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.