SENATE AMENDMENT
Bill No. CS for SB 1578
Amendment No. ___ Barcode 313534
CHAMBER ACTION
Senate House
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04/28/2004 11:01 AM .
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11 Senator Smith moved the following amendment:
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13 Senate Amendment (with title amendment)
14 On page 5, between lines 3 and 4,
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16 insert:
17 Section 2. Section 743.0645, Florida Statutes, is
18 amended to read:
19 743.0645 Other persons who may consent to medical care
20 or treatment of a minor; Center for Juvenile Psychotropic
21 Studies; creation; purpose; advisory board; report.--
22 (1) As used in this section, the term:
23 (a) "Blood testing" includes Early Periodic Screening,
24 Diagnosis, and Treatment (EPSDT) testing and other blood
25 testing deemed necessary by documented history or
26 symptomatology but excludes HIV testing and controlled
27 substance testing or any other testing for which separate
28 court order or informed consent as provided by law is
29 required.
30 (b) "Medical care and treatment" includes ordinary and
31 necessary medical and dental examination and treatment,
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1 including blood testing, preventive care including ordinary
2 immunizations, tuberculin testing, and well-child care, but
3 does not include surgery, general anesthesia, provision of
4 psychotropic medications, or other extraordinary procedures
5 for which a separate court order, power of attorney, or
6 informed consent as provided by law is required.
7 (c) "Person who has the power to consent as otherwise
8 provided by law" includes a natural or adoptive parent, legal
9 custodian, or legal guardian.
10 (d) "Psychotropic medication" means a medicine that may
11 not be dispensed or administered without a prescription which
12 is used for the treatment of medical disorders, and includes
13 hypnotics, antipsychotics, antidepressants, antianxiety
14 agents, sedatives, and mood stabilizers such as lithium,
15 Depakote, and other anticonvulsants used as mood stabilizers
16 and psychomotor stimulants. This paragraph expires July 1,
17 2005.
18 (2) Any of the following persons, in order of priority
19 listed, may consent to the medical care or treatment of a
20 minor who is not committed to the Department of Children and
21 Family Services or the Department of Juvenile Justice or in
22 their custody under chapter 39, chapter 984, or chapter 985
23 when, after a reasonable attempt, a person who has the power
24 to consent as otherwise provided by law cannot be contacted by
25 the treatment provider and actual notice to the contrary has
26 not been given to the provider by that person:
27 (a) A person who possesses a power of attorney to
28 provide medical consent for the minor. A power of attorney
29 executed after July 1, 2001, to provide medical consent for a
30 minor includes the power to consent to medically necessary
31 surgical and general anesthesia services for the minor unless
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SENATE AMENDMENT
Bill No. CS for SB 1578
Amendment No. ___ Barcode 313534
1 such services are excluded by the individual executing the
2 power of attorney.
3 (b) The stepparent.
4 (c) The grandparent of the minor.
5 (d) An adult brother or sister of the minor.
6 (e) An adult aunt or uncle of the minor.
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8 There shall be maintained in the treatment provider's records
9 of the minor documentation that a reasonable attempt was made
10 to contact the person who has the power to consent.
11 (3) The Department of Children and Family Services or
12 the Department of Juvenile Justice caseworker, juvenile
13 probation officer, or person primarily responsible for the
14 case management of the child, the administrator of any
15 facility licensed by the department under s. 393.067, s.
16 394.875, or s. 409.175, or the administrator of any
17 state-operated or state-contracted delinquency residential
18 treatment facility may consent to the medical care or
19 treatment of any minor committed to it or in its custody under
20 chapter 39, chapter 984, or chapter 985, when the person who
21 has the power to consent as otherwise provided by law cannot
22 be contacted and such person has not expressly objected to
23 such consent. There shall be maintained in the records of the
24 minor documentation that a reasonable attempt was made to
25 contact the person who has the power to consent as otherwise
26 provided by law.
27 (4) The medical provider shall notify the parent or
28 other person who has the power to consent as otherwise
29 provided by law as soon as possible after the medical care or
30 treatment is administered pursuant to consent given under this
31 section. The medical records shall reflect the reason consent
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Bill No. CS for SB 1578
Amendment No. ___ Barcode 313534
1 as otherwise provided by law was not initially obtained and
2 shall be open for inspection by the parent or other person who
3 has the power to consent as otherwise provided by law.
4 (5) The person who gives consent; a physician,
5 dentist, nurse, or other health care professional licensed to
6 practice in this state; or a hospital or medical facility,
7 including, but not limited to, county health departments,
8 shall not incur civil liability by reason of the giving of
9 consent, examination, or rendering of treatment, provided that
10 such consent, examination, or treatment was given or rendered
11 as a reasonable prudent person or similar health care
12 professional would give or render it under the same or similar
13 circumstances.
14 (6) The Center for Juvenile Psychotropic Studies is
15 created within the Department of Psychiatry of the College of
16 Medicine of the University of Florida. The purpose of the
17 center is to collect, track, and assess information regarding
18 minors in state custody held pursuant to chapter 39, chapter
19 984, or chapter 985 who have been or are currently being
20 prescribed psychotropic medications.
21 (a) In addition to determining the number of children
22 in state custody who are receiving psychotropic medications,
23 the types and dosages of medication being prescribed to those
24 children, and any other data relevant to scientifically
25 assessing the status of minors in state custody who are
26 receiving psychotropic medications, the center shall evaluate:
27 1. Whether the child received a full and complete
28 medical evaluation and, to the extent that the medication was
29 prescribed for a psychiatric condition and it is possible to
30 determine from available records, whether or not all other
31 possible physical causes had been ruled out prior to the
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Bill No. CS for SB 1578
Amendment No. ___ Barcode 313534
1 prescribing of psychotropic medication.
2 2. What other treatments and services were recommended
3 for the child in addition to psychotropic medication and
4 whether or not those services were offered or delivered.
5 3. Whether or not informed consent was received from a
6 parent, legal guardian, or the court prior to initiating
7 treatment.
8 4. Whether or not followup monitoring and treatment
9 appropriate to the child's diagnosis and prescribed medication
10 were provided to the child.
11 5. In cases where court authorization was sought,
12 whether a full and complete child resource record was provided
13 to the court for decisionmaking purposes.
14 6. Whether or not the prescription for and type of
15 psychotropic medications prescribed for the child were
16 appropriate for the age and diagnosis of the child and
17 consistent with the medical standard of care for the treatment
18 of the child's condition.
19 (b) The director of the Center for Juvenile
20 Psychotropic Studies shall be appointed by the Dean of the
21 College of Medicine of the University of Florida.
22 (c) There is created an advisory board that shall
23 periodically and objectively review and advise the center on
24 the academic rigor and research parameters of all actions
25 taken pursuant to this subsection. The board shall consist of
26 the following nine members who have backgrounds in psychiatric
27 health:
28 1. The Secretary of Children and Family Services or
29 his or her designee;
30 2. The Secretary of Juvenile Justice or his or her
31 designee;
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Amendment No. ___ Barcode 313534
1 3. The Secretary of Health Care Administration or his
2 or her designee;
3 4. The Secretary of Health or his or her designee;
4 5. One member appointed by the President of the Senate
5 from the Florida Psychiatric Society who specializes in
6 treating children and adolescents;
7 6. One member appointed by the Speaker of the House of
8 Representatives who is a pediatrician experienced in treating
9 children and adolescents with psychiatric diseases;
10 7. One member appointed by the President of the
11 University of Florida who is an epidemiologist; and
12 8. Two members appointed by the Governor, one of whom
13 has experience serving as a guardian ad litem to children and
14 adolescents in the custody of the state who have psychiatric
15 diseases, and one of whom is employed by the Louis de la Parte
16 Florida Mental Health Institute and has experience in the
17 academic study of children and adolescents with psychiatric
18 diseases.
19 (d) The center shall work in conjunction with the
20 Department of Children and Family Services, the Department of
21 Juvenile Justice, the Agency for Health Care Administration,
22 and the Department of Health, and, to the extent allowed by
23 the privacy requirements of federal and state laws, those
24 agencies shall work with the center and make available to the
25 center data regarding such dependent minors, including, but
26 not limited to:
27 1. Demographic information, including, but not limited
28 to, age, geographic location, and economic status.
29 2. A family history of each dependent minor,
30 including, but not limited to, the minor's involvement with
31 the child welfare system or the juvenile justice system, all
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1 applicable social service records, and all applicable court
2 records.
3 3. A medical history of each dependent minor,
4 including, but not limited to, the minor's medical condition.
5 4. All information regarding the medications
6 prescribed or administered to each minor, including, but not
7 limited to, information contained in each minor's medication
8 administration record.
9 5. Practice patterns, licensure, and board
10 certification of prescribing physicians.
11 (e) All oral and written records, information,
12 letters, and reports received, made, or maintained by the
13 center shall be maintained in a manner consistent with all
14 applicable state and federal law.
15 (f) A privilege against civil liability is granted to
16 any person furnishing medical records in furtherance of the
17 charge of the center, unless such person furnishing medical
18 records acted in bad faith or with malice in providing such
19 information. A person who participates in the center's
20 research activities or provides information to the center with
21 regard to the incompetence, impairment, or unprofessional
22 conduct of any health care provider licensed under chapter
23 458, chapter 459, chapter 460, chapter 461, chapter 462,
24 chapter 463, chapter 464, chapter 465, or chapter 466 may not
25 be held liable in any civil action for furnishing such medical
26 records if such person acts without intentional fraud or
27 malice.
28 (g) By January 1, 2005, the center shall report its
29 findings regarding psychotropic medications prescribed to
30 dependent minors in state custody to the President of the
31 Senate, the Speaker of the House of Representatives, and the
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SENATE AMENDMENT
Bill No. CS for SB 1578
Amendment No. ___ Barcode 313534
1 appropriate committee chairs of the Senate and the House of
2 Representatives.
3 (h) This subsection expires July 1, 2005.
4 (7)(6) The Department of Children and Family Services
5 and the Department of Juvenile Justice may adopt rules to
6 implement this section.
7 (8)(7) This section does not affect other statutory
8 provisions of this state that relate to medical consent for
9 minors.
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11 (Redesignate subsequent sections.)
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14 ================ T I T L E A M E N D M E N T ===============
15 And the title is amended as follows:
16 On page 2, line 1, after the semicolon,
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18 insert:
19 amending s. 743.0645, F.S.; defining the term
20 "psychotropic medication"; creating the Center
21 for Juvenile Psychotropic Studies within the
22 Department of Psychiatry of the College of
23 Medicine of the University of Florida;
24 providing the purpose of the center; providing
25 for the appointment of a director; creating an
26 advisory board; providing for board membership;
27 requiring the center to work with the
28 Department of Children and Family Services, the
29 Department of Juvenile Justice, the Agency for
30 Health Care Administration, and the Department
31 of Health; requiring certain data relating to
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SENATE AMENDMENT
Bill No. CS for SB 1578
Amendment No. ___ Barcode 313534
1 dependent minors for whom psychotropic
2 medications have been prescribed to be made
3 available to the center, as legally allowed;
4 requiring the center to report to legislative
5 leaders by a specified date; providing for
6 future repeal;
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