SENATE AMENDMENT
Bill No. CS for SB 1578
Amendment No. ___ Barcode 684128
CHAMBER ACTION
Senate House
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04/28/2004 04:36 PM .
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11 Senator Smith moved the following amendment to amendment
12 (030792):
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14 Senate Amendment (with title amendment)
15 On page 2, line 5,
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17 insert:
18 Section 2. 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 (b) "Medical care and treatment" includes ordinary and
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Bill No. CS for SB 1578
Amendment No. ___ Barcode 684128
1 necessary medical and dental examination and treatment,
2 including blood testing, preventive care including ordinary
3 immunizations, tuberculin testing, and well-child care, but
4 does not include surgery, general anesthesia, provision of
5 psychotropic medications, or other extraordinary procedures
6 for which a separate court order, power of attorney, or
7 informed consent as provided by law is required.
8 (c) "Person who has the power to consent as otherwise
9 provided by law" includes a natural or adoptive parent, legal
10 custodian, or legal guardian.
11 (d) "Psychotropic medication" means a medicine that may
12 not be dispensed or administered without a prescription which
13 is used for the treatment of medical disorders, and includes
14 hypnotics, antipsychotics, antidepressants, antianxiety
15 agents, sedatives, and mood stabilizers such as lithium,
16 Depakote, and other anticonvulsants used as mood stabilizers
17 and psychomotor stimulants. This paragraph expires July 1,
18 2005.
19 (2) Any of the following persons, in order of priority
20 listed, may consent to the medical care or treatment of a
21 minor who is not committed to the Department of Children and
22 Family Services or the Department of Juvenile Justice or in
23 their custody under chapter 39, chapter 984, or chapter 985
24 when, after a reasonable attempt, a person who has the power
25 to consent as otherwise provided by law cannot be contacted by
26 the treatment provider and actual notice to the contrary has
27 not been given to the provider by that person:
28 (a) A person who possesses a power of attorney to
29 provide medical consent for the minor. A power of attorney
30 executed after July 1, 2001, to provide medical consent for a
31 minor includes the power to consent to medically necessary
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SENATE AMENDMENT
Bill No. CS for SB 1578
Amendment No. ___ Barcode 684128
1 surgical and general anesthesia services for the minor unless
2 such services are excluded by the individual executing the
3 power of attorney.
4 (b) The stepparent.
5 (c) The grandparent of the minor.
6 (d) An adult brother or sister of the minor.
7 (e) An adult aunt or uncle of the minor.
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9 There shall be maintained in the treatment provider's records
10 of the minor documentation that a reasonable attempt was made
11 to contact the person who has the power to consent.
12 (3) The Department of Children and Family Services or
13 the Department of Juvenile Justice caseworker, juvenile
14 probation officer, or person primarily responsible for the
15 case management of the child, the administrator of any
16 facility licensed by the department under s. 393.067, s.
17 394.875, or s. 409.175, or the administrator of any
18 state-operated or state-contracted delinquency residential
19 treatment facility may consent to the medical care or
20 treatment of any minor committed to it or in its custody under
21 chapter 39, chapter 984, or chapter 985, when the person who
22 has the power to consent as otherwise provided by law cannot
23 be contacted and such person has not expressly objected to
24 such consent. There shall be maintained in the records of the
25 minor documentation that a reasonable attempt was made to
26 contact the person who has the power to consent as otherwise
27 provided by law.
28 (4) The medical provider shall notify the parent or
29 other person who has the power to consent as otherwise
30 provided by law as soon as possible after the medical care or
31 treatment is administered pursuant to consent given under this
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SENATE AMENDMENT
Bill No. CS for SB 1578
Amendment No. ___ Barcode 684128
1 section. The medical records shall reflect the reason consent
2 as otherwise provided by law was not initially obtained and
3 shall be open for inspection by the parent or other person who
4 has the power to consent as otherwise provided by law.
5 (5) The person who gives consent; a physician,
6 dentist, nurse, or other health care professional licensed to
7 practice in this state; or a hospital or medical facility,
8 including, but not limited to, county health departments,
9 shall not incur civil liability by reason of the giving of
10 consent, examination, or rendering of treatment, provided that
11 such consent, examination, or treatment was given or rendered
12 as a reasonable prudent person or similar health care
13 professional would give or render it under the same or similar
14 circumstances.
15 (6) The Center for Juvenile Psychotropic Studies is
16 created within the Department of Psychiatry of the College of
17 Medicine of the University of Florida. The purpose of the
18 center is to collect, track, and assess information regarding
19 minors in state custody held pursuant to chapter 39, chapter
20 984, or chapter 985 who have been or are currently being
21 prescribed psychotropic medications.
22 (a) In addition to determining the number of children
23 in state custody who are receiving psychotropic medications,
24 the types and dosages of medication being prescribed to those
25 children, and any other data relevant to scientifically
26 assessing the status of minors in state custody who are
27 receiving psychotropic medications, the center shall evaluate:
28 1. Whether the child received a full and complete
29 medical evaluation and, to the extent that the medication was
30 prescribed for a psychiatric condition and it is possible to
31 determine from available records, whether or not all other
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Bill No. CS for SB 1578
Amendment No. ___ Barcode 684128
1 possible physical causes had been ruled out prior to the
2 prescribing of psychotropic medication.
3 2. What other treatments and services were recommended
4 for the child in addition to psychotropic medication and
5 whether or not those services were offered or delivered.
6 3. Whether or not informed consent was received from a
7 parent, legal guardian, or the court prior to initiating
8 treatment.
9 4. Whether or not followup monitoring and treatment
10 appropriate to the child's diagnosis and prescribed medication
11 were provided to the child.
12 5. In cases where court authorization was sought,
13 whether a full and complete child resource record was provided
14 to the court for decisionmaking purposes.
15 6. Whether or not the prescription for and type of
16 psychotropic medications prescribed for the child were
17 appropriate for the age and diagnosis of the child and
18 consistent with the medical standard of care for the treatment
19 of the child's condition.
20 (b) The director of the Center for Juvenile
21 Psychotropic Studies shall be appointed by the Dean of the
22 College of Medicine of the University of Florida.
23 (c) There is created an advisory board that shall
24 periodically and objectively review and advise the center on
25 the academic rigor and research parameters of all actions
26 taken pursuant to this subsection. The board shall consist of
27 the following nine members who have backgrounds in psychiatric
28 health:
29 1. The Secretary of Children and Family Services or
30 his or her designee;
31 2. The Secretary of Juvenile Justice or his or her
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Amendment No. ___ Barcode 684128
1 designee;
2 3. The Secretary of Health Care Administration or his
3 or her designee;
4 4. The Secretary of Health or his or her designee;
5 5. One member appointed by the President of the Senate
6 from the Florida Psychiatric Society who specializes in
7 treating children and adolescents;
8 6. One member appointed by the Speaker of the House of
9 Representatives who is a pediatrician experienced in treating
10 children and adolescents with psychiatric diseases;
11 7. One member appointed by the President of the
12 University of Florida who is an epidemiologist; and
13 8. Two members appointed by the Governor, one of whom
14 has experience serving as a guardian ad litem to children and
15 adolescents in the custody of the state who have psychiatric
16 diseases, and one of whom is employed by the Louis de la Parte
17 Florida Mental Health Institute and has experience in the
18 academic study of children and adolescents with psychiatric
19 diseases.
20 (d) The center shall work in conjunction with the
21 Department of Children and Family Services, the Department of
22 Juvenile Justice, the Agency for Health Care Administration,
23 and the Department of Health, and, to the extent allowed by
24 the privacy requirements of federal and state laws, those
25 agencies shall work with the center and make available to the
26 center data regarding such dependent minors, including, but
27 not limited to:
28 1. Demographic information, including, but not limited
29 to, age, geographic location, and economic status.
30 2. A family history of each dependent minor,
31 including, but not limited to, the minor's involvement with
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SENATE AMENDMENT
Bill No. CS for SB 1578
Amendment No. ___ Barcode 684128
1 the child welfare system or the juvenile justice system, all
2 applicable social service records, and all applicable court
3 records.
4 3. A medical history of each dependent minor,
5 including, but not limited to, the minor's medical condition.
6 4. All information regarding the medications
7 prescribed or administered to each minor, including, but not
8 limited to, information contained in each minor's medication
9 administration record.
10 5. Practice patterns, licensure, and board
11 certification of prescribing physicians.
12 (e) All oral and written records, information,
13 letters, and reports received, made, or maintained by the
14 center shall be maintained in a manner consistent with all
15 applicable state and federal law.
16 (f) A privilege against civil liability is granted to
17 any person furnishing medical records in furtherance of the
18 charge of the center, unless such person furnishing medical
19 records acted in bad faith or with malice in providing such
20 information. A person who participates in the center's
21 research activities or provides information to the center with
22 regard to the incompetence, impairment, or unprofessional
23 conduct of any health care provider licensed under chapter
24 458, chapter 459, chapter 460, chapter 461, chapter 462,
25 chapter 463, chapter 464, chapter 465, or chapter 466 may not
26 be held liable in any civil action for furnishing such medical
27 records if such person acts without intentional fraud or
28 malice.
29 (g) By January 1, 2005, the center shall report its
30 findings regarding psychotropic medications prescribed to
31 dependent minors in state custody to the President of the
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SENATE AMENDMENT
Bill No. CS for SB 1578
Amendment No. ___ Barcode 684128
1 Senate, the Speaker of the House of Representatives, and the
2 appropriate committee chairs of the Senate and the House of
3 Representatives.
4 (h) This subsection expires July 1, 2005.
5 (7)(6) The Department of Children and Family Services
6 and the Department of Juvenile Justice may adopt rules to
7 implement this section.
8 (8)(7) This section does not affect other statutory
9 provisions of this state that relate to medical consent for
10 minors.
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14 And the title is amended as follows:
15 On page 2, line 21, after the semicolon,
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17 insert:
18 amending s. 743.0645, F.S.; defining the term
19 "psychotropic medication"; creating the Center
20 for Juvenile Psychotropic Studies within the
21 Department of Psychiatry of the College of
22 Medicine of the University of Florida;
23 providing the purpose of the center; providing
24 for the appointment of a director; creating an
25 advisory board; providing for board membership;
26 requiring the center to work with the
27 Department of Children and Family Services, the
28 Department of Juvenile Justice, the Agency for
29 Health Care Administration, and the Department
30 of Health; requiring certain data relating to
31 dependent minors for whom psychotropic
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SENATE AMENDMENT
Bill No. CS for SB 1578
Amendment No. ___ Barcode 684128
1 medications have been prescribed to be made
2 available to the center, as legally allowed;
3 requiring the center to report to legislative
4 leaders by a specified date; providing for
5 future repeal;
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