HB 0261 2003
1	CHAMBER ACTION
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6	The Committee on Judiciary recommends the following:
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8	Committee Substitute
9	Remove the entire bill and insert:
10	A bill to be entitled
11	An act relating to dependent children; amending s. 39.01,
12	F.S.; defining the term "child resource record"; amending
13	ss. 39.0015, 39.205, 39.302, 39.828, and 419.001, F.S.;
14	conforming cross references; amending s. 39.407, F.S.;
15	specifying conditions under which the Department of
16	Children and Family Services may consent to the dispensing
17	of psychotropic medication to a child in its legal custody
18	prior to a court order; providing requirements for a
19	petition to the court for authority to dispense
20	psychotropic medication to such a child; providing for
21	prior review of the child's medical history and evidence
22	demonstrating that the treatment is appropriate for the
23	child's condition; providing for the burden of proof;
24	providing for further medical consultation, including
25	second opinions, under certain circumstances; providing
26	conditions for discontinuation of prescribed psychotropic
27	medication or for the provision of other services;
28	providing for periodic court review of the child's
29	progress; directing the department to adopt rules;
30	amending s. 743.0645, F.S.; providing an exception to the
31	limitations on the dispensing of psychotropic medications;
32	providing an effective date.
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34	Be It Enacted by the Legislature of the State of Florida:
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36	Section 1. Paragraph (b) of subsection (3) of section
37	39.0015, Florida Statutes, is amended to read:
38	39.0015 Child abuse prevention training in the district
39	school system.--
40	(3) DEFINITIONS.--As used in this section:
41	(b) "Child abuse" means those acts as defined in ss.
42	39.01(1), (2), (31), (44), (46), (53), and (64)(30), (43),
43	(45), (52), and (63), 827.04, and 984.03(1), (2), and (37).
44	Section 2. Subsection (10) of section 39.01, Florida
45	Statutes, is amended, subsections (14) through (72) are
46	renumbered as subsections (15) through (73), respectively, and a
47	new subsection (14) is added to said section, to read:
48	39.01 Definitions.--When used in this chapter, unless the
49	context otherwise requires:
50	(10) "Caregiver" means the parent, legal custodian, adult
51	household member, or other person responsible for a child's
52	welfare as defined in subsection (48)(47).
53	(14) "Child resource record" means a standardized folder
54	that contains copies of the basic legal, demographic, and known
55	medical information pertaining to a specific child, as well as
56	any documents necessary for the child to be provided medical
57	treatment.
58	Section 3. Subsection (5) of section 39.205, Florida
59	Statutes, is amended to read:
60	39.205 Penalties relating to reporting of child abuse,
61	abandonment, or neglect.--
62	(5) If the department or its authorized agent has
63	determined after its investigation that a report is false, the
64	department shall, with the consent of the alleged perpetrator,
65	refer the report to the local law enforcement agency having
66	jurisdiction for an investigation to determine whether
67	sufficient evidence exists to refer the case for prosecution for
68	filing a false report as defined in s. 39.01(28)(27). During the
69	pendency of the investigation by the local law enforcement
70	agency, the department must notify the local law enforcement
71	agency of, and the local law enforcement agency must respond to,
72	all subsequent reports concerning children in that same family
73	in accordance with s. 39.301. If the law enforcement agency
74	believes that there are indicators of abuse, abandonment, or
75	neglect, it must immediately notify the department, which must
76	assure the safety of the children. If the law enforcement agency
77	finds sufficient evidence for prosecution for filing a false
78	report, it must refer the case to the appropriate state attorney
79	for prosecution.
80	Section 4. Subsection (1) of section 39.302, Florida
81	Statutes, is amended to read:
82	39.302 Protective investigations of institutional child
83	abuse, abandonment, or neglect.--
84	(1) The department shall conduct a child protective
85	investigation of each report of institutional child abuse,
86	abandonment, or neglect. Upon receipt of a report which alleges
87	that an employee or agent of the department, or any other entity
88	or person covered by s. 39.01(32)(31) or (48)(47), acting in an
89	official capacity, has committed an act of child abuse,
90	abandonment, or neglect, the department shall immediately
91	initiate a child protective investigation and orally notify the
92	appropriate state attorney, law enforcement agency, and
93	licensing agency. These agencies shall immediately conduct a
94	joint investigation, unless independent investigations are more
95	feasible. When conducting investigations onsite or having face-
96	to-face interviews with the child, such investigation visits
97	shall be unannounced unless it is determined by the department
98	or its agent that such unannounced visits would threaten the
99	safety of the child. When a facility is exempt from licensing,
100	the department shall inform the owner or operator of the
101	facility of the report. Each agency conducting a joint
102	investigation shall be entitled to full access to the
103	information gathered by the department in the course of the
104	investigation. A protective investigation must include an onsite
105	visit of the child's place of residence. In all cases, the
106	department shall make a full written report to the state
107	attorney within 3 working days after making the oral report. A
108	criminal investigation shall be coordinated, whenever possible,
109	with the child protective investigation of the department. Any
110	interested person who has information regarding the offenses
111	described in this subsection may forward a statement to the
112	state attorney as to whether prosecution is warranted and
113	appropriate. Within 15 days after the completion of the
114	investigation, the state attorney shall report the findings to
115	the department and shall include in such report a determination
116	of whether or not prosecution is justified and appropriate in
117	view of the circumstances of the specific case.
118	Section 5. Subsections (3) through (14) of section 39.407,
119	Florida Statutes, are renumbered as subsections (4) through
120	(15), respectively, a new subsection (3) is added to said
121	section, and present subsection (4) of said section is amended,
122	to read:
123	39.407 Medical, psychiatric, and psychological examination
124	and treatment of child; physical or mental examination of parent
125	or person requesting custody of child.--
126	(3)(a) If a child in the legal custody of the department
127	was taking prescribed psychotropic medication at the time the
128	child was removed from the home, the department may take
129	possession of the remaining medication when the department takes
130	the child and may provide consent for the dispensing of that
131	medication on a temporary basis until the next regularly
132	scheduled court hearing required under this chapter, other than
133	the shelter hearing, if such hearing occurs within 60 days after
134	the time the child was removed.
135	(b) If the prescribing physician certifies in the signed
136	medical report required in paragraph (d) that delay in
137	dispensing the prescribed psychotropic medication would more
138	likely than not cause significant harm to the child, the
139	medication may be dispensed in advance of issuance of a court
140	order. In such event, the physician's medical report shall be
141	submitted to the court, the child's guardian ad litem, and all
142	other parties within 3 business days after the commencement of
143	dispensing the medication to the child. The order required under
144	this subsection shall be sought by the department at the next
145	regularly scheduled court hearing required under this chapter,
146	or within 30 days after the date of the prescription, whichever
147	is sooner.
148	(c) Psychotropic medications may be dispensed in an acute
149	care setting.
150	(d) A motion seeking court authority to dispense
151	psychotropic medication to a child in the legal custody of the
152	department must be supported by the prescribing physician's
153	signed medical report indicating:
154	1. The name of the child and the name and range of the
155	dosage of the psychotropic medication and indicating that there
156	is a need to prescribe psychotropic medication to the child
157	based upon a diagnosed condition for which such medication is
158	indicated and that there is a plan of treatment that addresses
159	treatment alternatives that are or are not available or
160	desirable.
161	2. That the psychotropic medication at its prescribed
162	dosage is appropriate for the treatment of the child's diagnosed
163	medical condition, as well as the behaviors and symptoms the
164	medication at its prescribed dosage level is expected to
165	address.
166	3. That the prescribing physician has provided to the
167	child, if age-appropriate, the department, and any person
168	responsible for the child in his or her residential setting a
169	clinically appropriate explanation of the nature and purpose of
170	the treatment; the recognized side effects, risks, and
171	contraindications of the medication; and drug interaction
172	precautions.
173	4. Whether the psychotropic medication will replace or
174	supplement any other currently prescribed medications or
175	treatments; the length of time the child is expected to be
176	taking the medication; and any additional medical, counseling,
177	or other services that the prescribing physician believes are
178	necessary or would be beneficial for the treatment of the
179	child's medical condition and that the physician expects or
180	advises to be provided to the child in concert with the
181	medication.
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183	The department has the burden of compliance with and proof of
184	compliance with the provisions of this paragraph.
185	(e) At a hearing to determine whether to initially allow
186	dispensing of psychotropic medication to a child in the legal
187	custody of the department, or at a hearing for continuation of
188	such medication, the medical report described in paragraph (d)
189	is admissible in evidence. The prescribing physician is not
190	required to attend the hearing or testify unless the court
191	specifically orders such attendance or testimony. If the medical
192	report, the child resource record, and other evidence are in
193	accord with the requirements of this subsection, the court may
194	order the dispensing or continuation of psychotropic medication
195	without further testimony or evidence. The court shall further
196	inquire of the department as to whether additional medical,
197	counseling, or other services that the prescribing physician
198	believes are necessary or would be beneficial for the treatment
199	of the child's medical condition, and that the physician expects
200	or advises to be provided to the child in concert with the
201	medication, are being provided to the child by the department.
202	The court may require further medical consultation, including
203	obtaining a second opinion, based upon considerations of the
204	best interests of the child, and the court may not order the
205	discontinuation of prescribed psychotropic medication contrary
206	to the decision of the prescribing physician without first
207	obtaining a second opinion from a licensed psychiatrist, if
208	available, or, if not available, a physician licensed under
209	chapter 458 or chapter 459 that the psychotropic medication
210	should be discontinued.
211	(f) The court shall review the child resource record and
212	the status of the child's progress on psychotropic medication at
213	least every 6 months, which may be accomplished during timely
214	scheduled judicial review hearings pursuant to s. 39.701. On its
215	own motion or on good cause shown by any party, including any
216	guardian ad litem, attorney, or attorney ad litem who has been
217	appointed to represent the child or his or her interests, the
218	court may review the status more frequently than required in
219	this paragraph.
220	(g) If at any time the court determines that the statutory
221	requirements for continued use of the psychotropic medication
222	are not being met, the court may, in the best interests of the
223	child, order the department to either produce evidence of
224	compliance with the requirements of this section or obtain a
225	medical opinion that continued use of the medication under the
226	circumstances is safe and medically appropriate. If at any time
227	the court determines that the additional medical, counseling, or
228	other services that the prescribing physician believes are
229	necessary or would be beneficial for the treatment of the
230	child's medical condition and that the physician expects or
231	advises to be provided to the child in concert with the
232	medication are not being provided, the court may, in the best
233	interests of the child, order the department to either produce
234	evidence of compliance with the requirement of providing those
235	services or obtain a medical opinion that such services are not
236	medically appropriate.
237	(h) The department shall adopt rules to ensure that
238	children receive timely access to clinically appropriate
239	psychotropic medications. These rules must, at a minimum,
240	describe a uniform process for obtaining informed consent and
241	procedures for obtaining court authorization, including adoption
242	of uniform forms to be used in requesting court authorization
243	for use of psychotropic medication.
244	(5)(4)A judge may order a child in an out-of-home
245	placement to be treated by a licensed health care professional
246	based on evidence that the child should receive treatment. The
247	judge may also order such child to receive mental health or
248	developmental disabilities services from a psychiatrist,
249	psychologist, or other appropriate service provider. Except as
250	provided in subsection (6)(5), if it is necessary to place the
251	child in a residential facility for such services, the
252	procedures and criteria established in s. 394.467 or chapter 393
253	shall be used, whichever is applicable. A child may be provided
254	developmental disabilities or mental health services in
255	emergency situations, pursuant to the procedures and criteria
256	contained in s. 394.463(1) or chapter 393, whichever is
257	applicable.
258	Section 6. Paragraph (a) of subsection (1) of section
259	39.828, Florida Statutes, is amended to read:
260	39.828 Grounds for appointment of a guardian advocate.--
261	(1) The court shall appoint the person named in the
262	petition as a guardian advocate with all the powers and duties
263	specified in s. 39.829 for an initial term of 1 year upon a
264	finding that:
265	(a) The child named in the petition is or was a drug
266	dependent newborn as described in s. 39.01(31)(30)(g);
267	Section 7. Paragraph (d) of subsection (1) of section
268	419.001, Florida Statutes, is amended to read:
269	419.001 Site selection of community residential homes.--
270	(1) For the purposes of this section, the following
271	definitions shall apply:
272	(d) "Resident" means any of the following: a frail elder
273	as defined in s. 400.618; a physically disabled or handicapped
274	person as defined in s. 760.22(7)(a); a developmentally disabled
275	person as defined in s. 393.063(12); a nondangerous mentally ill
276	person as defined in s. 394.455(18); or a child as defined in s.
277	39.01(15)(14), s. 984.03(9) or (12), or s. 985.03(8).
278	Section 8. Paragraph (b) of subsection (1) of section
279	743.0645, Florida Statutes, is amended to read:
280	743.0645 Other persons who may consent to medical care or
281	treatment of a minor.--
282	(1) As used in this section, the term:
283	(b) "Medical care and treatment" includes ordinary and
284	necessary medical and dental examination and treatment,
285	including blood testing, preventive care including ordinary
286	immunizations, tuberculin testing, and well-child care, but does
287	not include surgery, general anesthesia, provision of
288	psychotropic medications, or other extraordinary procedures for
289	which a separate court order, power of attorney, or informed
290	consent as provided by law is required, except as provided in s.
291	39.407(3)(a).
292	Section 9. This act shall take effect July 1, 2003.
293