Florida Senate - 2014                                    SB 1670
       
       
        
       By the Committee on Children, Families, and Elder Affairs; and
       Senator Grimsley
       
       
       
       
       586-02452-14                                          20141670__
    1                        A bill to be entitled                      
    2         An act relating to medically complex children;
    3         amending s. 39.001, F.S.; revising the purposes of ch.
    4         39, F.S.; providing for the provision of services for
    5         medically complex children; conforming cross
    6         references; amending s. 39.01, F.S.; defining the term
    7         “medical neglect”; conforming cross-references;
    8         amending s. 39.303, F.S.; revising legislative intent;
    9         providing requirements for a child protection team
   10         that evaluates a report of medical neglect and
   11         assesses the health care needs of a medically complex
   12         child; creating s. 39.3068, F.S.; providing
   13         requirements for an investigation of medical neglect;
   14         amending s. 409.165, F.S.; revising provisions
   15         relating to the cost of services; requiring the
   16         Department of Children and Families to work with the
   17         Department of Health and the Agency for Health Care
   18         Administration to care for medically complex children;
   19         allowing the Department of Children and Families to
   20         place children in a medical foster home; conforming
   21         provisions to changes made by the act; amending s.
   22         409.962, F.S.; redefining the term “provider service
   23         network”; amending s. 409.967, F.S.; requiring
   24         Medicaid managed care plans to provide specified
   25         information on children under the care of the
   26         Department of Children and Families; amending s.
   27         409.974, F.S.; providing for contracting with eligible
   28         plans; revising provisions relating to negotiation
   29         with a provider service network; providing
   30         requirements for termination of a contract with a
   31         provider service network; amending ss. 39.302, 39.524,
   32         316.613, 409.1678, and 960.065, F.S.; conforming
   33         cross-references; providing an effective date.
   34          
   35  Be It Enacted by the Legislature of the State of Florida:
   36  
   37         Section 1. Paragraph (o) is added to subsection (1) of
   38  section 39.001, Florida Statutes, and paragraph (k) of that
   39  subsection is amended, present paragraphs (f) through (h) of
   40  subsection (3) of that section are redesignated as paragraphs
   41  (g) through (i), respectively, and a new paragraph (f) is added
   42  to that subsection, and present subsections (4) through (11) of
   43  that section are redesignated as subsections (5) through (12),
   44  respectively, a new subsection (4) is added to that section, and
   45  paragraph (c) of present subsection (8) and paragraph (b) of
   46  present subsection (10) of that section are amended, to read:
   47         39.001 Purposes and intent; personnel standards and
   48  screening.—
   49         (1) PURPOSES OF CHAPTER.—The purposes of this chapter are:
   50         (k) To make every possible effort, if when two or more
   51  children who are in the care or under the supervision of the
   52  department are siblings, to place the siblings in the same home;
   53  and in the event of permanent placement of the siblings, to
   54  place them in the same adoptive home or, if the siblings are
   55  separated while under the care or supervision of the department
   56  or in a permanent placement, to keep them in contact with each
   57  other.
   58         (o) To preserve and strengthen families who are caring for
   59  medically complex children.
   60         (3) GENERAL PROTECTIONS FOR CHILDREN.—It is a purpose of
   61  the Legislature that the children of this state be provided with
   62  the following protections:
   63         (f) Access to sufficient home and community-based support
   64  for medically complex children to allow them to remain in the
   65  least restrictive and most nurturing environment, which includes
   66  sufficient home and community-based services in an amount and
   67  scope comparable to those the child would receive in out-of-home
   68  care placement.
   69         (4) SERVICES FOR MEDICALLY COMPLEX CHILDREN.—The department
   70  shall maintain a program of family-centered services and
   71  supports for medically complex children. The purpose of the
   72  program is to prevent abuse and neglect of medically complex
   73  children while enhancing the capacity of families to provide for
   74  their children’s needs. Program services must include outreach,
   75  early intervention, and provision of home and community-based
   76  services such as care coordination, respite care, and direct
   77  home care. The department shall work with the Agency for Health
   78  Care Administration and the Department of Health to provide
   79  needed services.
   80         (9)(8) OFFICE OF ADOPTION AND CHILD PROTECTION.—
   81         (c) The office is authorized and directed to:
   82         1. Oversee the preparation and implementation of the state
   83  plan established under subsection (10) (9) and revise and update
   84  the state plan as necessary.
   85         2. Provide for or make available continuing professional
   86  education and training in the prevention of child abuse and
   87  neglect.
   88         3. Work to secure funding in the form of appropriations,
   89  gifts, and grants from the state, the Federal Government, and
   90  other public and private sources in order to ensure that
   91  sufficient funds are available for the promotion of adoption,
   92  support of adoptive families, and child abuse prevention
   93  efforts.
   94         4. Make recommendations pertaining to agreements or
   95  contracts for the establishment and development of:
   96         a. Programs and services for the promotion of adoption,
   97  support of adoptive families, and prevention of child abuse and
   98  neglect.
   99         b. Training programs for the prevention of child abuse and
  100  neglect.
  101         c. Multidisciplinary and discipline-specific training
  102  programs for professionals with responsibilities affecting
  103  children, young adults, and families.
  104         d. Efforts to promote adoption.
  105         e. Postadoptive services to support adoptive families.
  106         5. Monitor, evaluate, and review the development and
  107  quality of local and statewide services and programs for the
  108  promotion of adoption, support of adoptive families, and
  109  prevention of child abuse and neglect and shall publish and
  110  distribute an annual report of its findings on or before January
  111  1 of each year to the Governor, the Speaker of the House of
  112  Representatives, the President of the Senate, the head of each
  113  state agency affected by the report, and the appropriate
  114  substantive committees of the Legislature. The report shall
  115  include:
  116         a. A summary of the activities of the office.
  117         b. A summary of the adoption data collected and reported to
  118  the federal Adoption and Foster Care Analysis and Reporting
  119  System (AFCARS) and the federal Administration for Children and
  120  Families.
  121         c. A summary of the child abuse prevention data collected
  122  and reported to the National Child Abuse and Neglect Data System
  123  (NCANDS) and the federal Administration for Children and
  124  Families.
  125         d. A summary detailing the timeliness of the adoption
  126  process for children adopted from within the child welfare
  127  system.
  128         e. Recommendations, by state agency, for the further
  129  development and improvement of services and programs for the
  130  promotion of adoption, support of adoptive families, and
  131  prevention of child abuse and neglect.
  132         f. Budget requests, adoption promotion and support needs,
  133  and child abuse prevention program needs by state agency.
  134         6. Work with the direct-support organization established
  135  under s. 39.0011 to receive financial assistance.
  136         (11)(10) FUNDING AND SUBSEQUENT PLANS.—
  137         (b) The office and the other agencies and organizations
  138  listed in paragraph (10)(a) (9)(a) shall readdress the state
  139  plan and make necessary revisions every 5 years, at a minimum.
  140  Such revisions shall be submitted to the Speaker of the House of
  141  Representatives and the President of the Senate no later than
  142  June 30 of each year divisible by 5. At least biennially, the
  143  office shall review the state plan and make any necessary
  144  revisions based on changing needs and program evaluation
  145  results. An annual progress report shall be submitted to update
  146  the state plan in the years between the 5-year intervals. In
  147  order to avoid duplication of effort, these required plans may
  148  be made a part of or merged with other plans required by either
  149  the state or Federal Government, so long as the portions of the
  150  other state or Federal Government plan that constitute the state
  151  plan for the promotion of adoption, support of adoptive
  152  families, and prevention of child abuse, abandonment, and
  153  neglect are clearly identified as such and are provided to the
  154  Speaker of the House of Representatives and the President of the
  155  Senate as required above.
  156         Section 2. Present subsections (42) through (76) of section
  157  39.01, Florida Statutes, are redesignated as subsections (43)
  158  through (77), respectively, a new subsection (42) is added to
  159  that section, and subsections (10) and (33) are amended, to
  160  read:
  161         39.01 Definitions.—When used in this chapter, unless the
  162  context otherwise requires:
  163         (10) “Caregiver” means the parent, legal custodian,
  164  permanent guardian, adult household member, or other person
  165  responsible for a child’s welfare as defined in subsection (48)
  166  (47).
  167         (33) “Institutional child abuse or neglect” means
  168  situations of known or suspected child abuse or neglect in which
  169  the person allegedly perpetrating the child abuse or neglect is
  170  an employee of a private school, public or private day care
  171  center, residential home, institution, facility, or agency or
  172  any other person at such institution responsible for the child’s
  173  care as defined in subsection (48) (47).
  174         (42) “Medical neglect” means the failure to provide or to
  175  allow needed care as recommended by a health care practitioner
  176  for a physical injury, illness, medical condition, or
  177  impairment, or the failure to seek timely and appropriate
  178  medical care for a serious health problem that a reasonable
  179  person would have recognized as requiring professional medical
  180  attention. Medical neglect does not occur if:
  181         (a)The parent or legal custodian of the child has made
  182  reasonable attempts to obtain necessary health care services or
  183  the immediate health condition giving rise to the allegation of
  184  neglect is a known and expected complication of the child’s
  185  diagnosis or treatment; and
  186         (b) The recommended care offers limited net benefit to the
  187  child and the morbidity or other side effects of the treatment
  188  may be considered to be greater than the anticipated benefit.
  189         Section 3. Section 39.303, Florida Statutes, is amended to
  190  read:
  191         39.303 Child protection teams; services; eligible cases.
  192  The Children’s Medical Services Program in the Department of
  193  Health shall develop, maintain, and coordinate the services of
  194  one or more multidisciplinary child protection teams in each of
  195  the service districts of the Department of Children and Family
  196  Services. Such teams may be composed of appropriate
  197  representatives of school districts and appropriate health,
  198  mental health, social service, legal service, and law
  199  enforcement agencies. The Legislature finds that optimal
  200  coordination of child protection teams and sexual abuse
  201  treatment programs requires collaboration between The Department
  202  of Health and the Department of Children and Families Family
  203  Services. The two departments shall maintain an interagency
  204  agreement that establishes protocols for oversight and
  205  operations of child protection teams and sexual abuse treatment
  206  programs. The State Surgeon General and the Deputy Secretary for
  207  Children’s Medical Services, in consultation with the Secretary
  208  of Children and Family Services, shall maintain the
  209  responsibility for the screening, employment, and, if necessary,
  210  the termination of child protection team medical directors, at
  211  headquarters and in the 15 districts. Child protection team
  212  medical directors shall be responsible for oversight of the
  213  teams in the districts.
  214         (1) The Department of Health shall use utilize and convene
  215  the teams to supplement the assessment and protective
  216  supervision activities of the family safety and preservation
  217  program of the Department of Children and Families Family
  218  Services. Nothing in This section does not shall be construed to
  219  remove or reduce the duty and responsibility of any person to
  220  report pursuant to this chapter all suspected or actual cases of
  221  child abuse, abandonment, or neglect or sexual abuse of a child.
  222  The role of the teams shall be to support activities of the
  223  program and to provide services deemed by the teams to be
  224  necessary and appropriate to abused, abandoned, and neglected
  225  children upon referral. The specialized diagnostic assessment,
  226  evaluation, coordination, consultation, and other supportive
  227  services that a child protection team shall be capable of
  228  providing include, but are not limited to, the following:
  229         (a) Medical diagnosis and evaluation services, including
  230  provision or interpretation of X rays and laboratory tests, and
  231  related services, as needed, and documentation of related
  232  findings relative thereto.
  233         (b) Telephone consultation services in emergencies and in
  234  other situations.
  235         (c) Medical evaluation related to abuse, abandonment, or
  236  neglect, as defined by policy or rule of the Department of
  237  Health.
  238         (d) Such psychological and psychiatric diagnosis and
  239  evaluation services for the child or the child’s parent or
  240  parents, legal custodian or custodians, or other caregivers, or
  241  any other individual involved in a child abuse, abandonment, or
  242  neglect case, as the team may determine to be needed.
  243         (e) Expert medical, psychological, and related professional
  244  testimony in court cases.
  245         (f) Case staffings to develop treatment plans for children
  246  whose cases have been referred to the team. A child protection
  247  team may provide consultation with respect to a child who is
  248  alleged or is shown to be abused, abandoned, or neglected. The,
  249  which consultation shall be provided at the request of a
  250  representative of the family safety and preservation program or
  251  at the request of any other professional involved with a child
  252  or the child’s parent or parents, legal custodian or custodians,
  253  or other caregivers. In every such child protection team case
  254  staffing, consultation, or staff activity involving a child, a
  255  family safety and preservation program representative shall
  256  attend and participate.
  257         (g) Case service coordination and assistance, including the
  258  location of services available from other public and private
  259  agencies in the community.
  260         (h) Such training services for program and other employees
  261  of the Department of Children and Families Family Services,
  262  employees of the Department of Health, and other medical
  263  professionals as is deemed appropriate to enable them to develop
  264  and maintain their professional skills and abilities in handling
  265  child abuse, abandonment, and neglect cases.
  266         (i) Educational and community awareness campaigns on child
  267  abuse, abandonment, and neglect in an effort to enable citizens
  268  more successfully to prevent, identify, and treat child abuse,
  269  abandonment, and neglect in the community.
  270         (j) Child protection team assessments that include, as
  271  appropriate, medical evaluations, medical consultations, family
  272  psychosocial interviews, specialized clinical interviews, or
  273  forensic interviews.
  274  
  275  All medical personnel participating on a child protection team
  276  must successfully complete the required child protection team
  277  training curriculum as set forth in protocols determined by the
  278  Deputy Secretary for Children’s Medical Services and the
  279  Statewide Medical Director for Child Protection. A child
  280  protection team that is evaluating a report of medical neglect
  281  and assessing the health care needs of a medically complex child
  282  shall consult with a physician who has experience in treating
  283  children with the same condition.
  284         (2) The child abuse, abandonment, and neglect reports that
  285  must be referred by the department to child protection teams of
  286  the Department of Health for an assessment and other appropriate
  287  available support services as set forth in subsection (1) must
  288  include cases involving:
  289         (a) Injuries to the head, bruises to the neck or head,
  290  burns, or fractures in a child of any age.
  291         (b) Bruises anywhere on a child 5 years of age or under.
  292         (c) Any report alleging sexual abuse of a child.
  293         (d) Any sexually transmitted disease in a prepubescent
  294  child.
  295         (e) Reported malnutrition of a child and failure of a child
  296  to thrive.
  297         (f) Reported medical neglect of a child.
  298         (g) Any family in which one or more children have been
  299  pronounced dead on arrival at a hospital or other health care
  300  facility, or have been injured and later died, as a result of
  301  suspected abuse, abandonment, or neglect, when any sibling or
  302  other child remains in the home.
  303         (h) Symptoms of serious emotional problems in a child when
  304  emotional or other abuse, abandonment, or neglect is suspected.
  305         (3) All abuse and neglect cases transmitted for
  306  investigation to a district by the hotline must be
  307  simultaneously transmitted to the Department of Health child
  308  protection team for review. For the purpose of determining
  309  whether face-to-face medical evaluation by a child protection
  310  team is necessary, all cases transmitted to the child protection
  311  team which meet the criteria in subsection (2) must be timely
  312  reviewed by:
  313         (a) A physician licensed under chapter 458 or chapter 459
  314  who holds board certification in pediatrics and is a member of a
  315  child protection team;
  316         (b) A physician licensed under chapter 458 or chapter 459
  317  who holds board certification in a specialty other than
  318  pediatrics, who may complete the review only when working under
  319  the direction of a physician licensed under chapter 458 or
  320  chapter 459 who holds board certification in pediatrics and is a
  321  member of a child protection team;
  322         (c) An advanced registered nurse practitioner licensed
  323  under chapter 464 who has a specialty speciality in pediatrics
  324  or family medicine and is a member of a child protection team;
  325         (d) A physician assistant licensed under chapter 458 or
  326  chapter 459, who may complete the review only when working under
  327  the supervision of a physician licensed under chapter 458 or
  328  chapter 459 who holds board certification in pediatrics and is a
  329  member of a child protection team; or
  330         (e) A registered nurse licensed under chapter 464, who may
  331  complete the review only when working under the direct
  332  supervision of a physician licensed under chapter 458 or chapter
  333  459 who holds certification in pediatrics and is a member of a
  334  child protection team.
  335         (4) A face-to-face medical evaluation by a child protection
  336  team is not necessary when:
  337         (a) The child was examined for the alleged abuse or neglect
  338  by a physician who is not a member of the child protection team,
  339  and a consultation between the child protection team board
  340  certified pediatrician, advanced registered nurse practitioner,
  341  physician assistant working under the supervision of a child
  342  protection team board-certified pediatrician, or registered
  343  nurse working under the direct supervision of a child protection
  344  team board-certified pediatrician, and the examining physician
  345  concludes that a further medical evaluation is unnecessary;
  346         (b) The child protective investigator, with supervisory
  347  approval, has determined, after conducting a child safety
  348  assessment, that there are no indications of injuries as
  349  described in paragraphs (2)(a)-(h) as reported; or
  350         (c) The child protection team board-certified pediatrician,
  351  as authorized in subsection (3), determines that a medical
  352  evaluation is not required.
  353  
  354  Notwithstanding paragraphs (a), (b), and (c), a child protection
  355  team pediatrician, as authorized in subsection (3), may
  356  determine that a face-to-face medical evaluation is necessary.
  357         (5) In all instances in which a child protection team is
  358  providing certain services to abused, abandoned, or neglected
  359  children, other offices and units of the Department of Health,
  360  and offices and units of the Department of Children and Families
  361  Family Services, shall avoid duplicating the provision of those
  362  services.
  363         (6) The Department of Health child protection team quality
  364  assurance program and the Department of Children and Families’
  365  Family Services’ Family Safety Program Office quality assurance
  366  program shall collaborate to ensure referrals and responses to
  367  child abuse, abandonment, and neglect reports are appropriate.
  368  Each quality assurance program shall include a review of records
  369  in which there are no findings of abuse, abandonment, or
  370  neglect, and the findings of these reviews shall be included in
  371  each department’s quality assurance reports.
  372         Section 4. Section 39.3068, Florida Statutes, is created to
  373  read:
  374         39.3068 Reports of medical neglect.—
  375         (1)A report of medical neglect as defined in s. 39.01 must
  376  be investigated by staff who have specialized training in
  377  medical neglect and medically complex children.
  378         (2)The investigation must identify any immediate medical
  379  needs of the child and must use a family-centered approach to
  380  assess the capacity of the family to meet those needs.
  381         (3)A family-centered approach is intended to increase
  382  independence on the part of the family, accessibility to
  383  programs and services within the community, and collaboration
  384  between families and their service providers. The ethnic,
  385  cultural, economic, racial, social, and religious diversity of
  386  families must be respected and considered in the development and
  387  provision of services.
  388         (4)An investigation of cases involving medically complex
  389  children must include determination of Medicaid coverage for
  390  needed services and coordination with the Agency for Health Care
  391  Administration to secure such covered services.
  392         Section 5. Section 409.165, Florida Statutes, is amended to
  393  read:
  394         409.165 Alternate care for children.—
  395         (1) Within funds appropriated, the department shall
  396  establish and supervise a program of emergency shelters, runaway
  397  shelters, foster homes, group homes, agency-operated group
  398  treatment homes, nonpsychiatric residential group care
  399  facilities, psychiatric residential treatment facilities, and
  400  other appropriate facilities to provide shelter and care for
  401  dependent children who must be placed away from their families.
  402  The department, in accordance with outcome established goals
  403  established in s. 409.986, shall contract for the provision of
  404  such shelter and care by counties, municipalities, nonprofit
  405  corporations, and other entities capable of providing needed
  406  services if:
  407         (a) The services so provided comply with all department
  408  standards, policies, and procedures are available;
  409         (b) The services can be so provided at a reasonable cost
  410  are more cost-effective than those provided by the department;
  411  and
  412         (c) Unless otherwise provided by law, such providers of
  413  shelter and care are licensed by the department.
  414  
  415  It is the legislative intent that the
  416         (2) Funds appropriated for the alternate care of children
  417  as described in this section may be used to meet the needs of
  418  children in their own homes or those of relatives if the
  419  children can be safely served in such settings their own homes,
  420  or the homes of relatives, and the expenditure of funds in such
  421  manner is equal to or less than the cost of out-of-home
  422  placement calculated by the department to be an eventual cost
  423  savings over placement of children.
  424         (3)(2) The department shall may cooperate with all child
  425  service institutions or agencies within the state which meet the
  426  department’s standards in order to maintain a comprehensive,
  427  coordinated, and inclusive system for promoting and protecting
  428  the well-being of children, consistent with the goals
  429  established in s. 409.986 rules for proper care and supervision
  430  prescribed by the department for the well-being of children.
  431         (a) The department shall work with the Department of Health
  432  in the development, utilization, and monitoring of medical
  433  foster homes for medically complex children.
  434         (b)The department shall work with the Agency for Health
  435  Care Administration to provide such home and community-based
  436  services as may be necessary to maintain medically complex
  437  children in the least restrictive and most nurturing
  438  environment.
  439         (4)(3) With the written consent of parents, custodians, or
  440  guardians, or in accordance with those provisions in chapter 39
  441  that relate to dependent children, the department, under rules
  442  properly adopted, may place a child:
  443         (a) With a relative;
  444         (b) With an adult nonrelative approved by the court for
  445  long-term custody;
  446         (c) With a person who is considering the adoption of a
  447  child in the manner provided for by law;
  448         (d) When limited, except as provided in paragraph (b), to
  449  temporary emergency situations, with a responsible adult
  450  approved by the court;
  451         (e) With a person or family approved by the department to
  452  serve as a medical foster home;
  453         (f)(e) With a person or agency licensed by the department
  454  in accordance with s. 409.175; or
  455         (g)(f) In a subsidized independent living situation,
  456  subject to the provisions of s. 409.1451(4)(c),
  457  
  458  under such conditions as are determined to be for the best
  459  interests or the welfare of the child. Any child placed in an
  460  institution or in a family home by the department or its agency
  461  may be removed by the department or its agency, and such other
  462  disposition may be made as is for the best interest of the
  463  child, including transfer of the child to another institution,
  464  another home, or the home of the child. Expenditure of funds
  465  appropriated for out-of-home care can be used to meet the needs
  466  of a child in the child’s own home or the home of a relative if
  467  the child can be safely served in the child’s own home or that
  468  of a relative if placement can be avoided by the expenditure of
  469  such funds, and if the expenditure of such funds in this manner
  470  is equal to or less than the cost of out-of-home placement
  471  calculated by the department to be a potential cost savings.
  472         Section 6. Subsection (13) of section 409.962, Florida
  473  Statutes, is amended to read:
  474         409.962 Definitions.—As used in this part, except as
  475  otherwise specifically provided, the term:
  476         (13) “Provider service network” means an entity qualified
  477  pursuant to s. 409.912(4)(d) of which a controlling interest is
  478  owned by a health care provider, or group of affiliated
  479  providers affiliated for the purpose of providing health care,
  480  or a public agency or entity that delivers health services.
  481  Health care providers include Florida-licensed health care
  482  professionals or licensed health care facilities, federally
  483  qualified health care centers, and home health care agencies.
  484         Section 7. Paragraph (c) of subsection (2) of section
  485  409.967, Florida Statutes, is amended to read:
  486         409.967 Managed care plan accountability.—
  487         (2) The agency shall establish such contract requirements
  488  as are necessary for the operation of the statewide managed care
  489  program. In addition to any other provisions the agency may deem
  490  necessary, the contract must require:
  491         (c) Access.—
  492         1. The agency shall establish specific standards for the
  493  number, type, and regional distribution of providers in managed
  494  care plan networks to ensure access to care for both adults and
  495  children. Each plan must maintain a regionwide network of
  496  providers in sufficient numbers to meet the access standards for
  497  specific medical services for all recipients enrolled in the
  498  plan. The exclusive use of mail-order pharmacies may not be
  499  sufficient to meet network access standards. Consistent with the
  500  standards established by the agency, provider networks may
  501  include providers located outside the region. A plan may
  502  contract with a new hospital facility before the date the
  503  hospital becomes operational if the hospital has commenced
  504  construction, will be licensed and operational by January 1,
  505  2013, and a final order has issued in any civil or
  506  administrative challenge. Each plan shall establish and maintain
  507  an accurate and complete electronic database of contracted
  508  providers, including information about licensure or
  509  registration, locations and hours of operation, specialty
  510  credentials and other certifications, specific performance
  511  indicators, and such other information as the agency deems
  512  necessary. The database must be available online to both the
  513  agency and the public and have the capability to compare the
  514  availability of providers to network adequacy standards and to
  515  accept and display feedback from each provider’s patients. Each
  516  plan shall submit quarterly reports to the agency identifying
  517  the number of enrollees assigned to each primary care provider.
  518         2. Each managed care plan must publish any prescribed drug
  519  formulary or preferred drug list on the plan’s website in a
  520  manner that is accessible to and searchable by enrollees and
  521  providers. The plan must update the list within 24 hours after
  522  making a change. Each plan must ensure that the prior
  523  authorization process for prescribed drugs is readily accessible
  524  to health care providers, including posting appropriate contact
  525  information on its website and providing timely responses to
  526  providers. For Medicaid recipients diagnosed with hemophilia who
  527  have been prescribed anti-hemophilic-factor replacement
  528  products, the agency shall provide for those products and
  529  hemophilia overlay services through the agency’s hemophilia
  530  disease management program.
  531         3. Managed care plans, and their fiscal agents or
  532  intermediaries, must accept prior authorization requests for any
  533  service electronically.
  534         4. Managed care plans serving children in the care and
  535  custody of the Department of Children and Families must maintain
  536  complete medical, dental, and behavioral health information and
  537  provide such information to the department for inclusion in the
  538  state’s child welfare data system. Using such documentation, the
  539  agency and the department shall determine the plan’s compliance
  540  with standards for access to medical, dental, and behavioral
  541  health services, the use of psychotropic medications, and
  542  followup on all medically necessary services recommended as a
  543  result of early and periodic screening diagnosis and treatment.
  544         Section 8. Subsection (1) of section 409.974, Florida
  545  Statutes, is amended to read:
  546         409.974 Eligible plans.—
  547         (1) ELIGIBLE PLAN SELECTION AND CONTRACTING.—The agency
  548  shall select eligible plans through the procurement process
  549  described in s. 409.966. The agency shall notice invitations to
  550  negotiate no later than January 1, 2013.
  551         (a) The agency shall procure and contract with two plans
  552  for Region 1. At least one plan shall be a provider service
  553  network if any provider service networks submit a responsive
  554  bid.
  555         (b) The agency shall procure and contract with two plans
  556  for Region 2. At least one plan shall be a provider service
  557  network if any provider service networks submit a responsive
  558  bid.
  559         (c) The agency shall procure and contract with at least
  560  three plans and up to five plans for Region 3. At least one plan
  561  must be a provider service network if any provider service
  562  networks submit a responsive bid.
  563         (d) The agency shall procure and contract with at least
  564  three plans and up to five plans for Region 4. At least one plan
  565  must be a provider service network if any provider service
  566  networks submit a responsive bid.
  567         (e) The agency shall procure and contract with at least two
  568  plans and up to four plans for Region 5. At least one plan must
  569  be a provider service network if any provider service networks
  570  submit a responsive bid.
  571         (f) The agency shall procure and contract with at least
  572  four plans and up to seven plans for Region 6. At least one plan
  573  must be a provider service network if any provider service
  574  networks submit a responsive bid.
  575         (g) The agency shall procure and contract with at least
  576  three plans and up to six plans for Region 7. At least one plan
  577  must be a provider service network if any provider service
  578  networks submit a responsive bid.
  579         (h) The agency shall procure and contract with at least two
  580  plans and up to four plans for Region 8. At least one plan must
  581  be a provider service network if any provider service networks
  582  submit a responsive bid.
  583         (i) The agency shall procure and contract with at least two
  584  plans and up to four plans for Region 9. At least one plan must
  585  be a provider service network if any provider service networks
  586  submit a responsive bid.
  587         (j) The agency shall procure and contract with at least two
  588  plans and up to four plans for Region 10. At least one plan must
  589  be a provider service network if any provider service networks
  590  submit a responsive bid.
  591         (k) The agency shall procure and contract with at least
  592  five plans and up to 10 plans for Region 11. At least one plan
  593  must be a provider service network if any provider service
  594  networks submit a responsive bid.
  595  
  596  If no provider service network submits a responsive bid, the
  597  agency shall procure and contract with no more than one less
  598  than the maximum number of eligible plans permitted in that
  599  region, and, within the next. Within 12 months after the initial
  600  invitation to negotiate, the agency shall issue an invitation to
  601  negotiate in order attempt to procure and contract with a
  602  provider service network. The agency shall terminate the
  603  contract and provide notice for another invitation to negotiate
  604  when changes in the corporate ownership and structure of the
  605  only with provider service network networks in a region causes
  606  the managed care plan to no longer meet the definition of a
  607  provider service network under s. 409.962(13) those regions
  608  where no provider service network has been selected.
  609         Section 9. Subsection (1) of section 39.302, Florida
  610  Statutes, is amended to read:
  611         39.302 Protective investigations of institutional child
  612  abuse, abandonment, or neglect.—
  613         (1) The department shall conduct a child protective
  614  investigation of each report of institutional child abuse,
  615  abandonment, or neglect. Upon receipt of a report that alleges
  616  that an employee or agent of the department, or any other entity
  617  or person covered by s. 39.01(33) or (48) (47), acting in an
  618  official capacity, has committed an act of child abuse,
  619  abandonment, or neglect, the department shall initiate a child
  620  protective investigation within the timeframe established under
  621  s. 39.201(5) and notify the appropriate state attorney, law
  622  enforcement agency, and licensing agency, which shall
  623  immediately conduct a joint investigation, unless independent
  624  investigations are more feasible. When conducting investigations
  625  or having face-to-face interviews with the child, investigation
  626  visits shall be unannounced unless it is determined by the
  627  department or its agent that unannounced visits threaten the
  628  safety of the child. If a facility is exempt from licensing, the
  629  department shall inform the owner or operator of the facility of
  630  the report. Each agency conducting a joint investigation is
  631  entitled to full access to the information gathered by the
  632  department in the course of the investigation. A protective
  633  investigation must include an interview with the child’s parent
  634  or legal guardian. The department shall make a full written
  635  report to the state attorney within 3 working days after making
  636  the oral report. A criminal investigation shall be coordinated,
  637  whenever possible, with the child protective investigation of
  638  the department. Any interested person who has information
  639  regarding the offenses described in this subsection may forward
  640  a statement to the state attorney as to whether prosecution is
  641  warranted and appropriate. Within 15 days after the completion
  642  of the investigation, the state attorney shall report the
  643  findings to the department and shall include in the report a
  644  determination of whether or not prosecution is justified and
  645  appropriate in view of the circumstances of the specific case.
  646         Section 10. Subsection (1) of section 39.524, Florida
  647  Statutes, is amended to read:
  648         39.524 Safe-harbor placement.—
  649         (1) Except as provided in s. 39.407 or s. 985.801, a
  650  dependent child 6 years of age or older who has been found to be
  651  a victim of sexual exploitation as defined in s. 39.01(68)(g) s.
  652  39.01(67)(g) must be assessed for placement in a safe house as
  653  provided in s. 409.1678. The assessment shall be conducted by
  654  the department or its agent and shall incorporate and address
  655  current and historical information from any law enforcement
  656  reports; psychological testing or evaluation that has occurred;
  657  current and historical information from the guardian ad litem,
  658  if one has been assigned; current and historical information
  659  from any current therapist, teacher, or other professional who
  660  has knowledge of the child and has worked with the child; and
  661  any other information concerning the availability and
  662  suitability of safe-house placement. If such placement is
  663  determined to be appropriate as a result of this assessment, the
  664  child may be placed in a safe house, if one is available. As
  665  used in this section, the term “available” as it relates to a
  666  placement means a placement that is located within the circuit
  667  or otherwise reasonably accessible.
  668         Section 11. Subsection (6) of section 316.613, Florida
  669  Statutes, is amended to read:
  670         316.613 Child restraint requirements.—
  671         (6) The child restraint requirements imposed by this
  672  section do not apply to a chauffeur-driven taxi, limousine,
  673  sedan, van, bus, motor coach, or other passenger vehicle if the
  674  operator and the motor vehicle are hired and used for the
  675  transportation of persons for compensation. It is the obligation
  676  and responsibility of the parent, guardian, or other person
  677  responsible for a child’s welfare, as defined in s. 39.01(47),
  678  to comply with the requirements of this section.
  679         Section 12. Paragraph (d) of subsection (1) of section
  680  409.1678, Florida Statutes, is amended to read:
  681         409.1678 Safe harbor for children who are victims of sexual
  682  exploitation.—
  683         (1) As used in this section, the term:
  684         (d) “Sexually exploited child” means a dependent child who
  685  has suffered sexual exploitation as defined in s. 39.01(68)(g)
  686  s. 39.01(67)(g) and is ineligible for relief and benefits under
  687  the federal Trafficking Victims Protection Act, 22 U.S.C. ss.
  688  7101 et seq.
  689         Section 13. Subsection (5) of section 960.065, Florida
  690  Statutes, is amended to read:
  691         960.065 Eligibility for awards.—
  692         (5) A person is not ineligible for an award pursuant to
  693  paragraph (2)(a), paragraph (2)(b), or paragraph (2)(c) if that
  694  person is a victim of sexual exploitation of a child as defined
  695  in s. 39.01(68)(g) s. 39.01(67)(g).
  696         Section 14. This act shall take effect July 1, 2014.