Florida Senate - 2025 CS for SB 304
By the Committee on Children, Families, and Elder Affairs; and
Senators Sharief and Garcia
586-02326-25 2025304c1
1 A bill to be entitled
2 An act relating to specific medical diagnoses in child
3 protective investigations; amending s. 39.201, F.S.;
4 requiring that reports made by certain persons contain
5 a summary of a specified analysis; amending s. 39.301,
6 F.S.; providing an exception to the requirement that
7 the Department of Children and Families immediately
8 forward certain allegations to a law enforcement
9 agency; requiring a child protective investigator to
10 inform the subject of an investigation of a certain
11 duty; conforming a cross-reference; amending s.
12 39.303, F.S.; requiring Child Protection Teams to
13 consult with a licensed physician or advanced practice
14 registered nurse when evaluating certain reports;
15 conforming provisions to changes made by the act;
16 amending s. 39.304, F.S.; authorizing, under a certain
17 circumstance, a parent or legal custodian from whom a
18 child was removed to request specified examinations of
19 the child; requiring that certain examinations be paid
20 for by the parent or legal custodian making the
21 request or as otherwise covered by insurance or
22 Medicaid; prohibiting the request of an examination
23 for a specified purpose; providing an effective date.
24
25 Be It Enacted by the Legislature of the State of Florida:
26
27 Section 1. Paragraph (d) is added to subsection (1) of
28 section 39.201, Florida Statutes, to read:
29 39.201 Required reports of child abuse, abandonment, or
30 neglect, sexual abuse of a child, and juvenile sexual abuse;
31 required reports of death; reports involving a child who has
32 exhibited inappropriate sexual behavior.—
33 (1) MANDATORY REPORTING.—
34 (d) Any report made by a person whose occupation is listed
35 in sub-subparagraph (b)2.a. must contain a summary of the
36 analysis used to rule out a differential diagnosis of the
37 conditions specified in s. 39.303(4)(b).
38 Section 2. Paragraph (a) of subsection (2), paragraph (a)
39 of subsection (5), and paragraph (c) of subsection (14) of
40 section 39.301, Florida Statutes, are amended to read:
41 39.301 Initiation of protective investigations.—
42 (2)(a) The department shall immediately forward allegations
43 of criminal conduct to the municipal or county law enforcement
44 agency of the municipality or county in which the alleged
45 conduct has occurred, unless the parent or legal custodian:
46 1. Has alleged that the child has a preexisting diagnosis
47 specified in s. 39.303(4)(b); or
48 2. Is requesting that the child have an examination under
49 s. 39.304(1)(c).
50
51 Allegations of criminal conduct that are not immediately
52 forwarded to the law enforcement agency pursuant to subparagraph
53 1. or subparagraph 2. must be immediately forwarded to the law
54 enforcement agency upon completion of the investigation under
55 this part if criminal conduct is still alleged.
56 (5)(a) Upon commencing an investigation under this part,
57 the child protective investigator shall inform any subject of
58 the investigation of the following:
59 1. The names of the investigators and identifying
60 credentials from the department.
61 2. The purpose of the investigation.
62 3. The right to obtain his or her own attorney and ways
63 that the information provided by the subject may be used.
64 4. The possible outcomes and services of the department’s
65 response.
66 5. The right of the parent or legal custodian to be engaged
67 to the fullest extent possible in determining the nature of the
68 allegation and the nature of any identified problem and the
69 remedy.
70 6. The duty of the parent or legal custodian to report any
71 change in the residence or location of the child to the
72 investigator and that the duty to report continues until the
73 investigation is closed.
74 7. The duty of the parent or legal custodian to report any
75 preexisting diagnosis for the child which is specified in s.
76 39.303(4)(b) and provide any medical records that support that
77 diagnosis in a timely manner.
78 (14)
79 (c) The department, in consultation with the judiciary,
80 shall adopt by rule:
81 1. Criteria that are factors requiring that the department
82 take the child into custody, petition the court as provided in
83 this chapter, or, if the child is not taken into custody or a
84 petition is not filed with the court, conduct an administrative
85 review. Such factors must include, but are not limited to,
86 noncompliance with a safety plan or the case plan developed by
87 the department, and the family under this chapter, and prior
88 abuse reports with findings that involve the child, the child’s
89 sibling, or the child’s caregiver.
90 2. Requirements that if after an administrative review the
91 department determines not to take the child into custody or
92 petition the court, the department shall document the reason for
93 its decision in writing and include it in the investigative
94 file. For all cases that were accepted by the local law
95 enforcement agency for criminal investigation pursuant to
96 subsection (2), the department must include in the file written
97 documentation that the administrative review included input from
98 law enforcement. In addition, for all cases that must be
99 referred to Child Protection Teams pursuant to s. 39.303(5) and
100 (6) s. 39.303(4) and (5), the file must include written
101 documentation that the administrative review included the
102 results of the team’s evaluation.
103 Section 3. Present subsections (4) through (10) of section
104 39.303, Florida Statutes, are redesignated as subsections (5)
105 through (11), respectively, a new subsection (4) is added to
106 that section, and subsection (3) and present subsections (5) and
107 (6) of that section are amended, to read:
108 39.303 Child Protection Teams and sexual abuse treatment
109 programs; services; eligible cases.—
110 (3) The Department of Health shall use and convene the
111 Child Protection Teams to supplement the assessment and
112 protective supervision activities of the family safety and
113 preservation program of the Department of Children and Families.
114 This section does not remove or reduce the duty and
115 responsibility of any person to report pursuant to this chapter
116 all suspected or actual cases of child abuse, abandonment, or
117 neglect or sexual abuse of a child. The role of the Child
118 Protection Teams is to support activities of the program and to
119 provide services deemed by the Child Protection Teams to be
120 necessary and appropriate to abused, abandoned, and neglected
121 children upon referral. The specialized diagnostic assessment,
122 evaluation, coordination, consultation, and other supportive
123 services that a Child Protection Team must be capable of
124 providing include, but are not limited to, the following:
125 (a) Medical diagnosis and evaluation services, including
126 provision or interpretation of X rays and laboratory tests, and
127 related services, as needed, and documentation of related
128 findings.
129 (b) Telephone consultation services in emergencies and in
130 other situations.
131 (c) Medical evaluation related to abuse, abandonment, or
132 neglect, as defined by policy or rule of the Department of
133 Health.
134 (d) Such psychological and psychiatric diagnosis and
135 evaluation services for the child or the child’s parent or
136 parents, legal custodian or custodians, or other caregivers, or
137 any other individual involved in a child abuse, abandonment, or
138 neglect case, as the team may determine to be needed.
139 (e) Expert medical, psychological, and related professional
140 testimony in court cases.
141 (f) Case staffings to develop treatment plans for children
142 whose cases have been referred to the team. A Child Protection
143 Team may provide consultation with respect to a child who is
144 alleged or is shown to be abused, abandoned, or neglected, which
145 consultation shall be provided at the request of a
146 representative of the family safety and preservation program or
147 at the request of any other professional involved with a child
148 or the child’s parent or parents, legal custodian or custodians,
149 or other caregivers. In every such Child Protection Team case
150 staffing, consultation, or staff activity involving a child, a
151 family safety and preservation program representative shall
152 attend and participate.
153 (g) Case service coordination and assistance, including the
154 location of services available from other public and private
155 agencies in the community.
156 (h) Such training services for program and other employees
157 of the Department of Children and Families, employees of the
158 Department of Health, and other medical professionals as is
159 deemed appropriate to enable them to develop and maintain their
160 professional skills and abilities in handling child abuse,
161 abandonment, and neglect cases. The training service must
162 include training in the recognition of and appropriate responses
163 to head trauma and brain injury in a child under 6 years of age
164 as required by ss. 402.402(2) and 409.988.
165 (i) Educational and community awareness campaigns on child
166 abuse, abandonment, and neglect in an effort to enable citizens
167 more successfully to prevent, identify, and treat child abuse,
168 abandonment, and neglect in the community.
169 (j) Child Protection Team assessments that include, as
170 appropriate, medical evaluations, medical consultations, family
171 psychosocial interviews, specialized clinical interviews, or
172 forensic interviews.
173
174 A Child Protection Team that is evaluating a report of medical
175 neglect and assessing the health care needs of a medically
176 complex child shall consult with a physician who has experience
177 in treating children with the same condition.
178 (4) A Child Protection Team shall consult with a physician
179 licensed under chapter 458 or chapter 459 or an advanced
180 practice registered nurse licensed under chapter 464 who has
181 experience in and routinely provides medical care to pediatric
182 patients when evaluating a report of:
183 (a) Medical neglect and assessing the needs of a medically
184 complex child; or
185 (b) A child with a reported preexisting diagnosis of any of
186 the following:
187 1. Rickets.
188 2. Ehlers-Danlos syndrome.
189 3. Osteogenesis imperfecta.
190 4. Vitamin D deficiency.
191 5. Any other medical condition known to appear to be caused
192 by, or known to be misdiagnosed as, abuse.
193 (6)(5) All abuse and neglect cases transmitted for
194 investigation to a circuit by the hotline must be simultaneously
195 transmitted to the Child Protection Team for review. For the
196 purpose of determining whether a face-to-face medical evaluation
197 by a Child Protection Team is necessary, all cases transmitted
198 to the Child Protection Team which meet the criteria in
199 subsection (5) (4) must be timely reviewed by:
200 (a) A physician licensed under chapter 458 or chapter 459
201 who holds board certification in pediatrics and is a member of a
202 Child Protection Team;
203 (b) A physician licensed under chapter 458 or chapter 459
204 who holds board certification in a specialty other than
205 pediatrics, who may complete the review only when working under
206 the direction of the Child Protection Team medical director or a
207 physician licensed under chapter 458 or chapter 459 who holds
208 board certification in pediatrics and is a member of a Child
209 Protection Team;
210 (c) An advanced practice registered nurse licensed under
211 chapter 464 who has a specialty in pediatrics or family medicine
212 and is a member of a Child Protection Team;
213 (d) A physician assistant licensed under chapter 458 or
214 chapter 459, who may complete the review only when working under
215 the supervision of the Child Protection Team medical director or
216 a physician licensed under chapter 458 or chapter 459 who holds
217 board certification in pediatrics and is a member of a Child
218 Protection Team; or
219 (e) A registered nurse licensed under chapter 464, who may
220 complete the review only when working under the direct
221 supervision of the Child Protection Team medical director or a
222 physician licensed under chapter 458 or chapter 459 who holds
223 board certification in pediatrics and is a member of a Child
224 Protection Team.
225 (7)(6) A face-to-face medical evaluation by a Child
226 Protection Team is not necessary when:
227 (a) The child was examined for the alleged abuse or neglect
228 by a physician who is not a member of the Child Protection Team,
229 and a consultation between the Child Protection Team medical
230 director or a Child Protection Team board-certified
231 pediatrician, advanced practice registered nurse, physician
232 assistant working under the supervision of a Child Protection
233 Team medical director or a Child Protection Team board-certified
234 pediatrician, or registered nurse working under the direct
235 supervision of a Child Protection Team medical director or a
236 Child Protection Team board-certified pediatrician, and the
237 examining physician concludes that a further medical evaluation
238 is unnecessary;
239 (b) The child protective investigator, with supervisory
240 approval, has determined, after conducting a child safety
241 assessment, that there are no indications of injuries as
242 described in paragraphs (5)(a)-(h) (4)(a)-(h) as reported; or
243 (c) The Child Protection Team medical director or a Child
244 Protection Team board-certified pediatrician, as authorized in
245 subsection (6) (5), determines that a medical evaluation is not
246 required.
247
248 Notwithstanding paragraphs (a), (b), and (c), a Child Protection
249 Team medical director or a Child Protection Team pediatrician,
250 as authorized in subsection (6) (5), may determine that a face
251 to-face medical evaluation is necessary.
252 Section 4. Paragraph (c) is added to subsection (1) of
253 section 39.304, Florida Statutes, to read:
254 39.304 Photographs, medical examinations, X rays, and
255 medical treatment of abused, abandoned, or neglected child.—
256 (1)
257 (c) If an examination is performed on a child under
258 paragraph (b), the parent or legal custodian from whom the child
259 was removed pursuant to s. 39.401 may:
260 1. If the initial examination was not performed by the
261 Child Protection Team, request that the child be examined by the
262 Child Protection Team as soon as practicable;
263 2. If the initial examination was performed by the Child
264 Protection Team, for the purpose of obtaining a second opinion
265 on diagnosis or treatment, request that the child be examined by
266 a physician licensed under chapter 458 or chapter 459 or an
267 advanced practice registered nurse licensed under chapter 464 of
268 his or her choosing who routinely provides medical care to
269 pediatric patients; or
270 3. For the purpose of ruling out a differential diagnosis,
271 request that the child be examined by a physician licensed under
272 chapter 458 or chapter 459 or an advanced practice registered
273 nurse licensed under chapter 464 who routinely provides
274 diagnosis of and medical care to pediatric patients for the
275 conditions specified in s. 39.303(4)(b).
276
277 An examination requested under subparagraph 2. or subparagraph
278 3. must be paid for by the parent or legal custodian making such
279 request or as otherwise covered by insurance or Medicaid. An
280 examination may not be requested under this paragraph for the
281 purpose of obtaining a second opinion as to whether a child has
282 been sexually abused.
283 Section 5. This act shall take effect July 1, 2025.