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.