Florida Senate - 2025                        COMMITTEE AMENDMENT
       Bill No. SB 304
       
       
       
       
       
       
                                Ì826378RÎ826378                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  03/13/2025           .                                
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       The Committee on Children, Families, and Elder Affairs (Sharief)
       recommended the following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Paragraph (d) is added to subsection (1) of
    6  section 39.201, Florida Statutes, to read:
    7         39.201 Required reports of child abuse, abandonment, or
    8  neglect, sexual abuse of a child, and juvenile sexual abuse;
    9  required reports of death; reports involving a child who has
   10  exhibited inappropriate sexual behavior.—
   11         (1) MANDATORY REPORTING.—
   12         (d) Any report made by a person whose occupation is listed
   13  in sub-subparagraph (b)2.a. must contain a summary of the
   14  analysis used to rule out a differential diagnosis of the
   15  conditions specified in s. 39.303(4)(b).
   16         Section 2. Paragraph (a) of subsection (2), paragraph (a)
   17  of subsection (5), and paragraph (c) of subsection (14) of
   18  section 39.301, Florida Statutes, are amended to read:
   19         39.301 Initiation of protective investigations.—
   20         (2)(a) The department shall immediately forward allegations
   21  of criminal conduct to the municipal or county law enforcement
   22  agency of the municipality or county in which the alleged
   23  conduct has occurred, unless the parent or legal custodian:
   24         1. Has alleged that the child has a preexisting diagnosis
   25  specified in s. 39.303(4)(b); or
   26         2. Is requesting that the child have an examination under
   27  s. 39.304(1)(c).
   28  
   29  Allegations of criminal conduct that are not immediately
   30  forwarded to the law enforcement agency pursuant to subparagraph
   31  1. or subparagraph 2. must be immediately forwarded to the law
   32  enforcement agency upon completion of the investigation under
   33  this part if criminal conduct is still alleged.
   34         (5)(a) Upon commencing an investigation under this part,
   35  the child protective investigator shall inform any subject of
   36  the investigation of the following:
   37         1. The names of the investigators and identifying
   38  credentials from the department.
   39         2. The purpose of the investigation.
   40         3. The right to obtain his or her own attorney and ways
   41  that the information provided by the subject may be used.
   42         4. The possible outcomes and services of the department’s
   43  response.
   44         5. The right of the parent or legal custodian to be engaged
   45  to the fullest extent possible in determining the nature of the
   46  allegation and the nature of any identified problem and the
   47  remedy.
   48         6. The duty of the parent or legal custodian to report any
   49  change in the residence or location of the child to the
   50  investigator and that the duty to report continues until the
   51  investigation is closed.
   52         7. The duty of the parent or legal custodian to report any
   53  preexisting diagnosis for the child which is specified in s.
   54  39.303(4)(b) and provide any medical records that support that
   55  diagnosis in a timely manner.
   56         (14)
   57         (c) The department, in consultation with the judiciary,
   58  shall adopt by rule:
   59         1. Criteria that are factors requiring that the department
   60  take the child into custody, petition the court as provided in
   61  this chapter, or, if the child is not taken into custody or a
   62  petition is not filed with the court, conduct an administrative
   63  review. Such factors must include, but are not limited to,
   64  noncompliance with a safety plan or the case plan developed by
   65  the department, and the family under this chapter, and prior
   66  abuse reports with findings that involve the child, the child’s
   67  sibling, or the child’s caregiver.
   68         2. Requirements that if after an administrative review the
   69  department determines not to take the child into custody or
   70  petition the court, the department shall document the reason for
   71  its decision in writing and include it in the investigative
   72  file. For all cases that were accepted by the local law
   73  enforcement agency for criminal investigation pursuant to
   74  subsection (2), the department must include in the file written
   75  documentation that the administrative review included input from
   76  law enforcement. In addition, for all cases that must be
   77  referred to Child Protection Teams pursuant to s. 39.303(5) and
   78  (6) s. 39.303(4) and (5), the file must include written
   79  documentation that the administrative review included the
   80  results of the team’s evaluation.
   81         Section 3. Present subsections (4) through (10) of section
   82  39.303, Florida Statutes, are redesignated as subsections (5)
   83  through (11), respectively, a new subsection (4) is added to
   84  that section, and subsection (3) and present subsections (5) and
   85  (6) of that section are amended, to read:
   86         39.303 Child Protection Teams and sexual abuse treatment
   87  programs; services; eligible cases.—
   88         (3) The Department of Health shall use and convene the
   89  Child Protection Teams to supplement the assessment and
   90  protective supervision activities of the family safety and
   91  preservation program of the Department of Children and Families.
   92  This section does not remove or reduce the duty and
   93  responsibility of any person to report pursuant to this chapter
   94  all suspected or actual cases of child abuse, abandonment, or
   95  neglect or sexual abuse of a child. The role of the Child
   96  Protection Teams is to support activities of the program and to
   97  provide services deemed by the Child Protection Teams to be
   98  necessary and appropriate to abused, abandoned, and neglected
   99  children upon referral. The specialized diagnostic assessment,
  100  evaluation, coordination, consultation, and other supportive
  101  services that a Child Protection Team must be capable of
  102  providing include, but are not limited to, the following:
  103         (a) Medical diagnosis and evaluation services, including
  104  provision or interpretation of X rays and laboratory tests, and
  105  related services, as needed, and documentation of related
  106  findings.
  107         (b) Telephone consultation services in emergencies and in
  108  other situations.
  109         (c) Medical evaluation related to abuse, abandonment, or
  110  neglect, as defined by policy or rule of the Department of
  111  Health.
  112         (d) Such psychological and psychiatric diagnosis and
  113  evaluation services for the child or the child’s parent or
  114  parents, legal custodian or custodians, or other caregivers, or
  115  any other individual involved in a child abuse, abandonment, or
  116  neglect case, as the team may determine to be needed.
  117         (e) Expert medical, psychological, and related professional
  118  testimony in court cases.
  119         (f) Case staffings to develop treatment plans for children
  120  whose cases have been referred to the team. A Child Protection
  121  Team may provide consultation with respect to a child who is
  122  alleged or is shown to be abused, abandoned, or neglected, which
  123  consultation shall be provided at the request of a
  124  representative of the family safety and preservation program or
  125  at the request of any other professional involved with a child
  126  or the child’s parent or parents, legal custodian or custodians,
  127  or other caregivers. In every such Child Protection Team case
  128  staffing, consultation, or staff activity involving a child, a
  129  family safety and preservation program representative shall
  130  attend and participate.
  131         (g) Case service coordination and assistance, including the
  132  location of services available from other public and private
  133  agencies in the community.
  134         (h) Such training services for program and other employees
  135  of the Department of Children and Families, employees of the
  136  Department of Health, and other medical professionals as is
  137  deemed appropriate to enable them to develop and maintain their
  138  professional skills and abilities in handling child abuse,
  139  abandonment, and neglect cases. The training service must
  140  include training in the recognition of and appropriate responses
  141  to head trauma and brain injury in a child under 6 years of age
  142  as required by ss. 402.402(2) and 409.988.
  143         (i) Educational and community awareness campaigns on child
  144  abuse, abandonment, and neglect in an effort to enable citizens
  145  more successfully to prevent, identify, and treat child abuse,
  146  abandonment, and neglect in the community.
  147         (j) Child Protection Team assessments that include, as
  148  appropriate, medical evaluations, medical consultations, family
  149  psychosocial interviews, specialized clinical interviews, or
  150  forensic interviews.
  151  
  152  A Child Protection Team that is evaluating a report of medical
  153  neglect and assessing the health care needs of a medically
  154  complex child shall consult with a physician who has experience
  155  in treating children with the same condition.
  156         (4) A Child Protection Team shall consult with a physician
  157  licensed under chapter 458 or chapter 459 or an advanced
  158  practice registered nurse licensed under chapter 464 who has
  159  experience in and routinely provides medical care to pediatric
  160  patients when evaluating a report of:
  161         (a) Medical neglect and assessing the needs of a medically
  162  complex child; or
  163         (b) A child with a reported preexisting diagnosis of any of
  164  the following:
  165         1. Rickets.
  166         2. Ehlers-Danlos syndrome.
  167         3. Osteogenesis imperfecta.
  168         4. Vitamin D deficiency.
  169         5. Any other medical condition known to appear to be caused
  170  by, or known to be misdiagnosed as, abuse.
  171         (6)(5) All abuse and neglect cases transmitted for
  172  investigation to a circuit by the hotline must be simultaneously
  173  transmitted to the Child Protection Team for review. For the
  174  purpose of determining whether a face-to-face medical evaluation
  175  by a Child Protection Team is necessary, all cases transmitted
  176  to the Child Protection Team which meet the criteria in
  177  subsection (5) (4) must be timely reviewed by:
  178         (a) A physician licensed under chapter 458 or chapter 459
  179  who holds board certification in pediatrics and is a member of a
  180  Child Protection Team;
  181         (b) A physician licensed under chapter 458 or chapter 459
  182  who holds board certification in a specialty other than
  183  pediatrics, who may complete the review only when working under
  184  the direction of the Child Protection Team medical director or a
  185  physician licensed under chapter 458 or chapter 459 who holds
  186  board certification in pediatrics and is a member of a Child
  187  Protection Team;
  188         (c) An advanced practice registered nurse licensed under
  189  chapter 464 who has a specialty in pediatrics or family medicine
  190  and is a member of a Child Protection Team;
  191         (d) A physician assistant licensed under chapter 458 or
  192  chapter 459, who may complete the review only when working under
  193  the supervision of the Child Protection Team medical director or
  194  a physician licensed under chapter 458 or chapter 459 who holds
  195  board certification in pediatrics and is a member of a Child
  196  Protection Team; or
  197         (e) A registered nurse licensed under chapter 464, who may
  198  complete the review only when working under the direct
  199  supervision of the Child Protection Team medical director or a
  200  physician licensed under chapter 458 or chapter 459 who holds
  201  board certification in pediatrics and is a member of a Child
  202  Protection Team.
  203         (7)(6) A face-to-face medical evaluation by a Child
  204  Protection Team is not necessary when:
  205         (a) The child was examined for the alleged abuse or neglect
  206  by a physician who is not a member of the Child Protection Team,
  207  and a consultation between the Child Protection Team medical
  208  director or a Child Protection Team board-certified
  209  pediatrician, advanced practice registered nurse, physician
  210  assistant working under the supervision of a Child Protection
  211  Team medical director or a Child Protection Team board-certified
  212  pediatrician, or registered nurse working under the direct
  213  supervision of a Child Protection Team medical director or a
  214  Child Protection Team board-certified pediatrician, and the
  215  examining physician concludes that a further medical evaluation
  216  is unnecessary;
  217         (b) The child protective investigator, with supervisory
  218  approval, has determined, after conducting a child safety
  219  assessment, that there are no indications of injuries as
  220  described in paragraphs (5)(a)-(h) (4)(a)-(h) as reported; or
  221         (c) The Child Protection Team medical director or a Child
  222  Protection Team board-certified pediatrician, as authorized in
  223  subsection (6) (5), determines that a medical evaluation is not
  224  required.
  225  
  226  Notwithstanding paragraphs (a), (b), and (c), a Child Protection
  227  Team medical director or a Child Protection Team pediatrician,
  228  as authorized in subsection (6) (5), may determine that a face
  229  to-face medical evaluation is necessary.
  230         Section 4. Paragraph (c) is added to subsection (1) of
  231  section 39.304, Florida Statutes, to read:
  232         39.304 Photographs, medical examinations, X rays, and
  233  medical treatment of abused, abandoned, or neglected child.—
  234         (1)
  235         (c) If an examination is performed on a child under
  236  paragraph (b), the parent or legal custodian from whom the child
  237  was removed pursuant to s. 39.401 may:
  238         1. If the initial examination was not performed by the
  239  Child Protection Team, request that the child be examined by the
  240  Child Protection Team as soon as practicable;
  241         2. If the initial examination was performed by the Child
  242  Protection Team, for the purpose of obtaining a second opinion
  243  on diagnosis or treatment, request that the child be examined by
  244  a physician licensed under chapter 458 or chapter 459 or an
  245  advanced practice registered nurse licensed under chapter 464 of
  246  his or her choosing who routinely provides medical care to
  247  pediatric patients; or
  248         3. For the purpose of ruling out a differential diagnosis,
  249  request that the child be examined by a physician licensed under
  250  chapter 458 or chapter 459 or an advanced practice registered
  251  nurse licensed under chapter 464 who routinely provides
  252  diagnosis of and medical care to pediatric patients for the
  253  conditions specified in s. 39.303(4)(b).
  254  
  255  An examination requested under subparagraph 2. or subparagraph
  256  3. must be paid for by the parent or legal custodian making such
  257  request or as otherwise covered by insurance or Medicaid. An
  258  examination may not be requested under this paragraph for the
  259  purpose of obtaining a second opinion as to whether a child has
  260  been sexually abused.
  261         Section 5. This act shall take effect July 1, 2025.
  262  
  263  ================= T I T L E  A M E N D M E N T ================
  264  And the title is amended as follows:
  265         Delete everything before the enacting clause
  266  and insert:
  267                        A bill to be entitled                      
  268         An act relating to specific medical diagnoses in child
  269         protective investigations; amending s. 39.201, F.S.;
  270         requiring that reports made by certain persons contain
  271         a summary of a specified analysis; amending s. 39.301,
  272         F.S.; providing an exception to the requirement that
  273         the Department of Children and Families immediately
  274         forward certain allegations to a law enforcement
  275         agency; requiring a child protective investigator to
  276         inform the subject of an investigation of a certain
  277         duty; conforming a cross-reference; amending s.
  278         39.303, F.S.; requiring Child Protection Teams to
  279         consult with a licensed physician or advanced practice
  280         registered nurse when evaluating certain reports;
  281         conforming provisions to changes made by the act;
  282         amending s. 39.304, F.S.; authorizing, under a certain
  283         circumstance, a parent or legal custodian from whom a
  284         child was removed to request specified examinations of
  285         the child; requiring that certain examinations be paid
  286         for by the parent or legal custodian making the
  287         request or as otherwise covered by insurance or
  288         Medicaid; prohibiting the request of an examination
  289         for a specified purpose; providing an effective date.