HB 0261 2003
1	A bill to be entitled
2	An act relating to dependent children; amending s. 39.01,
3	F.S.; defining the term "medical passport"; amending ss.
4	39.0015, 39.302, F.S.; conforming cross-references;
5	amending s. 39.407, F.S.; specifying conditions under
6	which a court order is not required for dispensing
7	psychotropic medication to a child in the legal custody of
8	the Department of Children and Family Services; providing
9	requirements for a petition to the court for authority to
10	dispense psychotropic medication to such a child;
11	providing for prior review of the child's medical history
12	and evidence demonstrating that the treatment is
13	appropriate for the child's condition; providing for the
14	burden of proof; providing for further medical
15	consultation, including second opinions, under certain
16	circumstances; providing conditions for discontinuation of
17	prescribed psychotropic medication or for the provision of
18	other services; providing for periodic court review of the
19	child's progress; providing an effective date.
20
21	Be It Enacted by the Legislature of the State of Florida:
22
23	Section 1. Paragraph (b) of subsection (3) of section
24	39.0015, Florida Statutes, is amended to read:
25	39.0015 Child abuse prevention training in the district
26	school system.--
27	(3) DEFINITIONS.--As used in this section:
28	(b) "Child abuse" means those acts as defined in ss.
29	39.01(1), (2), (30),(43),(45),(47), (54), and (65)(52),
30	and(63), 827.04, and 984.03(1), (2), and (37).
31	Section 2. Present subsections (40) and (42) of section
32	39.01, Florida Statutes, are renumbered as subsections (42) and
33	(43), respectively, present subsection (41) of that section is
34	renumbered as subsection (40), present subsection (72) of that
35	section is renumbered as subsection (41), present subsections
36	(43) through (71) of that section are renumbered as subsections
37	(45) through (73), respectively, and a new subsection (44) is
38	added to that section, to read:
39	39.01 Definitions.--When used in this chapter, unless the
40	context otherwise requires:
41	(44) "Medical passport" means a written health history of
42	a child in shelter status or foster care which is used to
43	document health care and must be kept with the child's caregiver
44	in the child's resource record and updated at each visit to a
45	health care provider. The department shall ensure that the
46	medical passport is current, complete, and accurate.
47	Section 3. Subsection (1) of section 39.302, Florida
48	Statutes, is amended to read:
49	39.302 Protective investigations of institutional child
50	abuse, abandonment, or neglect.--
51	(1) The department shall conduct a child protective
52	investigation of each report of institutional child abuse,
53	abandonment, or neglect. Upon receipt of a report which alleges
54	that an employee or agent of the department, or any other entity
55	or person covered by s. 39.01(31) or(49)(47), acting in an
56	official capacity, has committed an act of child abuse,
57	abandonment, or neglect, the department shall immediately
58	initiate a child protective investigation and orally notify the
59	appropriate state attorney, law enforcement agency, and
60	licensing agency. These agencies shall immediately conduct a
61	joint investigation, unless independent investigations are more
62	feasible. When conducting investigations onsite or having face-
63	to-face interviews with the child, such investigation visits
64	shall be unannounced unless it is determined by the department
65	or its agent that such unannounced visits would threaten the
66	safety of the child. When a facility is exempt from licensing,
67	the department shall inform the owner or operator of the
68	facility of the report. Each agency conducting a joint
69	investigation shall be entitled to full access to the
70	information gathered by the department in the course of the
71	investigation. A protective investigation must include an onsite
72	visit of the child's place of residence. In all cases, the
73	department shall make a full written report to the state
74	attorney within 3 working days after making the oral report. A
75	criminal investigation shall be coordinated, whenever possible,
76	with the child protective investigation of the department. Any
77	interested person who has information regarding the offenses
78	described in this subsection may forward a statement to the
79	state attorney as to whether prosecution is warranted and
80	appropriate. Within 15 days after the completion of the
81	investigation, the state attorney shall report the findings to
82	the department and shall include in such report a determination
83	of whether or not prosecution is justified and appropriate in
84	view of the circumstances of the specific case.
85	Section 4. Subsections (3) through (14) of section 39.407,
86	Florida Statutes, are renumbered as subsections (4) through
87	(15), respectively, and a new subsection (3) is added to that
88	section, to read:
89	39.407 Medical, psychiatric, and psychological examination
90	and treatment of child; physical or mental examination of parent
91	or person requesting custody of child.--
92	(3) The provision of psychotropic medication to a child in
93	the legal custody of the department, and in compliance with this
94	subsection, shall be deemed in compliance with the restrictions
95	in s. 743.0645(1)(b).
96	(a) A court order is not required to dispense psychotropic
97	medication to a child in the legal custody of the department
98	under any of the following conditions:
99	1. If a child was taking prescribed psychotropic
100	medications at the time the child was removed from the home, the
101	department may take possession of the remaining medications when
102	the department takes the child and may dispense those
103	medications on a temporary basis until the next regularly
104	scheduled court hearing required under this chapter, other than
105	the shelter hearing, if such hearing occurs within 60 days after
106	the time the child was removed.
107	2. Psychotropic medications may be dispensed in advance of
108	issuance of a court order if the prescribing physician indicates
109	in writing that delay in dispensing the medication could be
110	detrimental to the child. The order required under this
111	subsection shall be sought by the department at the next
112	regularly scheduled court hearing required under this chapter,
113	or within 60 days after the date of the prescription, whichever
114	is sooner.
115	3. Psychotropic medications may be dispensed in an acute
116	care setting.
117	(b) A motion seeking court authority to dispense
118	psychotropic medication to a child in the legal custody of the
119	department must be supported by the prescribing physician's
120	signed medical report or, if not available, an affidavit from
121	the prescribing physician indicating:
122	1. The name of the child and the name and dosage of the
123	psychotropic medication and indicating that there is a need to
124	prescribe psychotropic medication to the child based upon a
125	diagnosed condition for which such medication is indicated and
126	that there is a plan of treatment that addresses treatment
127	alternatives that are or are not available or desirable.
128	2. That the psychotropic medication at its prescribed
129	dosage is appropriate for the treatment of the child's diagnosed
130	medical condition, as well as the behaviors and symptoms the
131	medication at its prescribed dosage level is expected to
132	address.
133	3. That the prescribing physician has provided to the
134	child, if age-appropriate, the department, and any person
135	responsible for the child in his or her residential setting a
136	clinically appropriate explanation of the nature and purpose of
137	the treatment; the recognized side effects, risks, and
138	contraindications of the medication; and drug interaction
139	precautions.
140	4. Whether the psychotropic medication will replace or
141	supplement any other currently prescribed medications or
142	treatments; the length of time the child is expected to be
143	taking the medication; and any additional medical, counseling,
144	or other services that the prescribing physician believes are
145	necessary or would be beneficial for the treatment of the
146	child's medical condition and that the physician expects or
147	advises to be provided to the child in concert with the
148	medication.
149
150	The department has the burden of compliance with and proof of
151	the provisions of this paragraph.
152	(c) At a hearing to determine whether to initially allow
153	dispensing of psychotropic medication to a child in the legal
154	custody of the department, or at a hearing for continuation of
155	such medication, the medical report or affidavit described in
156	paragraph (b) is admissible in evidence. The prescribing
157	physician is not required to attend the hearing or testify
158	unless the court specifically orders such attendance or
159	testimony. If the medical report or affidavit, the medical
160	passport, and other evidence are in accord with the requirements
161	of this subsection, the court shall order the dispensing or
162	continuation of psychotropic medication without further
163	testimony or evidence. The court shall further inquire of the
164	department as to whether the additional medical, counseling, or
165	other services that the prescribing physician believes are
166	necessary or would be beneficial for the treatment of the
167	child's medical condition and that the physician expects or
168	advises to be provided to the child in concert with the
169	medication are being provided to the child by the department.
170	The court may require further medical consultation, including
171	obtaining a second opinion, based upon considerations of the
172	best interests of the child, and the court may not order the
173	discontinuation of prescribed psychotropic medication contrary
174	to the decision of the prescribing physician without first
175	obtaining a second opinion from a licensed physician that the
176	psychotropic medication should be discontinued.
177	(d) The court shall review the medical passport and the
178	status of the child's progress on psychotropic medication at
179	least every 6 months, which may be accomplished during timely
180	scheduled judicial review hearings pursuant to s. 39.701. On its
181	own motion or on good cause shown by any party, including any
182	guardian ad litem, attorney, or attorney ad litem who has been
183	appointed to represent the child or his or her interests, the
184	court may review the status more frequently than required in
185	this paragraph.
186	(e) If at any time the court determines that the statutory
187	requirements for continued use of the psychotropic medication
188	are not being met, the court may, in the best interests of the
189	child, order the department to either produce evidence of
190	compliance with the requirements of this section or obtain a
191	medical opinion that continued use of the medication under the
192	circumstances is safe and medically appropriate. If at any time
193	the court determines that the additional medical, counseling, or
194	other services that the prescribing physician believes are
195	necessary or would be beneficial for the treatment of the
196	child's medical condition and that the physician expects or
197	advises to be provided to the child in concert with the
198	medication are not being provided, the court may, in the best
199	interests of the child, order the department to either produce
200	evidence of compliance with the requirement of providing those
201	services or obtain a medical opinion that such services are not
202	medically appropriate.
203	Section 5. This act shall take effect July 1, 2003.
204