the task force are not entitled to per diem
  276  or other payment for service on the task force.
  277         (10)The Children’s Medical Services program in the
  278  Department of Health shall develop, maintain, and coordinate the
  279  services of one or more sexual abuse treatment programs.
  280         (a) A child under the age of 18 who is alleged to be a
  281  victim of sexual abuse, his or her siblings, non-offending
  282  caregivers, and family members who have been impacted by sexual
  283  abuse are eligible for services.
  284         (b) Sexual abuse treatment programs must provide
  285  specialized therapeutic treatment to victims of child sexual
  286  abuse, their siblings, nonoffending caregivers, and family
  287  members to assist in recovery from sexual abuse, to prevent
  288  developmental impairment, to restore the children’s pre-abuse
  289  level of developmental functioning, and to promote healthy, non
  290  abusive relationships. Therapeutic intervention services must
  291  include crisis intervention, clinical treatment, and individual,
  292  family, and group therapy.
  293         (c) The sexual abuse treatment programs and child
  294  protection teams must provide referrals for victims of child
  295  sexual abuse and their families, as appropriate.
  296         Section 2. Section 39.3031, Florida Statutes, is amended to
  297  read:
  298         39.3031 Rules for implementation of s. 39.303.—The
  299  Department of Health, in consultation with the Department of
  300  Children and Families, shall adopt rules governing the child
  301  protection teams and sexual abuse treatment programs pursuant to
  302  s. 39.303, including definitions, organization, roles and
  303  responsibilities, eligibility, services and their availability,
  304  qualifications of staff, and a waiver-request process.
  305         Section 3. Paragraph (c) of subsection (2) of section
  306  458.3175, Florida Statutes, is amended to read:
  307         458.3175 Expert witness certificate.—
  308         (2) An expert witness certificate authorizes the physician
  309  to whom the certificate is issued to do only the following:
  310         (c) Provide expert testimony in criminal child abuse and
  311  neglect cases pursuant to chapter 827, dependency cases pursuant
  312  to chapter 39, and cases involving sexual battery of a child
  313  pursuant to chapter 794 in this state.
  314         Section 4. Paragraph (c) of subsection (2) of section
  315  459.0066, Florida Statutes, is amended to read:
  316         459.0066 Expert witness certificate.—
  317         (2) An expert witness certificate authorizes the physician
  318  to whom the certificate is issued to do only the following:
  319         (c) Provide expert testimony in criminal child abuse and
  320  neglect cases pursuant to chapter 827, dependency cases pursuant
  321  to chapter 39, and cases involving sexual battery of a child
  322  pursuant to chapter 794 in this state.
  323         Section 5. Paragraph (d) of subsection (3) of section
  324  827.03, Florida Statutes, is amended to read:
  325         827.03 Abuse, aggravated abuse, and neglect of a child;
  326  penalties.—
  327         (3) EXPERT TESTIMONY.—
  328         (d) The expert testimony requirements of this subsection
  329  apply only to criminal child abuse and neglect cases pursuant to
  330  chapter 827, dependency cases pursuant to chapter 39, and cases
  331  involving sexual battery of a child pursuant to chapter 794 and
  332  not to family court or dependency court cases.
  333         Section 6. This act shall take effect July 1, 2017.
  334  
  335  ================= T I T L E  A M E N D M E N T ================
  336  And the title is amended as follows:
  337         Delete everything before the enacting clause
  338  and insert:
  339                        A bill to be entitled                      
  340         An act relating to child protection; amending s.
  341         39.303, F.S.; revising the entities responsible for
  342         screening, employing, and terminating child protection
  343         team medical directors to include the Statewide
  344         Medical Director for Child Protection; revising the
  345         term “district medical director” to “child protection
  346         team medical director”; revising references to
  347         subdivisions of the state from “districts” to
  348         “circuits”; revising the required board certifications
  349         for child protection team medical directors and
  350         reviewing physicians; revising the timeframe in which
  351         child protection team medical directors must obtain
  352         certification; requiring Children’s Medical Services
  353         to convene a task force to develop a protocol for
  354         forensic interviewing of children suspected of having
  355         been abused; specifying membership of the task force;
  356         requiring Children’s Medical Services to develop,
  357         maintain, and coordinate one or more sexual abuse
  358         treatment programs; amending s. 39.3031, F.S.;
  359         requiring the Department of Health, in consultation
  360         with the Department of Children and Families, to adopt
  361         rules regarding sexual abuse treatment programs;
  362         amending ss. 458.3175, 459.0066, and 827.03, F.S.;
  363         revising provisions regarding expert testimony
  364         provided by certain entities to include criminal cases
  365         involving child abuse and neglect, dependency cases,
  366         and cases involving sexual abuse of a child; providing
  367         an effective date.