Florida Senate - 2025                       CS for CS for SB 304
       
       
        
       By the Committees on Judiciary; and Children, Families, and
       Elder Affairs; and Senators Sharief, Garcia, Rouson, Gaetz, and
       Collins
       
       
       
       590-02859-25                                           2025304c2
    1                        A bill to be entitled                      
    2         An act relating to specific medical diagnoses in child
    3         protective investigations; amending s. 39.301, F.S.;
    4         providing an exception to the requirement that the
    5         Department of Children and Families immediately
    6         forward certain allegations to a law enforcement
    7         agency; requiring a child protective investigator to
    8         inform the subject of an investigation of a certain
    9         duty; conforming a cross-reference; amending s.
   10         39.303, F.S.; requiring Child Protection Teams to
   11         consult with a licensed physician or advanced practice
   12         registered nurse when evaluating certain reports;
   13         conforming provisions to changes made by the act;
   14         amending s. 39.304, F.S.; authorizing, under a certain
   15         circumstance, a parent or legal custodian from whom a
   16         child was removed to request specified examinations of
   17         the child; requiring that certain examinations be paid
   18         for by the parent or legal custodian making the
   19         request or as otherwise covered by insurance or
   20         Medicaid; prohibiting the request of an examination
   21         for a specified purpose; providing an effective date.
   22          
   23  Be It Enacted by the Legislature of the State of Florida:
   24  
   25         Section 1. Paragraph (a) of subsection (2), paragraph (a)
   26  of subsection (5), and paragraph (c) of subsection (14) of
   27  section 39.301, Florida Statutes, are amended to read:
   28         39.301 Initiation of protective investigations.—
   29         (2)(a) The department shall immediately forward allegations
   30  of criminal conduct to the municipal or county law enforcement
   31  agency of the municipality or county in which the alleged
   32  conduct has occurred, unless the parent or legal custodian:
   33         1. Has alleged that the child has a preexisting diagnosis
   34  specified in s. 39.303(4)(b); or
   35         2. Is requesting that the child have an examination under
   36  s. 39.304(1)(c).
   37  
   38  Allegations of criminal conduct that are not immediately
   39  forwarded to the law enforcement agency pursuant to subparagraph
   40  1. or subparagraph 2. must be immediately forwarded to the law
   41  enforcement agency upon completion of the investigation under
   42  this part if criminal conduct is still alleged.
   43         (5)(a) Upon commencing an investigation under this part,
   44  the child protective investigator shall inform any subject of
   45  the investigation of the following:
   46         1. The names of the investigators and identifying
   47  credentials from the department.
   48         2. The purpose of the investigation.
   49         3. The right to obtain his or her own attorney and ways
   50  that the information provided by the subject may be used.
   51         4. The possible outcomes and services of the department’s
   52  response.
   53         5. The right of the parent or legal custodian to be engaged
   54  to the fullest extent possible in determining the nature of the
   55  allegation and the nature of any identified problem and the
   56  remedy.
   57         6. The duty of the parent or legal custodian to report any
   58  change in the residence or location of the child to the
   59  investigator and that the duty to report continues until the
   60  investigation is closed.
   61         7. The duty of the parent or legal custodian to report any
   62  preexisting diagnosis for the child which is specified in s.
   63  39.303(4)(b) and provide any medical records that support that
   64  diagnosis in a timely manner.
   65         (14)
   66         (c) The department, in consultation with the judiciary,
   67  shall adopt by rule:
   68         1. Criteria that are factors requiring that the department
   69  take the child into custody, petition the court as provided in
   70  this chapter, or, if the child is not taken into custody or a
   71  petition is not filed with the court, conduct an administrative
   72  review. Such factors must include, but are not limited to,
   73  noncompliance with a safety plan or the case plan developed by
   74  the department, and the family under this chapter, and prior
   75  abuse reports with findings that involve the child, the child’s
   76  sibling, or the child’s caregiver.
   77         2. Requirements that if after an administrative review the
   78  department determines not to take the child into custody or
   79  petition the court, the department shall document the reason for
   80  its decision in writing and include it in the investigative
   81  file. For all cases that were accepted by the local law
   82  enforcement agency for criminal investigation pursuant to
   83  subsection (2), the department must include in the file written
   84  documentation that the administrative review included input from
   85  law enforcement. In addition, for all cases that must be
   86  referred to Child Protection Teams pursuant to s. 39.303(5) and
   87  (6) s. 39.303(4) and (5), the file must include written
   88  documentation that the administrative review included the
   89  results of the team’s evaluation.
   90         Section 2. Present subsections (4) through (10) of section
   91  39.303, Florida Statutes, are redesignated as subsections (5)
   92  through (11), respectively, a new subsection (4) is added to
   93  that section, and subsection (3) and present subsections (5) and
   94  (6) of that section are amended, to read:
   95         39.303 Child Protection Teams and sexual abuse treatment
   96  programs; services; eligible cases.—
   97         (3) The Department of Health shall use and convene the
   98  Child Protection Teams to supplement the assessment and
   99  protective supervision activities of the family safety and
  100  preservation program of the Department of Children and Families.
  101  This section does not remove or reduce the duty and
  102  responsibility of any person to report pursuant to this chapter
  103  all suspected or actual cases of child abuse, abandonment, or
  104  neglect or sexual abuse of a child. The role of the Child
  105  Protection Teams is to support activities of the program and to
  106  provide services deemed by the Child Protection Teams to be
  107  necessary and appropriate to abused, abandoned, and neglected
  108  children upon referral. The specialized diagnostic assessment,
  109  evaluation, coordination, consultation, and other supportive
  110  services that a Child Protection Team must be capable of
  111  providing include, but are not limited to, the following:
  112         (a) Medical diagnosis and evaluation services, including
  113  provision or interpretation of X rays and laboratory tests, and
  114  related services, as needed, and documentation of related
  115  findings.
  116         (b) Telephone consultation services in emergencies and in
  117  other situations.
  118         (c) Medical evaluation related to abuse, abandonment, or
  119  neglect, as defined by policy or rule of the Department of
  120  Health.
  121         (d) Such psychological and psychiatric diagnosis and
  122  evaluation services for the child or the child’s parent or
  123  parents, legal custodian or custodians, or other caregivers, or
  124  any other individual involved in a child abuse, abandonment, or
  125  neglect case, as the team may determine to be needed.
  126         (e) Expert medical, psychological, and related professional
  127  testimony in court cases.
  128         (f) Case staffings to develop treatment plans for children
  129  whose cases have been referred to the team. A Child Protection
  130  Team may provide consultation with respect to a child who is
  131  alleged or is shown to be abused, abandoned, or neglected, which
  132  consultation shall be provided at the request of a
  133  representative of the family safety and preservation program or
  134  at the request of any other professional involved with a child
  135  or the child’s parent or parents, legal custodian or custodians,
  136  or other caregivers. In every such Child Protection Team case
  137  staffing, consultation, or staff activity involving a child, a
  138  family safety and preservation program representative shall
  139  attend and participate.
  140         (g) Case service coordination and assistance, including the
  141  location of services available from other public and private
  142  agencies in the community.
  143         (h) Such training services for program and other employees
  144  of the Department of Children and Families, employees of the
  145  Department of Health, and other medical professionals as is
  146  deemed appropriate to enable them to develop and maintain their
  147  professional skills and abilities in handling child abuse,
  148  abandonment, and neglect cases. The training service must
  149  include training in the recognition of and appropriate responses
  150  to head trauma and brain injury in a child under 6 years of age
  151  as required by ss. 402.402(2) and 409.988.
  152         (i) Educational and community awareness campaigns on child
  153  abuse, abandonment, and neglect in an effort to enable citizens
  154  more successfully to prevent, identify, and treat child abuse,
  155  abandonment, and neglect in the community.
  156         (j) Child Protection Team assessments that include, as
  157  appropriate, medical evaluations, medical consultations, family
  158  psychosocial interviews, specialized clinical interviews, or
  159  forensic interviews.
  160  
  161  A Child Protection Team that is evaluating a report of medical
  162  neglect and assessing the health care needs of a medically
  163  complex child shall consult with a physician who has experience
  164  in treating children with the same condition.
  165         (4) A Child Protection Team shall consult with a physician
  166  licensed under chapter 458 or chapter 459 or an advanced
  167  practice registered nurse licensed under chapter 464 who has
  168  experience in and routinely provides medical care to pediatric
  169  patients when evaluating a report of:
  170         (a) Medical neglect and assessing the needs of a medically
  171  complex child; or
  172         (b) A child with a reported preexisting diagnosis of any of
  173  the following:
  174         1. Rickets.
  175         2. Ehlers-Danlos syndrome.
  176         3. Osteogenesis imperfecta.
  177         4. Vitamin D deficiency.
  178         5. Any other medical condition known to appear to be caused
  179  by, or known to be misdiagnosed as, abuse.
  180         (6)(5) All abuse and neglect cases transmitted for
  181  investigation to a circuit by the hotline must be simultaneously
  182  transmitted to the Child Protection Team for review. For the
  183  purpose of determining whether a face-to-face medical evaluation
  184  by a Child Protection Team is necessary, all cases transmitted
  185  to the Child Protection Team which meet the criteria in
  186  subsection (5) (4) must be timely reviewed by:
  187         (a) A physician licensed under chapter 458 or chapter 459
  188  who holds board certification in pediatrics and is a member of a
  189  Child Protection Team;
  190         (b) A physician licensed under chapter 458 or chapter 459
  191  who holds board certification in a specialty other than
  192  pediatrics, who may complete the review only when working under
  193  the direction of the Child Protection Team medical director or a
  194  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;
  197         (c) An advanced practice registered nurse licensed under
  198  chapter 464 who has a specialty in pediatrics or family medicine
  199  and is a member of a Child Protection Team;
  200         (d) A physician assistant licensed under chapter 458 or
  201  chapter 459, who may complete the review only when working under
  202  the supervision of the Child Protection Team medical director or
  203  a physician licensed under chapter 458 or chapter 459 who holds
  204  board certification in pediatrics and is a member of a Child
  205  Protection Team; or
  206         (e) A registered nurse licensed under chapter 464, who may
  207  complete the review only when working under the direct
  208  supervision of the Child Protection Team medical director or a
  209  physician licensed under chapter 458 or chapter 459 who holds
  210  board certification in pediatrics and is a member of a Child
  211  Protection Team.
  212         (7)(6) A face-to-face medical evaluation by a Child
  213  Protection Team is not necessary when:
  214         (a) The child was examined for the alleged abuse or neglect
  215  by a physician who is not a member of the Child Protection Team,
  216  and a consultation between the Child Protection Team medical
  217  director or a Child Protection Team board-certified
  218  pediatrician, advanced practice registered nurse, physician
  219  assistant working under the supervision of a Child Protection
  220  Team medical director or a Child Protection Team board-certified
  221  pediatrician, or registered nurse working under the direct
  222  supervision of a Child Protection Team medical director or a
  223  Child Protection Team board-certified pediatrician, and the
  224  examining physician concludes that a further medical evaluation
  225  is unnecessary;
  226         (b) The child protective investigator, with supervisory
  227  approval, has determined, after conducting a child safety
  228  assessment, that there are no indications of injuries as
  229  described in paragraphs (5)(a)-(h) (4)(a)-(h) as reported; or
  230         (c) The Child Protection Team medical director or a Child
  231  Protection Team board-certified pediatrician, as authorized in
  232  subsection (6) (5), determines that a medical evaluation is not
  233  required.
  234  
  235  Notwithstanding paragraphs (a), (b), and (c), a Child Protection
  236  Team medical director or a Child Protection Team pediatrician,
  237  as authorized in subsection (6) (5), may determine that a face
  238  to-face medical evaluation is necessary.
  239         Section 3. Paragraph (c) is added to subsection (1) of
  240  section 39.304, Florida Statutes, to read:
  241         39.304 Photographs, medical examinations, X rays, and
  242  medical treatment of abused, abandoned, or neglected child.—
  243         (1)
  244         (c) If an examination is performed on a child under
  245  paragraph (b), the parent or legal custodian from whom the child
  246  was removed pursuant to s. 39.401 may:
  247         1. If the initial examination was not performed by the
  248  Child Protection Team, request that the child be examined by the
  249  Child Protection Team as soon as practicable;
  250         2. If the initial examination was performed by the Child
  251  Protection Team, for the purpose of obtaining a second opinion
  252  on diagnosis or treatment, request that the child be examined by
  253  a physician licensed under chapter 458 or chapter 459 or an
  254  advanced practice registered nurse licensed under chapter 464 of
  255  his or her choosing who routinely provides medical care to
  256  pediatric patients; or
  257         3. For the purpose of ruling out a differential diagnosis,
  258  request that the child be examined by a physician licensed under
  259  chapter 458 or chapter 459 or an advanced practice registered
  260  nurse licensed under chapter 464 who routinely provides
  261  diagnosis of and medical care to pediatric patients for the
  262  conditions specified in s. 39.303(4)(b).
  263  
  264  An examination requested under subparagraph 2. or subparagraph
  265  3. must be paid for by the parent or legal custodian making such
  266  request or as otherwise covered by insurance or Medicaid. An
  267  examination may not be requested under this paragraph for the
  268  purpose of obtaining a second opinion as to whether a child has
  269  been sexually abused.
  270         Section 4. This act shall take effect July 1, 2025.