Florida Senate - 2026                                     SB 560
       
       
        
       By Senator Garcia
       
       
       
       
       
       36-00652A-26                                           2026560__
    1                        A bill to be entitled                      
    2         An act relating to child welfare; amending s. 39.407,
    3         F.S.; providing that a new medical report relating to
    4         the provision of psychotropic medication to a child in
    5         the legal custody of the Department of Children and
    6         Families may be required only under certain
    7         circumstances; revising qualifications for persons who
    8         may serve as qualified evaluators for a certain
    9         purpose; amending s. 409.175, F.S.; revising the
   10         definition of the terms “personnel” and “placement
   11         screening”; amending s. 409.912, F.S.; requiring a
   12         physician to provide to a pharmacy a copy of certain
   13         documentation, rather than a signed attestation, with
   14         certain prescriptions; providing an effective date.
   15          
   16  Be It Enacted by the Legislature of the State of Florida:
   17  
   18         Section 1. Paragraph (c) of subsection (3) and paragraph
   19  (b) of subsection (6) of section 39.407, Florida Statutes, are
   20  amended to read:
   21         39.407 Medical, psychiatric, and psychological examination
   22  and treatment of child; physical, mental, or substance abuse
   23  examination of person with or requesting child custody.—
   24         (3)
   25         (c) Except as provided in paragraphs (b) and (e), the
   26  department must file a motion seeking the court’s authorization
   27  to initially provide or continue to provide psychotropic
   28  medication to a child in its legal custody. The motion must be
   29  supported by a written report prepared by the department which
   30  describes the efforts made to enable the prescribing physician
   31  or psychiatric nurse, as defined in s. 394.455, to obtain
   32  express and informed consent for providing the medication to the
   33  child and other treatments considered or recommended for the
   34  child. In addition, the motion must be supported by the
   35  prescribing physician’s or psychiatric nurse’s signed medical
   36  report providing:
   37         1. The name of the child, the name and range of the dosage
   38  of the psychotropic medication, and that there is a need to
   39  prescribe psychotropic medication to the child based upon a
   40  diagnosed condition for which such medication is being
   41  prescribed.
   42         2. A statement indicating that the physician or psychiatric
   43  nurse, as defined in s. 394.455, has reviewed all medical
   44  information concerning the child which has been provided.
   45         3. A statement indicating that the psychotropic medication,
   46  at its prescribed dosage, is appropriate for treating the
   47  child’s diagnosed medical condition, as well as the behaviors
   48  and symptoms the medication, at its prescribed dosage, is
   49  expected to address.
   50         4. An explanation of the nature and purpose of the
   51  treatment; the recognized side effects, risks, and
   52  contraindications of the medication; drug-interaction
   53  precautions; the possible effects of stopping the medication;
   54  and how the treatment will be monitored, followed by a statement
   55  indicating that this explanation was provided to the child if
   56  age appropriate and to the child’s caregiver.
   57         5. Documentation addressing whether the psychotropic
   58  medication will replace or supplement any other currently
   59  prescribed medications or treatments; the length of time the
   60  child is expected to be taking the medication; and any
   61  additional medical, mental health, behavioral, counseling, or
   62  other services that the prescribing physician or psychiatric
   63  nurse, as defined in s. 394.455, recommends.
   64  
   65  A new medical report may be required only when there is a change
   66  in the dosage or dosage range of the medication, the type of
   67  medication prescribed, the manner of administration of the
   68  medication, or the prescribing physician or psychiatric nurse.
   69  For purposes of this paragraph, prescribing physicians and
   70  psychiatric nurses belonging to the same group practice are
   71  considered a single prescriber.
   72         (6) Children in the legal custody of the department may be
   73  placed by the department, without prior approval of the court,
   74  in a residential treatment center licensed under s. 394.875 or a
   75  hospital licensed under chapter 395 for residential mental
   76  health treatment only pursuant to this section or may be placed
   77  by the court in accordance with an order of involuntary
   78  examination or involuntary placement entered pursuant to s.
   79  394.463 or s. 394.467. All children placed in a residential
   80  treatment program under this subsection must have a guardian ad
   81  litem appointed.
   82         (b) Whenever the department believes that a child in its
   83  legal custody is emotionally disturbed and may need residential
   84  treatment, an examination and suitability assessment must be
   85  conducted by a qualified evaluator appointed by the department.
   86  This suitability assessment must be completed before the
   87  placement of the child in a residential treatment program.
   88         1. The qualified evaluator for placement in a residential
   89  treatment center, other than a therapeutic group home, or a
   90  hospital must be a psychiatrist or a psychologist licensed in
   91  this state who has at least 3 years of experience in the
   92  diagnosis and treatment of serious emotional disturbances in
   93  children and adolescents or a licensed clinical social worker or
   94  licensed marriage and family therapist with comparable
   95  experience. In addition, the qualified evaluator may not have an
   96  and who has no actual or perceived conflict of interest with any
   97  inpatient facility or residential treatment center or program.
   98         2. The qualified evaluator for placement in a therapeutic
   99  group home must be a psychiatrist licensed under chapter 458 or
  100  chapter 459, a psychologist licensed under chapter 490, or a
  101  mental health counselor licensed under chapter 491 who has at
  102  least 2 years of experience in the diagnosis and treatment of
  103  serious emotional or behavioral disturbance in children and
  104  adolescents and who has no actual or perceived conflict of
  105  interest with any residential treatment center or program.
  106         Section 2. Paragraphs (j) and (k) of subsection (2) of
  107  section 409.175, Florida Statutes, are amended to read:
  108         409.175 Licensure of family foster homes, residential
  109  child-caring agencies, and child-placing agencies; public
  110  records exemption.—
  111         (2) As used in this section, the term:
  112         (j) “Personnel” means all owners, operators, employees, and
  113  volunteers working in a child-placing agency or residential
  114  child-caring agency who may be employed by or do volunteer work
  115  for a person, corporation, or agency that holds a license as a
  116  child-placing agency or a residential child-caring agency, but
  117  the term does not include those who do not work on the premises
  118  where child care is furnished and have no direct contact with a
  119  child or have no contact with a child outside of the presence of
  120  the child’s parent or guardian. For purposes of screening, the
  121  term includes any member, over the age of 12 years, of the
  122  family of the owner or operator or any person other than a
  123  client, a child who is found to be dependent as defined in s.
  124  39.01, or a child as defined in s. 39.6251(1), over the age of
  125  12 years, residing with the owner or operator if the agency is
  126  located in or adjacent to the home of the owner or operator or
  127  if the family member of, or person residing with, the owner or
  128  operator has any direct contact with the children. Members of
  129  the family of the owner or operator, or persons residing with
  130  the owner or operator, who are between the ages of 12 years and
  131  18 years are not required to be fingerprinted, but must be
  132  screened for delinquency records. For purposes of screening, the
  133  term also includes owners, operators, employees, and volunteers
  134  working in summer day camps, or summer 24-hour camps providing
  135  care for children. A volunteer who assists on an intermittent
  136  basis for less than 10 hours per month shall not be included in
  137  the term “personnel” for the purposes of screening if a person
  138  who meets the screening requirement of this section is always
  139  present and has the volunteer in his or her line of sight.
  140         (k) “Placement screening” means the act of assessing the
  141  background of household members in the family foster home and
  142  includes, but is not limited to, criminal history records checks
  143  as provided in s. 39.0138 using the standards for screening set
  144  forth in that section. The term “household member” means a
  145  member of the family or a person, other than the child being
  146  placed, a child who is found to be dependent as defined in s.
  147  39.01, or a child as defined in s. 39.6251(1), over the age of
  148  12 years who resides with the owner who operates the family
  149  foster home if such family member or person has any direct
  150  contact with the child. Household members who are between the
  151  ages of 12 and 18 years are not required to be fingerprinted but
  152  must be screened for delinquency records.
  153         Section 3. Subsection (13) of section 409.912, Florida
  154  Statutes, is amended to read:
  155         409.912 Cost-effective purchasing of health care.—The
  156  agency shall purchase goods and services for Medicaid recipients
  157  in the most cost-effective manner consistent with the delivery
  158  of quality medical care. To ensure that medical services are
  159  effectively utilized, the agency may, in any case, require a
  160  confirmation or second physician’s opinion of the correct
  161  diagnosis for purposes of authorizing future services under the
  162  Medicaid program. This section does not restrict access to
  163  emergency services or poststabilization care services as defined
  164  in 42 C.F.R. s. 438.114. Such confirmation or second opinion
  165  shall be rendered in a manner approved by the agency. The agency
  166  shall maximize the use of prepaid per capita and prepaid
  167  aggregate fixed-sum basis services when appropriate and other
  168  alternative service delivery and reimbursement methodologies,
  169  including competitive bidding pursuant to s. 287.057, designed
  170  to facilitate the cost-effective purchase of a case-managed
  171  continuum of care. The agency shall also require providers to
  172  minimize the exposure of recipients to the need for acute
  173  inpatient, custodial, and other institutional care and the
  174  inappropriate or unnecessary use of high-cost services. The
  175  agency shall contract with a vendor to monitor and evaluate the
  176  clinical practice patterns of providers in order to identify
  177  trends that are outside the normal practice patterns of a
  178  provider’s professional peers or the national guidelines of a
  179  provider’s professional association. The vendor must be able to
  180  provide information and counseling to a provider whose practice
  181  patterns are outside the norms, in consultation with the agency,
  182  to improve patient care and reduce inappropriate utilization.
  183  The agency may mandate prior authorization, drug therapy
  184  management, or disease management participation for certain
  185  populations of Medicaid beneficiaries, certain drug classes, or
  186  particular drugs to prevent fraud, abuse, overuse, and possible
  187  dangerous drug interactions. The Pharmaceutical and Therapeutics
  188  Committee shall make recommendations to the agency on drugs for
  189  which prior authorization is required. The agency shall inform
  190  the Pharmaceutical and Therapeutics Committee of its decisions
  191  regarding drugs subject to prior authorization. The agency is
  192  authorized to limit the entities it contracts with or enrolls as
  193  Medicaid providers by developing a provider network through
  194  provider credentialing. The agency may competitively bid single
  195  source-provider contracts if procurement of goods or services
  196  results in demonstrated cost savings to the state without
  197  limiting access to care. The agency may limit its network based
  198  on the assessment of beneficiary access to care, provider
  199  availability, provider quality standards, time and distance
  200  standards for access to care, the cultural competence of the
  201  provider network, demographic characteristics of Medicaid
  202  beneficiaries, practice and provider-to-beneficiary standards,
  203  appointment wait times, beneficiary use of services, provider
  204  turnover, provider profiling, provider licensure history,
  205  previous program integrity investigations and findings, peer
  206  review, provider Medicaid policy and billing compliance records,
  207  clinical and medical record audits, and other factors. Providers
  208  are not entitled to enrollment in the Medicaid provider network.
  209  The agency shall determine instances in which allowing Medicaid
  210  beneficiaries to purchase durable medical equipment and other
  211  goods is less expensive to the Medicaid program than long-term
  212  rental of the equipment or goods. The agency may establish rules
  213  to facilitate purchases in lieu of long-term rentals in order to
  214  protect against fraud and abuse in the Medicaid program as
  215  defined in s. 409.913. The agency may seek federal waivers
  216  necessary to administer these policies.
  217         (13) The agency may not pay for psychotropic medication
  218  prescribed for a child in the Medicaid program without the
  219  express and informed consent of the child’s parent or legal
  220  guardian. The physician shall document the consent in the
  221  child’s medical record and provide a copy of such documentation
  222  to the pharmacy with a signed attestation of this documentation
  223  with the prescription. The express and informed consent or court
  224  authorization for a prescription of psychotropic medication for
  225  a child in the custody of the Department of Children and
  226  Families shall be obtained pursuant to s. 39.407.
  227         Section 4. This act shall take effect July 1, 2026.