This docum ent does not reflect the intent or official position of the bill sponsor or House of Representatives.
STORAGE NAME: h1007c.HHS
DATE: 4/24/2023
HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: CS/CS/HB 1007 Children Removed from Caregivers
SPONSOR(S): Health & Human Services Committee, Children, Families & Seniors Subcommittee, Borrero
TIED BILLS: IDEN./SIM. BILLS: SB 1064
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
1) Children, Families & Seniors Subcommittee 16 Y, 0 N, As CS Brazzell Brazzell
2) Health & Human Services Committee 20 Y, 0 N, As CS Brazzell Calamas
SUMMARY ANALYSIS
Florida’s dependency system identifies children and families in need of services through reports to the central
abuse hotline and child protective investigations. The Department of Children and Families (DCF) and the
community-based care lead agencies (CBCs) throughout Florida work with those families to address the
problems endangering children, if possible. If the problems are not addressed, DCF and the CBC’s find safe
out-of-home placements for these children.
The process of child protective investigation, removal and placement can be traumatic for children. However,
the degree to which an individual child experiences these events as traumatic depends on several factors,
such as the child’s age and resilience. Children who enter out-of-home care have typically often already
experienced multiple traumatic events.
According to the National Child Traumatic Stress Network, a “trauma-informed mental health assessment
offers a structured framework for (1) gathering information across several key domains of functioning, (2)
identifying and addressing the needs of children and families exposed to traumatic events, and (3) coding and
summarizing this information, so that it can be communicated to families and other providers.” Currently, a
Comprehensive Behavioral Health Assessment is conducted for children who are sheltered in out-of-home
care; this must be performed within 30 days.
CS/CS/HB 1007 adds requirements regarding trauma screening, assessment, and therapeutic response to the
assessment and placement process for children being placed in out-of-home care under s. 39.523, F.S. The
bill requires DCF and CBC’s to refer a child to a trauma assessment within 30 days of removal from the child’s
home, if indicated by a trauma screening performed as soon as practicable and at a minimum within 21 days of
a child’s shelter, and provide supports to the caregiver.
The bill does not have a fiscal impact on state or local governments.
The bill has an effective date of July 1, 2023. STORAGE NAME: h1007c.HHS PAGE: 2
DATE: 4/24/2023
FULL ANALYSIS
I. SUBSTANTIVE ANALYSIS
A. EFFECT OF PROPOSED CHANGES:
Florida’s Dependency System
Chapter 39, F.S., creates the dependency system charged with protecting child welfare. Florida’s
dependency system identifies children and families in need of services through reports to the central
abuse hotline and child protective investigations. DCF and the 17 community-based care lead agencies
(CBCs) throughout Florida
1
work with those families to address the problems endangering children, if
possible. If the problems are not addressed, DCF and the CBC’s find safe out-of-home placements for
these children.
DCF’s practice model is based on the safety of the child within the home by using in-home services,
such as parenting coaching and counseling, to maintain and strengthen that child’s natural supports in
his or her environment.
DCF contracts with CBCs for case management, out-of-home services, and related services. The
outsourced provision of child welfare services is intended to increase local community ownership of
service delivery and design. CBCs contract with a number of subcontractors for case management and
direct care services to children and their families.
DCF remains responsible for a number of child welfare functions, including operating the central abuse
hotline, performing child protective investigations, and providing children’s legal services.
2
Ultimately,
DCF is responsible for program oversight and the overall performance of the child welfare system.
3
Dependency Process
Current law requires any person who knows or suspects that a child has been abused, abandoned,
or neglected to report such knowledge or suspicion to the central abuse hotline (hotline).
4
The hotline
5
receives more than 350,000 child-related calls annually.
6
Calls received are screened to determine if
the criteria are met to initiate a protective investigation. Statewide, there are more than 240,000 child
protective investigations conducted annually.
7
When child welfare necessitates that DCF remove a child from the home, a series of dependency court
proceedings must occur to adjudicate the child dependent and place that child in out-of-home care.
Steps in the dependency process may include:
A report to the hotline.
A child protective investigation to determine the safety of the child.
The court finding the child dependent.
Case planning for the parents to address the problems resulting in their child’s dependency.
Placement in out-of-home care, if necessary.
Reunification with the child’s parent or another option to establish permanency, such as
adoption.
8
1
These 17 CBCs together serve the state’s 20 judicial circuits.
2
Ch. 39, F.S.
3
Id.
4
Section 39.201(1), F.S.
5
Department of Children and Families, Florida Abuse Hotline, Overview, https://www2.myflfamilies.com/service-programs/abuse-
hotline/overview.shtml, (last visited March 11, 2023).
6
Department of Children and Families, Child Welfare Key Indicators Monthly Report, Feb. 2023, System Overview, p. 8,
https://www2.myflfamilies.com/service-programs/child-welfare/kids/results-oriented-
accountability/performanceManagement/docs/KI_Monthly_Report_December%202022.pdf (last visited March 23, 2023).
7
Id.
8
The state has a compelling interest in providing stable and permanent homes for adoptive children in a prompt manner, in preventing
the disruption of adoptive placements, and in holding parents accountable for meeting the needs of children. S. 63.022, F.S. STORAGE NAME: h1007c.HHS PAGE: 3
DATE: 4/24/2023
The graphic below presents key statistics regarding children and families having contact with the child
welfare system in FY 2021-22.
9
Out-of-Home Care
When children cannot safely remain at home with parents, Florida’s child welfare system finds safe out-of-
home placements for such children. After an assessment to determine the most appropriate out-of-home
placement, a child may be placed with a relative, fictive kin, licensed foster parent, in a group home or
residential setting.
10
While in out-of-home care, the child and his or her parents receive services to address
problems that led to the removal so that reunification or other permanency option may be reached as
quickly as possible.
11
As the graphic above indicates, slightly more than half of children with cases open for services in FY 2021-
22 were served in out of home care. The graph below shows the number of children in out-of-home care by
placement type, as of January 2023.
12
9
Supra note 6, p. 9.
10
R. 65C-28.004, F.A.C.
11
Child Welfare Information Gateway, Out-of- Home Care Overview,
https://www.childwelfare.gov/topics/outofhome/overview/#:~:text=Out%2Dof%2Dhome%20care%20is,to%20abuse%20and%2For%20n
eglect. (last visited Jan. 18, 2023).
12
Supra note 6, p. 31. Licensed foster homes include relative and nonrelative placements that are licensed to care for a specific child,
as well as traditional licensed family foster homes. STORAGE NAME: h1007c.HHS PAGE: 4
DATE: 4/24/2023
Community-Based Care Organizations and Services
DCF typically enters into 5-year contracts with CBCs.
13
There are minimum requirements with which
CBC’s must comply to be eligible to contract with DCF, including:
Being organized as a Florida corporation or a governmental entity.
14
Having a board of directors or board committee with authority to approve the CBC’s budget
and hire a CBC executive director.
15
Demonstrating financial responsibility by having a plan for regular fiscal audits and securing
a performance bond.
16
DCF must ensure contracts with CBCs:
Provide for the services as required under s. 409.988, F.S.
17
Require CBC’s to specify how they will carry out certain child welfare best practices.
18
Provide relevant information to DCF related to the quality assurance program and the child
welfare results-oriented accountability system.
19
Include tiered interventions and graduated penalties for failure to comply with the contract
or performance deficiencies.
20
Require CBCs to provide current and accurate information about their activities related to
case records in the statewide automated child welfare information system.
21
Specify the procedures to resolve differences in interpreting the contract or to resolve a
disagreement amongst the parties regarding compliance with the contract.
22
CBCs are obligated to perform a variety of duties including to:
Serve the children who are referred as a result of abuse, neglect, or abandonment reports to
DCF’s central abuse hotline.
13
S. 409.987(3), F.S.
14
S. 409.987(4)(a), F.S.
15
S. 409.987(4)(b), F.S.
16
S. 409.987(4)(c), F.S.
17
S. 409.996(1)(a), F.S.
18
S. 409.996(1)(b), F.S.
19
S. 409.996(1)(c), F.S.
20
S. 409.996(1)(d), F.S.
21
S. 409.996(1)(e), F.S.
22
S. 409.996(1)(f), F.S.
0
2,000
4,000
6,000
8,000
10,000
12,000
Relative Non-Relative Group CareLicensed Foster
Home
Residential
Treatment Center
Children in Out-of-Home Care by Placement Type
(As of Jan. 31, 2023) STORAGE NAME: h1007c.HHS PAGE: 5
DATE: 4/24/2023
Provide DCF with accurate and timely information necessary for oversight by DCF pursuant
to the child welfare results-oriented accountability system.
Follow financial guidelines developed by DCF and provide for regular independent audits.
Post its current budget, including the salaries, bonuses and other compensation paid to the
agency’s chief executive officer, chief financial officer, and chief operating officer, or their
equivalents, on the CBC’s website.
Prepare and file all necessary court documents and attend dependency court proceedings.
Ensure all individuals providing care to dependent children receive training and specified
information and meet employment requirements.
Maintain eligibility to receive all available federal child welfare funds.
Maintain written agreements with Healthy Families Florida entities in its service area.
Comply with federal and state statutory requirements and agency rules in the provision of
contractual rules.
Use authority to subcontract for the provision of services provided CBCs contribute to
services and meet specified criteria.
Post information regarding case management services on its website.
23
DCF contracts with the following CBCs as illustrated in the following table and map:
24
Lead Agency Judicial Circuit(s)
Northwest Florida Health Network 1
Northwest Florida Health Network 2 & 14
Partnership for Strong Families 3 & 8
Family Support Services of North Florida, Inc. 4 (Duval and Nassau)
Kids First of Florida, Inc. 4 (Clay)
Kids Central, Inc. 5
Family Support Services of SunCoast 6 (Pasco and Pinellas)
St Johns County Board of County Commissioners 7 (St Johns)
Community Partnership for Children, Inc. 7 (Flagler, Volusia,
Putnam)
Embrace Families 9 and 18 (Seminole)
Heartland for Children 10
Citrus Family Care Network 11 and 16
Safe Children Coalition 12
Children’s Network of Hillsborough 13
ChildNet Inc. 15 and 17
Brevard Family Partnership 18 (Brevard)
Communities Connected for Kids 19
Children’s Network of SW Florida 20
23
S. 409.988(1), F.S. Further, s. 409.988(1)(k), F.S., provides that CBCs and subcontracted case management providers must disclose
the average caseload of case managers for filled positions, the turnover rate for case managers and their supervisors for the previous
12 months, the percentage of required home visits completed, and performance on outcome measures required under s. 409.997, F.S.,
for the previous 12 months.
24
Florida Department of Children and Families, Lead Agency Information, https://www.myflfamilies.com/services/child-family/child-and-
family-well-being/community-based-care/lead-agency-information (accessed April 24, 2023). STORAGE NAME: h1007c.HHS PAGE: 6
DATE: 4/24/2023
Children and Trauma
Traumatic Events
According to the National Child Traumatic Stress Network, a traumatic event is “a frightening,
dangerous, or violent event that poses a threat to a child’s life or bodily integrity. Witnessing a
traumatic event that threatens life or physical security of a loved one can also be traumatic. This is
particularly important for young children as their sense of safety depends on the perceived safety of
their attachment figures.”
25
Many experiences that may be traumatic to a child are also reasons why a child may be subject to a
child protective investigation and removal from the home, such as:
Physical or psychological abuse.
Neglect.
Sexual abuse, including sexual exploitation and human trafficking.
Family violence.
Substance use disorder (personal or familial).
26
Child Traumatic Stress
25
National Child Traumatic Stress Network, About Child Trauma, https://www.nctsn.org/what-is-child-trauma/about-child-trauma
(accessed March 23, 2023).
26
Id. STORAGE NAME: h1007c.HHS PAGE: 7
DATE: 4/24/2023
According to the National Child Traumatic Stress Network, children who suffer from child traumatic
stress are those who have been exposed to one or more traumas over the course of their lives and
develop reactions that persist and affect their daily lives after the events have ended.
Children can have a variety of reactions to traumatic events. Examples are:
intense and ongoing emotional upset,
depressive symptoms or anxiety,
behavioral changes,
difficulties with self-regulation,
problems relating to others or forming attachments,
regression or loss of previously acquired skills,
attention and academic difficulties,
nightmares,
difficulty sleeping and eating, and
physical symptoms, such as aches and pains.
use of drugs or alcohol,
behaving in risky ways, and
engaging in unhealthy sexual activity.
27
Although many people experience reactions to stress from time to time, when a child is experiencing
traumatic stress, these reactions interfere with the child’s daily life and ability to function and interact
with others. Any child may suffer effects of traumatic experience, including infants and toddlers.
However, the way that traumatic stress manifests will vary from child to child, and will depend on
factors such as the child’s age and developmental level.
According to the National Child Traumatic Stress Network, “without treatment, repeated childhood
exposure to traumatic events can affect the brain and nervous system and increase health-risk
behaviors (e.g., smoking, eating disorders, substance use, and high-risk activities). Research shows
that child trauma survivors can be more likely to have long-term health problems (e.g., diabetes and
heart disease) or to die at an earlier age. Traumatic stress can also lead to increased use of health and
mental health services and increased involvement with the child welfare and juvenile justice systems.
Adult survivors of traumatic events may also have difficulty in establishing fulfilling relationships and
maintaining employment.”
Trauma and Response to Investigation, Removal and Placement
The process of child protective investigation, removal and placement can be traumatic for children.
However, the degree to which an individual child experiences these elements as traumatic depends on
several factors, such as the child’s age and resilience. Casey Family Programs describes frequent
responses from children as follows:
Surprise and shock. Intervention is particularly traumatic when it happens suddenly or
unexpectedly, and with a high level of conflict. Children may be confused about cause and
effect, not understanding why they have been removed from the home. (e.g., “We were just
eating dinner and then I was taken away.”) The degree of trauma to the child will depend to
some degree on the level of hostility in the interactions between the parent and the
professional, and how much distress vs. calm the parent exhibits.
Negative views of police and social workers. Children may have been told to fear the police
and/or the child protection agency, or they may have heard horror stories about foster care
that exacerbate their own fears.
Betrayal and loss of trust. Children may feel betrayed by the person who reported the
family. They may feel surrounded by people they cannot trust.
27
Id. STORAGE NAME: h1007c.HHS PAGE: 8
DATE: 4/24/2023
Loss of control, helplessness. Children experiencing removal face many unknowns. They
may not know where they are going, what will happen to them, what is happening to their
parents and siblings, and how long they will be away from home. Any feeling that they are
unable to speak up on their own behalf and ask questions may compound their
disorientation. Other traumatic elements of the situation may make it difficult for children to
absorb or retain information provided to them.
Worry about parents and siblings. Older children may feel responsible for taking care of
other family members. They may feel guilty that the disruption to the family is their fault, or
that they have failed to protect parents or siblings.
Repeated interviewing about traumatic events. Having to tell the story of “what happened”
multiple times to different professionals (school staff, caseworker, police) may exacerbate
trauma and/or reinforce feelings of guilt or betrayal.
Loss of the familiar. Children who are removed from their home face losses on multiple
levels: family (including extended family members, pets, belongings, routines),
neighborhood and school (familiar places, friends, teachers, extracurricular activities), and
culture (language, race/ ethnicity, religion). All of these elements may create or reinforce a
belief that the world is unpredictable and unsafe.
28
Multiple Traumatic Events
Children with some level of trauma typically have experienced a variety of traumatic events. In a study
of 14,088 children and adolescents served by National Child Traumatic Stress Network service centers,
nearly 80% of those screened reported an experience of at least one traumatic event. However, of the
11,104 who had trauma exposure:
77% had more than one type of trauma;
27% had experienced 3-4 types of trauma; and
31% had experienced 5 or more types.
29
In a sample of 2,251 children and adolescents in foster care referred to National Child Traumatic Stress
Network service centers between 2004 and 2010, the mean number of types of traumatic exposure was
5, indicating that exposure to multiple types of trauma is common for children in the child welfare
system.
30
This may lead to their experiencing complex trauma, or have interactions between the traumatic events.
Trauma screening instruments do not screen for only one type of trauma (such as removal), nor is it
clinically advisable given the variety of traumas to which a child may have been exposed.
31
Risk and Protective Factors
Fortunately, even when children experience a traumatic event, they don’t always develop traumatic
stress. Many factors contribute to symptoms, and protective factors can reduce the negative impact of
trauma on a child. According to the National Child Traumatic Stress Network, some factors that affect
how a child is impacted by a traumatic event include:
28
Casey Family Programs, Issue Brief: How does investigation, removal, and placement cause trauma for children? May 2018, p. 2
https://www.casey.org/media/SC_Investigation-removal-placement-causes-trauma.pdf (accessed March 23, 2023).
29
National Child Traumatic Stress Network, Facts for Policymakers: Child and Adolescent Trauma Exposure and Service Use
Histories: Highlights from the NCCTS Core Data Set
https://www.nctsn.org/sites/default/files/resources//facts_policymakers_child_adolescent_trauma_exposure_service_use_histories_high
lights_core_data_set.pdf (accessed March 23, 2023).
30
National Child Traumatic Stress Network, Facts for Policymakers: Complex Trauma and Mental Health of Children Placed in Foster
Care Highlights from the National Center for Child Traumatic Stress (NCCTS) Core Data Set
https://www.nctsn.org/sites/default/files/resources//facts_policymakers_complex_trauma_mental_health_children_placed_in_foster_car
e.pdf (accessed March 23, 2023).
31
Email from L. Amaya-Jackson, M.D., M.P.H., Co- Director, UCLA-Duke National Center for Child Traumatic Stress, Professor, Dept.
of Psychiatry & Behavioral Sciences, Duke University School of Medicine, quick response needed if you have input: Question--
assessing/treating individual sources of trauma vs. general trauma experienced (March 19, 2023). STORAGE NAME: h1007c.HHS PAGE: 9
DATE: 4/24/2023
Severity of the event. How serious was the event? How badly was the child or someone
she loves physically hurt? Did they or someone they love need to go to the hospital? Were
the police involved? Were children separated from their caregivers? Were they interviewed
by a principal, police officer, or counselor? Did a friend or family member die?
Proximity to the event. Was the child actually at the place where the event occurred? Did
they see the event happen to someone else or were they a victim? Did the child watch the
event on television? Did they hear a loved one talk about what happened?
Caregivers’ reactions. Did the child’s family believe that he or she was telling the truth? Did
caregivers take the child’s reactions seriously? How did caregivers respond to the child’s
needs, and how did they cope with the event themselves?
Prior history of trauma. Children continually exposed to traumatic events are more likely to
develop traumatic stress reactions.
Family and community factors. The culture, race, and ethnicity of children, their families,
and their communities can be a protective factor, meaning that children and families have
qualities and or resources that help buffer against the harmful effects of traumatic
experiences and their aftermath.
32
Screening, Assessing, and Responding to Trauma in Children
Screening is used to determine whether the next steps, a trauma-focused assessment or treatment, is
helpful for a child. Brief screening tools are available for this purpose.
33
Trauma screening determines
whether someone has experienced one or more traumatic events, has reactions to them, has specific
mental or behavioral health needs, and/or needs a referral for a comprehensive trauma-informed
mental health assessment. Screening is a “wide-net” process.
34
Experts recommend screening for a
range of traumatic events rather than for a specific single event.
35
According to the National Child Traumatic Stress Network, a “trauma-informed mental health
assessment offers a structured framework for (1) gathering information across several key domains of
functioning, (2) identifying and addressing the needs of children and families exposed to traumatic
events, and (3) coding and summarizing this information, so that it can be communicated to families
and other providers.”
36
Examples of domains include trauma exposure, trauma reminders and triggers,
caregiver/family functioning and response to trauma, and resilience and strengths of the child, family
and community.
37
Recommended practices include gathering information from multiple perspectives,
such as the child, all caregivers, teachers, and other relevant professionals working with the child.
Additionally, clinicians should use a variety of assessment approaches and techniques.
There are evidence-based treatments and services that are highly effective for child traumatic stress.
38
A wide variety of trauma treatments exist that vary based on the age of the child, the nature of the
traumatic exposure and response, and modalities used (such as individual, family, or group). Some are
32
Supra note 25.
33
National Child Traumatic Stress Network, Assessment of Complex Trauma Information for Non-Mental Health Professionals, p. 2,
https://www.nctsn.org/sites/default/files/resources/fact-
sheet/assessment_of_complex_trauma_information_for_nonmental_health_professio.pdf (accessed March 23, 2023).
34
National Child Traumatic Stress Network, Screening and Assessment, http://www.nctsn.org/treatments-and-practices/screening-and-
assessment (accessed March 23, 2023).
35
Supra note 31.
36
National Child Traumatic Stress Network, Trauma-Informed Mental Health Assessment, https://www.nctsn.org/treatments-and-
practices/screening-and-assessments/trauma-informed-mental-health-assessment (accessed March 23, 2023).
37
National Child Traumatic Stress Network, Assessment of Complex Trauma by Mental Health Professionals, p. 3,
https://www.nctsn.org/sites/default/files/resources/fact-sheet/assessment_of_complex_trauma_by_mental_health_professionals.pdf
(accessed March 23, 2023).
38
National Child Traumatic Stress Network, Understanding Child Trauma, https://www.nctsn.org/sites/default/files/resources/fact-
sheet/understanding_child_trauma_and_the_nctsn_0.pdf (accessed March 23, 2023). STORAGE NAME: h1007c.HHS PAGE: 10
DATE: 4/24/2023
offered by the Medicaid program, such as Trauma-Focused Cognitive Behavioral Therapy (TF-CBT).
39
Additional supports are available as well.
40
Comprehensive Assessments of Children in the Child Welfare System in Florida
Section 39.01(17), F.S., defines “comprehensive assessment” or “assessment” as the gathering of
information for the evaluation of a child’s and caregiver’s physical, psychiatric, psychological, or mental
health; developmental delays or challenges; and educational, vocational, and social condition and
family environment as they relate to the child’s and caregiver’s need for rehabilitative and treatment
services, including substance abuse treatment services, mental health services, developmental
services, literacy services, medical services, family services, and other specialized services, as
appropriate.
Chapter 65C-28.014, Florida Administrative Code (F.A.C.) requires a child to be referred for a
Comprehensive Behavioral Health Assessment (CBHA) in the following circumstances:
a) When a child is in shelter status, the child welfare professional responsible for the case shall
refer the child for a CBHA within seven calendar days of being removed from his or her
household, or
b) If a child is already in out-of-home care and is exhibiting emotional or behavioral issues that
might result, or may have already resulted, in the child losing his or her placement, the child
welfare professional responsible for the case may refer the child for a CBHA to assist in
determining services that would allow the child to maintain his or her placement. This may be
done if a CBHA has not been conducted on the child within the past year; and,
c) The child has been determined to be Medicaid enrolled. If the child is not Medicaid enrolled, the
child welfare professional responsible for the case shall take all steps necessary to ensure the
child becomes enrolled as soon as possible, including assisting the child’s out-of-home
caregiver to establish enrollment.
41
The actual assessment is completed by a provider during the provision of case management services.
42
The CBHA provider must complete the assessment within 24 calendar days of receiving the
authorization.
43
CBC’s report that they administer a trauma assessment as part of the CBHA.
44
The child welfare professional must review and consider any interventions or services recommended in
a CBHA. Specifically, Rule 65C-28.014, F.A.C., requires that when service needs are identified through
the CBHA, children shall be referred to mental health providers in the community who accept the child’s
Medicaid Managed Medical Assistance plan. If a Medicaid provider is not available, the child welfare
professional shall refer to a provider that best meets the child’s needs. The child welfare professional
has the primary responsibility throughout the case for coordinating, managing, and monitoring all
aspects of the child’s care and treatment.
45
Effect of Proposed Changes
39
Sunshine Health, New Child Welfare Value-Based Incentive Program: Trauma-Focused Evidence Based Practice
https://www.sunshinehealth.com/newsroom/trauma-focused-evidence-based-practice.html (accessed March 23, 2023).
40
One resource offered by Florida Medicaid Sunshine Health Child Welfare Specialty Plan is training is offered to all caregivers
including foster parents, adoptive parents, relative caregivers, biological parents and other caregivers on Trauma Informed Care and
other trauma training. See Member Handbook, p. 37 https://www.sunshinehealth.com/content/dam/centene/Sunshine/pdfs/CWSP-
Member-Handbook.pdf (accessed March 23, 2023).
41
Florida Department of Children and Families, Agency Analysis of 2023 HB 1007, p. 2 (March 8, 2023).
42
Id.
43
Department of Children and Families, CFOP 170-18, Comprehensive Behavioral Health Assessments, Aug. 21, 2020, pg. 2-2
https://www.myflfamilies.com/sites/default/files/2022-12/cfop_170-18_chapter_02_comprehensive_behavioral_health_assessments.pdf
(accessed March 23, 2023).
44
Email from Caleb Hawkes, Director of Government Affairs, Florida Coalition for Children, Re: HB 1007/SB 1064--questions for CBC's
on screening/addressing trauma of removal, March 21, 2023.
45
Supra note 41. STORAGE NAME: h1007c.HHS PAGE: 11
DATE: 4/24/2023
CS/CS/HB 1007 adds legislative intent that the timely identification of and therapeutic response to
acute presentation of symptoms indicative of trauma can reduce adverse outcomes for a child, aid in
the identification of services to enhance initial placement stability and of supports to caregivers, and
reduce placement disruption.
The bill adds requirements regarding trauma screening, assessment, and therapeutic response to the
assessment and placement process for children being placed in out-of-home care under s. 39.523, F.S.
DCF must adopt rules to require DCF or the CBC to conduct a trauma screening as soon as practicable
after a child's removal, but no later than 21 days after the shelter hearing. If indicated as appropriate or
necessary by the screening, DCF or the CBC must promptly refer the child to appropriate trauma
assessment, which must be completed within 30 days, and if appropriate, services and intervention as
needed. To the extent possible, the trauma screening, assessment, and services and intervention shall
be integrated into the child's overall behavioral health treatment planning and services. In addition,
DCF or the CBC must provide information and support to the caregiver of the child to help the caregiver
respond to and care for the child in a trauma-informed and therapeutic manner. This may include but
need not be limited to, consultation, coaching, training, and referrals to services
The bill has an effective date of July 1, 2023.
.
B. SECTION DIRECTORY:
Section 1: amending s. 39.523, F.S., relating to placement in out-of-home care.
Section 2: providing an effective date.
II. FISCAL ANALYSIS & ECONOMIC IMPACT STATEMENT
A. FISCAL IMPACT ON STATE GOVERNMENT:
1. Revenues:
None.
2. Expenditures:
None.
B. FISCAL IMPACT ON LOCAL GOVERNMENTS:
1. Revenues:
None.
2. Expenditures:
None.
C. DIRECT ECONOMIC IMPACT ON PRIVATE SECTOR:
The bill may require CBC’s to conduct trauma screenings; provide referrals to trauma assessments,
services, and interventions for children; and provide supports and information to caregivers. If any CBC
is not engaged in this full scope of responsibilities, there may be a fiscal impact on that CBC to carry
out the requirements of the bill. However, the bill also tasks DCF with these responsibilities, so it is
unknown the degree to which any new responsibilities would fall on DCF as opposed to the CBC’s.
D. FISCAL COMMENTS:
None. STORAGE NAME: h1007c.HHS PAGE: 12
DATE: 4/24/2023
III. COMMENTS
A. CONSTITUTIONAL ISSUES:
1. Applicability of Municipality/County Mandates Provision:
Not Applicable. This bill does not appear to affect county or municipal governments.
2. Other:
None.
B. RULE-MAKING AUTHORITY:
DCF has sufficient rulemaking authority to implement the bill.
C. DRAFTING ISSUES OR OTHER COMMENTS:
The bill implies that CBC’s are to refer children to therapy if recommended by the screening but does
not specifically obligate CBC’s to do so.
IV. AMENDMENTS/COMMITTEE SUBSTITUTE CHANGES
On March 27, 2023, the Children, Families, and Seniors Subcommittee adopted an amendment and
reported the bill favorably as a committee substitute. The amendment requires a validated trauma-focused
screening instead of an assessment.
On April 24, 2023, the Health and Human Services Committee adopted an amendment and reported the
bill favorably as a committee substitute. The amendment:
includes Legislative intent provisions.
requires DCF and CBC’s to refer children to a trauma screening within 21 days of removal, and if
necessary and appropriate, to an assessment within 30 days of removal and provide information
and supports to their caregivers.
addresses all trauma rather than specifically the trauma related to the child’s removal.
removes references to the managing entity involvement in the trauma screening process,
requirements to offer voluntary services to families whose children are removed but not sheltered,
and direction to DCF to include these provisions in CBC contracts.
This analysis is drafted to the committee substitute as passed by the Health and Human Services
Committee.