Bill Text: FL S0724 | 2010 | Regular Session | Engrossed

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Review/DCFS/Florida Government Accountability Act [SPSC]

Spectrum: Partisan Bill (Republican 2-0)

Status: (Failed) 2010-04-30 - Died in Messages, companion bill(s) passed, see CS/CS/SB 1412 (Ch. 2010-102) [S0724 Detail]

Download: Florida-2010-S0724-Engrossed.html

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CS for CS for CS for SB 724                     Second Engrossed 
2010724e2 
1 
2                        A bill to be entitled 
3         An act relating to a review of the Department of 
4         Children and Family Services under the Florida 
5         Government Accountability Act; reenacting and amending 
6         s. 20.19, F.S., relating to the establishment of the 
7         department; changing the name of the Department of 
8         Children and Family Services to the Department of 
9         Children and Families; revising provisions relating to 
10         the establishment and structure of, and services 
11         provided by, the department; providing for operating 
12         units called circuits that conform to the geographic 
13         boundaries of judicial circuits; providing for the 
14         establishment of and requirements for membership and 
15         participation in community alliances and community 
16         partnerships; amending s. 20.04, F.S.; authorizing the 
17         department to establish circuits or regions headed by 
18         circuit administrators or region directors and 
19         deleting a requirement for statutory enactment for 
20         additional divisions or offices in the department; 
21         amending s. 20.43, F.S.; revising provisions relating 
22         to service area boundaries; amending s. 394.47865, 
23         F.S.; deleting obsolete provisions relating to the 
24         privatization of South Florida State Hospital; 
25         amending s. 394.78, F.S.; deleting an obsolete 
26         provision relating to dispute resolution; amending s. 
27         402.313, F.S.; revising licensure requirements for 
28         family day care homes; amending s. 402.315, F.S.; 
29         requiring the county, rather than the department, to 
30         bear the costs of licensing family day care homes, 
31         under certain circumstances; amending s. 402.40, F.S.; 
32         defining the terms “child welfare certification” and 
33         “core competency”; requiring that professionals 
34         providing child welfare services demonstrate core 
35         competency; requiring that the department recognize 
36         certain certifications; requiring that certain persons 
37         hold active certification; amending s. 409.1671, F.S.; 
38         revising provisions relating to lead agencies; 
39         requiring the department to annually evaluate each 
40         agency; conforming provision to changes made by the 
41         act; amending s. 409.1755, F.S.; decreasing the 
42         membership of the One Church, One Child of Florida 
43         Corporation, to conform to changes made by the act; 
44         amending s. 420.621, F.S.; revising the definition of 
45         the term “district” to conform to changes made by the 
46         act; amending s. 420.622, F.S.; deleting a requirement 
47         for the Governor to appoint the executive director of 
48         the State Office of Homelessness; conforming a 
49         provision; amending ss. 20.195, 39.001, 39.01, 
50         39.0121, 39.301, 39.302, 39.303, 39.806, 39.828, 
51         49.011, 381.0072, 394.493, 394.4985, 394.67, 394.73, 
52         394.74, 394.75, 394.76, 394.82, 394.9084, 397.821, 
53         402.49, 409.152, 409.1685, 410.0245, 410.603, 410.604, 
54         411.224, 414.24, 415.1113, 420.623, 420.625, 429.35, 
55         and 1002.67, F.S.; revising provisions to conform to 
56         changes made by the act; correcting cross-references; 
57         repealing ss. 39.311, 39.312, 39.313, 39.314, 39.315, 
58         39.316, 39.317, and 39.318, F.S., relating to the 
59         Family Builders Program; repealing s. 394.9083, F.S., 
60         relating to the Behavioral Health Services Integration 
61         Workgroup; repealing s. 402.35, F.S., which provides 
62         for department employees to be governed by Department 
63         of Management rules; amending s. 39.407, F.S.; 
64         requiring the provision of a comprehensive mental 
65         health treatment plan; specifying eligibility; 
66         prescribing duties for the Department of Children and 
67         Family Services; deleting provisions relating to the 
68         provision of psychotropic medications to children in 
69         out-of-home care; creating s. 39.4071, F.S.; providing 
70         legislative findings and intent; providing 
71         definitions; requiring that a guardian ad litem be 
72         appointed by the court to represent a child in the 
73         custody of the Department of Children and Family 
74         Services who is prescribed a psychotropic medication; 
75         prescribing the duties of the guardian ad litem; 
76         requiring that the department or lead agency notify 
77         the guardian ad litem of any change in the status of 
78         the child; providing for psychiatric evaluation of the 
79         child; requiring that express and informed consent and 
80         assent be obtained from a child or the child’s parent 
81         or guardian; providing requirements for a prescribing 
82         physician in obtaining consent and assent; providing 
83         for the invalidation of a parent’s informed consent; 
84         requiring the department to seek informed consent from 
85         the legal guardian in certain circumstances; requiring 
86         the department to file a motion for the administration 
87         of psychotropic medication with the final judgment of 
88         termination of parental rights under certain 
89         circumstances; requiring that a court authorize the 
90         administration of psychotropic medication to a child 
91         who is in shelter care or in foster care and for whom 
92         informed consent from the parents or a legal guardian 
93         has not been obtained; providing requirements for the 
94         motion to the court; requiring that any party 
95         objecting to the administration of psychotropic 
96         medication file its objection within a specified 
97         period; authorizing the court to obtain a second 
98         opinion regarding the proposed administration; 
99         requiring that the court hold a hearing if any party 
100         objects to the proposed administration; specifying 
101         circumstances under which the department may provide 
102         psychotropic medication to a child before court 
103         authorization is obtained; requiring that the 
104         department seek court authorization for continued 
105         administration of the medication; providing for an 
106         expedited hearing on such motion under certain 
107         circumstances; requiring the department to provide 
108         notice to all parties and the court for each emergency 
109         use of psychotropic medication under certain 
110         conditions; providing for discontinuation, alteration, 
111         and destruction of medication; requiring that a mental 
112         health treatment plan be developed for each child or 
113         youth who needs mental health services; requiring 
114         certain information to be included in a mental health 
115         treatment plan; requiring the department to develop 
116         and administer procedures to require the caregiver and 
117         prescribing physician to report any adverse side 
118         effects; requiring documentation of the adverse side 
119         effects; prohibiting the prescription of psychotropic 
120         medication to certain children who are in out-of-home 
121         care absent certain conditions; requiring review by a 
122         licensed child psychiatrist before psychotropic 
123         medication is administered to certain children who are 
124         in out-of-home care under certain conditions; 
125         prohibiting authorization for a child in the custody 
126         of the department to participate in any clinical trial 
127         designed to evaluate the use of psychotropic 
128         medication in children; amending s. 743.0645, F.S.; 
129         conforming a cross-reference; directing the Division 
130         of Statutory Revision to prepare a reviser’s bill; 
131         requiring the Agency for Persons with Disabilities to 
132         prepare a plan to perform its own administrative and 
133         operational functions separate from the department; 
134         directing the department to define legal services 
135         associated with dependency proceeding and modify lead 
136         agency funding; directing the Children and Youth 
137         Cabinet to submit a plan to the Legislature addressing 
138         the inappropriate and excessive prescribing of 
139         psychotropic medication for certain children; 
140         providing an effective date. 
141 
142  Be It Enacted by the Legislature of the State of Florida: 
143 
144         Section 1. Section 20.19, Florida Statutes, is reenacted 
145  and amended to read: 
146         (Substantial rewording of section. See 
147         s. 20.19, F.S., for present text.) 
148         20.19 Department of Children and Families.—There is created 
149  a Department of Children and Families. 
150         (1) MISSION AND PLAN.— 
151         (a) The mission of the Department of Children and Families 
152  is to work in partnership with local communities to ensure the 
153  safety, well-being, and self-sufficiency of the people served. 
154         (b) The department shall develop a strategic plan for 
155  fulfilling its mission and establish a set of measurable goals, 
156  objectives, performance standards, and quality assurance 
157  requirements to ensure that the department is accountable to the 
158  people of Florida. 
159         (c) To the extent allowed by law and within specific 
160  appropriations, the department shall deliver services by 
161  contract through private providers. 
162         (2) SECRETARY OF CHILDREN AND FAMILIES.— 
163         (a) The head of the department is the Secretary of Children 
164  and Families. The Governor shall appoint the secretary, who is 
165  subject to confirmation by the Senate. The secretary serves at 
166  the pleasure of the Governor. 
167         (b) The secretary is responsible for planning, 
168  coordinating, and managing the delivery of all services that are 
169  the responsibility of the department. 
170         (c) The secretary shall appoint a deputy secretary who 
171  shall act in the absence of the secretary. The deputy secretary 
172  is directly responsible to the secretary, performs such duties 
173  as are assigned by the secretary, and serves at the pleasure of 
174  the secretary. 
175         (d) The secretary shall appoint an Assistant Secretary for 
176  Substance Abuse and Mental Health and may establish assistant 
177  secretary positions as necessary to administer the requirements 
178  of this section. All persons appointed to such positions shall 
179  serve at the pleasure of the secretary. The department shall 
180  integrate substance abuse and mental health programs into the 
181  overall structure and priorities of the department. 
182         (3) SERVICES PROVIDED.— 
183         (a) The department shall establish the following program 
184  offices, each of which shall be headed by a program director who 
185  shall be appointed by and serve at the pleasure of the 
186  secretary: 
187         1. Adult protection. 
188         2. Child care licensure. 
189         3. Domestic violence. 
190         4. Economic self-sufficiency. 
191         5. Family safety. 
192         6. Mental health. 
193         7. Refugee services. 
194         8. Substance abuse. 
195         9. Homelessness. 
196         (b) The secretary may appoint additional directors as 
197  necessary for the effective management of the program services 
198  provided by the department. 
199         (4) OPERATING UNITS.— 
200         (a) The department shall plan and administer its program 
201  services through operating units called “circuits” that conform 
202  to the geographic boundaries of the judicial circuits 
203  established in s. 26.021. The department may also establish one 
204  or more regions consisting of one or more circuits. A region 
205  shall provide administrative, management, and infrastructure 
206  support to the circuits operating within the region. The region 
207  shall consolidate support functions to provide the most 
208  efficient use of resources to support the circuits operating 
209  within the region. 
210         (b) The secretary may appoint a circuit administrator for 
211  each circuit and a region director for each region who shall 
212  serve at the pleasure of the secretary and shall perform such 
213  duties as are assigned by the secretary. 
214         (5) COMMUNITY ALLIANCES AND PARTNERSHIPS; ADVISORY GROUPS. 
215  The department may, or at the request of a county government 
216  shall, establish in each circuit one or more community alliances 
217  or community partnerships. The purpose of a community alliance 
218  or community partnership is to provide a focal point for 
219  community participation and the governance of community-based 
220  services. The membership of a community alliance or community 
221  partnership shall represent the diversity of a community and 
222  consist of stakeholders, community leaders, client 
223  representatives, and entities that fund human services. The 
224  secretary may also establish advisory groups at the state level 
225  as necessary to ensure and enhance communication and provide 
226  liaison with stakeholders, community leaders, and client 
227  representatives. 
228         (a) The duties of a community alliance or community 
229  partnership may include, but are not limited to: 
230         1. Participating in joint planning for the effective use of 
231  resources in the community, including resources appropriated to 
232  the department, and any funds that local funding sources choose 
233  to provide. 
234         2. Performing a needs assessment and establishing community 
235  priorities for service delivery. 
236         3. Determining community outcome goals to supplement state 
237  required outcomes. 
238         4. Serving as a catalyst for community resource 
239  development. 
240         5. Providing for community education and advocacy on issues 
241  related to service delivery. 
242         6. Promoting prevention and early intervention services. 
243         (b) If one or more community alliances or community 
244  partnerships are established in a circuit, the department shall 
245  ensure, to the greatest extent possible, that the formation of 
246  each alliance or partnership builds on the strengths of the 
247  existing community human services infrastructure. 
248         (c) Members of community alliances, community partnerships, 
249  and advisory groups shall serve without compensation, but are 
250  entitled to reimbursement for per diem and travel expenses in 
251  accordance with s. 112.061. The department may also authorize 
252  payment for preapproved child care expenses or lost wages for 
253  members who are consumers of services provided by the 
254  department. 
255         (d) Members of community alliances, community partnerships, 
256  and advisory groups are subject to part III of chapter 112, the 
257  Code of Ethics for Public Officers and Employees. 
258         (e) Actions taken by community alliances, community 
259  partnerships, and advisory groups must be consistent with 
260  department policy and state and federal laws, rules, and 
261  regulations. 
262         (f) Each member of a community alliance or community 
263  partnership must submit annually to the inspector general of the 
264  department a disclosure statement of any interest in services 
265  provided by the department. Any member who has an interest in a 
266  matter under consideration by the community alliance, community 
267  partnership, or advisory group must abstain from voting on that 
268  matter. 
269         (g) All meetings of community alliances, community 
270  partnerships, and advisory groups are open to the public 
271  pursuant to s. 286.011 and are subject to the public-records 
272  provisions of s. 119.07(1). 
273         (6) CONSULTATION WITH COUNTIES ON MANDATED PROGRAMS.—It is 
274  the intent of the Legislature that when county governments are 
275  required by law to participate in the funding of programs 
276  serviced by the department, the department shall consult with 
277  designated representatives of county governments in developing 
278  policies and service delivery plans for those programs. 
279         Section 2. Subsection (4) and paragraph (b) of subsection 
280  (7) of section 20.04, Florida Statutes, are amended to read: 
281         20.04 Structure of executive branch.—The executive branch 
282  of state government is structured as follows: 
283         (4) Within the Department of Children and Families Family 
284  Services there are organizational units called “program 
285  offices,” headed by program directors, and operating units 
286  called “circuits,” headed by circuit administrators. In 
287  addition, there may be “regions,” headed by region directors. 
288         (7) 
289         (b) Within the limitations of this subsection, the head of 
290  the department may recommend the establishment of additional 
291  divisions, bureaus, sections, and subsections of the department 
292  to promote efficient and effective operation of the department. 
293  However, additional divisions, or offices in the Department of 
294  Children and Family Services, the Department of Corrections, and 
295  the Department of Transportation, may be established only by 
296  specific statutory enactment. New bureaus, sections, and 
297  subsections of departments may be initiated by a department and 
298  established as recommended by the Department of Management 
299  Services and approved by the Executive Office of the Governor, 
300  or may be established by specific statutory enactment. 
301         Section 3. Paragraph (a) of subsection (4) of section 
302  20.195, Florida Statutes, is amended to read: 
303         20.195 Department of Children and Family Services; trust 
304  funds.—The following trust funds shall be administered by the 
305  Department of Children and Family Services: 
306         (4) Domestic Violence Trust Fund. 
307         (a) Funds to be credited to and uses of the trust fund 
308  shall be administered in accordance with the provisions of s. 
309  28.101, part XII XIII of chapter 39, and chapter 741. 
310         Section 4. Subsection (5) of section 20.43, Florida 
311  Statutes, is amended to read: 
312         20.43 Department of Health.—There is created a Department 
313  of Health. 
314         (5) The department shall plan and administer its public 
315  health programs through its county health departments and may, 
316  for administrative purposes and efficient service delivery, 
317  establish up to 15 service areas to carry out such duties as may 
318  be prescribed by the State Surgeon General. The boundaries of 
319  the service areas shall be the same as, or combinations of, the 
320  service districts of the Department of Children and Family 
321  Services established in s. 20.19 and, to the extent practicable, 
322  shall take into consideration the boundaries of the jobs and 
323  education regional boards. 
324         Section 5. Paragraph (o) is added to subsection (1) of 
325  section 39.001, Florida Statutes, to read: 
326         39.001 Purposes and intent; personnel standards and 
327  screening.— 
328         (1) PURPOSES OF CHAPTER.—The purposes of this chapter are: 
329         (o) To provide all children and families with a fully 
330  integrated, comprehensive approach to handling all cases that 
331  involve children and families and a resolution of family 
332  disputes in a fair, timely efficient and cost-effective manner. 
333  It is the intent of the Legislature that the courts of this 
334  state embrace methods of resolving disputes that do not cause 
335  additional emotional harm to the children and families who are 
336  required to interact with the judicial system. It is the intent 
337  of the Legislature to support the development of a unified 
338  family court in a revenue neutral manner and to support the 
339  efforts of the state courts system to improve the resolution of 
340  disputes involving children and families through a fully 
341  integrated, comprehensive approach that includes coordinated 
342  case management; the concept of “one family, one judge”; 
343  collaboration with the community for referral to needed 
344  services; and methods of alternative dispute resolution. The 
345  Legislature supports the goal that the legal system focus on the 
346  needs of children who are involved in the litigation, refer 
347  families to resources that will make families’ relationships 
348  stronger, coordinate families’ cases to provide consistent 
349  results, and strive to leave families in better condition than 
350  when the families entered the system. 
351         Section 6. Subsections (18) through (76) of section 39.01, 
352  Florida Statutes, are renumbered as subsections (19) through 
353  (75), respectively, subsection (10) is amended, present 
354  subsection (26) is repealed, and present subsection (27) of that 
355  section is renumbered as subsection (18) and amended, to read: 
356         39.01 Definitions.—When used in this chapter, unless the 
357  context otherwise requires: 
358         (10) “Caregiver” means the parent, legal custodian, 
359  permanent guardian, adult household member, or other person 
360  responsible for a child’s welfare as defined in subsection (46) 
361  (47). 
362         (26) “District” means any one of the 15 service districts 
363  of the department established pursuant to s. 20.19. 
364         (18)(27) “Circuit District administrator” means the chief 
365  operating officer of each circuit service district of the 
366  department as defined in s. 20.19(5) and, where appropriate, 
367  includes any district administrator whose service district falls 
368  within the boundaries of a judicial circuit. 
369         Section 7. Subsection (10) of section 39.0121, Florida 
370  Statutes, is amended to read: 
371         39.0121 Specific rulemaking authority.—Pursuant to the 
372  requirements of s. 120.536, the department is specifically 
373  authorized to adopt, amend, and repeal administrative rules 
374  which implement or interpret law or policy, or describe the 
375  procedure and practice requirements necessary to implement this 
376  chapter, including, but not limited to, the following: 
377         (10) The Family Builders Program, the Intensive Crisis 
378  Counseling Program, and any other early intervention programs 
379  and kinship care assistance programs. 
380         Section 8. Paragraph (a) of subsection (15) of section 
381  39.301, Florida Statutes, is amended to read: 
382         39.301 Initiation of protective investigations.— 
383         (15)(a) If the department or its agent determines that a 
384  child requires immediate or long-term protection through: 
385         1. Medical or other health care; or 
386         2. Homemaker care, day care, protective supervision, or 
387  other services to stabilize the home environment, including 
388  intensive family preservation services through the Family 
389  Builders Program or the Intensive Crisis Counseling Program, or 
390  both, 
391 
392  such services shall first be offered for voluntary acceptance 
393  unless there are high-risk factors that may impact the ability 
394  of the parents or legal custodians to exercise judgment. Such 
395  factors may include the parents’ or legal custodians’ young age 
396  or history of substance abuse or domestic violence. 
397         Section 9. Subsection (1) of section 39.302, Florida 
398  Statutes, is amended to read: 
399         39.302 Protective investigations of institutional child 
400  abuse, abandonment, or neglect.— 
401         (1) The department shall conduct a child protective 
402  investigation of each report of institutional child abuse, 
403  abandonment, or neglect. Upon receipt of a report that alleges 
404  that an employee or agent of the department, or any other entity 
405  or person covered by s. 39.01(32)(33) or (46)(47), acting in an 
406  official capacity, has committed an act of child abuse, 
407  abandonment, or neglect, the department shall initiate a child 
408  protective investigation within the timeframe established under 
409  s. 39.201(5) and orally notify the appropriate state attorney, 
410  law enforcement agency, and licensing agency, which shall 
411  immediately conduct a joint investigation, unless independent 
412  investigations are more feasible. When conducting investigations 
413  onsite or having face-to-face interviews with the child, 
414  investigation visits shall be unannounced unless it is 
415  determined by the department or its agent that unannounced 
416  visits threaten the safety of the child. If a facility is exempt 
417  from licensing, the department shall inform the owner or 
418  operator of the facility of the report. Each agency conducting a 
419  joint investigation is entitled to full access to the 
420  information gathered by the department in the course of the 
421  investigation. A protective investigation must include an onsite 
422  visit of the child’s place of residence. The department shall 
423  make a full written report to the state attorney within 3 
424  working days after making the oral report. A criminal 
425  investigation shall be coordinated, whenever possible, with the 
426  child protective investigation of the department. Any interested 
427  person who has information regarding the offenses described in 
428  this subsection may forward a statement to the state attorney as 
429  to whether prosecution is warranted and appropriate. Within 15 
430  days after the completion of the investigation, the state 
431  attorney shall report the findings to the department and shall 
432  include in the report a determination of whether or not 
433  prosecution is justified and appropriate in view of the 
434  circumstances of the specific case. 
435         Section 10. Section 39.303, Florida Statutes, is amended to 
436  read: 
437         39.303 Child protection teams; services; eligible cases. 
438  The Children’s Medical Services Program in the Department of 
439  Health shall develop, maintain, and coordinate the services of 
440  one or more multidisciplinary child protection teams in each of 
441  the circuits service districts of the Department of Children and 
442  Families Family Services. Such teams may be composed of 
443  appropriate representatives of school districts and appropriate 
444  health, mental health, social service, legal service, and law 
445  enforcement agencies. The Legislature finds that optimal 
446  coordination of child protection teams and sexual abuse 
447  treatment programs requires collaboration between the Department 
448  of Health and the Department of Children and Families Family 
449  Services. The two departments shall maintain an interagency 
450  agreement that establishes protocols for oversight and 
451  operations of child protection teams and sexual abuse treatment 
452  programs. The State Surgeon General and the Deputy Secretary for 
453  Children’s Medical Services, in consultation with the Secretary 
454  of Children and Families Family Services, shall maintain the 
455  responsibility for the screening, employment, and, if necessary, 
456  the termination of child protection team medical directors, at 
457  headquarters and in the circuits 15 districts. Child protection 
458  team medical directors shall be responsible for oversight of the 
459  teams in the circuits districts. 
460         (1) The Department of Health shall utilize and convene the 
461  teams to supplement the assessment and protective supervision 
462  activities of the family safety and preservation program of the 
463  Department of Children and Families Family Services. Nothing in 
464  this section shall be construed to remove or reduce the duty and 
465  responsibility of any person to report pursuant to this chapter 
466  all suspected or actual cases of child abuse, abandonment, or 
467  neglect or sexual abuse of a child. The role of the teams shall 
468  be to support activities of the program and to provide services 
469  deemed by the teams to be necessary and appropriate to abused, 
470  abandoned, and neglected children upon referral. The specialized 
471  diagnostic assessment, evaluation, coordination, consultation, 
472  and other supportive services that a child protection team shall 
473  be capable of providing include, but are not limited to, the 
474  following: 
475         (a) Medical diagnosis and evaluation services, including 
476  provision or interpretation of X rays and laboratory tests, and 
477  related services, as needed, and documentation of findings 
478  relative thereto. 
479         (b) Telephone consultation services in emergencies and in 
480  other situations. 
481         (c) Medical evaluation related to abuse, abandonment, or 
482  neglect, as defined by policy or rule of the Department of 
483  Health. 
484         (d) Such psychological and psychiatric diagnosis and 
485  evaluation services for the child or the child’s parent or 
486  parents, legal custodian or custodians, or other caregivers, or 
487  any other individual involved in a child abuse, abandonment, or 
488  neglect case, as the team may determine to be needed. 
489         (e) Expert medical, psychological, and related professional 
490  testimony in court cases. 
491         (f) Case staffings to develop treatment plans for children 
492  whose cases have been referred to the team. A child protection 
493  team may provide consultation with respect to a child who is 
494  alleged or is shown to be abused, abandoned, or neglected, which 
495  consultation shall be provided at the request of a 
496  representative of the family safety and preservation program or 
497  at the request of any other professional involved with a child 
498  or the child’s parent or parents, legal custodian or custodians, 
499  or other caregivers. In every such child protection team case 
500  staffing, consultation, or staff activity involving a child, a 
501  family safety and preservation program representative shall 
502  attend and participate. 
503         (g) Case service coordination and assistance, including the 
504  location of services available from other public and private 
505  agencies in the community. 
506         (h) Such training services for program and other employees 
507  of the Department of Children and Families Family Services, 
508  employees of the Department of Health, and other medical 
509  professionals as is deemed appropriate to enable them to develop 
510  and maintain their professional skills and abilities in handling 
511  child abuse, abandonment, and neglect cases. 
512         (i) Educational and community awareness campaigns on child 
513  abuse, abandonment, and neglect in an effort to enable citizens 
514  more successfully to prevent, identify, and treat child abuse, 
515  abandonment, and neglect in the community. 
516         (j) Child protection team assessments that include, as 
517  appropriate, medical evaluations, medical consultations, family 
518  psychosocial interviews, specialized clinical interviews, or 
519  forensic interviews. 
520 
521  All medical personnel participating on a child protection team 
522  must successfully complete the required child protection team 
523  training curriculum as set forth in protocols determined by the 
524  Deputy Secretary for Children’s Medical Services and the 
525  Statewide Medical Director for Child Protection. 
526         (2) The child abuse, abandonment, and neglect reports that 
527  must be referred by the department to child protection teams of 
528  the Department of Health for an assessment and other appropriate 
529  available support services as set forth in subsection (1) must 
530  include cases involving: 
531         (a) Injuries to the head, bruises to the neck or head, 
532  burns, or fractures in a child of any age. 
533         (b) Bruises anywhere on a child 5 years of age or under. 
534         (c) Any report alleging sexual abuse of a child. 
535         (d) Any sexually transmitted disease in a prepubescent 
536  child. 
537         (e) Reported malnutrition of a child and failure of a child 
538  to thrive. 
539         (f) Reported medical neglect of a child. 
540         (g) Any family in which one or more children have been 
541  pronounced dead on arrival at a hospital or other health care 
542  facility, or have been injured and later died, as a result of 
543  suspected abuse, abandonment, or neglect, when any sibling or 
544  other child remains in the home. 
545         (h) Symptoms of serious emotional problems in a child when 
546  emotional or other abuse, abandonment, or neglect is suspected. 
547         (3) All abuse and neglect cases transmitted for 
548  investigation to a circuit district by the hotline must be 
549  simultaneously transmitted to the Department of Health child 
550  protection team for review. For the purpose of determining 
551  whether face-to-face medical evaluation by a child protection 
552  team is necessary, all cases transmitted to the child protection 
553  team which meet the criteria in subsection (2) must be timely 
554  reviewed by: 
555         (a) A physician licensed under chapter 458 or chapter 459 
556  who holds board certification in pediatrics and is a member of a 
557  child protection team; 
558         (b) A physician licensed under chapter 458 or chapter 459 
559  who holds board certification in a specialty other than 
560  pediatrics, who may complete the review only when working under 
561  the direction of a physician licensed under chapter 458 or 
562  chapter 459 who holds board certification in pediatrics and is a 
563  member of a child protection team; 
564         (c) An advanced registered nurse practitioner licensed 
565  under chapter 464 who has a specialty speciality in pediatrics 
566  or family medicine and is a member of a child protection team; 
567         (d) A physician assistant licensed under chapter 458 or 
568  chapter 459, who may complete the review only when working under 
569  the supervision of a physician licensed under chapter 458 or 
570  chapter 459 who holds board certification in pediatrics and is a 
571  member of a child protection team; or 
572         (e) A registered nurse licensed under chapter 464, who may 
573  complete the review only when working under the direct 
574  supervision of a physician licensed under chapter 458 or chapter 
575  459 who holds certification in pediatrics and is a member of a 
576  child protection team. 
577         (4) A face-to-face medical evaluation by a child protection 
578  team is not necessary when: 
579         (a) The child was examined for the alleged abuse or neglect 
580  by a physician who is not a member of the child protection team, 
581  and a consultation between the child protection team board 
582  certified pediatrician, advanced registered nurse practitioner, 
583  physician assistant working under the supervision of a child 
584  protection team board-certified pediatrician, or registered 
585  nurse working under the direct supervision of a child protection 
586  team board-certified pediatrician, and the examining physician 
587  concludes that a further medical evaluation is unnecessary; 
588         (b) The child protective investigator, with supervisory 
589  approval, has determined, after conducting a child safety 
590  assessment, that there are no indications of injuries as 
591  described in paragraphs (2)(a)-(h) as reported; or 
592         (c) The child protection team board-certified pediatrician, 
593  as authorized in subsection (3), determines that a medical 
594  evaluation is not required. 
595 
596  Notwithstanding paragraphs (a), (b), and (c), a child protection 
597  team pediatrician, as authorized in subsection (3), may 
598  determine that a face-to-face medical evaluation is necessary. 
599         (5) In all instances in which a child protection team is 
600  providing certain services to abused, abandoned, or neglected 
601  children, other offices and units of the Department of Health, 
602  and offices and units of the Department of Children and Families 
603  Family Services, shall avoid duplicating the provision of those 
604  services. 
605         (6) The Department of Health child protection team quality 
606  assurance program and the Department of Children and Families’ 
607  Family Services’ Family Safety Program Office quality assurance 
608  program shall collaborate to ensure referrals and responses to 
609  child abuse, abandonment, and neglect reports are appropriate. 
610  Each quality assurance program shall include a review of records 
611  in which there are no findings of abuse, abandonment, or 
612  neglect, and the findings of these reviews shall be included in 
613  each department’s quality assurance reports. 
614         Section 11. Paragraph (k) of subsection (1) of section 
615  39.806, Florida Statutes, is amended to read: 
616         39.806 Grounds for termination of parental rights.— 
617         (1) Grounds for the termination of parental rights may be 
618  established under any of the following circumstances: 
619         (k) A test administered at birth that indicated that the 
620  child’s blood, urine, or meconium contained any amount of 
621  alcohol or a controlled substance or metabolites of such 
622  substances, the presence of which was not the result of medical 
623  treatment administered to the mother or the newborn infant, and 
624  the biological mother of the child is the biological mother of 
625  at least one other child who was adjudicated dependent after a 
626  finding of harm to the child’s health or welfare due to exposure 
627  to a controlled substance or alcohol as defined in s. 
628  39.01(31)(32)(g), after which the biological mother had the 
629  opportunity to participate in substance abuse treatment. 
630         Section 12. Paragraph (a) of subsection (1) of section 
631  39.828, Florida Statutes, is amended to read: 
632         39.828 Grounds for appointment of a guardian advocate.— 
633         (1) The court shall appoint the person named in the 
634  petition as a guardian advocate with all the powers and duties 
635  specified in s. 39.829 for an initial term of 1 year upon a 
636  finding that: 
637         (a) The child named in the petition is or was a drug 
638  dependent newborn as described in s. 39.01(31)(32)(g); 
639         (b) The parent or parents of the child have voluntarily 
640  relinquished temporary custody of the child to a relative or 
641  other responsible adult; 
642         (c) The person named in the petition to be appointed the 
643  guardian advocate is capable of carrying out the duties as 
644  provided in s. 39.829; and 
645         (d) A petition to adjudicate the child dependent under this 
646  chapter has not been filed. 
647         Section 13. Subsection (13) of section 49.011, Florida 
648  Statutes, is amended to read: 
649         49.011 Service of process by publication; cases in which 
650  allowed.—Service of process by publication may be made in any 
651  court on any party identified in s. 49.021 in any action or 
652  proceeding: 
653         (13) For termination of parental rights pursuant to part 
654  VIII IX of chapter 39 or chapter 63. 
655         Section 14. Paragraph (a) of subsection (3) of section 
656  381.0072, Florida Statutes, is amended to read: 
657         381.0072 Food service protection.—It shall be the duty of 
658  the Department of Health to adopt and enforce sanitation rules 
659  consistent with law to ensure the protection of the public from 
660  food-borne illness. These rules shall provide the standards and 
661  requirements for the storage, preparation, serving, or display 
662  of food in food service establishments as defined in this 
663  section and which are not permitted or licensed under chapter 
664  500 or chapter 509. 
665         (3) LICENSES REQUIRED.— 
666         (a) Licenses; annual renewals.—Each food service 
667  establishment regulated under this section shall obtain a 
668  license from the department annually. Food service establishment 
669  licenses shall expire annually and are not transferable from one 
670  place or individual to another. However, those facilities 
671  licensed by the department’s Office of Licensure and 
672  Certification, the Child Care Licensure Services Program Office, 
673  or the Agency for Persons with Disabilities are exempt from this 
674  subsection. It shall be a misdemeanor of the second degree, 
675  punishable as provided in s. 381.0061, s. 775.082, or s. 
676  775.083, for such an establishment to operate without this 
677  license. The department may refuse a license, or a renewal 
678  thereof, to any establishment that is not constructed or 
679  maintained in accordance with law and with the rules of the 
680  department. Annual application for renewal is not required. 
681         Section 15. Subsection (3) of section 394.47865, Florida 
682  Statutes, is amended to read: 
683         394.47865 South Florida State Hospital; privatization.— 
684         (3)(a) Current South Florida State Hospital employees who 
685  are affected by the privatization shall be given first 
686  preference for continued employment by the contractor. The 
687  department shall make reasonable efforts to find suitable job 
688  placements for employees who wish to remain within the state 
689  Career Service System. 
690         (b) Any savings that result from the privatization of South 
691  Florida State Hospital shall be directed to the department’s 
692  service districts 9, 10, and 11 for the delivery of community 
693  mental health services. 
694         Section 16. Subsection (2) of section 394.493, Florida 
695  Statutes, is amended to read: 
696         394.493 Target populations for child and adolescent mental 
697  health services funded through the department.— 
698         (2) Each mental health provider under contract with the 
699  department to provide mental health services to the target 
700  population shall collect fees from the parent or legal guardian 
701  of the child or adolescent receiving services. The fees shall be 
702  based on a sliding fee scale for families whose net family 
703  income is at or above 150 percent of the Federal Poverty Income 
704  Guidelines. The department shall adopt, by rule, a sliding fee 
705  scale for statewide implementation. Fees collected from families 
706  shall be retained in the circuit service district and used for 
707  expanding child and adolescent mental health treatment services. 
708         Section 17. Section 394.4985, Florida Statutes, is amended 
709  to read: 
710         394.4985 Circuitwide Districtwide information and referral 
711  network; implementation.— 
712         (1) Each circuit service district of the Department of 
713  Children and Families Family Services shall develop a detailed 
714  implementation plan for a circuitwide districtwide comprehensive 
715  child and adolescent mental health information and referral 
716  network to be operational by July 1, 1999. The plan must include 
717  an operating budget that demonstrates cost efficiencies and 
718  identifies funding sources for the circuit district information 
719  and referral network. The plan must be submitted by the 
720  department to the Legislature by October 1, 1998. The circuit 
721  district shall use existing circuit district information and 
722  referral providers if, in the development of the plan, it is 
723  concluded that these providers would deliver information and 
724  referral services in a more efficient and effective manner when 
725  compared to other alternatives. The circuit district information 
726  and referral network must include: 
727         (a) A resource file that contains information about the 
728  child and adolescent mental health services as described in s. 
729  394.495, including, but not limited to: 
730         1. Type of program; 
731         2. Hours of service; 
732         3. Ages of persons served; 
733         4. Program description; 
734         5. Eligibility requirements; and 
735         6. Fees. 
736         (b) Information about private providers and professionals 
737  in the community which serve children and adolescents with an 
738  emotional disturbance. 
739         (c) A system to document requests for services that are 
740  received through the network referral process, including, but 
741  not limited to: 
742         1. Number of calls by type of service requested; 
743         2. Ages of the children and adolescents for whom services 
744  are requested; and 
745         3. Type of referral made by the network. 
746         (d) The ability to share client information with the 
747  appropriate community agencies. 
748         (e) The submission of an annual report to the department, 
749  the Agency for Health Care Administration, and appropriate local 
750  government entities, which contains information about the 
751  sources and frequency of requests for information, types and 
752  frequency of services requested, and types and frequency of 
753  referrals made. 
754         (2) In planning the information and referral network, the 
755  circuit district shall consider the establishment of a 24-hour 
756  toll-free telephone number, staffed at all times, for parents 
757  and other persons to call for information that concerns child 
758  and adolescent mental health services and a community public 
759  service campaign to inform the public about information and 
760  referral services. 
761         Section 18. Subsections (2) through (6) of section 394.67, 
762  Florida Statutes, are renumbered as subsections (4) and (8), 
763  respectively, and present subsections (7) and (8) are renumbered 
764  as subsections (2) and (3), respectively, and amended to read: 
765         394.67 Definitions.—As used in this part, the term: 
766         (2)(7) “Circuit District administrator” means the person 
767  appointed by the Secretary of Children and Families Family 
768  Services for the purpose of administering a department circuit 
769  service district as set forth in s. 20.19. 
770         (3)(8) “Circuit District plan” or “plan” means the combined 
771  circuit district substance abuse and mental health plan approved 
772  by the circuit district administrator and governing bodies in 
773  accordance with this part. 
774         Section 19. Section 394.73, Florida Statutes, is amended to 
775  read: 
776         394.73 Joint alcohol, drug abuse, and mental health service 
777  programs in two or more counties.— 
778         (1) Subject to rules established by the department, any 
779  county within a circuit service district shall have the same 
780  power to contract for alcohol, drug abuse, and mental health 
781  services as the department has under existing statutes. 
782         (2) In order to carry out the intent of this part and to 
783  provide alcohol, drug abuse, and mental health services in 
784  accordance with the circuit district plan, the counties within a 
785  circuit service district may enter into agreements with each 
786  other for the establishment of joint service programs. The 
787  agreements may provide for the joint provision or operation of 
788  services and facilities or for the provision or operation of 
789  services and facilities by one participating county under 
790  contract with other participating counties. 
791         (3) When a circuit service district comprises two or more 
792  counties or portions thereof, it is the obligation of the 
793  planning council to submit to the governing bodies, prior to the 
794  budget submission date of each governing body, an estimate of 
795  the proportionate share of costs of alcohol, drug abuse, and 
796  mental health services proposed to be borne by each such 
797  governing body. 
798         (4) Any county desiring to withdraw from a joint program 
799  may submit to the circuit district administrator a resolution 
800  requesting withdrawal therefrom together with a plan for the 
801  equitable adjustment and division of the assets, property, 
802  debts, and obligations, if any, of the joint program. 
803         Section 20. Paragraph (a) of subsection (3) of section 
804  394.74, Florida Statutes, is amended to read: 
805         394.74 Contracts for provision of local substance abuse and 
806  mental health programs.— 
807         (3) Contracts shall include, but are not limited to: 
808         (a) A provision that, within the limits of available 
809  resources, substance abuse and mental health crisis services, as 
810  defined in s. 394.67(5)(3), shall be available to any individual 
811  residing or employed within the service area, regardless of 
812  ability to pay for such services, current or past health 
813  condition, or any other factor; 
814         Section 21. Subsection (10) of section 394.75, Florida 
815  Statutes, is amended to read: 
816         394.75 State and circuit district substance abuse and 
817  mental health plans.— 
818         (10) The circuit district administrator shall ensure that 
819  the circuit district plan: 
820         (a) Conforms to the priorities in the state plan, the 
821  requirements of this part, and the standards adopted under this 
822  part; 
823         (b) Ensures that the most effective and economical use will 
824  be made of available public and private substance abuse and 
825  mental health resources in the circuit service district; and 
826         (c) Has adequate provisions made for review and evaluation 
827  of the services provided in the circuit service district. 
828         Section 22. Subsection (2) of section 394.76, Florida 
829  Statutes, is amended to read: 
830         394.76 Financing of circuit district programs and 
831  services.—If the local match funding level is not provided in 
832  the General Appropriations Act or the substantive bill 
833  implementing the General Appropriations Act, such funding level 
834  shall be provided as follows: 
835         (2) If in any fiscal year the approved state appropriation 
836  is insufficient to finance the programs and services specified 
837  by this part, the department shall have the authority to 
838  determine the amount of state funds available to each circuit 
839  service district for such purposes in accordance with the 
840  priorities in both the state and circuit district plans. The 
841  circuit district administrator shall consult with the planning 
842  council to ensure that the summary operating budget conforms to 
843  the approved plan. 
844         Section 23. Subsection (5) of section 394.78, Florida 
845  Statutes, is amended to read: 
846         394.78 Operation and administration; personnel standards; 
847  procedures for audit and monitoring of service providers; 
848  resolution of disputes.— 
849         (5) In unresolved disputes regarding this part or rules 
850  established pursuant to this part, providers and district health 
851  and human services boards shall adhere to formal procedures 
852  specified under s. 20.19(8)(n). 
853         Section 24. Subsections (3) and (4) of section 394.82, 
854  Florida Statutes, are amended to read: 
855         394.82 Funding of expanded services.— 
856         (3) Each fiscal year, any funding increases for crisis 
857  services or community mental health services that are included 
858  in the General Appropriations Act shall be appropriated in a 
859  lump-sum category as defined in s. 216.011(1)(aa). In accordance 
860  with s. 216.181(6)(a), the Executive Office of the Governor 
861  shall require the Department of Children and Families Family 
862  Services to submit a spending plan for the use of funds 
863  appropriated for this purpose. The spending plan must include a 
864  schedule for phasing in the new community mental health services 
865  in each circuit service district of the department and must 
866  describe how the new services will be integrated and coordinated 
867  with all current community-based health and human services. 
868         (4) By January 1, 2004, the crisis services defined in s. 
869  394.67(5)(3) shall be implemented, as appropriate, in the 
870  state’s public community mental health system to serve children 
871  and adults who are experiencing an acute mental or emotional 
872  crisis, as defined in s. 394.67(17). By January 1, 2006, the 
873  mental health services defined in s. 394.67(15) shall be 
874  implemented, as appropriate, in the state’s public community 
875  mental health system to serve adults and older adults who have a 
876  severe and persistent mental illness and to serve children who 
877  have a serious emotional disturbance or mental illness, as 
878  defined in s. 394.492(6). 
879         Section 25. Subsection (1) of section 394.9084, Florida 
880  Statutes, is amended to read: 
881         394.9084 Florida Self-Directed Care program.— 
882         (1) The Department of Children and Families Family 
883  Services, in cooperation with the Agency for Health Care 
884  Administration, may provide a client-directed and choice-based 
885  Florida Self-Directed Care program in all department circuits 
886  service districts, in addition to the pilot projects established 
887  in district 4 and district 8, to provide mental health treatment 
888  and support services to adults who have a serious mental 
889  illness. The department may also develop and implement a client 
890  directed and choice-based pilot project in one circuit district 
891  to provide mental health treatment and support services for 
892  children with a serious emotional disturbance who live at home. 
893  If established, any staff who work with children must be 
894  screened under s. 435.04. The department shall implement a 
895  payment mechanism in which each client controls the money that 
896  is available for that client’s mental health treatment and 
897  support services. The department shall establish interagency 
898  cooperative agreements and work with the agency, the Division of 
899  Vocational Rehabilitation, and the Social Security 
900  Administration to implement and administer the Florida Self 
901  Directed Care program. 
902         Section 26. Subsection (1) of section 397.821, Florida 
903  Statutes, is amended to read: 
904         397.821 Juvenile substance abuse impairment prevention and 
905  early intervention councils.— 
906         (1) Each judicial circuit as set forth in s. 26.021 may 
907  establish a juvenile substance abuse impairment prevention and 
908  early intervention council composed of at least 12 members, 
909  including representatives from law enforcement, the department, 
910  school districts, state attorney and public defender offices, 
911  the circuit court, the religious community, substance abuse 
912  impairment professionals, child advocates from the community, 
913  business leaders, parents, and high school students. However, 
914  those circuits which already have in operation a council of 
915  similar composition may designate the existing body as the 
916  juvenile substance abuse impairment prevention and early 
917  intervention council for the purposes of this section. Each 
918  council shall establish bylaws providing for the length of term 
919  of its members, but the term may not exceed 4 years. The circuit 
920  substate entity administrator, as defined in s. 20.19, and the 
921  chief judge of the circuit court shall each appoint six members 
922  of the council. The circuit substate entity administrator shall 
923  appoint a representative from the department, a school district 
924  representative, a substance abuse impairment treatment 
925  professional, a child advocate, a parent, and a high school 
926  student. The chief judge of the circuit court shall appoint a 
927  business leader and representatives from the state attorney’s 
928  office, the public defender’s office, the religious community, 
929  the circuit court, and law enforcement agencies. 
930         Section 27. Subsection (1) of section 402.313, Florida 
931  Statutes, is amended to read: 
932         402.313 Family day care homes.— 
933         (1) Family day care homes shall be licensed under this act 
934  if they are presently being licensed under an existing county 
935  licensing ordinance, if they are participating in the subsidized 
936  child care program, or if the board of county commissioners 
937  passes a resolution that family day care homes be licensed. If 
938  no county authority exists for the licensing of a family day 
939  care home and the county passes a resolution requiring 
940  licensure, the department shall have the authority to license 
941  family day care homes under contract with the county for the 
942  purchase-of-service system in the subsidized child care program. 
943         (a) If not subject to license, family day care homes shall 
944  register annually with the department, providing the following 
945  information: 
946         1. The name and address of the home. 
947         2. The name of the operator. 
948         3. The number of children served. 
949         4. Proof of a written plan to provide at least one other 
950  competent adult to be available to substitute for the operator 
951  in an emergency. This plan shall include the name, address, and 
952  telephone number of the designated substitute. 
953         5. Proof of screening and background checks. 
954         6. Proof of successful completion of the 30-hour training 
955  course, as evidenced by passage of a competency examination, 
956  which shall include: 
957         a. State and local rules and regulations that govern child 
958  care. 
959         b. Health, safety, and nutrition. 
960         c. Identifying and reporting child abuse and neglect. 
961         d. Child development, including typical and atypical 
962  language development; and cognitive, motor, social, and self 
963  help skills development. 
964         e. Observation of developmental behaviors, including using 
965  a checklist or other similar observation tools and techniques to 
966  determine a child’s developmental level. 
967         f. Specialized areas, including early literacy and language 
968  development of children from birth to 5 years of age, as 
969  determined by the department, for owner-operators of family day 
970  care homes. 
971         7. Proof that immunization records are kept current. 
972         8. Proof of completion of the required continuing education 
973  units or clock hours. 
974         (b) A family day care home not participating in the 
975  subsidized child care program may volunteer to be licensed under 
976  the provisions of this act. 
977         (c) The department may provide technical assistance to 
978  counties and family day care home providers to enable counties 
979  and family day care providers to achieve compliance with family 
980  day care homes standards. 
981         Section 28. Subsection (2) of section 402.315, Florida 
982  Statutes, is amended to read: 
983         402.315 Funding; license fees.— 
984         (2) The county department shall bear the costs of the 
985  licensing of family day care homes when contracting with the 
986  department pursuant to s. 402.313(1) child care facilities when 
987  contracted to do so by a county or when directly responsible for 
988  licensing in a county which fails to meet or exceed state 
989  minimum standards. 
990         Section 29. Subsections (2), (3), and (7) of section 
991  402.40, Florida Statutes, are amended to read: 
992         402.40 Child welfare training.— 
993         (2) DEFINITIONS.—As used in this section, the term: 
994         (a) “Child welfare certification” means a professional 
995  credential awarded by the department or by a credentialing 
996  entity recognized by the department to individuals demonstrating 
997  core competency in any child welfare services practice area. 
998         (b) “Child welfare services” means any intake, protective 
999  investigations, preprotective services, protective services, 
1000  foster care, shelter and group care, and adoption and related 
1001  services program, including supportive services, supervision, 
1002  and legal services, provided to children who are alleged to have 
1003  been abused, abandoned, or neglected, or who are at risk of 
1004  becoming, are alleged to be, or have been found dependent 
1005  pursuant to chapter 39. 
1006         (c) “Core competency” means the knowledge, skills, and 
1007  abilities necessary to carry out work responsibilities. 
1008         (d)(b) “Person providing child welfare services” means a 
1009  person who has a responsibility for supervisory, legal, direct 
1010  care or support related work in the provision of child welfare 
1011  services pursuant to chapter 39. 
1012         (3) CHILD WELFARE TRAINING PROGRAM.—The department shall 
1013  establish a program for training pursuant to the provisions of 
1014  this section, and all persons providing child welfare services 
1015  shall be required to demonstrate core competency by earning and 
1016  maintaining a department or third-party-awarded child welfare 
1017  certification and participate in and successfully complete the 
1018  program of training pertinent to their areas of responsibility. 
1019         (7) CERTIFICATION AND TRAINER QUALIFICATIONS.—The 
1020  department shall, in collaboration with the professionals and 
1021  providers described in subsection (5), develop minimum standards 
1022  for a certification process that ensures that participants have 
1023  successfully attained the knowledge, skills, and abilities 
1024  necessary to competently carry out their work responsibilities. 
1025  The department shall recognize third-party certification for 
1026  child welfare services staff which satisfies the core 
1027  competencies and meets the certification requirements 
1028  established in this section and shall develop minimum standards 
1029  for trainer qualifications which must be required of training 
1030  academies in the offering of the training curricula. Any person 
1031  providing child welfare services shall be required to master the 
1032  core competencies and hold an active child welfare certification 
1033  components of the curriculum that is are particular to that 
1034  person’s work responsibilities. 
1035         Section 30. Subsection (2) of section 402.49, Florida 
1036  Statutes, is amended to read: 
1037         402.49 Mediation process established.— 
1038         (2)(a) The department shall appoint at least one mediation 
1039  panel in each of the department’s circuits service districts. 
1040  Each panel shall have at least three and not more than five 
1041  members and shall include a representative from the department, 
1042  a representative of an agency that provides similar services to 
1043  those provided by the agency that is a party to the dispute, and 
1044  additional members who are mutually acceptable to the department 
1045  and the agency that is a party to the dispute. Such additional 
1046  members may include laypersons who are involved in advocacy 
1047  organizations, members of boards of directors of agencies 
1048  similar to the agency that is a party to the dispute, members of 
1049  families of department clients, members of department planning 
1050  councils in the area of services that are the subject of the 
1051  dispute, and interested and informed members of the local 
1052  community. 
1053         (b) If the parties to the conflict agree, a mediation panel 
1054  may hear a complaint that is filed outside of the panel’s 
1055  circuit service district. 
1056         Section 31. Subsection (3) of section 409.152, Florida 
1057  Statutes, is amended to read: 
1058         409.152 Service integration and family preservation.— 
1059         (3) Each circuit service district of the department shall 
1060  develop a family preservation service integration plan that 
1061  identifies various programs that can be organized at the point 
1062  of service delivery into a logical and cohesive family-centered 
1063  services constellation. The plan shall include: 
1064         (a) Goals and objectives for integrating services for 
1065  families and avoiding barriers to service integration, 
1066  procedures for centralized intake and assessment, a 
1067  comprehensive service plan for each family, and an evaluation 
1068  method of program outcome. 
1069         (b) Recommendations for proposed changes to fiscal and 
1070  substantive policies, regulations, and laws at local, circuit 
1071  district, and state delivery levels, including budget and 
1072  personnel policies; purchasing flexibility and workforce 
1073  incentives; discretionary resources; and incentives to reduce 
1074  dependency on government programs and services. 
1075         (c) Strategies for creating partnerships with the 
1076  community, clients, and consumers of services which establish, 
1077  maintain, and preserve family units. 
1078         Section 32. Paragraph (e) of subsection (1) and subsection 
1079  (8) of section 409.1671, Florida Statutes, are amended, and 
1080  paragraph (m) is added to subsection (1) of that section, to 
1081  read: 
1082         409.1671 Foster care and related services; outsourcing.— 
1083         (1) 
1084         (e) As used in this section, the term “eligible lead 
1085  community-based provider” means a single agency with which the 
1086  department contracts shall contract for the provision of child 
1087  protective services in a community that is no smaller than a 
1088  county. The secretary of the department may authorize more than 
1089  one eligible lead community-based provider within a single 
1090  county if it when to do so will result in more effective 
1091  delivery of foster care and related services. To compete for an 
1092  outsourcing project, such agency must have: 
1093         1. The ability to coordinate, integrate, and manage all 
1094  child protective services in the designated community in 
1095  cooperation with child protective investigations. 
1096         2. The ability to ensure continuity of care from entry to 
1097  exit for all children referred from the protective investigation 
1098  and court systems. 
1099         3. The ability to provide directly, or contract for through 
1100  a local network of providers, for all necessary child protective 
1101  services. Such agencies should directly provide no more than 35 
1102  percent of all child protective services provided. 
1103         4. The willingness to be accountable accept accountability 
1104  for meeting the outcomes and performance standards related to 
1105  child protective services established by the Legislature and the 
1106  Federal Government. 
1107         5. The capability and the willingness to serve all children 
1108  referred to it from the protective investigation and court 
1109  systems, regardless of the level of funding allocated to the 
1110  community by the state if, provided all related funding is 
1111  transferred. 
1112         6. The willingness to ensure that each individual who 
1113  provides child protective services completes the training 
1114  required of child protective service workers by the Department 
1115  of Children and Family Services. 
1116         7. The ability to maintain eligibility to receive all 
1117  federal child welfare funds, including Title IV-E and IV-A 
1118  funds, currently being used by the Department of Children and 
1119  Family Services. 
1120         8. Written agreements with Healthy Families Florida lead 
1121  entities in their community, pursuant to s. 409.153, to promote 
1122  cooperative planning for the provision of prevention and 
1123  intervention services. 
1124         9. A board of directors, of which at least 51 percent of 
1125  the membership is comprised of persons residing in this state. 
1126  Of the state residents, at least 51 percent must also reside 
1127  within the service area of the eligible lead community-based 
1128  provider. 
1129         (m) In order to ensure an efficient and effective 
1130  community-based care system, the department shall annually 
1131  evaluate each lead agency’s success in developing an effective 
1132  network of local providers, improving the coordination and 
1133  delivery of services to children, and investing appropriated 
1134  funds into the community for direct services to children and 
1135  families. 
1136         (8) Notwithstanding the provisions of s. 215.425, all 
1137  documented federal funds earned for the current fiscal year by 
1138  the department and community-based agencies which exceed the 
1139  amount appropriated by the Legislature shall be distributed to 
1140  all entities that contributed to the excess earnings based on a 
1141  schedule and methodology developed by the department and 
1142  approved by the Executive Office of the Governor. Distribution 
1143  shall be pro rata based on total earnings and shall be made only 
1144  to those entities that contributed to excess earnings. Excess 
1145  earnings of community-based agencies shall be used only in the 
1146  circuit service district in which they were earned. Additional 
1147  state funds appropriated by the Legislature for community-based 
1148  agencies or made available pursuant to the budgetary amendment 
1149  process described in s. 216.177 shall be transferred to the 
1150  community-based agencies. The department shall amend a 
1151  community-based agency’s contract to permit expenditure of the 
1152  funds. 
1153         Section 33. Section 409.1685, Florida Statutes, is amended 
1154  to read: 
1155         409.1685 Children in foster care; annual report to 
1156  Legislature.—The Department of Children and Family Services 
1157  shall submit a written report to the substantive committees of 
1158  the Legislature concerning the status of children in foster care 
1159  and concerning the judicial review mandated by part IX X of 
1160  chapter 39. This report shall be submitted by March 1 of each 
1161  year and shall include the following information for the prior 
1162  calendar year: 
1163         (1) The number of 6-month and annual judicial reviews 
1164  completed during that period. 
1165         (2) The number of children in foster care returned to a 
1166  parent, guardian, or relative as a result of a 6-month or annual 
1167  judicial review hearing during that period. 
1168         (3) The number of termination of parental rights 
1169  proceedings instituted during that period including which shall 
1170  include: 
1171         (a) The number of termination of parental rights 
1172  proceedings initiated pursuant to former s. 39.703; and 
1173         (b) The total number of terminations of parental rights 
1174  ordered. 
1175         (4) The number of foster care children placed for adoption 
1176  during that period. 
1177         Section 34. Paragraph (a) of subsection (4) of section 
1178  409.1755, Florida Statutes, is amended to read: 
1179         409.1755 One Church, One Child of Florida Corporation Act; 
1180  creation; duties.— 
1181         (4) BOARD OF DIRECTORS.— 
1182         (a) The One Church, One Child of Florida Corporation shall 
1183  operate subject to the supervision and approval of a board of 
1184  directors consisting of 21 23 members, with one two directors 
1185  representing each circuit service district of the Department of 
1186  Children and Families Family Services and one director who shall 
1187  be an at-large member. 
1188         Section 35. Paragraph (a) of subsection (1) and subsection 
1189  (2) of section 410.0245, Florida Statutes, are amended to read: 
1190         410.0245 Study of service needs; report; multiyear plan.— 
1191         (1)(a) The Adult Protection Services Program Office of the 
1192  Department of Children and Families Family Services shall 
1193  contract for a study of the service needs of the 18-to-59-year 
1194  old disabled adult population served or waiting to be served by 
1195  the community care for disabled adults program. The Division of 
1196  Vocational Rehabilitation of the Department of Education and 
1197  other appropriate state agencies shall provide information to 
1198  the Department of Children and Families Family Services when 
1199  requested for the purposes of this study. 
1200         (2) Based on the findings of the study, the Adult 
1201  Protection Services Program of the Department of Children and 
1202  Families Family Services shall develop a multiyear plan which 
1203  shall provide for the needs of disabled adults in this state and 
1204  shall provide strategies for statewide coordination of all 
1205  services for disabled adults. The multiyear plan shall include 
1206  an inventory of existing services and an analysis of costs 
1207  associated with existing and projected services. The multiyear 
1208  plan shall be presented to the Governor, the President of the 
1209  Senate, and the Speaker of the House of Representatives every 3 
1210  years on or before March 1, beginning in 1992. On or before 
1211  March 1 of each intervening year, the department shall submit an 
1212  analysis of the status of the implementation of each element of 
1213  the multiyear plan, any continued unmet need, and the 
1214  relationship between that need and the department’s budget 
1215  request for that year. 
1216         Section 36. Subsections (1) and (2) of section 410.603, 
1217  Florida Statutes, are renumbered as subsections (2) and (3), 
1218  respectively, and present subsection (3) of that section is 
1219  renumbered as subsection (1) and amended to read: 
1220         410.603 Definitions relating to Community Care for Disabled 
1221  Adults Act.—As used in ss. 410.601-410.606: 
1222         (1)(3) “Circuit District” means a specified geographic 
1223  service area that conforms to the judicial circuits established 
1224  in s. 26.021, as defined in s. 20.19, in which the programs of 
1225  the department are administered and services are delivered. 
1226         Section 37. Subsection (2) of section 410.604, Florida 
1227  Statutes, is amended to read: 
1228         410.604 Community care for disabled adults program; powers 
1229  and duties of the department.— 
1230         (2) Any person who meets the definition of a disabled adult 
1231  pursuant to s. 410.603(3)(2) is eligible to receive the services 
1232  of the community care for disabled adults program. However, the 
1233  community care for disabled adults program shall operate within 
1234  the funds appropriated by the Legislature. Priority shall be 
1235  given to disabled adults who are not eligible for comparable 
1236  services in programs of or funded by the department or the 
1237  Division of Vocational Rehabilitation of the Department of 
1238  Education; who are determined to be at risk of 
1239  institutionalization; and whose income is at or below the 
1240  existing institutional care program eligibility standard. 
1241         Section 38. Section 411.224, Florida Statutes, is amended 
1242  to read: 
1243         411.224 Family support planning process.—The Legislature 
1244  establishes a family support planning process to be used by the 
1245  Department of Children and Families Family Services as the 
1246  service planning process for targeted individuals, children, and 
1247  families under its purview. 
1248         (1) The Department of Education shall take all appropriate 
1249  and necessary steps to encourage and facilitate the 
1250  implementation of the family support planning process for 
1251  individuals, children, and families within its purview. 
1252         (2) To the extent possible within existing resources, the 
1253  following populations must be included in the family support 
1254  planning process: 
1255         (a) Children from birth to age 5 who are served by the 
1256  clinic and programs of the Division of Children’s Medical 
1257  Services of the Department of Health. 
1258         (b) Children participating in the developmental evaluation 
1259  and intervention program of the Division of Children’s Medical 
1260  Services of the Department of Health. 
1261         (c) Children from age 3 through age 5 who are served by the 
1262  Agency for Persons with Disabilities. 
1263         (d) Children from birth through age 5 who are served by the 
1264  Mental Health Program Office of the Department of Children and 
1265  Families Family Services. 
1266         (e) Participants who are served by the Children’s Early 
1267  Investment Program established in s. 411.232. 
1268         (f) Healthy Start participants in need of ongoing service 
1269  coordination. 
1270         (g) Children from birth through age 5 who are served by the 
1271  voluntary family services, protective supervision, foster care, 
1272  or adoption and related services programs of the Child Care 
1273  Licensure Services Program Office of the Department of Children 
1274  and Families Family Services, and who are eligible for ongoing 
1275  services from one or more other programs or agencies that 
1276  participate in family support planning; however, children served 
1277  by the voluntary family services program, where the planned 
1278  length of intervention is 30 days or less, are excluded from 
1279  this population. 
1280         (3) When individuals included in the target population are 
1281  served by Head Start, local education agencies, or other 
1282  prevention and early intervention programs, providers must be 
1283  notified and efforts made to facilitate the concerned agency’s 
1284  participation in family support planning. 
1285         (4) Local education agencies are encouraged to use a family 
1286  support planning process for children from birth through 5 years 
1287  of age who are served by the prekindergarten program for 
1288  children with disabilities, in lieu of the Individual Education 
1289  Plan. 
1290         (5) There must be only a single-family support plan to 
1291  address the problems of the various family members unless the 
1292  family requests that an individual family support plan be 
1293  developed for different members of that family. The family 
1294  support plan must replace individual habilitation plans for 
1295  children from 3 through 5 years old who are served by the Agency 
1296  for Persons with Disabilities. 
1297         (6) The family support plan at a minimum must include the 
1298  following information: 
1299         (a) The family’s statement of family concerns, priorities, 
1300  and resources. 
1301         (b) Information related to the health, educational, 
1302  economic and social needs, and overall development of the 
1303  individual and the family. 
1304         (c) The outcomes that the plan is intended to achieve. 
1305         (d) Identification of the resources and services to achieve 
1306  each outcome projected in the plan. These resources and services 
1307  are to be provided based on availability and funding. 
1308         (7) A family support plan meeting must be held with the 
1309  family to initially develop the family support plan and annually 
1310  thereafter to update the plan as necessary. The family includes 
1311  anyone who has an integral role in the life of the individual or 
1312  child as identified by the individual or family. The family 
1313  support plan must be reviewed periodically during the year, at 
1314  least at 6-month intervals, to modify and update the plan as 
1315  needed. Such periodic reviews do not require a family support 
1316  plan team meeting but may be accomplished through other means 
1317  such as a case file review and telephone conference with the 
1318  family. 
1319         (8) The initial family support plan must be developed 
1320  within a 90-day period. If exceptional circumstances make it 
1321  impossible to complete the evaluation activities and to hold the 
1322  initial family support plan team meeting within a reasonable 
1323  time period, these circumstances must be documented, and the 
1324  individual or family must be notified of the reason for the 
1325  delay. With the agreement of the family and the provider, 
1326  services for which either the individual or the family is 
1327  eligible may be initiated before the completion of the 
1328  evaluation activities and the family support plan. 
1329         (9) The Department of Children and Families Family 
1330  Services, the Department of Health, and the Department of 
1331  Education, to the extent that funds are available, must offer 
1332  technical assistance to communities to facilitate the 
1333  implementation of the family support plan. 
1334         (10) The Department of Children and Families Family 
1335  Services, the Department of Health, and the Department of 
1336  Education shall adopt rules necessary to implement this act. 
1337         Section 39. Section 414.24, Florida Statutes, is amended to 
1338  read: 
1339         414.24 Integrated welfare reform and child welfare 
1340  services.—The department shall develop integrated service 
1341  delivery strategies to better meet the needs of families subject 
1342  to work activity requirements who are involved in the child 
1343  welfare system or are at high risk of involvement in the child 
1344  welfare system. To the extent that resources are available, the 
1345  department and the Department of Labor and Employment Security 
1346  shall provide funds to one or more circuits service districts to 
1347  promote development of integrated, nonduplicative case 
1348  management within the department, the Department of Labor and 
1349  Employment Security, other participating government agencies, 
1350  and community partners. Alternative delivery systems shall be 
1351  encouraged which include well-defined, pertinent outcome 
1352  measures. Other factors to be considered shall include 
1353  innovation regarding training, enhancement of existing 
1354  resources, and increased private sector and business sector 
1355  participation. 
1356         Section 40. Subsection (8) of section 415.1113, Florida 
1357  Statutes, is amended to read: 
1358         415.1113 Administrative fines for false report of abuse, 
1359  neglect, or exploitation of a vulnerable adult.— 
1360         (8) All amounts collected under this section must be 
1361  deposited into the Operations and Maintenance Trust Fund within 
1362  the Adult Protection Services Program of the department. 
1363         Section 41. Subsections (1) through (3) of section 420.621, 
1364  Florida Statutes, are renumbered as subsections (2) through (4), 
1365  respectively, and present subsection (4) of that section is 
1366  renumbered as subsection (1) and amended to read: 
1367         420.621 Definitions.—As used in ss. 420.621-420.628, the 
1368  term: 
1369         (1)(4) “Circuit District” means a specified geographic 
1370  service area that conforms to the judicial circuits established 
1371  in s. 26.021 service district of the department, as set forth in 
1372  s. 20.19. 
1373         Section 42. Subsection (1) of section 420.622, Florida 
1374  Statutes, is amended to read: 
1375         420.622 State Office on Homelessness; Council on 
1376  Homelessness.— 
1377         (1) The State Office on Homelessness is created within the 
1378  Department of Children and Families Family Services to provide 
1379  interagency, council, and other related coordination on issues 
1380  relating to homelessness. An executive director of the office 
1381  shall be appointed by the Governor. 
1382         Section 43. Subsection (4) of section 420.623, Florida 
1383  Statutes, is amended to read: 
1384         420.623 Local coalitions for the homeless.— 
1385         (4) ANNUAL REPORTS.—The department shall submit to the 
1386  Governor, the Speaker of the House of Representatives, and the 
1387  President of the Senate, by June 30, an annual report consisting 
1388  of a compilation of data collected by local coalitions, progress 
1389  made in the development and implementation of local homeless 
1390  assistance continuums of care plans in each circuit district, 
1391  local spending plans, programs and resources available at the 
1392  local level, and recommendations for programs and funding. 
1393         Section 44. Subsections (4) through (8) of section 420.625, 
1394  Florida Statutes, are amended to read: 
1395         420.625 Grant-in-aid program.— 
1396         (4) APPLICATION PROCEDURE.—Local agencies shall submit an 
1397  application for grant-in-aid funds to the circuit district 
1398  administrator for review. During the first year of 
1399  implementation, circuit district administrators shall begin to 
1400  accept applications for circuit district funds no later than 
1401  October 1, 1988, and by August 1 of each year thereafter for 
1402  which funding for this section is provided. Circuit District 
1403  funds shall be made available to local agencies no more than 30 
1404  days after the deadline date for applications for each funding 
1405  cycle. 
1406         (5) SPENDING PLANS.—The department shall develop guidelines 
1407  for the development of spending plans and for the evaluation and 
1408  approval by circuit district administrators of spending plans, 
1409  based upon such factors as: 
1410         (a) The demonstrated level of need for the program. 
1411         (b) The demonstrated ability of the local agency or 
1412  agencies seeking assistance to deliver the services and to 
1413  assure that identified needs will be met. 
1414         (c) The ability of the local agency or agencies seeking 
1415  assistance to deliver a wide range of services as enumerated in 
1416  subsection (3). 
1417         (d) The adequacy and reasonableness of proposed budgets and 
1418  planned expenditures, and the demonstrated capacity of the local 
1419  agency or agencies to administer the funds sought. 
1420         (e) A statement from the local coalition for the homeless 
1421  as to the steps to be taken to assure coordination and 
1422  integration of services in the circuit district to avoid 
1423  unnecessary duplication and costs. 
1424         (f) Assurances by the local coalition for the homeless that 
1425  alternative funding strategies for meeting needs through the 
1426  reallocation of existing resources, utilization of volunteers, 
1427  and local government or private agency funding have been 
1428  explored. 
1429         (g) The existence of an evaluation component designed to 
1430  measure program outcomes and determine the overall effectiveness 
1431  of the local programs for the homeless for which funding is 
1432  sought. 
1433         (6) ALLOCATION OF GRANT FUNDS TO CIRCUITS DISTRICTS.—State 
1434  grant-in-aid funds for local initiatives for the homeless shall 
1435  be allocated by the department to, and administered by, 
1436  department circuits districts. Allocations shall be based upon 
1437  sufficient documentation of: 
1438         (a) The magnitude of the problem of homelessness in the 
1439  circuit district, and the demonstrated level of unmet need for 
1440  services in the circuit district for those who are homeless or 
1441  are about to become homeless. 
1442         (b) A strong local commitment to seriously address the 
1443  problem of homelessness as evidenced by coordinated programs 
1444  involving preventive, emergency, and transitional services and 
1445  by the existence of active local organizations committed to 
1446  serving those who have become, or are about to become, homeless. 
1447         (c) Agreement by local government and private agencies 
1448  currently serving the homeless not to reduce current 
1449  expenditures for services presently provided to those who are 
1450  homeless or are about to become homeless if grant assistance is 
1451  provided pursuant to this section. 
1452         (d) Geographic distribution of circuit district programs to 
1453  ensure that such programs serve both rural and urban areas, as 
1454  needed. 
1455         (7) DISTRIBUTION TO LOCAL AGENCIES.—Circuit District funds 
1456  so allocated shall be available for distribution by the circuit 
1457  district administrator to local agencies to fund programs such 
1458  as those set forth in subsection (3), based upon the 
1459  recommendations of the local coalitions in accordance with 
1460  spending plans developed by the coalitions and approved by the 
1461  circuit district administrator. Not more than 10 percent of the 
1462  total state funds awarded under a spending plan may be used by 
1463  the local coalition for staffing and administration. 
1464         (8) LOCAL MATCHING FUNDS.—Entities contracting to provide 
1465  services through financial assistance obtained under this 
1466  section shall provide a minimum of 25 percent of the funding 
1467  necessary for the support of project operations. In-kind 
1468  contributions, whether materials, commodities, transportation, 
1469  office space, other types of facilities, or personal services, 
1470  and contributions of money or services from homeless persons may 
1471  be evaluated and counted as part or all of this required local 
1472  funding, in the discretion of the circuit district 
1473  administrator. 
1474         Section 45. Subsection (2) of section 429.35, Florida 
1475  Statutes, is amended to read: 
1476         429.35 Maintenance of records; reports.— 
1477         (2) Within 60 days after the date of the biennial 
1478  inspection visit required under s. 408.811 or within 30 days 
1479  after the date of any interim visit, the agency shall forward 
1480  the results of the inspection to the local ombudsman council in 
1481  whose planning and service area, as defined in part II of 
1482  chapter 400, the facility is located; to at least one public 
1483  library or, in the absence of a public library, the county seat 
1484  in the county in which the inspected assisted living facility is 
1485  located; and, when appropriate, to the circuit district Adult 
1486  Protection Services and Mental Health Program Offices. 
1487         Section 46. Paragraph (d) of subsection (3) of section 
1488  1002.67, Florida Statutes, is amended to read: 
1489         1002.67 Performance standards; curricula and 
1490  accountability.— 
1491         (3) 
1492         (d) Each early learning coalition, the Agency for Workforce 
1493  Innovation, and the department shall coordinate with the Child 
1494  Care Licensure Services Program Office of the Department of 
1495  Children and Families Family Services to minimize interagency 
1496  duplication of activities for monitoring private prekindergarten 
1497  providers for compliance with requirements of the Voluntary 
1498  Prekindergarten Education Program under this part, the school 
1499  readiness programs under s. 411.01, and the licensing of 
1500  providers under ss. 402.301-402.319. 
1501         Section 47. Sections 39.311, 39.312, 39.313, 39.314, 
1502  39.315, 39.316, 39.317, 39.318, 394.9083, and 402.35, Florida 
1503  Statutes, are repealed. 
1504         Section 48. Subsection (3) of section 39.407, Florida 
1505  Statutes, is amended to read: 
1506         39.407 Medical, psychiatric, and psychological examination 
1507  and treatment of child; physical, mental, or substance abuse 
1508  examination of person with or requesting child custody.— 
1509         (3)(a) All children placed in out-of-home care shall be 
1510  provided with a comprehensive behavioral health assessment. The 
1511  child protective investigator or dependency case manager shall 
1512  submit a referral for such assessment within 7 days after the 
1513  child is placed in out-of-home care. 
1514         (b) Any child who has been in out-of-home care for more 
1515  than 1 year, or who did not receive a comprehensive behavioral 
1516  health assessment when placed into out-of-home care, is eligible 
1517  to receive a comprehensive behavioral health assessment. Such 
1518  assessments evaluate behaviors that give rise to the concern 
1519  that the child has unmet mental health needs. Any party to the 
1520  dependency proceeding, or the court on its own motion, may 
1521  request that an assessment be performed. 
1522         (c) The child protective investigator or dependency case 
1523  manager is responsible for ensuring that all recommendations in 
1524  the comprehensive behavioral health assessment are incorporated 
1525  into the child’s case plan and that the recommended services are 
1526  provided in a timely manner. If, at a case planning conference, 
1527  a determination is made that a specific recommendation should 
1528  not be included in a child’s case plan, a written explanation 
1529  must be provided to the court as to why the recommendation is 
1530  not being followed. 
1531         (d) This subsection does not to prevent a child from 
1532  receiving any other form of psychological assessment if needed. 
1533         (e) If it is determined that a child is in need of mental 
1534  health services, the comprehensive behavioral health assessment 
1535  must be provided to the physician involved in developing the 
1536  child’s mental health treatment plan, pursuant to s. 39.4071(9). 
1537         (3)(a)1. Except as otherwise provided in subparagraph (b)1. 
1538  or paragraph (e), before the department provides psychotropic 
1539  medications to a child in its custody, the prescribing physician 
1540  shall attempt to obtain express and informed consent, as defined 
1541  in s. 394.455(9) and as described in s. 394.459(3)(a), from the 
1542  child’s parent or legal guardian. The department must take steps 
1543  necessary to facilitate the inclusion of the parent in the 
1544  child’s consultation with the physician. However, if the 
1545  parental rights of the parent have been terminated, the parent’s 
1546  location or identity is unknown or cannot reasonably be 
1547  ascertained, or the parent declines to give express and informed 
1548  consent, the department may, after consultation with the 
1549  prescribing physician, seek court authorization to provide the 
1550  psychotropic medications to the child. Unless parental rights 
1551  have been terminated and if it is possible to do so, the 
1552  department shall continue to involve the parent in the 
1553  decisionmaking process regarding the provision of psychotropic 
1554  medications. If, at any time, a parent whose parental rights 
1555  have not been terminated provides express and informed consent 
1556  to the provision of a psychotropic medication, the requirements 
1557  of this section that the department seek court authorization do 
1558  not apply to that medication until such time as the parent no 
1559  longer consents. 
1560         2. Any time the department seeks a medical evaluation to 
1561  determine the need to initiate or continue a psychotropic 
1562  medication for a child, the department must provide to the 
1563  evaluating physician all pertinent medical information known to 
1564  the department concerning that child. 
1565         (b)1. If a child who is removed from the home under s. 
1566  39.401 is receiving prescribed psychotropic medication at the 
1567  time of removal and parental authorization to continue providing 
1568  the medication cannot be obtained, the department may take 
1569  possession of the remaining medication and may continue to 
1570  provide the medication as prescribed until the shelter hearing, 
1571  if it is determined that the medication is a current 
1572  prescription for that child and the medication is in its 
1573  original container. 
1574         2. If the department continues to provide the psychotropic 
1575  medication to a child when parental authorization cannot be 
1576  obtained, the department shall notify the parent or legal 
1577  guardian as soon as possible that the medication is being 
1578  provided to the child as provided in subparagraph 1. The child’s 
1579  official departmental record must include the reason parental 
1580  authorization was not initially obtained and an explanation of 
1581  why the medication is necessary for the child’s well-being. 
1582         3. If the department is advised by a physician licensed 
1583  under chapter 458 or chapter 459 that the child should continue 
1584  the psychotropic medication and parental authorization has not 
1585  been obtained, the department shall request court authorization 
1586  at the shelter hearing to continue to provide the psychotropic 
1587  medication and shall provide to the court any information in its 
1588  possession in support of the request. Any authorization granted 
1589  at the shelter hearing may extend only until the arraignment 
1590  hearing on the petition for adjudication of dependency or 28 
1591  days following the date of removal, whichever occurs sooner. 
1592         4. Before filing the dependency petition, the department 
1593  shall ensure that the child is evaluated by a physician licensed 
1594  under chapter 458 or chapter 459 to determine whether it is 
1595  appropriate to continue the psychotropic medication. If, as a 
1596  result of the evaluation, the department seeks court 
1597  authorization to continue the psychotropic medication, a motion 
1598  for such continued authorization shall be filed at the same time 
1599  as the dependency petition, within 21 days after the shelter 
1600  hearing. 
1601         (c) Except as provided in paragraphs (b) and (e), the 
1602  department must file a motion seeking the court’s authorization 
1603  to initially provide or continue to provide psychotropic 
1604  medication to a child in its legal custody. The motion must be 
1605  supported by a written report prepared by the department which 
1606  describes the efforts made to enable the prescribing physician 
1607  to obtain express and informed consent for providing the 
1608  medication to the child and other treatments considered or 
1609  recommended for the child. In addition, the motion must be 
1610  supported by the prescribing physician’s signed medical report 
1611  providing: 
1612         1. The name of the child, the name and range of the dosage 
1613  of the psychotropic medication, and that there is a need to 
1614  prescribe psychotropic medication to the child based upon a 
1615  diagnosed condition for which such medication is being 
1616  prescribed. 
1617         2. A statement indicating that the physician has reviewed 
1618  all medical information concerning the child which has been 
1619  provided. 
1620         3. A statement indicating that the psychotropic medication, 
1621  at its prescribed dosage, is appropriate for treating the 
1622  child’s diagnosed medical condition, as well as the behaviors 
1623  and symptoms the medication, at its prescribed dosage, is 
1624  expected to address. 
1625         4. An explanation of the nature and purpose of the 
1626  treatment; the recognized side effects, risks, and 
1627  contraindications of the medication; drug-interaction 
1628  precautions; the possible effects of stopping the medication; 
1629  and how the treatment will be monitored, followed by a statement 
1630  indicating that this explanation was provided to the child if 
1631  age appropriate and to the child’s caregiver. 
1632         5. Documentation addressing whether the psychotropic 
1633  medication will replace or supplement any other currently 
1634  prescribed medications or treatments; the length of time the 
1635  child is expected to be taking the medication; and any 
1636  additional medical, mental health, behavioral, counseling, or 
1637  other services that the prescribing physician recommends. 
1638         (d)1. The department must notify all parties of the 
1639  proposed action taken under paragraph (c) in writing or by 
1640  whatever other method best ensures that all parties receive 
1641  notification of the proposed action within 48 hours after the 
1642  motion is filed. If any party objects to the department’s 
1643  motion, that party shall file the objection within 2 working 
1644  days after being notified of the department’s motion. If any 
1645  party files an objection to the authorization of the proposed 
1646  psychotropic medication, the court shall hold a hearing as soon 
1647  as possible before authorizing the department to initially 
1648  provide or to continue providing psychotropic medication to a 
1649  child in the legal custody of the department. At such hearing 
1650  and notwithstanding s. 90.803, the medical report described in 
1651  paragraph (c) is admissible in evidence. The prescribing 
1652  physician need not attend the hearing or testify unless the 
1653  court specifically orders such attendance or testimony, or a 
1654  party subpoenas the physician to attend the hearing or provide 
1655  testimony. If, after considering any testimony received, the 
1656  court finds that the department’s motion and the physician’s 
1657  medical report meet the requirements of this subsection and that 
1658  it is in the child’s best interests, the court may order that 
1659  the department provide or continue to provide the psychotropic 
1660  medication to the child without additional testimony or 
1661  evidence. At any hearing held under this paragraph, the court 
1662  shall further inquire of the department as to whether additional 
1663  medical, mental health, behavioral, counseling, or other 
1664  services are being provided to the child by the department which 
1665  the prescribing physician considers to be necessary or 
1666  beneficial in treating the child’s medical condition and which 
1667  the physician recommends or expects to provide to the child in 
1668  concert with the medication. The court may order additional 
1669  medical consultation, including consultation with the MedConsult 
1670  line at the University of Florida, if available, or require the 
1671  department to obtain a second opinion within a reasonable 
1672  timeframe as established by the court, not to exceed 21 calendar 
1673  days, after such order based upon consideration of the best 
1674  interests of the child. The department must make a referral for 
1675  an appointment for a second opinion with a physician within 1 
1676  working day. The court may not order the discontinuation of 
1677  prescribed psychotropic medication if such order is contrary to 
1678  the decision of the prescribing physician unless the court first 
1679  obtains an opinion from a licensed psychiatrist, if available, 
1680  or, if not available, a physician licensed under chapter 458 or 
1681  chapter 459, stating that more likely than not, discontinuing 
1682  the medication would not cause significant harm to the child. 
1683  If, however, the prescribing psychiatrist specializes in mental 
1684  health care for children and adolescents, the court may not 
1685  order the discontinuation of prescribed psychotropic medication 
1686  unless the required opinion is also from a psychiatrist who 
1687  specializes in mental health care for children and adolescents. 
1688  The court may also order the discontinuation of prescribed 
1689  psychotropic medication if a child’s treating physician, 
1690  licensed under chapter 458 or chapter 459, states that 
1691  continuing the prescribed psychotropic medication would cause 
1692  significant harm to the child due to a diagnosed nonpsychiatric 
1693  medical condition. 
1694         2. The burden of proof at any hearing held under this 
1695  paragraph shall be by a preponderance of the evidence. 
1696         (e)1. If the child’s prescribing physician certifies in the 
1697  signed medical report required in paragraph (c) that delay in 
1698  providing a prescribed psychotropic medication would more likely 
1699  than not cause significant harm to the child, the medication may 
1700  be provided in advance of the issuance of a court order. In such 
1701  event, the medical report must provide the specific reasons why 
1702  the child may experience significant harm and the nature and the 
1703  extent of the potential harm. The department must submit a 
1704  motion seeking continuation of the medication and the 
1705  physician’s medical report to the court, the child’s guardian ad 
1706  litem, and all other parties within 3 working days after the 
1707  department commences providing the medication to the child. The 
1708  department shall seek the order at the next regularly scheduled 
1709  court hearing required under this chapter, or within 30 days 
1710  after the date of the prescription, whichever occurs sooner. If 
1711  any party objects to the department’s motion, the court shall 
1712  hold a hearing within 7 days. 
1713         2. Psychotropic medications may be administered in advance 
1714  of a court order in hospitals, crisis stabilization units, and 
1715  in statewide inpatient psychiatric programs. Within 3 working 
1716  days after the medication is begun, the department must seek 
1717  court authorization as described in paragraph (c). 
1718         (f)1. The department shall fully inform the court of the 
1719  child’s medical and behavioral status as part of the social 
1720  services report prepared for each judicial review hearing held 
1721  for a child for whom psychotropic medication has been prescribed 
1722  or provided under this subsection. As a part of the information 
1723  provided to the court, the department shall furnish copies of 
1724  all pertinent medical records concerning the child which have 
1725  been generated since the previous hearing. On its own motion or 
1726  on good cause shown by any party, including any guardian ad 
1727  litem, attorney, or attorney ad litem who has been appointed to 
1728  represent the child or the child’s interests, the court may 
1729  review the status more frequently than required in this 
1730  subsection. 
1731         2. The court may, in the best interests of the child, order 
1732  the department to obtain a medical opinion addressing whether 
1733  the continued use of the medication under the circumstances is 
1734  safe and medically appropriate. 
1735         (g) The department shall adopt rules to ensure that 
1736  children receive timely access to clinically appropriate 
1737  psychotropic medications. These rules must include, but need not 
1738  be limited to, the process for determining which adjunctive 
1739  services are needed, the uniform process for facilitating the 
1740  prescribing physician’s ability to obtain the express and 
1741  informed consent of a child’s parent or guardian, the procedures 
1742  for obtaining court authorization for the provision of a 
1743  psychotropic medication, the frequency of medical monitoring and 
1744  reporting on the status of the child to the court, how the 
1745  child’s parents will be involved in the treatment-planning 
1746  process if their parental rights have not been terminated, and 
1747  how caretakers are to be provided information contained in the 
1748  physician’s signed medical report. The rules must also include 
1749  uniform forms to be used in requesting court authorization for 
1750  the use of a psychotropic medication and provide for the 
1751  integration of each child’s treatment plan and case plan. The 
1752  department must begin the formal rulemaking process within 90 
1753  days after the effective date of this act. 
1754         Section 49. Section 39.4071, Florida Statutes, is created 
1755  to read: 
1756         39.4071 Use of psychotropic medication for children in out 
1757  of-home placement.— 
1758         (1) LEGISLATIVE FINDINGS AND INTENT.— 
1759         (a) The Legislature finds that children in out-of-home 
1760  placements often have multiple risk factors that predispose them 
1761  to emotional and behavioral disorders and that they receive 
1762  mental health services at higher rates and are more likely to be 
1763  given psychotropic medications than children from comparable 
1764  backgrounds. 
1765         (b) The Legislature also finds that the use of psychotropic 
1766  medications for the treatment of children in out-of-home 
1767  placements who have emotional and behavioral disturbances has 
1768  increased over recent years. While the increased use of 
1769  psychotropic medications is paralleled by an increase in the 
1770  rate of the coadministration of two or more psychotropic 
1771  medications, data on the safety and efficacy of many of the 
1772  psychotropic medications used in children and research 
1773  supporting the coadministration of two or more psychotropic 
1774  medications in this population is limited. 
1775         (c) The Legislature further finds that significant 
1776  challenges are encountered in providing quality mental health 
1777  care to children in out-of-home placements. Not uncommonly, 
1778  children in out-of-home placements are subjected to multiple 
1779  placements and many service providers, with communication 
1780  between providers often poor, resulting in fragmented medical 
1781  and mental health care. The dependable, ongoing therapeutic and 
1782  caregiving relationships these children need are hampered by the 
1783  high turnover among child welfare caseworkers and care 
1784  providers. Furthermore, children in out-of-home placements, 
1785  unlike children from intact families, often have no consistent 
1786  interested party who is available to coordinate treatment and 
1787  monitoring plans or to provide longitudinal oversight of care. 
1788         (d) The Legislature recognizes the important role the 
1789  Guardian ad Litem Program has played in Florida’s dependency 
1790  system for the past 30 years serving the state’s most vulnerable 
1791  children through the use of trained volunteers, case 
1792  coordinators, child advocates and attorneys. The program’s 
1793  singular focus is on the child and its mission is to advocate 
1794  for the best interest of the child. It is often the guardian ad 
1795  litem who is the constant in a child’s life, maintaining 
1796  consistent contact with the child, the child’s caseworkers, and 
1797  others involved with the child, including family, doctors, 
1798  teachers, and service providers. Studies have shown that a child 
1799  assigned a guardian ad litem will, on average, experience fewer 
1800  placement changes than a child without a guardian ad litem. It 
1801  is therefore the intent of the Legislature that children in out 
1802  of-home placements who may benefit from psychotropic medications 
1803  receive those medications safely as part of a comprehensive 
1804  mental health treatment plan requiring the appointment of a 
1805  guardian ad litem whose responsibility is to monitor the plan 
1806  for compliance and suitability as to the child’s best interest. 
1807         (2) DEFINITIONS.—As used in this section, the term: 
1808         (a) “Behavior analysis” means services rendered by a 
1809  provider who is certified by the Behavior Analysis Certification 
1810  Board in accordance with chapter 393. 
1811         (b) “Obtaining assent” means a process by which a provider 
1812  of medical services helps a child achieve a developmentally 
1813  appropriate awareness of the nature of his or her condition, 
1814  informs the child of what can be expected through tests and 
1815  treatment, makes a clinical assessment of the child’s 
1816  understanding of the situation and the factors influencing how 
1817  he or she is responding, and solicits an expression of the 
1818  child’s willingness to adhere to the proposed care. The mere 
1819  absence of an objection by the child may not be construed as 
1820  assent. 
1821         (c) “Comprehensive behavioral health assessment” means an 
1822  in-depth and detailed assessment of the child’s emotional, 
1823  social, behavioral, and developmental functioning within the 
1824  family home, school, and community. A comprehensive behavioral 
1825  health assessment includes direct observation of the child in 
1826  the home, school, and community, as well as in the clinical 
1827  setting, and adheres to the requirements in the Florida Medicaid 
1828  Community Behavioral Health Services Coverage and Limitations 
1829  Handbook. 
1830         (d) “Express and informed consent” means a process by which 
1831  a provider of medical services obtains voluntary consent from a 
1832  parent whose rights have not been terminated or a legal guardian 
1833  of the child who has received full, accurate, and sufficient 
1834  information and an explanation about the child’s medical 
1835  condition, medication, and treatment in order to enable the 
1836  parent or guardian to make a knowledgeable decision without any 
1837  element of fraud, deceit, duress, or other form of coercion. 
1838         (e) “Mental health treatment plan” means a plan that lists 
1839  the particular mental health needs of the child and the services 
1840  that will be provided to address those needs. If the plan 
1841  includes prescribing psychotropic medication to a child in out 
1842  of-home placement, the plan must also include the information 
1843  required under subsection (9). 
1844         (f) “Psychotropic medication” means a prescription 
1845  medication that is used for the treatment of mental disorders 
1846  and includes, without limitation, hypnotics, antipsychotics, 
1847  antidepressants, antianxiety agents, sedatives, stimulants, and 
1848  mood stabilizers. 
1849         (3) APPOINTMENT OF GUARDIAN AD LITEM.— 
1850         (a) If not already appointed, a guardian ad litem shall be 
1851  appointed by the court at the earliest possible time to 
1852  represent the best interests of a child in out-of-home placement 
1853  who is prescribed a psychotropic medication or is being 
1854  evaluated for the initiation of psychotropic medication. 
1855  Pursuant to s. 39.820, the appointed guardian ad litem is a 
1856  party to any judicial proceeding as a representative of the 
1857  child and serves until discharged by the court. 
1858         (b) Pursuant to this section, the guardian ad litem shall 
1859  participate in the development of the mental health treatment 
1860  plan, monitor whether all requirements of the mental health 
1861  treatment plan are being provided to the child, including 
1862  counseling, behavior analysis, or other services, medications, 
1863  and treatment modalities; and notice the court of the child’s 
1864  objections, if any, to the mental health treatment plan. The 
1865  guardian ad litem shall prepare and submit to the court a 
1866  written report every 45 days or as directed by the court, 
1867  advising the court and the parties as to the status of the care, 
1868  health, and medical treatment of the child pursuant to the 
1869  mental health treatment plan and any change in the status of the 
1870  child. The guardian ad litem must immediately notify parties as 
1871  soon as a medical emergency of the child becomes known. The 
1872  guardian ad litem shall ensure that the prescribing physician 
1873  has been provided with all pertinent medical information 
1874  concerning the child. 
1875         (c) The department and the community-based care lead agency 
1876  shall notify the court and the guardian ad litem, and, if 
1877  applicable, the child’s attorney, in writing within 24 hours 
1878  after any change in the status of the child, including, but not 
1879  limited to, a change in placement, a change in school, a change 
1880  in medical condition or medication, or a change in prescribing 
1881  physician, other service providers, counseling, or treatment 
1882  scheduling. 
1883         (4) PSYCHIATRIC EVALUATION OF CHILD.—Whenever the 
1884  department believes that a child in its legal custody may need 
1885  psychiatric treatment, an evaluation must be conducted by a 
1886  physician licensed under chapter 458 or chapter 459. 
1887         (5) EXPRESS AND INFORMED CONSENT AND ASSENT.—If, at the 
1888  time of removal from his or her home, a child is being provided, 
1889  or at any time is being evaluated for the initiation of, 
1890  prescribed psychotropic medication under this section, express 
1891  and informed consent and assent shall be sought by the 
1892  prescribing physician. 
1893         (a) The prescribing physician shall obtain assent from the 
1894  child, unless the prescribing physician determines that it is 
1895  not appropriate. In making this assessment, the prescribing 
1896  physician shall consider the capacity of the child to make an 
1897  independent decision based on his or her age, maturity, and 
1898  psychological and emotional state. If the physician determines 
1899  that it is not appropriate, the physician must document the 
1900  decision in the mental health treatment plan. If the physician 
1901  determines it is appropriate and the child refuses to give 
1902  assent, the physician must document the child’s refusal in the 
1903  mental health treatment plan. 
1904         1. Assent from a child shall be sought in a manner that is 
1905  understandable to the child using a developmentally appropriate 
1906  assent form. The child shall be provided with sufficient 
1907  information, such as the nature and purpose of the medication, 
1908  how it will be administered, the probable risks and benefits, 
1909  alternative treatments and the risks and benefits thereof, and 
1910  the risks and benefits of refusing or discontinuing the 
1911  medication, and when it may be appropriately discontinued. 
1912  Assent may be oral or written and must be documented by the 
1913  prescribing physician. 
1914         2. Oral assent is appropriate for a child who is younger 
1915  than 7 years of age. Assent from a child who is 7 to 13 years of 
1916  age may be sought orally or in a simple form that is written at 
1917  the second-grade or third-grade reading level. A child who is 14 
1918  years of age or older may understand the language presented in 
1919  the consent form for parents or legal guardians. If so, the 
1920  child may sign the consent form along with the parent or legal 
1921  guardian. Forms for parents and older children shall be written 
1922  at the sixth grade to eighth-grade reading level. 
1923         3. In each case where assent is obtained, a copy of the 
1924  assent documents must be provided to the parent or legal 
1925  guardian and the guardian ad litem, with the original assent 
1926  documents becoming a part of the child’s mental health treatment 
1927  plan and filed with the court. 
1928         (b) Express and informed consent for the administration of 
1929  psychotropic medication may be given only by a parent whose 
1930  rights have not been terminated or a legal guardian of the child 
1931  who has received full, accurate, and sufficient information and 
1932  an explanation about the child’s medical condition, medication, 
1933  and treatment in order to enable the parent or guardian to make 
1934  a knowledgeable decision. A sufficient explanation includes, but 
1935  need not be limited to, the following information, which must be 
1936  provided and explained in plain language by the prescribing 
1937  physician to the parent or legal guardian: the child’s 
1938  diagnosis, the symptoms to be addressed by the medication, the 
1939  name of the medication and its dosage ranges, the reason for 
1940  prescribing it, and its purpose or intended results; benefits, 
1941  side effects, risks, and contraindications, including effects of 
1942  not starting or stopping the medication; method for 
1943  administering the medication and how it will monitored; 
1944  potential drug interactions; alternative treatments to 
1945  psychotropic medication; a plan to reduce or eliminate ongoing 
1946  medication when medically appropriate; the counseling, 
1947  behavioral analysis, or other services used to complement the 
1948  use of medication, if applicable; and that the parent or legal 
1949  guardian may revoke the consent at any time. 
1950         1. Express and informed consent may be oral or written and 
1951  must be documented by the prescribing physician. If the 
1952  department or the physician is unable to obtain consent from the 
1953  parent or legal guardian, the reasons must be documented. 
1954         2. If express and informed consent is obtained, a copy of 
1955  the consent documents must be provided to the parent or legal 
1956  guardian and the guardian ad litem, with the original consent 
1957  documents becoming a part of the child’s mental health treatment 
1958  plan and filed with the court. 
1959         (c) The informed consent of any parent whose whereabouts 
1960  are unknown for 60 days, who is adjudicated incapacitated, who 
1961  does not have regular and frequent contact with the child, who 
1962  later revokes assent, or whose parental rights are terminated 
1963  after giving consent, is invalid. If the informed consent of a 
1964  parent becomes invalid, the department may seek informed consent 
1965  from any other parent or legal guardian. If the informed consent 
1966  provided by a parent whose parental rights have been terminated 
1967  is invalid and no other parent or legal guardian gives informed 
1968  consent, the department shall file a motion for the 
1969  administration of psychotropic medication along with the motion 
1970  for final judgment of termination of parental rights. 
1971         (d) If consent is revoked or becomes invalid the department 
1972  shall immediately notify all parties and, if applicable, the 
1973  child’s attorney. Medication shall be continued until such time 
1974  as the court rules on the motion. 
1975         (e) A medication may not be discontinued without explicit 
1976  instruction from a physician as to how to safely discontinue the 
1977  medication. 
1978         (6) ADMINISTRATION OF PSYCHOTROPIC MEDICATION TO A CHILD IN 
1979  SHELTER CARE OR IN FOSTER CARE WHEN INFORMED CONSENT HAS NOT 
1980  BEEN OBTAINED.— 
1981         (a) Motion for court authorization for administration of 
1982  psychotropic medications. 
1983         1. If a physician who has evaluated the child prescribes 
1984  psychotropic medication as part of the mental health treatment 
1985  plan and the child’s parents or legal guardians have not 
1986  provided express and informed consent as provided by law or such 
1987  consent is invalid as set forth in paragraph (5)(c), the 
1988  department or its agent shall file a motion with the court 
1989  within 3 working days to authorize the administration of the 
1990  psychotropic medication before the administration of the 
1991  medication, except as provided in subsection (7). In each case 
1992  in which a motion is required, the motion must include: 
1993         a. A written report by the department describing the 
1994  efforts made to enable the prescribing physician to obtain 
1995  express and informed consent and describing other treatments 
1996  attempted, considered, and recommended for the child; and 
1997         b. The prescribing physician’s completed and signed mental 
1998  health treatment plan. 
1999         2. The department must file a copy of the motion with the 
2000  court and, within 48 hours after filing the motion, notify all 
2001  parties in writing, or by whatever other method best ensures 
2002  that all parties receive notification, of its proposed 
2003  administration of psychotropic medication to the child. 
2004         3. If any party objects to the proposed administration of 
2005  the psychotropic medication to the child, that party must file 
2006  its objection within 2 working days after being notified of the 
2007  department’s motion. A party may request an extension of time to 
2008  object for good cause shown if such extension would be in the 
2009  best interests of the child. Any extension must be for a 
2010  specific number of days not to exceed the time absolutely 
2011  necessary. 
2012         4. Lack of assent from the child is deemed a timely 
2013  objection from the child. 
2014         (b) Court action on motion for administration of 
2015  psychotropic medication. 
2016         1. If no party timely files an objection to the 
2017  department’s motion and the motion is legally sufficient, the 
2018  court may enter its order authorizing the proposed 
2019  administration of the psychotropic medication without a hearing. 
2020  Based on its determination of the best interests of the child, 
2021  the court may order additional medical consultation, including 
2022  consultation with the MedConsult line at the University of 
2023  Florida, if available, or require the department to obtain a 
2024  second opinion within a reasonable time established by the 
2025  court, not to exceed 21 calendar days. If the court orders an 
2026  additional medical consultation or second medical opinion, the 
2027  department shall file a written report including the results of 
2028  this additional consultation or a copy of the second medical 
2029  opinion with the court within the time required by the court, 
2030  and serve a copy of the report on all parties. 
2031         2. If any party timely files its objection to the proposed 
2032  administration of the psychotropic medication, the court shall 
2033  hold a hearing as soon as possible on the department’s motion. 
2034         a. The signed mental health treatment plan of the 
2035  prescribing physician is admissible in evidence at the hearing. 
2036         b. The court shall ask the department whether additional 
2037  medical, mental health, behavior analysis, counseling, or other 
2038  services are being provided to the child which the prescribing 
2039  physician considers to be necessary or beneficial in treating 
2040  the child’s medical condition and which the physician recommends 
2041  or expects to be provided to the child along with the 
2042  medication. 
2043         3. The court may order additional medical consultation or a 
2044  second medical opinion, as provided in this paragraph. 
2045         4. After considering the department’s motion and any 
2046  testimony received, the court may enter its order authorizing 
2047  the department to provide or continue to provide the proposed 
2048  psychotropic medication. The court must find a compelling 
2049  governmental interest that the proposed psychotropic medication 
2050  is in the child’s best interest. In so determining the court 
2051  shall, at a minimum, consider the following factors: 
2052         a. The severity and likelihood of risks associated with the 
2053  treatment. 
2054         b. The magnitude and likelihood of benefits expected from 
2055  the treatment. 
2056         c. The child’s prognosis without the proposed psychotropic 
2057  medication. 
2058         d. The availability and effectiveness of alternative 
2059  treatments. 
2060         e. The wishes of the child concerning treatment 
2061  alternatives. 
2062         f. The recommendation of the parents or legal guardian. 
2063         g. The recommendation of the guardian ad litem. 
2064         (7) ADMINISTRATION OF PSYCHOTROPIC MEDICATION TO A CHILD IN 
2065  OUT-OF-HOME CARE BEFORE COURT AUTHORIZATION HAS BEEN OBTAINED. 
2066  The department may provide continued administration of 
2067  psychotropic medication to a child before authorization by the 
2068  court has been obtained only as provided in this subsection. 
2069         (a) If a child is removed from the home and taken into 
2070  custody under s. 39.401, the department may continue to 
2071  administer a current prescription of psychotropic medication; 
2072  however, the department shall request court authorization for 
2073  the continued administration of the medication at the shelter 
2074  hearing. This request shall be included in the shelter petition. 
2075         1. The department shall provide all information in its 
2076  possession to the court in support of its request at the shelter 
2077  hearing. The court may authorize the continued administration of 
2078  the psychotropic medication only until the arraignment hearing 
2079  on the petition for adjudication, or for 28 days following the 
2080  date of the child’s removal, whichever occurs first. 
2081         2. If the department believes, based on the required 
2082  physician’s evaluation, that it is appropriate to continue the 
2083  psychotropic medication beyond the time authorized by the court 
2084  at the shelter hearing, the department shall file a motion 
2085  seeking continued court authorization at the same time that it 
2086  files the dependency petition, but within 21 days after the 
2087  shelter hearing. 
2088         (b) If the department believes, based on the certification 
2089  of the prescribing physician, that delay in providing the 
2090  prescribed psychotropic medication would, more likely than not, 
2091  cause significant harm to the child, the department shall 
2092  administer the medication immediately. The department must 
2093  submit a motion to the court seeking continuation of the 
2094  medication within 3 working days after the department begins 
2095  providing the medication to the child. 
2096         1. The motion seeking authorization for the continued 
2097  administration of the psychotropic medication must include all 
2098  information required in this section. The required medical 
2099  report must also include the specific reasons why the child may 
2100  experience significant harm, and the nature and the extent of 
2101  the potential harm, resulting from a delay in authorizing the 
2102  prescribed medication. 
2103         2. The department shall serve the motion on all parties 
2104  within 3 working days after the department begins providing the 
2105  medication to the child. 
2106         3. The court shall hear the department’s motion at the next 
2107  regularly scheduled court hearing required by law, or within 30 
2108  days after the date of the prescription, whichever occurs first. 
2109  However, if any party files an objection to the motion, the 
2110  court must hold a hearing within 7 days. 
2111         (c) The department may authorize, in advance of a court 
2112  order, the administration of psychotropic medications to a child 
2113  in its custody in a hospital, crisis stabilization unit or 
2114  receiving facility, therapeutic group home, or statewide 
2115  inpatient psychiatric program. If the department does so, it 
2116  must file a motion to seek court authorization for the continued 
2117  administration of the medication within 3 working days as 
2118  required in this section. 
2119         (d) If a child receives a one-time dose of a psychotropic 
2120  medication during a crisis, the department shall provide 
2121  immediate notice to all parties and to the court of each such 
2122  emergency use. 
2123         (8) DISCONTINUATION OR ALTERATION OF MEDICATION; 
2124  DESTRUCTION OF MEDICATION.—A party may not alter the provision 
2125  of prescribed psychotropic medication in any way except upon 
2126  order of the court or advice of a physician. 
2127         (a) On the motion of any party or its own motion, the court 
2128  may order the discontinuation of a medication already 
2129  prescribed. Such discontinuation must be performed in 
2130  consultation with a physician in such a manner as to minimize 
2131  risk to the child. 
2132         (b) The child’s repeated refusal to take or continue to 
2133  take a medication shall be treated as a motion to discontinue 
2134  the medication and shall be set for hearing as soon as possible 
2135  but within 7 days after knowledge of such repeated refusal. 
2136         (c) Upon any discontinuation of a medication, the 
2137  department shall document the date and reason for the 
2138  discontinuation and notify all parties. The guardian ad litem 
2139  must be notified within 24 hours as previously provided herein. 
2140         (d) The department shall ensure the destruction of any 
2141  medication no longer being taken by the prescribed child. 
2142         (9) DEVELOPMENT OF MENTAL HEALTH TREATMENT PLAN.—Upon the 
2143  determination that a child needs mental health services, a 
2144  mental health treatment plan must be developed which lists the 
2145  particular mental health needs of the child and the services 
2146  that will be provided to address those needs. If possible, the 
2147  plan shall be developed in a face-to-face conference with the 
2148  child, the child’s parents, case manager, physician, therapist, 
2149  legal guardian, guardian ad litem, and any other interested 
2150  party. The mental health treatment plan shall be incorporated 
2151  into the case plan as tasks for the department and may be 
2152  amended under s. 39.6013. 
2153         (a) If the mental health treatment plan involves the 
2154  provision of psychotropic medication, the plan must include: 
2155         1. The name of the child, a statement indicating that there 
2156  is a need to prescribe psychotropic medication based upon a 
2157  diagnosed condition for which there is an evidence base for the 
2158  medication that is being prescribed, a statement indicating the 
2159  compelling governmental interest in prescribing the psychotropic 
2160  medication, and the name and range of the dosage of the 
2161  psychotropic medication. 
2162         2. A statement indicating that the physician has reviewed 
2163  all medical information concerning the child which has been 
2164  provided by the department or community-based care lead agency 
2165  and briefly listing all information received. 
2166         3. A medication profile, including all medications the 
2167  child is prescribed or will be prescribed, any previously 
2168  prescribed medications if known, and whether those medications 
2169  are being added, continued, or discontinued upon implementation 
2170  of the mental health treatment plan. 
2171         4. A statement indicating that the psychotropic medication, 
2172  at its prescribed dosage, is appropriate for treating the 
2173  child’s diagnosed medical condition, as well as the behaviors 
2174  and symptoms that the medication, at its prescribed dosage, is 
2175  expected to address. 
2176         5. An explanation of the nature and purpose of the 
2177  treatment; the recognized side effects, risks, and 
2178  contraindications of the medication, including procedures for 
2179  reporting adverse effects; drug-interaction precautions; the 
2180  possible effects of stopping or not initiating the medication; 
2181  and how the treatment will be monitored, followed by a statement 
2182  indicating that this explanation was provided to the child if 
2183  developmentally appropriate and to the child’s caregiver. 
2184         6. Documentation addressing whether the psychotropic 
2185  medication will replace or supplement any other currently 
2186  prescribed medications or treatments; the length of time the 
2187  child is expected to be taking the medication; a plan for the 
2188  discontinuation of any medication if medically appropriate; and 
2189  any additional medical, mental health, behavioral, counseling, 
2190  or other services that the prescribing physician recommends as 
2191  part of a comprehensive treatment plan. 
2192         7. A document describing those observable behaviors 
2193  warranting psychotropic treatment, the means for obtaining 
2194  reliable frequency data on these same observable behaviors, and 
2195  the reporting of this data with sufficient frequency to support 
2196  medication decisions. 
2197         (b) The department shall develop and administer procedures 
2198  to require the caregiver and prescribing physician to report any 
2199  adverse side effects of the medication to the department or its 
2200  designee and the guardian ad litem. Any adverse side effects 
2201  must be documented in the mental health treatment plan and 
2202  medical records for the child. 
2203         (10) REVIEW FOR ADMINISTRATION OF PSYCHOTROPIC MEDICATION 
2204  FOR CHILDREN FROM BIRTH THROUGH 10 YEARS OF AGE IN OUT-OF-HOME 
2205  CARE.— 
2206         (a) Absent a finding of a compelling state interest, a 
2207  psychotropic medication may not be authorized by the court for 
2208  any child from birth through 10 years of age who is in out-of 
2209  home placement. Based on a finding of a compelling state 
2210  interest but before a psychotropic medication is authorized by 
2211  the court for such child, a review of the administration must be 
2212  obtained from a child psychiatrist who is licensed under chapter 
2213  458 or chapter 459. The results of this review must be provided 
2214  to the child and the parent or legal guardian before final 
2215  express and informed consent is given. 
2216         (b) In advance of a court order, the department may 
2217  authorize the administration of psychotropic medications to a 
2218  child from birth through 10 years of age in its custody in the 
2219  following levels of residential care: 
2220         1. Hospital; 
2221         2. Crisis stabilization unit or receiving facility; 
2222         3. Therapeutic group home; or 
2223         4. Statewide inpatient psychiatric program. 
2224 
2225  These levels of care demonstrate the requirement of a compelling 
2226  state interest through the extensive admission criteria being 
2227  met. If the department does so, it must file a motion to seek 
2228  court authorization for the continued administration of the 
2229  medication within 3 working days. 
2230         (c) If a child receives a one-time dose of a psychotropic 
2231  medication during a crisis, the department shall provide 
2232  immediate notice to all parties and to the court of each such 
2233  emergency use. 
2234         (11) CLINICAL TRIALS.—A child in the custody of the 
2235  department may not participate in a clinical trial that is 
2236  designed to develop new psychotropic medications or evaluate 
2237  their application to children. 
2238         (12) JUDICIAL REVIEW HEARINGS.—The department shall fully 
2239  inform the court of the child’s medical and behavioral status as 
2240  part of the social services report prepared for each judicial 
2241  review hearing held for a child for whom psychotropic medication 
2242  has been prescribed or provided under this subsection. As a part 
2243  of the information provided, the department shall furnish copies 
2244  of all pertinent medical records concerning the child which have 
2245  been generated since the previous hearing. On its own motion or 
2246  on good cause shown by any party, including any guardian ad 
2247  litem, attorney, or attorney ad litem who has been appointed to 
2248  represent the child or the child’s interests, the court may 
2249  review the status more frequently than required under this 
2250  subsection. 
2251         (13) ADOPTION OF RULES.—The department may adopt rules to 
2252  ensure that children receive timely access to mental health 
2253  services, including, but not limited to, clinically appropriate 
2254  psychotropic medications. These rules must include, but need not 
2255  be limited to, the process for determining which adjunctive 
2256  services are needed, the uniform process for facilitating the 
2257  prescribing physician’s ability to obtain the express and 
2258  informed consent of a child’s parent or legal guardian, the 
2259  procedures for obtaining court authorization for the provision 
2260  of a psychotropic medication, the frequency of medical 
2261  monitoring and reporting on the status of the child to the 
2262  court, how the child’s parents will be involved in the 
2263  treatment-planning process if their parental rights have not 
2264  been terminated, and how caretakers are to be provided 
2265  information contained in the physician’s signed mental health 
2266  treatment plan. The rules must also include uniform forms or 
2267  standardized information to be used on a statewide basis in 
2268  requesting court authorization for the use of a psychotropic 
2269  medication and provide for the integration of each child’s 
2270  mental health treatment plan and case plan. The department must 
2271  begin the formal rulemaking process within 90 days after July 1, 
2272  2010. 
2273         Section 50. Paragraph (b) of subsection (1) of section 
2274  743.0645, Florida Statutes, is amended to read: 
2275         743.0645 Other persons who may consent to medical care or 
2276  treatment of a minor.— 
2277         (1) As used in this section, the term: 
2278         (b) “Medical care and treatment” includes ordinary and 
2279  necessary medical and dental examination and treatment, 
2280  including blood testing, preventive care including ordinary 
2281  immunizations, tuberculin testing, and well-child care, but does 
2282  not include surgery, general anesthesia, provision of 
2283  psychotropic medications, or other extraordinary procedures for 
2284  which a separate court order, power of attorney, or informed 
2285  consent as provided by law is required, except as provided in s. 
2286  39.4071 s. 39.407(3). 
2287         Section 51. The Division of Statutory Revision of the Joint 
2288  Legislative Management Committee is directed to prepare a 
2289  reviser’s bill for introduction at a subsequent session of the 
2290  Legislature to change the term “Department of Children and 
2291  Family Services” to “Department of Children and Families,” the 
2292  term “Secretary of Children and Family Services” to “Secretary 
2293  of Children and Families,” and the term “district administrator” 
2294  to “circuit administrator,” as that term relates to the 
2295  responsibilities of the Department of Children and Families, 
2296  wherever that term appears in the Florida Statutes. 
2297         Section 52. The Agency for Persons with Disabilities is 
2298  directed to prepare a plan that will enable it to perform all of 
2299  its own administrative and operational functions separate from 
2300  the Department of Children and Family Services by July 1, 2015. 
2301  The plan must identify resource requirements and a timeframe for 
2302  completing the transfer of responsibilities from the Department 
2303  of Children and Family Services, including submittal of a 
2304  detailed justification for each position the agency estimates it 
2305  would need to become administratively self-sufficient; an 
2306  analysis of each function to determine if the Department of 
2307  Children and Family Services could provide the service more 
2308  efficiently on a reimbursed cost basis through an interagency 
2309  agreement; and an estimate of the costs and benefits to be 
2310  derived through the separation. The Department of Children and 
2311  Family Services is directed to cooperate with the agency in 
2312  preparing the plan. The plan shall be presented to the Speaker 
2313  of the House of Representatives, the President of the Senate, 
2314  and the appropriate substantive committees by January 15, 2011. 
2315         Section 53. The Department of Children and Families, 
2316  through its Office of General Counsel and in consultation with 
2317  its contracted legal services providers and lead agency 
2318  administrators, shall define the types of legal services 
2319  associated with dependency proceedings. These legal services 
2320  include, but are not limited to, service of process, court 
2321  reporter and transcription services, expert witnesses, and legal 
2322  publication. The department shall delineate the specific costs 
2323  each lead agency will pay for those defined legal services, and 
2324  by contract amendment, modify lead agency funding amounts to 
2325  shift funding and responsibility for those costs to the 
2326  department through its Office of General Counsel. 
2327         Section 54. The Children and Youth Cabinet created pursuant 
2328  to s. 402.56, Florida Statutes, is directed to submit a plan to 
2329  the Legislature by January 15, 2011, for addressing the 
2330  inappropriate and excessive prescribing of psychotropic 
2331  medication for children who are in the custody of the Department 
2332  of Children and Family Services, who are clients of the Agency 
2333  for Persons with Disabilities, and who are otherwise on 
2334  Medicaid. 
2335         (1) At a minimum, the plan must include: 
2336         (a) The identification of all agencies and entities, public 
2337  and private, which are responsible for monitoring the care of 
2338  children who are being prescribed psychotropic medication; 
2339         (b) The development of a plan for interagency cooperation 
2340  in identifying and reporting prescribers; and 
2341         (c) An analysis of the prescribing practices of Medicaid 
2342  providers for these populations of children. 
2343         (2) The Children and Youth Cabinet shall also include 
2344  suggestions for any legislative changes necessary to implement 
2345  the plan. 
2346         Section 55. This act shall take effect July 1, 2010.