Bill Text: FL S0724 | 2010 | Regular Session | Engrossed
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
CS for CS for CS for SB 724 Third Engrossed 2010724e3 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, 39.01, 39.0121, 50 39.301, 39.302, 39.303, 39.806, 39.828, 49.011, 51 381.0072, 394.493, 394.4985, 394.67, 394.73, 394.74, 52 394.75, 394.76, 394.82, 394.9084, 397.821, 402.49, 53 409.152, 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 FamiliesFamily284Servicesthere 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 inthe Department of294Children 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 XIIXIIIof 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 of319the service areas shall be the same as, or combinations of, the320service districts of the Department of Children and Family321Services established in s.20.19and, to the extent practicable,322shall take into consideration the boundaries of the jobs and323education regional boards.324 Section 5. Subsections (18) through (76) of section 39.01, 325 Florida Statutes, are renumbered as subsections (19) through 326 (75), respectively, subsection (10) is amended, present 327 subsection (26) is repealed, and present subsection (27) of that 328 section is renumbered as subsection (18) and amended, to read: 329 39.01 Definitions.—When used in this chapter, unless the 330 context otherwise requires: 331 (10) “Caregiver” means the parent, legal custodian, 332 permanent guardian, adult household member, or other person 333 responsible for a child’s welfare as defined in subsection (46) 334(47). 335(26) “District” means any one of the 15 service districts336of the department established pursuant to s.20.19.337 (18)(27)“CircuitDistrictadministrator” means the chief 338 operating officer of each circuitservice districtof the 339 department as defined in s. 20.19(5) and, where appropriate,340includes any district administrator whose service district falls341within the boundaries of a judicial circuit. 342 Section 6. Subsection (10) of section 39.0121, Florida 343 Statutes, is amended to read: 344 39.0121 Specific rulemaking authority.—Pursuant to the 345 requirements of s. 120.536, the department is specifically 346 authorized to adopt, amend, and repeal administrative rules 347 which implement or interpret law or policy, or describe the 348 procedure and practice requirements necessary to implement this 349 chapter, including, but not limited to, the following: 350 (10) TheFamily Builders Program, theIntensive Crisis 351 Counseling Program,and any other early intervention programs 352 and kinship care assistance programs. 353 Section 7. Paragraph (a) of subsection (15) of section 354 39.301, Florida Statutes, is amended to read: 355 39.301 Initiation of protective investigations.— 356 (15)(a) If the department or its agent determines that a 357 child requires immediate or long-term protection through: 358 1. Medical or other health care; or 359 2. Homemaker care, day care, protective supervision, or 360 other services to stabilize the home environment, including 361 intensive family preservation services throughthe Family362Builders Program orthe Intensive Crisis Counseling Program,or363both,364 365 such services shall first be offered for voluntary acceptance 366 unless there are high-risk factors that may impact the ability 367 of the parents or legal custodians to exercise judgment. Such 368 factors may include the parents’ or legal custodians’ young age 369 or history of substance abuse or domestic violence. 370 Section 8. Subsection (1) of section 39.302, Florida 371 Statutes, is amended to read: 372 39.302 Protective investigations of institutional child 373 abuse, abandonment, or neglect.— 374 (1) The department shall conduct a child protective 375 investigation of each report of institutional child abuse, 376 abandonment, or neglect. Upon receipt of a report that alleges 377 that an employee or agent of the department, or any other entity 378 or person covered by s. 39.01(32)(33)or (46)(47), acting in an 379 official capacity, has committed an act of child abuse, 380 abandonment, or neglect, the department shall initiate a child 381 protective investigation within the timeframe established under 382 s. 39.201(5) and orally notify the appropriate state attorney, 383 law enforcement agency, and licensing agency, which shall 384 immediately conduct a joint investigation, unless independent 385 investigations are more feasible. When conducting investigations 386 onsite or having face-to-face interviews with the child, 387 investigation visits shall be unannounced unless it is 388 determined by the department or its agent that unannounced 389 visits threaten the safety of the child. If a facility is exempt 390 from licensing, the department shall inform the owner or 391 operator of the facility of the report. Each agency conducting a 392 joint investigation is entitled to full access to the 393 information gathered by the department in the course of the 394 investigation. A protective investigation must include an onsite 395 visit of the child’s place of residence. The department shall 396 make a full written report to the state attorney within 3 397 working days after making the oral report. A criminal 398 investigation shall be coordinated, whenever possible, with the 399 child protective investigation of the department. Any interested 400 person who has information regarding the offenses described in 401 this subsection may forward a statement to the state attorney as 402 to whether prosecution is warranted and appropriate. Within 15 403 days after the completion of the investigation, the state 404 attorney shall report the findings to the department and shall 405 include in the report a determination of whether or not 406 prosecution is justified and appropriate in view of the 407 circumstances of the specific case. 408 Section 9. Section 39.303, Florida Statutes, is amended to 409 read: 410 39.303 Child protection teams; services; eligible cases. 411 The Children’s Medical Services Program in the Department of 412 Health shall develop, maintain, and coordinate the services of 413 one or more multidisciplinary child protection teams in each of 414 the circuitsservice districtsof the Department of Children and 415 FamiliesFamily Services. Such teams may be composed of 416 appropriate representatives of school districts and appropriate 417 health, mental health, social service, legal service, and law 418 enforcement agencies. The Legislature finds that optimal 419 coordination of child protection teams and sexual abuse 420 treatment programs requires collaboration between the Department 421 of Health and the Department of Children and FamiliesFamily422Services. The two departments shall maintain an interagency 423 agreement that establishes protocols for oversight and 424 operations of child protection teams and sexual abuse treatment 425 programs. The State Surgeon General and the Deputy Secretary for 426 Children’s Medical Services, in consultation with the Secretary 427 of Children and FamiliesFamily Services, shall maintain the 428 responsibility for the screening, employment, and, if necessary, 429 the termination of child protection team medical directors, at 430 headquarters and in the circuits15 districts. Child protection 431 team medical directors shall be responsible for oversight of the 432 teams in the circuitsdistricts. 433 (1) The Department of Health shall utilize and convene the 434 teams to supplement the assessment and protective supervision 435 activities of the family safety and preservation program of the 436 Department of Children and FamiliesFamily Services. Nothing in 437 this section shall be construed to remove or reduce the duty and 438 responsibility of any person to report pursuant to this chapter 439 all suspected or actual cases of child abuse, abandonment, or 440 neglect or sexual abuse of a child. The role of the teams shall 441 be to support activities of the program and to provide services 442 deemed by the teams to be necessary and appropriate to abused, 443 abandoned, and neglected children upon referral. The specialized 444 diagnostic assessment, evaluation, coordination, consultation, 445 and other supportive services that a child protection team shall 446 be capable of providing include, but are not limited to, the 447 following: 448 (a) Medical diagnosis and evaluation services, including 449 provision or interpretation of X rays and laboratory tests, and 450 related services, as needed, and documentation of findings 451 relative thereto. 452 (b) Telephone consultation services in emergencies and in 453 other situations. 454 (c) Medical evaluation related to abuse, abandonment, or 455 neglect, as defined by policy or rule of the Department of 456 Health. 457 (d) Such psychological and psychiatric diagnosis and 458 evaluation services for the child or the child’s parent or 459 parents, legal custodian or custodians, or other caregivers, or 460 any other individual involved in a child abuse, abandonment, or 461 neglect case, as the team may determine to be needed. 462 (e) Expert medical, psychological, and related professional 463 testimony in court cases. 464 (f) Case staffings to develop treatment plans for children 465 whose cases have been referred to the team. A child protection 466 team may provide consultation with respect to a child who is 467 alleged or is shown to be abused, abandoned, or neglected, which 468 consultation shall be provided at the request of a 469 representative of the family safety and preservation program or 470 at the request of any other professional involved with a child 471 or the child’s parent or parents, legal custodian or custodians, 472 or other caregivers. In every such child protection team case 473 staffing, consultation, or staff activity involving a child, a 474 family safety and preservation program representative shall 475 attend and participate. 476 (g) Case service coordination and assistance, including the 477 location of services available from other public and private 478 agencies in the community. 479 (h) Such training services for program and other employees 480 of the Department of Children and FamiliesFamily Services, 481 employees of the Department of Health, and other medical 482 professionals as is deemed appropriate to enable them to develop 483 and maintain their professional skills and abilities in handling 484 child abuse, abandonment, and neglect cases. 485 (i) Educational and community awareness campaigns on child 486 abuse, abandonment, and neglect in an effort to enable citizens 487 more successfully to prevent, identify, and treat child abuse, 488 abandonment, and neglect in the community. 489 (j) Child protection team assessments that include, as 490 appropriate, medical evaluations, medical consultations, family 491 psychosocial interviews, specialized clinical interviews, or 492 forensic interviews. 493 494 All medical personnel participating on a child protection team 495 must successfully complete the required child protection team 496 training curriculum as set forth in protocols determined by the 497 Deputy Secretary for Children’s Medical Services and the 498 Statewide Medical Director for Child Protection. 499 (2) The child abuse, abandonment, and neglect reports that 500 must be referred by the department to child protection teams of 501 the Department of Health for an assessment and other appropriate 502 available support services as set forth in subsection (1) must 503 include cases involving: 504 (a) Injuries to the head, bruises to the neck or head, 505 burns, or fractures in a child of any age. 506 (b) Bruises anywhere on a child 5 years of age or under. 507 (c) Any report alleging sexual abuse of a child. 508 (d) Any sexually transmitted disease in a prepubescent 509 child. 510 (e) Reported malnutrition of a child and failure of a child 511 to thrive. 512 (f) Reported medical neglect of a child. 513 (g) Any family in which one or more children have been 514 pronounced dead on arrival at a hospital or other health care 515 facility, or have been injured and later died, as a result of 516 suspected abuse, abandonment, or neglect, when any sibling or 517 other child remains in the home. 518 (h) Symptoms of serious emotional problems in a child when 519 emotional or other abuse, abandonment, or neglect is suspected. 520 (3) All abuse and neglect cases transmitted for 521 investigation to a circuitdistrictby the hotline must be 522 simultaneously transmitted to the Department of Health child 523 protection team for review. For the purpose of determining 524 whether face-to-face medical evaluation by a child protection 525 team is necessary, all cases transmitted to the child protection 526 team which meet the criteria in subsection (2) must be timely 527 reviewed by: 528 (a) A physician licensed under chapter 458 or chapter 459 529 who holds board certification in pediatrics and is a member of a 530 child protection team; 531 (b) A physician licensed under chapter 458 or chapter 459 532 who holds board certification in a specialty other than 533 pediatrics, who may complete the review only when working under 534 the direction of a physician licensed under chapter 458 or 535 chapter 459 who holds board certification in pediatrics and is a 536 member of a child protection team; 537 (c) An advanced registered nurse practitioner licensed 538 under chapter 464 who has a specialtyspecialityin pediatrics 539 or family medicine and is a member of a child protection team; 540 (d) A physician assistant licensed under chapter 458 or 541 chapter 459, who may complete the review only when working under 542 the supervision of a physician licensed under chapter 458 or 543 chapter 459 who holds board certification in pediatrics and is a 544 member of a child protection team; or 545 (e) A registered nurse licensed under chapter 464, who may 546 complete the review only when working under the direct 547 supervision of a physician licensed under chapter 458 or chapter 548 459 who holds certification in pediatrics and is a member of a 549 child protection team. 550 (4) A face-to-face medical evaluation by a child protection 551 team is not necessary when: 552 (a) The child was examined for the alleged abuse or neglect 553 by a physician who is not a member of the child protection team, 554 and a consultation between the child protection team board 555 certified pediatrician, advanced registered nurse practitioner, 556 physician assistant working under the supervision of a child 557 protection team board-certified pediatrician, or registered 558 nurse working under the direct supervision of a child protection 559 team board-certified pediatrician, and the examining physician 560 concludes that a further medical evaluation is unnecessary; 561 (b) The child protective investigator, with supervisory 562 approval, has determined, after conducting a child safety 563 assessment, that there are no indications of injuries as 564 described in paragraphs (2)(a)-(h) as reported; or 565 (c) The child protection team board-certified pediatrician, 566 as authorized in subsection (3), determines that a medical 567 evaluation is not required. 568 569 Notwithstanding paragraphs (a), (b), and (c), a child protection 570 team pediatrician, as authorized in subsection (3), may 571 determine that a face-to-face medical evaluation is necessary. 572 (5) In all instances in which a child protection team is 573 providing certain services to abused, abandoned, or neglected 574 children, other offices and units of the Department of Health, 575 and offices and units of the Department of Children and Families 576Family Services, shall avoid duplicating the provision of those 577 services. 578 (6) The Department of Health child protection team quality 579 assurance program and the Department of Children and Families’ 580Family Services’Family Safety Program Office quality assurance 581 program shall collaborate to ensure referrals and responses to 582 child abuse, abandonment, and neglect reports are appropriate. 583 Each quality assurance program shall include a review of records 584 in which there are no findings of abuse, abandonment, or 585 neglect, and the findings of these reviews shall be included in 586 each department’s quality assurance reports. 587 Section 10. Paragraph (k) of subsection (1) of section 588 39.806, Florida Statutes, is amended to read: 589 39.806 Grounds for termination of parental rights.— 590 (1) Grounds for the termination of parental rights may be 591 established under any of the following circumstances: 592 (k) A test administered at birth that indicated that the 593 child’s blood, urine, or meconium contained any amount of 594 alcohol or a controlled substance or metabolites of such 595 substances, the presence of which was not the result of medical 596 treatment administered to the mother or the newborn infant, and 597 the biological mother of the child is the biological mother of 598 at least one other child who was adjudicated dependent after a 599 finding of harm to the child’s health or welfare due to exposure 600 to a controlled substance or alcohol as defined in s. 601 39.01(31)(32)(g), after which the biological mother had the 602 opportunity to participate in substance abuse treatment. 603 Section 11. Paragraph (a) of subsection (1) of section 604 39.828, Florida Statutes, is amended to read: 605 39.828 Grounds for appointment of a guardian advocate.— 606 (1) The court shall appoint the person named in the 607 petition as a guardian advocate with all the powers and duties 608 specified in s. 39.829 for an initial term of 1 year upon a 609 finding that: 610 (a) The child named in the petition is or was a drug 611 dependent newborn as described in s. 39.01(31)(32)(g); 612 (b) The parent or parents of the child have voluntarily 613 relinquished temporary custody of the child to a relative or 614 other responsible adult; 615 (c) The person named in the petition to be appointed the 616 guardian advocate is capable of carrying out the duties as 617 provided in s. 39.829; and 618 (d) A petition to adjudicate the child dependent under this 619 chapter has not been filed. 620 Section 12. Subsection (13) of section 49.011, Florida 621 Statutes, is amended to read: 622 49.011 Service of process by publication; cases in which 623 allowed.—Service of process by publication may be made in any 624 court on any party identified in s. 49.021 in any action or 625 proceeding: 626 (13) For termination of parental rights pursuant to part 627 VIIIIXof chapter 39 or chapter 63. 628 Section 13. Paragraph (a) of subsection (3) of section 629 381.0072, Florida Statutes, is amended to read: 630 381.0072 Food service protection.—It shall be the duty of 631 the Department of Health to adopt and enforce sanitation rules 632 consistent with law to ensure the protection of the public from 633 food-borne illness. These rules shall provide the standards and 634 requirements for the storage, preparation, serving, or display 635 of food in food service establishments as defined in this 636 section and which are not permitted or licensed under chapter 637 500 or chapter 509. 638 (3) LICENSES REQUIRED.— 639 (a) Licenses; annual renewals.—Each food service 640 establishment regulated under this section shall obtain a 641 license from the department annually. Food service establishment 642 licenses shall expire annually and are not transferable from one 643 place or individual to another. However, those facilities 644 licensed by the department’s Office of Licensure and 645 Certification, the Child Care LicensureServicesProgram Office, 646 or the Agency for Persons with Disabilities are exempt from this 647 subsection. It shall be a misdemeanor of the second degree, 648 punishable as provided in s. 381.0061, s. 775.082, or s. 649 775.083, for such an establishment to operate without this 650 license. The department may refuse a license, or a renewal 651 thereof, to any establishment that is not constructed or 652 maintained in accordance with law and with the rules of the 653 department. Annual application for renewal is not required. 654 Section 14. Subsection (3) of section 394.47865, Florida 655 Statutes, is amended to read: 656 394.47865 South Florida State Hospital; privatization.— 657(3)(a) Current South Florida State Hospital employees who658are affected by the privatization shall be given first659preference for continued employment by the contractor. The660department shall make reasonable efforts to find suitable job661placements for employees who wish to remain within the state662Career Service System.663(b) Any savings that result from the privatization of South664Florida State Hospital shall be directed to the department’s665service districts 9, 10, and 11 for the delivery of community666mental health services.667 Section 15. Subsection (2) of section 394.493, Florida 668 Statutes, is amended to read: 669 394.493 Target populations for child and adolescent mental 670 health services funded through the department.— 671 (2) Each mental health provider under contract with the 672 department to provide mental health services to the target 673 population shall collect fees from the parent or legal guardian 674 of the child or adolescent receiving services. The fees shall be 675 based on a sliding fee scale for families whose net family 676 income is at or above 150 percent of the Federal Poverty Income 677 Guidelines. The department shall adopt, by rule, a sliding fee 678 scale for statewide implementation. Fees collected from families 679 shall be retained in the circuitservice districtand used for 680 expanding child and adolescent mental health treatment services. 681 Section 16. Section 394.4985, Florida Statutes, is amended 682 to read: 683 394.4985 CircuitwideDistrictwideinformation and referral 684 network; implementation.— 685 (1) Each circuitservice districtof the Department of 686 Children and FamiliesFamily Servicesshall develop a detailed 687 implementation plan for a circuitwidedistrictwidecomprehensive 688 child and adolescent mental health information and referral 689 network to be operational by July 1, 1999. The plan must include 690 an operating budget that demonstrates cost efficiencies and 691 identifies funding sources for the circuitdistrictinformation 692 and referral network. The plan must be submitted by the 693 department to the Legislature by October 1, 1998. The circuit 694districtshall use existing circuitdistrictinformation and 695 referral providers if, in the development of the plan, it is 696 concluded that these providers would deliver information and 697 referral services in a more efficient and effective manner when 698 compared to other alternatives. The circuitdistrictinformation 699 and referral network must include: 700 (a) A resource file that contains information about the 701 child and adolescent mental health services as described in s. 702 394.495, including, but not limited to: 703 1. Type of program; 704 2. Hours of service; 705 3. Ages of persons served; 706 4. Program description; 707 5. Eligibility requirements; and 708 6. Fees. 709 (b) Information about private providers and professionals 710 in the community which serve children and adolescents with an 711 emotional disturbance. 712 (c) A system to document requests for services that are 713 received through the network referral process, including, but 714 not limited to: 715 1. Number of calls by type of service requested; 716 2. Ages of the children and adolescents for whom services 717 are requested; and 718 3. Type of referral made by the network. 719 (d) The ability to share client information with the 720 appropriate community agencies. 721 (e) The submission of an annual report to the department, 722 the Agency for Health Care Administration, and appropriate local 723 government entities, which contains information about the 724 sources and frequency of requests for information, types and 725 frequency of services requested, and types and frequency of 726 referrals made. 727 (2) In planning the information and referral network, the 728 circuitdistrictshall consider the establishment of a 24-hour 729 toll-free telephone number, staffed at all times, for parents 730 and other persons to call for information that concerns child 731 and adolescent mental health services and a community public 732 service campaign to inform the public about information and 733 referral services. 734 Section 17. Subsections (2) through (6) of section 394.67, 735 Florida Statutes, are renumbered as subsections (4) and (8), 736 respectively, and present subsections (7) and (8) are renumbered 737 as subsections (2) and (3), respectively, and amended to read: 738 394.67 Definitions.—As used in this part, the term: 739 (2)(7)“CircuitDistrictadministrator” means the person 740 appointed by the Secretary of Children and FamiliesFamily741Servicesfor the purpose of administering a department circuit 742service districtas set forth in s. 20.19. 743 (3)(8)“CircuitDistrictplan” or “plan” means the combined 744 circuitdistrictsubstance abuse and mental health plan approved 745 by the circuitdistrictadministrator and governing bodies in 746 accordance with this part. 747 Section 18. Section 394.73, Florida Statutes, is amended to 748 read: 749 394.73 Joint alcohol, drug abuse, and mental health service 750 programs in two or more counties.— 751 (1) Subject to rules established by the department, any 752 county within a circuitservice districtshall have the same 753 power to contract for alcohol, drug abuse, and mental health 754 services as the department has under existing statutes. 755 (2) In order to carry out the intent of this part and to 756 provide alcohol, drug abuse, and mental health services in 757 accordance with the circuitdistrictplan, the counties within a 758 circuitservice districtmay enter into agreements with each 759 other for the establishment of joint service programs. The 760 agreements may provide for the joint provision or operation of 761 services and facilities or for the provision or operation of 762 services and facilities by one participating county under 763 contract with other participating counties. 764 (3) When a circuitservice districtcomprises two or more 765 counties or portions thereof, it is the obligation of the 766 planning council to submit to the governing bodies, prior to the 767 budget submission date of each governing body, an estimate of 768 the proportionate share of costs of alcohol, drug abuse, and 769 mental health services proposed to be borne by each such 770 governing body. 771 (4) Any county desiring to withdraw from a joint program 772 may submit to the circuitdistrictadministrator a resolution 773 requesting withdrawal therefrom together with a plan for the 774 equitable adjustment and division of the assets, property, 775 debts, and obligations, if any, of the joint program. 776 Section 19. Paragraph (a) of subsection (3) of section 777 394.74, Florida Statutes, is amended to read: 778 394.74 Contracts for provision of local substance abuse and 779 mental health programs.— 780 (3) Contracts shall include, but are not limited to: 781 (a) A provision that, within the limits of available 782 resources, substance abuse and mental health crisis services, as 783 defined in s. 394.67(5)(3), shall be available to any individual 784 residing or employed within the service area, regardless of 785 ability to pay for such services, current or past health 786 condition, or any other factor; 787 Section 20. Subsection (10) of section 394.75, Florida 788 Statutes, is amended to read: 789 394.75 State and circuitdistrictsubstance abuse and 790 mental health plans.— 791 (10) The circuitdistrictadministrator shall ensure that 792 the circuitdistrictplan: 793 (a) Conforms to the priorities in the state plan, the 794 requirements of this part, and the standards adopted under this 795 part; 796 (b) Ensures that the most effective and economical use will 797 be made of available public and private substance abuse and 798 mental health resources in the circuitservice district; and 799 (c) Has adequate provisions made for review and evaluation 800 of the services provided in the circuitservice district. 801 Section 21. Subsection (2) of section 394.76, Florida 802 Statutes, is amended to read: 803 394.76 Financing of circuitdistrictprograms and 804 services.—If the local match funding level is not provided in 805 the General Appropriations Act or the substantive bill 806 implementing the General Appropriations Act, such funding level 807 shall be provided as follows: 808 (2) If in any fiscal year the approved state appropriation 809 is insufficient to finance the programs and services specified 810 by this part, the department shall have the authority to 811 determine the amount of state funds available to each circuit 812service districtfor such purposes in accordance with the 813 priorities in both the state and circuitdistrictplans. The 814 circuitdistrictadministrator shall consult with the planning 815 council to ensure that the summary operating budget conforms to 816 the approved plan. 817 Section 22. Subsection (5) of section 394.78, Florida 818 Statutes, is amended to read: 819 394.78 Operation and administration; personnel standards; 820 procedures for audit and monitoring of service providers;821resolution of disputes.— 822(5) In unresolved disputes regarding this part or rules823established pursuant to this part, providers and district health824and human services boards shall adhere to formal procedures825specified under s.20.19(8)(n).826 Section 23. Subsections (3) and (4) of section 394.82, 827 Florida Statutes, are amended to read: 828 394.82 Funding of expanded services.— 829 (3) Each fiscal year, any funding increases for crisis 830 services or community mental health services that are included 831 in the General Appropriations Act shall be appropriated in a 832 lump-sum category as defined in s. 216.011(1)(aa). In accordance 833 with s. 216.181(6)(a), the Executive Office of the Governor 834 shall require the Department of Children and FamiliesFamily835Servicesto submit a spending plan for the use of funds 836 appropriated for this purpose. The spending plan must include a 837 schedule for phasing in the new community mental health services 838 in each circuitservice districtof the department and must 839 describe how the new services will be integrated and coordinated 840 with all current community-based health and human services. 841 (4) By January 1, 2004, the crisis services defined in s. 842 394.67(5)(3)shall be implemented, as appropriate, in the 843 state’s public community mental health system to serve children 844 and adults who are experiencing an acute mental or emotional 845 crisis, as defined in s. 394.67(17). By January 1, 2006, the 846 mental health services defined in s. 394.67(15) shall be 847 implemented, as appropriate, in the state’s public community 848 mental health system to serve adults and older adults who have a 849 severe and persistent mental illness and to serve children who 850 have a serious emotional disturbance or mental illness, as 851 defined in s. 394.492(6). 852 Section 24. Subsection (1) of section 394.9084, Florida 853 Statutes, is amended to read: 854 394.9084 Florida Self-Directed Care program.— 855 (1) The Department of Children and FamiliesFamily856Services, in cooperation with the Agency for Health Care 857 Administration, may provide a client-directed and choice-based 858 Florida Self-Directed Care program in all department circuits 859service districts, in addition to the pilot projects established 860 in district 4 and district 8, to provide mental health treatment 861 and support services to adults who have a serious mental 862 illness. The department may also develop and implement a client 863 directed and choice-based pilot project in one circuitdistrict864 to provide mental health treatment and support services for 865 children with a serious emotional disturbance who live at home. 866 If established, any staff who work with children must be 867 screened under s. 435.04. The department shall implement a 868 payment mechanism in which each client controls the money that 869 is available for that client’s mental health treatment and 870 support services. The department shall establish interagency 871 cooperative agreements and work with the agency, the Division of 872 Vocational Rehabilitation, and the Social Security 873 Administration to implement and administer the Florida Self 874 Directed Care program. 875 Section 25. Subsection (1) of section 397.821, Florida 876 Statutes, is amended to read: 877 397.821 Juvenile substance abuse impairment prevention and 878 early intervention councils.— 879 (1) Each judicial circuit as set forth in s. 26.021 may 880 establish a juvenile substance abuse impairment prevention and 881 early intervention council composed of at least 12 members, 882 including representatives from law enforcement, the department, 883 school districts, state attorney and public defender offices, 884 the circuit court, the religious community, substance abuse 885 impairment professionals, child advocates from the community, 886 business leaders, parents, and high school students. However, 887 those circuits which already have in operation a council of 888 similar composition may designate the existing body as the 889 juvenile substance abuse impairment prevention and early 890 intervention council for the purposes of this section. Each 891 council shall establish bylaws providing for the length of term 892 of its members, but the term may not exceed 4 years. The circuit 893substate entityadministrator, as defined in s. 20.19, and the 894 chief judge of the circuit court shall each appoint six members 895 of the council. The circuitsubstate entityadministrator shall 896 appoint a representative from the department, a school district 897 representative, a substance abuse impairment treatment 898 professional, a child advocate, a parent, and a high school 899 student. The chief judge of the circuit court shall appoint a 900 business leader and representatives from the state attorney’s 901 office, the public defender’s office, the religious community, 902 the circuit court, and law enforcement agencies. 903 Section 26. Subsection (1) of section 402.313, Florida 904 Statutes, is amended to read: 905 402.313 Family day care homes.— 906 (1) Family day care homes shall be licensed under this act 907 if they are presently being licensed under an existing county 908 licensing ordinance, if they are participating in the subsidized 909 child care program, or if the board of county commissioners 910 passes a resolution that family day care homes be licensed. If 911 no county authority exists for the licensing of a family day 912 care home and the county passes a resolution requiring 913 licensure, the department shall have the authority to license 914 family day care homes under contract with the countyfor the915purchase-of-service system in the subsidized child care program. 916 (a) If not subject to license, family day care homes shall 917 register annually with the department, providing the following 918 information: 919 1. The name and address of the home. 920 2. The name of the operator. 921 3. The number of children served. 922 4. Proof of a written plan to provide at least one other 923 competent adult to be available to substitute for the operator 924 in an emergency. This plan shall include the name, address, and 925 telephone number of the designated substitute. 926 5. Proof of screening and background checks. 927 6. Proof of successful completion of the 30-hour training 928 course, as evidenced by passage of a competency examination, 929 which shall include: 930 a. State and local rules and regulations that govern child 931 care. 932 b. Health, safety, and nutrition. 933 c. Identifying and reporting child abuse and neglect. 934 d. Child development, including typical and atypical 935 language development; and cognitive, motor, social, and self 936 help skills development. 937 e. Observation of developmental behaviors, including using 938 a checklist or other similar observation tools and techniques to 939 determine a child’s developmental level. 940 f. Specialized areas, including early literacy and language 941 development of children from birth to 5 years of age, as 942 determined by the department, for owner-operators of family day 943 care homes. 944 7. Proof that immunization records are kept current. 945 8. Proof of completion of the required continuing education 946 units or clock hours. 947 (b) A family day care home not participating in the 948 subsidized child care program may volunteer to be licensed under 949 the provisions of this act. 950 (c) The department may provide technical assistance to 951 counties and family day care home providers to enable counties 952 and family day care providers to achieve compliance with family 953 day care homes standards. 954 Section 27. Subsection (2) of section 402.315, Florida 955 Statutes, is amended to read: 956 402.315 Funding; license fees.— 957 (2) The countydepartmentshall bear the costs of the 958 licensing of family day care homes when contracting with the 959 department pursuant to s. 402.313(1)child care facilities when960contracted to do so by a county or when directly responsible for961licensing in a county which fails to meet or exceed state962minimum standards. 963 Section 28. Subsections (2), (3), and (7) of section 964 402.40, Florida Statutes, are amended to read: 965 402.40 Child welfare training.— 966 (2) DEFINITIONS.—As used in this section, the term: 967 (a) “Child welfare certification” means a professional 968 credential awarded by the department or by a credentialing 969 entity recognized by the department to individuals demonstrating 970 core competency in any child welfare services practice area. 971 (b) “Child welfare services” means any intake, protective 972 investigations, preprotective services, protective services, 973 foster care, shelter and group care, and adoption and related 974 services program, including supportive services, supervision, 975and legal services,provided to children who are alleged to have 976 been abused, abandoned, or neglected, or who are at risk of 977 becoming, are alleged to be, or have been found dependent 978 pursuant to chapter 39. 979 (c) “Core competency” means the knowledge, skills, and 980 abilities necessary to carry out work responsibilities. 981 (d)(b)“Person providing child welfare services” means a 982 person who has a responsibility for supervisory,legal,direct 983 care or support related work in the provision of child welfare 984 services pursuant to chapter 39. 985 (3) CHILD WELFARE TRAINING PROGRAM.—The department shall 986 establish a program for training pursuant to the provisions of 987 this section, and all persons providing child welfare services 988 shall be required to demonstrate core competency by earning and 989 maintaining a department or third-party-awarded child welfare 990 certification and participate in and successfully complete the 991 program of training pertinent to their areas of responsibility. 992 (7) CERTIFICATION AND TRAINER QUALIFICATIONS.—The 993 department shall, in collaboration with the professionals and 994 providers described in subsection (5), develop minimum standards 995 for a certification process that ensures that participants have 996 successfully attained the knowledge, skills, and abilities 997 necessary to competently carry out their work responsibilities. 998 The department shall recognize third-party certification for 999 child welfare services staff which satisfies the core 1000 competencies and meets the certification requirements 1001 established in this sectionand shall develop minimum standards1002for trainer qualifications which must be required of training1003academies in the offering of the training curricula. Any person 1004 providing child welfare services shall be required to master the 1005 core competencies and hold an active child welfare certification 1006components of the curriculumthat isareparticular to that 1007 person’s work responsibilities. 1008 Section 29. Subsection (2) of section 402.49, Florida 1009 Statutes, is amended to read: 1010 402.49 Mediation process established.— 1011 (2)(a) The department shall appoint at least one mediation 1012 panel in each of the department’s circuitsservice districts. 1013 Each panel shall have at least three and not more than five 1014 members and shall include a representative from the department, 1015 a representative of an agency that provides similar services to 1016 those provided by the agency that is a party to the dispute, and 1017 additional members who are mutually acceptable to the department 1018 and the agency that is a party to the dispute. Such additional 1019 members may include laypersons who are involved in advocacy 1020 organizations, members of boards of directors of agencies 1021 similar to the agency that is a party to the dispute, members of 1022 families of department clients, members of department planning 1023 councils in the area of services that are the subject of the 1024 dispute, and interested and informed members of the local 1025 community. 1026 (b) If the parties to the conflict agree, a mediation panel 1027 may hear a complaint that is filed outside of the panel’s 1028 circuitservice district. 1029 Section 30. Subsection (3) of section 409.152, Florida 1030 Statutes, is amended to read: 1031 409.152 Service integration and family preservation.— 1032 (3) Each circuitservice districtof the department shall 1033 develop a family preservation service integration plan that 1034 identifies various programs that can be organized at the point 1035 of service delivery into a logical and cohesive family-centered 1036 services constellation. The plan shall include: 1037 (a) Goals and objectives for integrating services for 1038 families and avoiding barriers to service integration, 1039 procedures for centralized intake and assessment, a 1040 comprehensive service plan for each family, and an evaluation 1041 method of program outcome. 1042 (b) Recommendations for proposed changes to fiscal and 1043 substantive policies, regulations, and laws at local, circuit 1044district, and state delivery levels, including budget and 1045 personnel policies; purchasing flexibility and workforce 1046 incentives; discretionary resources; and incentives to reduce 1047 dependency on government programs and services. 1048 (c) Strategies for creating partnerships with the 1049 community, clients, and consumers of services which establish, 1050 maintain, and preserve family units. 1051 Section 31. Paragraph (e) of subsection (1) and subsection 1052 (8) of section 409.1671, Florida Statutes, are amended, and 1053 paragraph (m) is added to subsection (1) of that section, to 1054 read: 1055 409.1671 Foster care and related services; outsourcing.— 1056 (1) 1057 (e) As used in this section, the term “eligible lead 1058 community-based provider” means a single agency with which the 1059 department contractsshall contractfor the provision of child 1060 protective services in a community that is no smaller than a 1061 county. The secretary of the department may authorize more than 1062 one eligible lead community-based provider within a single 1063 county if itwhen to do sowill result in more effective 1064 delivery of foster care and related services. To compete for an 1065 outsourcing project, such agency must have: 1066 1. The ability to coordinate, integrate, and manage all 1067 child protective services in the designated community in 1068 cooperation with child protective investigations. 1069 2. The ability to ensure continuity of care from entry to 1070 exit for all children referred from the protective investigation 1071 and court systems. 1072 3. The ability to provide directly, or contractforthrough 1073 a local network of providers, for all necessary child protective 1074 services. Such agencies should directly provide no more than 35 1075 percent of all child protective services provided. 1076 4. The willingness to be accountableaccept accountability1077 for meeting the outcomes and performance standards related to 1078 child protective services established by the Legislature and the 1079 Federal Government. 1080 5. The capability and the willingness to serve all children 1081 referred to it from the protective investigation and court 1082 systems, regardless of the level of funding allocated to the 1083 community by the state if, providedall related funding is 1084 transferred. 1085 6. The willingness to ensure that each individual who 1086 provides child protective services completes the training 1087 required of child protective service workers by the Department 1088 of Children and Family Services. 1089 7. The ability to maintain eligibility to receive all 1090 federal child welfare funds, including Title IV-E and IV-A 1091 funds, currently being used by the Department of Children and 1092 Family Services. 1093 8. Written agreements with Healthy Families Florida lead 1094 entities in their community, pursuant to s. 409.153, to promote 1095 cooperative planning for the provision of prevention and 1096 intervention services. 1097 9. A board of directors, of which at least 51 percent of 1098 the membership is comprised of persons residing in this state. 1099 Of the state residents, at least 51 percent must also reside 1100 within the service area of the eligible lead community-based 1101 provider. 1102 (m) In order to ensure an efficient and effective 1103 community-based care system, the department shall annually 1104 evaluate each lead agency’s success in developing an effective 1105 network of local providers, improving the coordination and 1106 delivery of services to children, and investing appropriated 1107 funds into the community for direct services to children and 1108 families. 1109 (8) Notwithstanding the provisions of s. 215.425, all 1110 documented federal funds earned for the current fiscal year by 1111 the department and community-based agencies which exceed the 1112 amount appropriated by the Legislature shall be distributed to 1113 all entities that contributed to the excess earnings based on a 1114 schedule and methodology developed by the department and 1115 approved by the Executive Office of the Governor. Distribution 1116 shall be pro rata based on total earnings and shall be made only 1117 to those entities that contributed to excess earnings. Excess 1118 earnings of community-based agencies shall be used only in the 1119 circuitservice districtin which they were earned. Additional 1120 state funds appropriated by the Legislature for community-based 1121 agencies or made available pursuant to the budgetary amendment 1122 process described in s. 216.177 shall be transferred to the 1123 community-based agencies. The department shall amend a 1124 community-based agency’s contract to permit expenditure of the 1125 funds. 1126 Section 32. Section 409.1685, Florida Statutes, is amended 1127 to read: 1128 409.1685 Children in foster care; annual report to 1129 Legislature.—The Department of Children and Family Services 1130 shall submit a written report to the substantive committees of 1131 the Legislature concerning the status of children in foster care 1132 and concerning the judicial review mandated by part IXXof 1133 chapter 39. This report shall be submitted by March 1 of each 1134 year andshallinclude the following information for the prior 1135 calendar year: 1136 (1) The number of 6-month and annual judicial reviews 1137 completed during that period. 1138 (2) The number of children in foster care returned to a 1139 parent, guardian, or relative as a result of a 6-month or annual 1140 judicial review hearing during that period. 1141 (3) The number of termination of parental rights 1142 proceedings instituted during that period includingwhich shall1143include: 1144 (a) The number of termination of parental rights 1145 proceedings initiated pursuant to former s. 39.703; and 1146 (b) The total number of terminations of parental rights 1147 ordered. 1148 (4) The number of foster care children placed for adoption 1149 during that period. 1150 Section 33. Paragraph (a) of subsection (4) of section 1151 409.1755, Florida Statutes, is amended to read: 1152 409.1755 One Church, One Child of Florida Corporation Act; 1153 creation; duties.— 1154 (4) BOARD OF DIRECTORS.— 1155 (a) The One Church, One Child of Florida Corporation shall 1156 operate subject to the supervision and approval of a board of 1157 directors consisting of 2123members, with onetwodirectors1158 representing each circuitservice districtof the Department of 1159 Children and FamiliesFamily Servicesand one director who shall 1160 be an at-large member. 1161 Section 34. Paragraph (a) of subsection (1) and subsection 1162 (2) of section 410.0245, Florida Statutes, are amended to read: 1163 410.0245 Study of service needs; report; multiyear plan.— 1164 (1)(a) The Adult ProtectionServicesProgram Office of the 1165 Department of Children and FamiliesFamily Servicesshall 1166 contract for a study of the service needs of the 18-to-59-year 1167 old disabled adult population served or waiting to be served by 1168 the community care for disabled adults program. The Division of 1169 Vocational Rehabilitation of the Department of Education and 1170 other appropriate state agencies shall provide information to 1171 the Department of Children and FamiliesFamily Serviceswhen 1172 requested for the purposes of this study. 1173 (2) Based on the findings of the study, the Adult 1174 ProtectionServicesProgram of the Department of Children and 1175 FamiliesFamily Servicesshall develop a multiyear plan which 1176 shall provide for the needs of disabled adults in this state and 1177 shall provide strategies for statewide coordination of all 1178 services for disabled adults. The multiyear plan shall include 1179 an inventory of existing services and an analysis of costs 1180 associated with existing and projected services. The multiyear 1181 plan shall be presented to the Governor, the President of the 1182 Senate, and the Speaker of the House of Representatives every 3 1183 years on or before March 1, beginning in 1992. On or before 1184 March 1 of each intervening year, the department shall submit an 1185 analysis of the status of the implementation of each element of 1186 the multiyear plan, any continued unmet need, and the 1187 relationship between that need and the department’s budget 1188 request for that year. 1189 Section 35. Subsections (1) and (2) of section 410.603, 1190 Florida Statutes, are renumbered as subsections (2) and (3), 1191 respectively, and present subsection (3) of that section is 1192 renumbered as subsection (1) and amended to read: 1193 410.603 Definitions relating to Community Care for Disabled 1194 Adults Act.—As used in ss. 410.601-410.606: 1195 (1)(3)“CircuitDistrict” means a specified geographic 1196 service area that conforms to the judicial circuits established 1197 in s. 26.021, as defined in s.20.19,in which the programs of 1198 the department are administered and services are delivered. 1199 Section 36. Subsection (2) of section 410.604, Florida 1200 Statutes, is amended to read: 1201 410.604 Community care for disabled adults program; powers 1202 and duties of the department.— 1203 (2) Any person who meets the definition of a disabled adult 1204 pursuant to s. 410.603(3)(2)is eligible to receive the services 1205 of the community care for disabled adults program. However, the 1206 community care for disabled adults program shall operate within 1207 the funds appropriated by the Legislature. Priority shall be 1208 given to disabled adults who are not eligible for comparable 1209 services in programs of or funded by the department or the 1210 Division of Vocational Rehabilitation of the Department of 1211 Education; who are determined to be at risk of 1212 institutionalization; and whose income is at or below the 1213 existing institutional care program eligibility standard. 1214 Section 37. Section 411.224, Florida Statutes, is amended 1215 to read: 1216 411.224 Family support planning process.—The Legislature 1217 establishes a family support planning process to be used by the 1218 Department of Children and FamiliesFamily Servicesas the 1219 service planning process for targeted individuals, children, and 1220 families under its purview. 1221 (1) The Department of Education shall take all appropriate 1222 and necessary steps to encourage and facilitate the 1223 implementation of the family support planning process for 1224 individuals, children, and families within its purview. 1225 (2) To the extent possible within existing resources, the 1226 following populations must be included in the family support 1227 planning process: 1228 (a) Children from birth to age 5 who are served by the 1229 clinic and programs of the Division of Children’s Medical 1230 Services of the Department of Health. 1231 (b) Children participating in the developmental evaluation 1232 and intervention program of the Division of Children’s Medical 1233 Services of the Department of Health. 1234 (c) Children from age 3 through age 5 who are served by the 1235 Agency for Persons with Disabilities. 1236 (d) Children from birth through age 5 who are served by the 1237 Mental Health Program Office of the Department of Children and 1238 FamiliesFamily Services. 1239 (e) Participants who are served by the Children’s Early 1240 Investment Program established in s. 411.232. 1241 (f) Healthy Start participants in need of ongoing service 1242 coordination. 1243 (g) Children from birth through age 5 who are served by the 1244 voluntary family services, protective supervision, foster care, 1245 or adoption and related services programs of the Child Care 1246 LicensureServicesProgram Office of the Department of Children 1247 and FamiliesFamily Services, and who are eligible for ongoing 1248 services from one or more other programs or agencies that 1249 participate in family support planning; however, children served 1250 by the voluntary family services program, where the planned 1251 length of intervention is 30 days or less, are excluded from 1252 this population. 1253 (3) When individuals included in the target population are 1254 served by Head Start, local education agencies, or other 1255 prevention and early intervention programs, providers must be 1256 notified and efforts made to facilitate the concerned agency’s 1257 participation in family support planning. 1258 (4) Local education agencies are encouraged to use a family 1259 support planning process for children from birth through 5 years 1260 of age who are served by the prekindergarten program for 1261 children with disabilities, in lieu of the Individual Education 1262 Plan. 1263 (5) There must be only a single-family support plan to 1264 address the problems of the various family members unless the 1265 family requests that an individual family support plan be 1266 developed for different members of that family. The family 1267 support plan must replace individual habilitation plans for 1268 children from 3 through 5 years old who are served by the Agency 1269 for Persons with Disabilities. 1270 (6) The family support plan at a minimum must include the 1271 following information: 1272 (a) The family’s statement of family concerns, priorities, 1273 and resources. 1274 (b) Information related to the health, educational, 1275 economic and social needs, and overall development of the 1276 individual and the family. 1277 (c) The outcomes that the plan is intended to achieve. 1278 (d) Identification of the resources and services to achieve 1279 each outcome projected in the plan. These resources and services 1280 are to be provided based on availability and funding. 1281 (7) A family support plan meeting must be held with the 1282 family to initially develop the family support plan and annually 1283 thereafter to update the plan as necessary. The family includes 1284 anyone who has an integral role in the life of the individual or 1285 child as identified by the individual or family. The family 1286 support plan must be reviewed periodically during the year, at 1287 least at 6-month intervals, to modify and update the plan as 1288 needed. Such periodic reviews do not require a family support 1289 plan team meeting but may be accomplished through other means 1290 such as a case file review and telephone conference with the 1291 family. 1292 (8) The initial family support plan must be developed 1293 within a 90-day period. If exceptional circumstances make it 1294 impossible to complete the evaluation activities and to hold the 1295 initial family support plan team meeting within a reasonable 1296 time period, these circumstances must be documented, and the 1297 individual or family must be notified of the reason for the 1298 delay. With the agreement of the family and the provider, 1299 services for which either the individual or the family is 1300 eligible may be initiated before the completion of the 1301 evaluation activities and the family support plan. 1302 (9) The Department of Children and FamiliesFamily1303Services, the Department of Health, and the Department of 1304 Education, to the extent that funds are available, must offer 1305 technical assistance to communities to facilitate the 1306 implementation of the family support plan. 1307 (10) The Department of Children and FamiliesFamily1308Services, the Department of Health, and the Department of 1309 Education shall adopt rules necessary to implement this act. 1310 Section 38. Section 414.24, Florida Statutes, is amended to 1311 read: 1312 414.24 Integrated welfare reform and child welfare 1313 services.—The department shall develop integrated service 1314 delivery strategies to better meet the needs of families subject 1315 to work activity requirements who are involved in the child 1316 welfare system or are at high risk of involvement in the child 1317 welfare system. To the extent that resources are available, the 1318 department and the Department of Labor and Employment Security 1319 shall provide funds to one or more circuitsservice districtsto 1320 promote development of integrated, nonduplicative case 1321 management within the department, the Department of Labor and 1322 Employment Security, other participating government agencies, 1323 and community partners. Alternative delivery systems shall be 1324 encouraged which include well-defined, pertinent outcome 1325 measures. Other factors to be considered shall include 1326 innovation regarding training, enhancement of existing 1327 resources, and increased private sector and business sector 1328 participation. 1329 Section 39. Subsection (8) of section 415.1113, Florida 1330 Statutes, is amended to read: 1331 415.1113 Administrative fines for false report of abuse, 1332 neglect, or exploitation of a vulnerable adult.— 1333 (8) All amounts collected under this section must be 1334 deposited into the Operations and Maintenance Trust Fund within 1335 the Adult ProtectionServicesProgram of the department. 1336 Section 40. Subsections (1) through (3) of section 420.621, 1337 Florida Statutes, are renumbered as subsections (2) through (4), 1338 respectively, and present subsection (4) of that section is 1339 renumbered as subsection (1) and amended to read: 1340 420.621 Definitions.—As used in ss. 420.621-420.628, the 1341 term: 1342 (1)(4)“CircuitDistrict” means a specified geographic 1343 service area that conforms to the judicial circuits established 1344 in s. 26.021service district of the department, as set forth in1345s.20.19. 1346 Section 41. Subsection (1) of section 420.622, Florida 1347 Statutes, is amended to read: 1348 420.622 State Office on Homelessness; Council on 1349 Homelessness.— 1350 (1) The State Office on Homelessness is created within the 1351 Department of Children and FamiliesFamily Servicesto provide 1352 interagency, council, and other related coordination on issues 1353 relating to homelessness.An executive director of the office1354shall be appointed by the Governor.1355 Section 42. Subsection (4) of section 420.623, Florida 1356 Statutes, is amended to read: 1357 420.623 Local coalitions for the homeless.— 1358 (4) ANNUAL REPORTS.—The department shall submit to the 1359 Governor, the Speaker of the House of Representatives, and the 1360 President of the Senate, by June 30, an annual report consisting 1361 of a compilation of data collected by local coalitions, progress 1362 made in the development and implementation of local homeless 1363 assistance continuums of care plans in each circuitdistrict, 1364 local spending plans, programs and resources available at the 1365 local level, and recommendations for programs and funding. 1366 Section 43. Subsections (4) through (8) of section 420.625, 1367 Florida Statutes, are amended to read: 1368 420.625 Grant-in-aid program.— 1369 (4) APPLICATION PROCEDURE.—Local agencies shall submit an 1370 application for grant-in-aid funds to the circuitdistrict1371 administrator for review. During the first year of 1372 implementation, circuitdistrictadministrators shall begin to 1373 accept applications for circuitdistrictfunds no later than 1374 October 1, 1988, and by August 1 of each year thereafter for 1375 which funding for this section is provided. CircuitDistrict1376 funds shall be made available to local agencies no more than 30 1377 days after the deadline date for applications for each funding 1378 cycle. 1379 (5) SPENDING PLANS.—The department shall develop guidelines 1380 for the development of spending plans and for the evaluation and 1381 approval by circuitdistrictadministrators of spending plans, 1382 based upon such factors as: 1383 (a) The demonstrated level of need for the program. 1384 (b) The demonstrated ability of the local agency or 1385 agencies seeking assistance to deliver the services and to 1386 assure that identified needs will be met. 1387 (c) The ability of the local agency or agencies seeking 1388 assistance to deliver a wide range of services as enumerated in 1389 subsection (3). 1390 (d) The adequacy and reasonableness of proposed budgets and 1391 planned expenditures, and the demonstrated capacity of the local 1392 agency or agencies to administer the funds sought. 1393 (e) A statement from the local coalition for the homeless 1394 as to the steps to be taken to assure coordination and 1395 integration of services in the circuitdistrictto avoid 1396 unnecessary duplication and costs. 1397 (f) Assurances by the local coalition for the homeless that 1398 alternative funding strategies for meeting needs through the 1399 reallocation of existing resources, utilization of volunteers, 1400 and local government or private agency funding have been 1401 explored. 1402 (g) The existence of an evaluation component designed to 1403 measure program outcomes and determine the overall effectiveness 1404 of the local programs for the homeless for which funding is 1405 sought. 1406 (6) ALLOCATION OF GRANT FUNDS TO CIRCUITSDISTRICTS.—State 1407 grant-in-aid funds for local initiatives for the homeless shall 1408 be allocated by the department to, and administered by, 1409 department circuitsdistricts. Allocations shall be based upon 1410 sufficient documentation of: 1411 (a) The magnitude of the problem of homelessness in the 1412 circuitdistrict, and the demonstrated level of unmet need for 1413 services in the circuitdistrictfor those who are homeless or 1414 are about to become homeless. 1415 (b) A strong local commitment to seriously address the 1416 problem of homelessness as evidenced by coordinated programs 1417 involving preventive, emergency, and transitional services and 1418 by the existence of active local organizations committed to 1419 serving those who have become, or are about to become, homeless. 1420 (c) Agreement by local government and private agencies 1421 currently serving the homeless not to reduce current 1422 expenditures for services presently provided to those who are 1423 homeless or are about to become homeless if grant assistance is 1424 provided pursuant to this section. 1425 (d) Geographic distribution of circuitdistrictprograms to 1426 ensure that such programs serve both rural and urban areas, as 1427 needed. 1428 (7) DISTRIBUTION TO LOCAL AGENCIES.—CircuitDistrictfunds 1429 so allocated shall be available for distribution by the circuit 1430districtadministrator to local agencies to fund programs such 1431 as those set forth in subsection (3), based upon the 1432 recommendations of the local coalitions in accordance with 1433 spending plans developed by the coalitions and approved by the 1434 circuitdistrictadministrator. Not more than 10 percent of the 1435 total state funds awarded under a spending plan may be used by 1436 the local coalition for staffing and administration. 1437 (8) LOCAL MATCHING FUNDS.—Entities contracting to provide 1438 services through financial assistance obtained under this 1439 section shall provide a minimum of 25 percent of the funding 1440 necessary for the support of project operations. In-kind 1441 contributions, whether materials, commodities, transportation, 1442 office space, other types of facilities, or personal services, 1443 and contributions of money or services from homeless persons may 1444 be evaluated and counted as part or all of this required local 1445 funding, in the discretion of the circuitdistrict1446 administrator. 1447 Section 44. Subsection (2) of section 429.35, Florida 1448 Statutes, is amended to read: 1449 429.35 Maintenance of records; reports.— 1450 (2) Within 60 days after the date of the biennial 1451 inspection visit required under s. 408.811 or within 30 days 1452 after the date of any interim visit, the agency shall forward 1453 the results of the inspection to the local ombudsman council in 1454 whose planning and service area, as defined in part II of 1455 chapter 400, the facility is located; to at least one public 1456 library or, in the absence of a public library, the county seat 1457 in the county in which the inspected assisted living facility is 1458 located; and, when appropriate, to the circuitdistrictAdult 1459 ProtectionServicesand Mental Health Program Offices. 1460 Section 45. Paragraph (d) of subsection (3) of section 1461 1002.67, Florida Statutes, is amended to read: 1462 1002.67 Performance standards; curricula and 1463 accountability.— 1464 (3) 1465 (d) Each early learning coalition, the Agency for Workforce 1466 Innovation, and the department shall coordinate with the Child 1467 Care LicensureServicesProgram Office of the Department of 1468 Children and FamiliesFamily Servicesto minimize interagency 1469 duplication of activities for monitoring private prekindergarten 1470 providers for compliance with requirements of the Voluntary 1471 Prekindergarten Education Program under this part, the school 1472 readiness programs under s. 411.01, and the licensing of 1473 providers under ss. 402.301-402.319. 1474 Section 46. Sections 39.311, 39.312, 39.313, 39.314, 1475 39.315, 39.316, 39.317, 39.318, 394.9083, and 402.35, Florida 1476 Statutes, are repealed. 1477 Section 47. Subsection (3) of section 39.407, Florida 1478 Statutes, is amended to read: 1479 39.407 Medical, psychiatric, and psychological examination 1480 and treatment of child; physical, mental, or substance abuse 1481 examination of person with or requesting child custody.— 1482 (3)(a) All children placed in out-of-home care shall be 1483 provided with a comprehensive behavioral health assessment. The 1484 child protective investigator or dependency case manager shall 1485 submit a referral for such assessment within 7 days after the 1486 child is placed in out-of-home care. 1487 (b) Any child who has been in out-of-home care for more 1488 than 1 year, or who did not receive a comprehensive behavioral 1489 health assessment when placed into out-of-home care, is eligible 1490 to receive a comprehensive behavioral health assessment. Such 1491 assessments evaluate behaviors that give rise to the concern 1492 that the child has unmet mental health needs. Any party to the 1493 dependency proceeding, or the court on its own motion, may 1494 request that an assessment be performed. 1495 (c) The child protective investigator or dependency case 1496 manager is responsible for ensuring that all recommendations in 1497 the comprehensive behavioral health assessment are incorporated 1498 into the child’s case plan and that the recommended services are 1499 provided in a timely manner. If, at a case planning conference, 1500 a determination is made that a specific recommendation should 1501 not be included in a child’s case plan, a written explanation 1502 must be provided to the court as to why the recommendation is 1503 not being followed. 1504 (d) This subsection does not to prevent a child from 1505 receiving any other form of psychological assessment if needed. 1506 (e) If it is determined that a child is in need of mental 1507 health services, the comprehensive behavioral health assessment 1508 must be provided to the physician involved in developing the 1509 child’s mental health treatment plan, pursuant to s. 39.4071(9). 1510(3)(a)1. Except as otherwise provided in subparagraph (b)1.1511or paragraph (e), before the department provides psychotropic1512medications to a child in its custody, the prescribing physician1513shall attempt to obtain express and informed consent, as defined1514in s.394.455(9) and as described in s.394.459(3)(a), from the1515child’s parent or legal guardian. The department must take steps1516necessary to facilitate the inclusion of the parent in the1517child’s consultation with the physician. However, if the1518parental rights of the parent have been terminated, the parent’s1519location or identity is unknown or cannot reasonably be1520ascertained, or the parent declines to give express and informed1521consent, the department may, after consultation with the1522prescribing physician, seek court authorization to provide the1523psychotropic medications to the child. Unless parental rights1524have been terminated and if it is possible to do so, the1525department shall continue to involve the parent in the1526decisionmaking process regarding the provision of psychotropic1527medications. If, at any time, a parent whose parental rights1528have not been terminated provides express and informed consent1529to the provision of a psychotropic medication, the requirements1530of this section that the department seek court authorization do1531not apply to that medication until such time as the parent no1532longer consents.15332. Any time the department seeks a medical evaluation to1534determine the need to initiate or continue a psychotropic1535medication for a child, the department must provide to the1536evaluating physician all pertinent medical information known to1537the department concerning that child.1538(b)1. If a child who is removed from the home under s.153939.401is receiving prescribed psychotropic medication at the1540time of removal and parental authorization to continue providing1541the medication cannot be obtained, the department may take1542possession of the remaining medication and may continue to1543provide the medication as prescribed until the shelter hearing,1544if it is determined that the medication is a current1545prescription for that child and the medication is in its1546original container.15472. If the department continues to provide the psychotropic1548medication to a child when parental authorization cannot be1549obtained, the department shall notify the parent or legal1550guardian as soon as possible that the medication is being1551provided to the child as provided in subparagraph 1. The child’s1552official departmental record must include the reason parental1553authorization was not initially obtained and an explanation of1554why the medication is necessary for the child’s well-being.15553.If the department is advised by a physician licensed1556under chapter 458 or chapter 459 that the child should continue1557the psychotropic medication and parental authorization has not1558been obtained, the department shall request court authorization1559at the shelter hearing to continue to provide the psychotropic1560medication and shall provide to the court any information in its1561possession in support of the request. Any authorization granted1562at the shelter hearing may extend only until the arraignment1563hearing on the petition for adjudication of dependency or 281564days following the date of removal, whichever occurs sooner.15654. Before filing the dependency petition, the department1566shall ensure that the child is evaluated by a physician licensed1567under chapter 458 or chapter 459 to determine whether it is1568appropriate to continue the psychotropic medication. If, as a1569result of the evaluation, the department seeks court1570authorization to continue the psychotropic medication, a motion1571for such continued authorization shall be filed at the same time1572as the dependency petition, within 21 days after the shelter1573hearing.1574(c) Except as provided in paragraphs (b) and (e), the1575department must file a motion seeking the court’s authorization1576to initially provide or continue to provide psychotropic1577medication to a child in its legal custody. The motion must be1578supported by a written report prepared by the department which1579describes the efforts made to enable the prescribing physician1580to obtain express and informed consent for providing the1581medication to the child and other treatments considered or1582recommended for the child. In addition, the motion must be1583supported by the prescribing physician’s signed medical report1584providing:15851. The name of the child, the name and range of the dosage1586of the psychotropic medication, and that there is a need to1587prescribe psychotropic medication to the child based upon a1588diagnosed condition for which such medication is being1589prescribed.15902. A statement indicating that the physician has reviewed1591all medical information concerning the child which has been1592provided.15933. A statement indicating that the psychotropic medication,1594at its prescribed dosage, is appropriate for treating the1595child’s diagnosed medical condition, as well as the behaviors1596and symptoms the medication, at its prescribed dosage, is1597expected to address.15984. An explanation of the nature and purpose of the1599treatment; the recognized side effects, risks, and1600contraindications of the medication; drug-interaction1601precautions; the possible effects of stopping the medication;1602and how the treatment will be monitored, followed by a statement1603indicating that this explanation was provided to the child if1604age appropriate and to the child’s caregiver.16055. Documentation addressing whether the psychotropic1606medication will replace or supplement any other currently1607prescribed medications or treatments; the length of time the1608child is expected to be taking the medication; and any1609additional medical, mental health, behavioral, counseling, or1610other services that the prescribing physician recommends.1611(d)1. The department must notify all parties of the1612proposed action taken under paragraph (c) in writing or by1613whatever other method best ensures that all parties receive1614notification of the proposed action within 48 hours after the1615motion is filed. If any party objects to the department’s1616motion, that party shall file the objection within 2 working1617days after being notified of the department’s motion. If any1618party files an objection to the authorization of the proposed1619psychotropic medication, the court shall hold a hearing as soon1620as possible before authorizing the department to initially1621provide or to continue providing psychotropic medication to a1622child in the legal custody of the department. At such hearing1623and notwithstanding s.90.803, the medical report described in1624paragraph (c) is admissible in evidence. The prescribing1625physician need not attend the hearing or testify unless the1626court specifically orders such attendance or testimony, or a1627party subpoenas the physician to attend the hearing or provide1628testimony. If, after considering any testimony received, the1629court finds that the department’s motion and the physician’s1630medical report meet the requirements of this subsection and that1631it is in the child’s best interests, the court may order that1632the department provide or continue to provide the psychotropic1633medication to the child without additional testimony or1634evidence. At any hearing held under this paragraph, the court1635shall further inquire of the department as to whether additional1636medical, mental health, behavioral, counseling, or other1637services are being provided to the child by the department which1638the prescribing physician considers to be necessary or1639beneficial in treating the child’s medical condition and which1640the physician recommends or expects to provide to the child in1641concert with the medication. The court may order additional1642medical consultation, including consultation with the MedConsult1643line at the University of Florida, if available, or require the1644department to obtain a second opinion within a reasonable1645timeframe as established by the court, not to exceed 21 calendar1646days, after such order based upon consideration of the best1647interests of the child. The department must make a referral for1648an appointment for a second opinion with a physician within 11649working day. The court may not order the discontinuation of1650prescribed psychotropic medication if such order is contrary to1651the decision of the prescribing physician unless the court first1652obtains an opinion from a licensed psychiatrist, if available,1653or, if not available, a physician licensed under chapter 458 or1654chapter 459, stating that more likely than not, discontinuing1655the medication would not cause significant harm to the child.1656If, however, the prescribing psychiatrist specializes in mental1657health care for children and adolescents, the court may not1658order the discontinuation of prescribed psychotropic medication1659unless the required opinion is also from a psychiatrist who1660specializes in mental health care for children and adolescents.1661The court may also order the discontinuation of prescribed1662psychotropic medication if a child’s treating physician,1663licensed under chapter 458 or chapter 459, states that1664continuing the prescribed psychotropic medication would cause1665significant harm to the child due to a diagnosed nonpsychiatric1666medical condition.16672. The burden of proof at any hearing held under this1668paragraph shall be by a preponderance of the evidence.1669(e)1. If the child’s prescribing physician certifies in the1670signed medical report required in paragraph (c) that delay in1671providing a prescribed psychotropic medication would more likely1672than not cause significant harm to the child, the medication may1673be provided in advance of the issuance of a court order. In such1674event, the medical report must provide the specific reasons why1675the child may experience significant harm and the nature and the1676extent of the potential harm. The department must submit a1677motion seeking continuation of the medication and the1678physician’s medical report to the court, the child’s guardian ad1679litem, and all other parties within 3 working days after the1680department commences providing the medication to the child. The1681department shall seek the order at the next regularly scheduled1682court hearing required under this chapter, or within 30 days1683after the date of the prescription, whichever occurs sooner. If1684any party objects to the department’s motion, the court shall1685hold a hearing within 7 days.16862. Psychotropic medications may be administered in advance1687of a court order in hospitals, crisis stabilization units, and1688in statewide inpatient psychiatric programs. Within 3 working1689days after the medication is begun, the department must seek1690court authorization as described in paragraph (c).1691(f)1. The department shall fully inform the court of the1692child’s medical and behavioral status as part of the social1693services report prepared for each judicial review hearing held1694for a child for whom psychotropic medication has been prescribed1695or provided under this subsection. As a part of the information1696provided to the court, the department shall furnish copies of1697all pertinent medical records concerning the child which have1698been generated since the previous hearing. On its own motion or1699on good cause shown by any party, including any guardian ad1700litem, attorney, or attorney ad litem who has been appointed to1701represent the child or the child’s interests, the court may1702review the status more frequently than required in this1703subsection.17042. The court may, in the best interests of the child, order1705the department to obtain a medical opinion addressing whether1706the continued use of the medication under the circumstances is1707safe and medically appropriate.1708(g) The department shall adopt rules to ensure that1709children receive timely access to clinically appropriate1710psychotropic medications. These rules must include, but need not1711be limited to, the process for determining which adjunctive1712services are needed, the uniform process for facilitating the1713prescribing physician’s ability to obtain the express and1714informed consent of a child’s parent or guardian, the procedures1715for obtaining court authorization for the provision of a1716psychotropic medication, the frequency of medical monitoring and1717reporting on the status of the child to the court, how the1718child’s parents will be involved in the treatment-planning1719process if their parental rights have not been terminated, and1720how caretakers are to be provided information contained in the1721physician’s signed medical report. The rules must also include1722uniform forms to be used in requesting court authorization for1723the use of a psychotropic medication and provide for the1724integration of each child’s treatment plan and case plan. The1725department must begin the formal rulemaking process within 901726days after the effective date of this act.1727 Section 48. Section 39.4071, Florida Statutes, is created 1728 to read: 1729 39.4071 Use of psychotropic medication for children in out 1730 of-home placement.— 1731 (1) LEGISLATIVE FINDINGS AND INTENT.— 1732 (a) The Legislature finds that children in out-of-home 1733 placements often have multiple risk factors that predispose them 1734 to emotional and behavioral disorders and that they receive 1735 mental health services at higher rates and are more likely to be 1736 given psychotropic medications than children from comparable 1737 backgrounds. 1738 (b) The Legislature also finds that the use of psychotropic 1739 medications for the treatment of children in out-of-home 1740 placements who have emotional and behavioral disturbances has 1741 increased over recent years. While the increased use of 1742 psychotropic medications is paralleled by an increase in the 1743 rate of the coadministration of two or more psychotropic 1744 medications, data on the safety and efficacy of many of the 1745 psychotropic medications used in children and research 1746 supporting the coadministration of two or more psychotropic 1747 medications in this population is limited. 1748 (c) The Legislature further finds that significant 1749 challenges are encountered in providing quality mental health 1750 care to children in out-of-home placements. Not uncommonly, 1751 children in out-of-home placements are subjected to multiple 1752 placements and many service providers, with communication 1753 between providers often poor, resulting in fragmented medical 1754 and mental health care. The dependable, ongoing therapeutic and 1755 caregiving relationships these children need are hampered by the 1756 high turnover among child welfare caseworkers and care 1757 providers. Furthermore, children in out-of-home placements, 1758 unlike children from intact families, often have no consistent 1759 interested party who is available to coordinate treatment and 1760 monitoring plans or to provide longitudinal oversight of care. 1761 (d) The Legislature recognizes the important role the 1762 Guardian ad Litem Program has played in Florida’s dependency 1763 system for the past 30 years serving the state’s most vulnerable 1764 children through the use of trained volunteers, case 1765 coordinators, child advocates and attorneys. The program’s 1766 singular focus is on the child and its mission is to advocate 1767 for the best interest of the child. It is often the guardian ad 1768 litem who is the constant in a child’s life, maintaining 1769 consistent contact with the child, the child’s caseworkers, and 1770 others involved with the child, including family, doctors, 1771 teachers, and service providers. Studies have shown that a child 1772 assigned a guardian ad litem will, on average, experience fewer 1773 placement changes than a child without a guardian ad litem. It 1774 is therefore the intent of the Legislature that children in out 1775 of-home placements who may benefit from psychotropic medications 1776 receive those medications safely as part of a comprehensive 1777 mental health treatment plan requiring the appointment of a 1778 guardian ad litem whose responsibility is to monitor the plan 1779 for compliance and suitability as to the child’s best interest. 1780 (2) DEFINITIONS.—As used in this section, the term: 1781 (a) “Behavior analysis” means services rendered by a 1782 provider who is certified by the Behavior Analysis Certification 1783 Board in accordance with chapter 393. 1784 (b) “Obtaining assent” means a process by which a provider 1785 of medical services helps a child achieve a developmentally 1786 appropriate awareness of the nature of his or her condition, 1787 informs the child of what can be expected through tests and 1788 treatment, makes a clinical assessment of the child’s 1789 understanding of the situation and the factors influencing how 1790 he or she is responding, and solicits an expression of the 1791 child’s willingness to adhere to the proposed care. The mere 1792 absence of an objection by the child may not be construed as 1793 assent. 1794 (c) “Comprehensive behavioral health assessment” means an 1795 in-depth and detailed assessment of the child’s emotional, 1796 social, behavioral, and developmental functioning within the 1797 family home, school, and community. A comprehensive behavioral 1798 health assessment includes direct observation of the child in 1799 the home, school, and community, as well as in the clinical 1800 setting, and adheres to the requirements in the Florida Medicaid 1801 Community Behavioral Health Services Coverage and Limitations 1802 Handbook. 1803 (d) “Express and informed consent” means a process by which 1804 a provider of medical services obtains voluntary consent from a 1805 parent whose rights have not been terminated or a legal guardian 1806 of the child who has received full, accurate, and sufficient 1807 information and an explanation about the child’s medical 1808 condition, medication, and treatment in order to enable the 1809 parent or guardian to make a knowledgeable decision without any 1810 element of fraud, deceit, duress, or other form of coercion. 1811 (e) “Mental health treatment plan” means a plan that lists 1812 the particular mental health needs of the child and the services 1813 that will be provided to address those needs. If the plan 1814 includes prescribing psychotropic medication to a child in out 1815 of-home placement, the plan must also include the information 1816 required under subsection (9). 1817 (f) “Psychotropic medication” means a prescription 1818 medication that is used for the treatment of mental disorders 1819 and includes, without limitation, hypnotics, antipsychotics, 1820 antidepressants, antianxiety agents, sedatives, stimulants, and 1821 mood stabilizers. 1822 (3) APPOINTMENT OF GUARDIAN AD LITEM.— 1823 (a) If not already appointed, a guardian ad litem shall be 1824 appointed by the court at the earliest possible time to 1825 represent the best interests of a child in out-of-home placement 1826 who is prescribed a psychotropic medication or is being 1827 evaluated for the initiation of psychotropic medication. 1828 Pursuant to s. 39.820, the appointed guardian ad litem is a 1829 party to any judicial proceeding as a representative of the 1830 child and serves until discharged by the court. 1831 (b) Pursuant to this section, the guardian ad litem shall 1832 participate in the development of the mental health treatment 1833 plan, monitor whether all requirements of the mental health 1834 treatment plan are being provided to the child, including 1835 counseling, behavior analysis, or other services, medications, 1836 and treatment modalities; and notice the court of the child’s 1837 objections, if any, to the mental health treatment plan. The 1838 guardian ad litem shall prepare and submit to the court a 1839 written report every 45 days or as directed by the court, 1840 advising the court and the parties as to the status of the care, 1841 health, and medical treatment of the child pursuant to the 1842 mental health treatment plan and any change in the status of the 1843 child. The guardian ad litem must immediately notify parties as 1844 soon as a medical emergency of the child becomes known. The 1845 guardian ad litem shall ensure that the prescribing physician 1846 has been provided with all pertinent medical information 1847 concerning the child. 1848 (c) The department and the community-based care lead agency 1849 shall notify the court and the guardian ad litem, and, if 1850 applicable, the child’s attorney, in writing within 24 hours 1851 after any change in the status of the child, including, but not 1852 limited to, a change in placement, a change in school, a change 1853 in medical condition or medication, or a change in prescribing 1854 physician, other service providers, counseling, or treatment 1855 scheduling. 1856 (4) PSYCHIATRIC EVALUATION OF CHILD.—Whenever the 1857 department believes that a child in its legal custody may need 1858 psychiatric treatment, an evaluation must be conducted by a 1859 physician licensed under chapter 458 or chapter 459. 1860 (5) EXPRESS AND INFORMED CONSENT AND ASSENT.—If, at the 1861 time of removal from his or her home, a child is being provided, 1862 or at any time is being evaluated for the initiation of, 1863 prescribed psychotropic medication under this section, express 1864 and informed consent and assent shall be sought by the 1865 prescribing physician. 1866 (a) The prescribing physician shall obtain assent from the 1867 child, unless the prescribing physician determines that it is 1868 not appropriate. In making this assessment, the prescribing 1869 physician shall consider the capacity of the child to make an 1870 independent decision based on his or her age, maturity, and 1871 psychological and emotional state. If the physician determines 1872 that it is not appropriate, the physician must document the 1873 decision in the mental health treatment plan. If the physician 1874 determines it is appropriate and the child refuses to give 1875 assent, the physician must document the child’s refusal in the 1876 mental health treatment plan. 1877 1. Assent from a child shall be sought in a manner that is 1878 understandable to the child using a developmentally appropriate 1879 assent form. The child shall be provided with sufficient 1880 information, such as the nature and purpose of the medication, 1881 how it will be administered, the probable risks and benefits, 1882 alternative treatments and the risks and benefits thereof, and 1883 the risks and benefits of refusing or discontinuing the 1884 medication, and when it may be appropriately discontinued. 1885 Assent may be oral or written and must be documented by the 1886 prescribing physician. 1887 2. Oral assent is appropriate for a child who is younger 1888 than 7 years of age. Assent from a child who is 7 to 13 years of 1889 age may be sought orally or in a simple form that is written at 1890 the second-grade or third-grade reading level. A child who is 14 1891 years of age or older may understand the language presented in 1892 the consent form for parents or legal guardians. If so, the 1893 child may sign the consent form along with the parent or legal 1894 guardian. Forms for parents and older children shall be written 1895 at the sixth grade to eighth-grade reading level. 1896 3. In each case where assent is obtained, a copy of the 1897 assent documents must be provided to the parent or legal 1898 guardian and the guardian ad litem, with the original assent 1899 documents becoming a part of the child’s mental health treatment 1900 plan and filed with the court. 1901 (b) Express and informed consent for the administration of 1902 psychotropic medication may be given only by a parent whose 1903 rights have not been terminated or a legal guardian of the child 1904 who has received full, accurate, and sufficient information and 1905 an explanation about the child’s medical condition, medication, 1906 and treatment in order to enable the parent or guardian to make 1907 a knowledgeable decision. A sufficient explanation includes, but 1908 need not be limited to, the following information, which must be 1909 provided and explained in plain language by the prescribing 1910 physician to the parent or legal guardian: the child’s 1911 diagnosis, the symptoms to be addressed by the medication, the 1912 name of the medication and its dosage ranges, the reason for 1913 prescribing it, and its purpose or intended results; benefits, 1914 side effects, risks, and contraindications, including effects of 1915 not starting or stopping the medication; method for 1916 administering the medication and how it will monitored; 1917 potential drug interactions; alternative treatments to 1918 psychotropic medication; a plan to reduce or eliminate ongoing 1919 medication when medically appropriate; the counseling, 1920 behavioral analysis, or other services used to complement the 1921 use of medication, if applicable; and that the parent or legal 1922 guardian may revoke the consent at any time. 1923 1. Express and informed consent may be oral or written and 1924 must be documented by the prescribing physician. If the 1925 department or the physician is unable to obtain consent from the 1926 parent or legal guardian, the reasons must be documented. 1927 2. If express and informed consent is obtained, a copy of 1928 the consent documents must be provided to the parent or legal 1929 guardian and the guardian ad litem, with the original consent 1930 documents becoming a part of the child’s mental health treatment 1931 plan and filed with the court. 1932 (c) The informed consent of any parent whose whereabouts 1933 are unknown for 60 days, who is adjudicated incapacitated, who 1934 does not have regular and frequent contact with the child, who 1935 later revokes assent, or whose parental rights are terminated 1936 after giving consent, is invalid. If the informed consent of a 1937 parent becomes invalid, the department may seek informed consent 1938 from any other parent or legal guardian. If the informed consent 1939 provided by a parent whose parental rights have been terminated 1940 is invalid and no other parent or legal guardian gives informed 1941 consent, the department shall file a motion for the 1942 administration of psychotropic medication along with the motion 1943 for final judgment of termination of parental rights. 1944 (d) If consent is revoked or becomes invalid the department 1945 shall immediately notify all parties and, if applicable, the 1946 child’s attorney. Medication shall be continued until such time 1947 as the court rules on the motion. 1948 (e) A medication may not be discontinued without explicit 1949 instruction from a physician as to how to safely discontinue the 1950 medication. 1951 (6) ADMINISTRATION OF PSYCHOTROPIC MEDICATION TO A CHILD IN 1952 SHELTER CARE OR IN FOSTER CARE WHEN INFORMED CONSENT HAS NOT 1953 BEEN OBTAINED.— 1954 (a) Motion for court authorization for administration of 1955 psychotropic medications. 1956 1. If a physician who has evaluated the child prescribes 1957 psychotropic medication as part of the mental health treatment 1958 plan and the child’s parents or legal guardians have not 1959 provided express and informed consent as provided by law or such 1960 consent is invalid as set forth in paragraph (5)(c), the 1961 department or its agent shall file a motion with the court 1962 within 3 working days to authorize the administration of the 1963 psychotropic medication before the administration of the 1964 medication, except as provided in subsection (7). In each case 1965 in which a motion is required, the motion must include: 1966 a. A written report by the department describing the 1967 efforts made to enable the prescribing physician to obtain 1968 express and informed consent and describing other treatments 1969 attempted, considered, and recommended for the child; and 1970 b. The prescribing physician’s completed and signed mental 1971 health treatment plan. 1972 2. The department must file a copy of the motion with the 1973 court and, within 48 hours after filing the motion, notify all 1974 parties in writing, or by whatever other method best ensures 1975 that all parties receive notification, of its proposed 1976 administration of psychotropic medication to the child. 1977 3. If any party objects to the proposed administration of 1978 the psychotropic medication to the child, that party must file 1979 its objection within 2 working days after being notified of the 1980 department’s motion. A party may request an extension of time to 1981 object for good cause shown if such extension would be in the 1982 best interests of the child. Any extension must be for a 1983 specific number of days not to exceed the time absolutely 1984 necessary. 1985 4. Lack of assent from the child is deemed a timely 1986 objection from the child. 1987 (b) Court action on motion for administration of 1988 psychotropic medication. 1989 1. If no party timely files an objection to the 1990 department’s motion and the motion is legally sufficient, the 1991 court may enter its order authorizing the proposed 1992 administration of the psychotropic medication without a hearing. 1993 Based on its determination of the best interests of the child, 1994 the court may order additional medical consultation, including 1995 consultation with the MedConsult line at the University of 1996 Florida, if available, or require the department to obtain a 1997 second opinion within a reasonable time established by the 1998 court, not to exceed 21 calendar days. If the court orders an 1999 additional medical consultation or second medical opinion, the 2000 department shall file a written report including the results of 2001 this additional consultation or a copy of the second medical 2002 opinion with the court within the time required by the court, 2003 and serve a copy of the report on all parties. 2004 2. If any party timely files its objection to the proposed 2005 administration of the psychotropic medication, the court shall 2006 hold a hearing as soon as possible on the department’s motion. 2007 a. The signed mental health treatment plan of the 2008 prescribing physician is admissible in evidence at the hearing. 2009 b. The court shall ask the department whether additional 2010 medical, mental health, behavior analysis, counseling, or other 2011 services are being provided to the child which the prescribing 2012 physician considers to be necessary or beneficial in treating 2013 the child’s medical condition and which the physician recommends 2014 or expects to be provided to the child along with the 2015 medication. 2016 3. The court may order additional medical consultation or a 2017 second medical opinion, as provided in this paragraph. 2018 4. After considering the department’s motion and any 2019 testimony received, the court may enter its order authorizing 2020 the department to provide or continue to provide the proposed 2021 psychotropic medication. The court must find a compelling 2022 governmental interest that the proposed psychotropic medication 2023 is in the child’s best interest. In so determining the court 2024 shall, at a minimum, consider the following factors: 2025 a. The severity and likelihood of risks associated with the 2026 treatment. 2027 b. The magnitude and likelihood of benefits expected from 2028 the treatment. 2029 c. The child’s prognosis without the proposed psychotropic 2030 medication. 2031 d. The availability and effectiveness of alternative 2032 treatments. 2033 e. The wishes of the child concerning treatment 2034 alternatives. 2035 f. The recommendation of the parents or legal guardian. 2036 g. The recommendation of the guardian ad litem. 2037 (7) ADMINISTRATION OF PSYCHOTROPIC MEDICATION TO A CHILD IN 2038 OUT-OF-HOME CARE BEFORE COURT AUTHORIZATION HAS BEEN OBTAINED. 2039 The department may provide continued administration of 2040 psychotropic medication to a child before authorization by the 2041 court has been obtained only as provided in this subsection. 2042 (a) If a child is removed from the home and taken into 2043 custody under s. 39.401, the department may continue to 2044 administer a current prescription of psychotropic medication; 2045 however, the department shall request court authorization for 2046 the continued administration of the medication at the shelter 2047 hearing. This request shall be included in the shelter petition. 2048 1. The department shall provide all information in its 2049 possession to the court in support of its request at the shelter 2050 hearing. The court may authorize the continued administration of 2051 the psychotropic medication only until the arraignment hearing 2052 on the petition for adjudication, or for 28 days following the 2053 date of the child’s removal, whichever occurs first. 2054 2. If the department believes, based on the required 2055 physician’s evaluation, that it is appropriate to continue the 2056 psychotropic medication beyond the time authorized by the court 2057 at the shelter hearing, the department shall file a motion 2058 seeking continued court authorization at the same time that it 2059 files the dependency petition, but within 21 days after the 2060 shelter hearing. 2061 (b) If the department believes, based on the certification 2062 of the prescribing physician, that delay in providing the 2063 prescribed psychotropic medication would, more likely than not, 2064 cause significant harm to the child, the department shall 2065 administer the medication immediately. The department must 2066 submit a motion to the court seeking continuation of the 2067 medication within 3 working days after the department begins 2068 providing the medication to the child. 2069 1. The motion seeking authorization for the continued 2070 administration of the psychotropic medication must include all 2071 information required in this section. The required medical 2072 report must also include the specific reasons why the child may 2073 experience significant harm, and the nature and the extent of 2074 the potential harm, resulting from a delay in authorizing the 2075 prescribed medication. 2076 2. The department shall serve the motion on all parties 2077 within 3 working days after the department begins providing the 2078 medication to the child. 2079 3. The court shall hear the department’s motion at the next 2080 regularly scheduled court hearing required by law, or within 30 2081 days after the date of the prescription, whichever occurs first. 2082 However, if any party files an objection to the motion, the 2083 court must hold a hearing within 7 days. 2084 (c) The department may authorize, in advance of a court 2085 order, the administration of psychotropic medications to a child 2086 in its custody in a hospital, crisis stabilization unit or 2087 receiving facility, therapeutic group home, or statewide 2088 inpatient psychiatric program. If the department does so, it 2089 must file a motion to seek court authorization for the continued 2090 administration of the medication within 3 working days as 2091 required in this section. 2092 (d) If a child receives a one-time dose of a psychotropic 2093 medication during a crisis, the department shall provide 2094 immediate notice to all parties and to the court of each such 2095 emergency use. 2096 (8) DISCONTINUATION OR ALTERATION OF MEDICATION; 2097 DESTRUCTION OF MEDICATION.—A party may not alter the provision 2098 of prescribed psychotropic medication in any way except upon 2099 order of the court or advice of a physician. 2100 (a) On the motion of any party or its own motion, the court 2101 may order the discontinuation of a medication already 2102 prescribed. Such discontinuation must be performed in 2103 consultation with a physician in such a manner as to minimize 2104 risk to the child. 2105 (b) The child’s repeated refusal to take or continue to 2106 take a medication shall be treated as a motion to discontinue 2107 the medication and shall be set for hearing as soon as possible 2108 but within 7 days after knowledge of such repeated refusal. 2109 (c) Upon any discontinuation of a medication, the 2110 department shall document the date and reason for the 2111 discontinuation and notify all parties. The guardian ad litem 2112 must be notified within 24 hours as previously provided herein. 2113 (d) The department shall ensure the destruction of any 2114 medication no longer being taken by the prescribed child. 2115 (9) DEVELOPMENT OF MENTAL HEALTH TREATMENT PLAN.—Upon the 2116 determination that a child needs mental health services, a 2117 mental health treatment plan must be developed which lists the 2118 particular mental health needs of the child and the services 2119 that will be provided to address those needs. If possible, the 2120 plan shall be developed in a face-to-face conference with the 2121 child, the child’s parents, case manager, physician, therapist, 2122 legal guardian, guardian ad litem, and any other interested 2123 party. The mental health treatment plan shall be incorporated 2124 into the case plan as tasks for the department and may be 2125 amended under s. 39.6013. 2126 (a) If the mental health treatment plan involves the 2127 provision of psychotropic medication, the plan must include: 2128 1. The name of the child, a statement indicating that there 2129 is a need to prescribe psychotropic medication based upon a 2130 diagnosed condition for which there is an evidence base for the 2131 medication that is being prescribed, a statement indicating the 2132 compelling governmental interest in prescribing the psychotropic 2133 medication, and the name and range of the dosage of the 2134 psychotropic medication. 2135 2. A statement indicating that the physician has reviewed 2136 all medical information concerning the child which has been 2137 provided by the department or community-based care lead agency 2138 and briefly listing all information received. 2139 3. A medication profile, including all medications the 2140 child is prescribed or will be prescribed, any previously 2141 prescribed medications if known, and whether those medications 2142 are being added, continued, or discontinued upon implementation 2143 of the mental health treatment plan. 2144 4. A statement indicating that the psychotropic medication, 2145 at its prescribed dosage, is appropriate for treating the 2146 child’s diagnosed medical condition, as well as the behaviors 2147 and symptoms that the medication, at its prescribed dosage, is 2148 expected to address. 2149 5. An explanation of the nature and purpose of the 2150 treatment; the recognized side effects, risks, and 2151 contraindications of the medication, including procedures for 2152 reporting adverse effects; drug-interaction precautions; the 2153 possible effects of stopping or not initiating the medication; 2154 and how the treatment will be monitored, followed by a statement 2155 indicating that this explanation was provided to the child if 2156 developmentally appropriate and to the child’s caregiver. 2157 6. Documentation addressing whether the psychotropic 2158 medication will replace or supplement any other currently 2159 prescribed medications or treatments; the length of time the 2160 child is expected to be taking the medication; a plan for the 2161 discontinuation of any medication if medically appropriate; and 2162 any additional medical, mental health, behavioral, counseling, 2163 or other services that the prescribing physician recommends as 2164 part of a comprehensive treatment plan. 2165 7. A document describing those observable behaviors 2166 warranting psychotropic treatment, the means for obtaining 2167 reliable frequency data on these same observable behaviors, and 2168 the reporting of this data with sufficient frequency to support 2169 medication decisions. 2170 (b) The department shall develop and administer procedures 2171 to require the caregiver and prescribing physician to report any 2172 adverse side effects of the medication to the department or its 2173 designee and the guardian ad litem. Any adverse side effects 2174 must be documented in the mental health treatment plan and 2175 medical records for the child. 2176 (10) REVIEW FOR ADMINISTRATION OF PSYCHOTROPIC MEDICATION 2177 FOR CHILDREN FROM BIRTH THROUGH 10 YEARS OF AGE IN OUT-OF-HOME 2178 CARE.— 2179 (a) Absent a finding of a compelling state interest, a 2180 psychotropic medication may not be authorized by the court for 2181 any child from birth through 10 years of age who is in out-of 2182 home placement. Based on a finding of a compelling state 2183 interest but before a psychotropic medication is authorized by 2184 the court for such child, a review of the administration must be 2185 obtained from a child psychiatrist who is licensed under chapter 2186 458 or chapter 459. The results of this review must be provided 2187 to the child and the parent or legal guardian before final 2188 express and informed consent is given. 2189 (b) In advance of a court order, the department may 2190 authorize the administration of psychotropic medications to a 2191 child from birth through 10 years of age in its custody in the 2192 following levels of residential care: 2193 1. Hospital; 2194 2. Crisis stabilization unit or receiving facility; 2195 3. Therapeutic group home; or 2196 4. Statewide inpatient psychiatric program. 2197 2198 These levels of care demonstrate the requirement of a compelling 2199 state interest through the extensive admission criteria being 2200 met. If the department does so, it must file a motion to seek 2201 court authorization for the continued administration of the 2202 medication within 3 working days. 2203 (c) If a child receives a one-time dose of a psychotropic 2204 medication during a crisis, the department shall provide 2205 immediate notice to all parties and to the court of each such 2206 emergency use. 2207 (11) CLINICAL TRIALS.—A child in the custody of the 2208 department may not participate in a clinical trial that is 2209 designed to develop new psychotropic medications or evaluate 2210 their application to children. 2211 (12) JUDICIAL REVIEW HEARINGS.—The department shall fully 2212 inform the court of the child’s medical and behavioral status as 2213 part of the social services report prepared for each judicial 2214 review hearing held for a child for whom psychotropic medication 2215 has been prescribed or provided under this subsection. As a part 2216 of the information provided, the department shall furnish copies 2217 of all pertinent medical records concerning the child which have 2218 been generated since the previous hearing. On its own motion or 2219 on good cause shown by any party, including any guardian ad 2220 litem, attorney, or attorney ad litem who has been appointed to 2221 represent the child or the child’s interests, the court may 2222 review the status more frequently than required under this 2223 subsection. 2224 (13) ADOPTION OF RULES.—The department may adopt rules to 2225 ensure that children receive timely access to mental health 2226 services, including, but not limited to, clinically appropriate 2227 psychotropic medications. These rules must include, but need not 2228 be limited to, the process for determining which adjunctive 2229 services are needed, the uniform process for facilitating the 2230 prescribing physician’s ability to obtain the express and 2231 informed consent of a child’s parent or legal guardian, the 2232 procedures for obtaining court authorization for the provision 2233 of a psychotropic medication, the frequency of medical 2234 monitoring and reporting on the status of the child to the 2235 court, how the child’s parents will be involved in the 2236 treatment-planning process if their parental rights have not 2237 been terminated, and how caretakers are to be provided 2238 information contained in the physician’s signed mental health 2239 treatment plan. The rules must also include uniform forms or 2240 standardized information to be used on a statewide basis in 2241 requesting court authorization for the use of a psychotropic 2242 medication and provide for the integration of each child’s 2243 mental health treatment plan and case plan. The department must 2244 begin the formal rulemaking process within 90 days after July 1, 2245 2010. 2246 Section 49. Paragraph (b) of subsection (1) of section 2247 743.0645, Florida Statutes, is amended to read: 2248 743.0645 Other persons who may consent to medical care or 2249 treatment of a minor.— 2250 (1) As used in this section, the term: 2251 (b) “Medical care and treatment” includes ordinary and 2252 necessary medical and dental examination and treatment, 2253 including blood testing, preventive care including ordinary 2254 immunizations, tuberculin testing, and well-child care, but does 2255 not include surgery, general anesthesia, provision of 2256 psychotropic medications, or other extraordinary procedures for 2257 which a separate court order, power of attorney, or informed 2258 consent as provided by law is required, except as provided in s. 2259 39.4071s.39.407(3). 2260 Section 50. The Division of Statutory Revision of the Joint 2261 Legislative Management Committee is directed to prepare a 2262 reviser’s bill for introduction at a subsequent session of the 2263 Legislature to change the term “Department of Children and 2264 Family Services” to “Department of Children and Families,” the 2265 term “Secretary of Children and Family Services” to “Secretary 2266 of Children and Families,” and the term “district administrator” 2267 to “circuit administrator,” as that term relates to the 2268 responsibilities of the Department of Children and Families, 2269 wherever that term appears in the Florida Statutes. 2270 Section 51. The Agency for Persons with Disabilities is 2271 directed to prepare a plan that will enable it to perform all of 2272 its own administrative and operational functions separate from 2273 the Department of Children and Family Services by July 1, 2015. 2274 The plan must identify resource requirements and a timeframe for 2275 completing the transfer of responsibilities from the Department 2276 of Children and Family Services, including submittal of a 2277 detailed justification for each position the agency estimates it 2278 would need to become administratively self-sufficient; an 2279 analysis of each function to determine if the Department of 2280 Children and Family Services could provide the service more 2281 efficiently on a reimbursed cost basis through an interagency 2282 agreement; and an estimate of the costs and benefits to be 2283 derived through the separation. The Department of Children and 2284 Family Services is directed to cooperate with the agency in 2285 preparing the plan. The plan shall be presented to the Speaker 2286 of the House of Representatives, the President of the Senate, 2287 and the appropriate substantive committees by January 15, 2011. 2288 Section 52. The Department of Children and Families, 2289 through its Office of General Counsel and in consultation with 2290 its contracted legal services providers and lead agency 2291 administrators, shall define the types of legal services 2292 associated with dependency proceedings. These legal services 2293 include, but are not limited to, service of process, court 2294 reporter and transcription services, expert witnesses, and legal 2295 publication. The department shall delineate the specific costs 2296 each lead agency will pay for those defined legal services, and 2297 by contract amendment, modify lead agency funding amounts to 2298 shift funding and responsibility for those costs to the 2299 department through its Office of General Counsel. 2300 Section 53. The Children and Youth Cabinet created pursuant 2301 to s. 402.56, Florida Statutes, is directed to submit a plan to 2302 the Legislature by January 15, 2011, for addressing the 2303 inappropriate and excessive prescribing of psychotropic 2304 medication for children who are in the custody of the Department 2305 of Children and Family Services, who are clients of the Agency 2306 for Persons with Disabilities, and who are otherwise on 2307 Medicaid. 2308 (1) At a minimum, the plan must include: 2309 (a) The identification of all agencies and entities, public 2310 and private, which are responsible for monitoring the care of 2311 children who are being prescribed psychotropic medication; 2312 (b) The development of a plan for interagency cooperation 2313 in identifying and reporting prescribers; and 2314 (c) An analysis of the prescribing practices of Medicaid 2315 providers for these populations of children. 2316 (2) The Children and Youth Cabinet shall also include 2317 suggestions for any legislative changes necessary to implement 2318 the plan. 2319 Section 54. This act shall take effect July 1, 2010.