Florida Senate - 2025 CS for CS for SB 304 By the Committees on Judiciary; and Children, Families, and Elder Affairs; and Senators Sharief, Garcia, Rouson, Gaetz, and Collins 590-02859-25 2025304c2 1 A bill to be entitled 2 An act relating to specific medical diagnoses in child 3 protective investigations; amending s. 39.301, F.S.; 4 providing an exception to the requirement that the 5 Department of Children and Families immediately 6 forward certain allegations to a law enforcement 7 agency; requiring a child protective investigator to 8 inform the subject of an investigation of a certain 9 duty; conforming a cross-reference; amending s. 10 39.303, F.S.; requiring Child Protection Teams to 11 consult with a licensed physician or advanced practice 12 registered nurse when evaluating certain reports; 13 conforming provisions to changes made by the act; 14 amending s. 39.304, F.S.; authorizing, under a certain 15 circumstance, a parent or legal custodian from whom a 16 child was removed to request specified examinations of 17 the child; requiring that certain examinations be paid 18 for by the parent or legal custodian making the 19 request or as otherwise covered by insurance or 20 Medicaid; prohibiting the request of an examination 21 for a specified purpose; providing an effective date. 22 23 Be It Enacted by the Legislature of the State of Florida: 24 25 Section 1.Paragraph (a) of subsection (2), paragraph (a) 26 of subsection (5), and paragraph (c) of subsection (14) of 27 section 39.301, Florida Statutes, are amended to read: 28 39.301Initiation of protective investigations. 29 (2)(a)The department shall immediately forward allegations 30 of criminal conduct to the municipal or county law enforcement 31 agency of the municipality or county in which the alleged 32 conduct has occurred, unless the parent or legal custodian: 33 1.Has alleged that the child has a preexisting diagnosis 34 specified in s. 39.303(4)(b); or 35 2.Is requesting that the child have an examination under 36 s. 39.304(1)(c). 37 38 Allegations of criminal conduct that are not immediately 39 forwarded to the law enforcement agency pursuant to subparagraph 40 1. or subparagraph 2. must be immediately forwarded to the law 41 enforcement agency upon completion of the investigation under 42 this part if criminal conduct is still alleged. 43 (5)(a)Upon commencing an investigation under this part, 44 the child protective investigator shall inform any subject of 45 the investigation of the following: 46 1.The names of the investigators and identifying 47 credentials from the department. 48 2.The purpose of the investigation. 49 3.The right to obtain his or her own attorney and ways 50 that the information provided by the subject may be used. 51 4.The possible outcomes and services of the departments 52 response. 53 5.The right of the parent or legal custodian to be engaged 54 to the fullest extent possible in determining the nature of the 55 allegation and the nature of any identified problem and the 56 remedy. 57 6.The duty of the parent or legal custodian to report any 58 change in the residence or location of the child to the 59 investigator and that the duty to report continues until the 60 investigation is closed. 61 7.The duty of the parent or legal custodian to report any 62 preexisting diagnosis for the child which is specified in s. 63 39.303(4)(b) and provide any medical records that support that 64 diagnosis in a timely manner. 65 (14) 66 (c)The department, in consultation with the judiciary, 67 shall adopt by rule: 68 1.Criteria that are factors requiring that the department 69 take the child into custody, petition the court as provided in 70 this chapter, or, if the child is not taken into custody or a 71 petition is not filed with the court, conduct an administrative 72 review. Such factors must include, but are not limited to, 73 noncompliance with a safety plan or the case plan developed by 74 the department, and the family under this chapter, and prior 75 abuse reports with findings that involve the child, the childs 76 sibling, or the childs caregiver. 77 2.Requirements that if after an administrative review the 78 department determines not to take the child into custody or 79 petition the court, the department shall document the reason for 80 its decision in writing and include it in the investigative 81 file. For all cases that were accepted by the local law 82 enforcement agency for criminal investigation pursuant to 83 subsection (2), the department must include in the file written 84 documentation that the administrative review included input from 85 law enforcement. In addition, for all cases that must be 86 referred to Child Protection Teams pursuant to s. 39.303(5) and 87 (6) s. 39.303(4) and (5), the file must include written 88 documentation that the administrative review included the 89 results of the teams evaluation. 90 Section 2.Present subsections (4) through (10) of section 91 39.303, Florida Statutes, are redesignated as subsections (5) 92 through (11), respectively, a new subsection (4) is added to 93 that section, and subsection (3) and present subsections (5) and 94 (6) of that section are amended, to read: 95 39.303Child Protection Teams and sexual abuse treatment 96 programs; services; eligible cases. 97 (3)The Department of Health shall use and convene the 98 Child Protection Teams to supplement the assessment and 99 protective supervision activities of the family safety and 100 preservation program of the Department of Children and Families. 101 This section does not remove or reduce the duty and 102 responsibility of any person to report pursuant to this chapter 103 all suspected or actual cases of child abuse, abandonment, or 104 neglect or sexual abuse of a child. The role of the Child 105 Protection Teams is to support activities of the program and to 106 provide services deemed by the Child Protection Teams to be 107 necessary and appropriate to abused, abandoned, and neglected 108 children upon referral. The specialized diagnostic assessment, 109 evaluation, coordination, consultation, and other supportive 110 services that a Child Protection Team must be capable of 111 providing include, but are not limited to, the following: 112 (a)Medical diagnosis and evaluation services, including 113 provision or interpretation of X rays and laboratory tests, and 114 related services, as needed, and documentation of related 115 findings. 116 (b)Telephone consultation services in emergencies and in 117 other situations. 118 (c)Medical evaluation related to abuse, abandonment, or 119 neglect, as defined by policy or rule of the Department of 120 Health. 121 (d)Such psychological and psychiatric diagnosis and 122 evaluation services for the child or the childs parent or 123 parents, legal custodian or custodians, or other caregivers, or 124 any other individual involved in a child abuse, abandonment, or 125 neglect case, as the team may determine to be needed. 126 (e)Expert medical, psychological, and related professional 127 testimony in court cases. 128 (f)Case staffings to develop treatment plans for children 129 whose cases have been referred to the team. A Child Protection 130 Team may provide consultation with respect to a child who is 131 alleged or is shown to be abused, abandoned, or neglected, which 132 consultation shall be provided at the request of a 133 representative of the family safety and preservation program or 134 at the request of any other professional involved with a child 135 or the childs parent or parents, legal custodian or custodians, 136 or other caregivers. In every such Child Protection Team case 137 staffing, consultation, or staff activity involving a child, a 138 family safety and preservation program representative shall 139 attend and participate. 140 (g)Case service coordination and assistance, including the 141 location of services available from other public and private 142 agencies in the community. 143 (h)Such training services for program and other employees 144 of the Department of Children and Families, employees of the 145 Department of Health, and other medical professionals as is 146 deemed appropriate to enable them to develop and maintain their 147 professional skills and abilities in handling child abuse, 148 abandonment, and neglect cases. The training service must 149 include training in the recognition of and appropriate responses 150 to head trauma and brain injury in a child under 6 years of age 151 as required by ss. 402.402(2) and 409.988. 152 (i)Educational and community awareness campaigns on child 153 abuse, abandonment, and neglect in an effort to enable citizens 154 more successfully to prevent, identify, and treat child abuse, 155 abandonment, and neglect in the community. 156 (j)Child Protection Team assessments that include, as 157 appropriate, medical evaluations, medical consultations, family 158 psychosocial interviews, specialized clinical interviews, or 159 forensic interviews. 160 161 A Child Protection Team that is evaluating a report of medical 162 neglect and assessing the health care needs of a medically 163 complex child shall consult with a physician who has experience 164 in treating children with the same condition. 165 (4)A Child Protection Team shall consult with a physician 166 licensed under chapter 458 or chapter 459 or an advanced 167 practice registered nurse licensed under chapter 464 who has 168 experience in and routinely provides medical care to pediatric 169 patients when evaluating a report of: 170 (a)Medical neglect and assessing the needs of a medically 171 complex child; or 172 (b)A child with a reported preexisting diagnosis of any of 173 the following: 174 1.Rickets. 175 2.Ehlers-Danlos syndrome. 176 3.Osteogenesis imperfecta. 177 4.Vitamin D deficiency. 178 5.Any other medical condition known to appear to be caused 179 by, or known to be misdiagnosed as, abuse. 180 (6)(5)All abuse and neglect cases transmitted for 181 investigation to a circuit by the hotline must be simultaneously 182 transmitted to the Child Protection Team for review. For the 183 purpose of determining whether a face-to-face medical evaluation 184 by a Child Protection Team is necessary, all cases transmitted 185 to the Child Protection Team which meet the criteria in 186 subsection (5) (4) must be timely reviewed by: 187 (a)A physician licensed under chapter 458 or chapter 459 188 who holds board certification in pediatrics and is a member of a 189 Child Protection Team; 190 (b)A physician licensed under chapter 458 or chapter 459 191 who holds board certification in a specialty other than 192 pediatrics, who may complete the review only when working under 193 the direction of the Child Protection Team medical director or a 194 physician licensed under chapter 458 or chapter 459 who holds 195 board certification in pediatrics and is a member of a Child 196 Protection Team; 197 (c)An advanced practice registered nurse licensed under 198 chapter 464 who has a specialty in pediatrics or family medicine 199 and is a member of a Child Protection Team; 200 (d)A physician assistant licensed under chapter 458 or 201 chapter 459, who may complete the review only when working under 202 the supervision of the Child Protection Team medical director or 203 a physician licensed under chapter 458 or chapter 459 who holds 204 board certification in pediatrics and is a member of a Child 205 Protection Team; or 206 (e)A registered nurse licensed under chapter 464, who may 207 complete the review only when working under the direct 208 supervision of the Child Protection Team medical director or a 209 physician licensed under chapter 458 or chapter 459 who holds 210 board certification in pediatrics and is a member of a Child 211 Protection Team. 212 (7)(6)A face-to-face medical evaluation by a Child 213 Protection Team is not necessary when: 214 (a)The child was examined for the alleged abuse or neglect 215 by a physician who is not a member of the Child Protection Team, 216 and a consultation between the Child Protection Team medical 217 director or a Child Protection Team board-certified 218 pediatrician, advanced practice registered nurse, physician 219 assistant working under the supervision of a Child Protection 220 Team medical director or a Child Protection Team board-certified 221 pediatrician, or registered nurse working under the direct 222 supervision of a Child Protection Team medical director or a 223 Child Protection Team board-certified pediatrician, and the 224 examining physician concludes that a further medical evaluation 225 is unnecessary; 226 (b)The child protective investigator, with supervisory 227 approval, has determined, after conducting a child safety 228 assessment, that there are no indications of injuries as 229 described in paragraphs (5)(a)-(h) (4)(a)-(h) as reported; or 230 (c)The Child Protection Team medical director or a Child 231 Protection Team board-certified pediatrician, as authorized in 232 subsection (6) (5), determines that a medical evaluation is not 233 required. 234 235 Notwithstanding paragraphs (a), (b), and (c), a Child Protection 236 Team medical director or a Child Protection Team pediatrician, 237 as authorized in subsection (6) (5), may determine that a face 238 to-face medical evaluation is necessary. 239 Section 3.Paragraph (c) is added to subsection (1) of 240 section 39.304, Florida Statutes, to read: 241 39.304Photographs, medical examinations, X rays, and 242 medical treatment of abused, abandoned, or neglected child. 243 (1) 244 (c)If an examination is performed on a child under 245 paragraph (b), the parent or legal custodian from whom the child 246 was removed pursuant to s. 39.401 may: 247 1.If the initial examination was not performed by the 248 Child Protection Team, request that the child be examined by the 249 Child Protection Team as soon as practicable; 250 2.If the initial examination was performed by the Child 251 Protection Team, for the purpose of obtaining a second opinion 252 on diagnosis or treatment, request that the child be examined by 253 a physician licensed under chapter 458 or chapter 459 or an 254 advanced practice registered nurse licensed under chapter 464 of 255 his or her choosing who routinely provides medical care to 256 pediatric patients; or 257 3.For the purpose of ruling out a differential diagnosis, 258 request that the child be examined by a physician licensed under 259 chapter 458 or chapter 459 or an advanced practice registered 260 nurse licensed under chapter 464 who routinely provides 261 diagnosis of and medical care to pediatric patients for the 262 conditions specified in s. 39.303(4)(b). 263 264 An examination requested under subparagraph 2. or subparagraph 265 3. must be paid for by the parent or legal custodian making such 266 request or as otherwise covered by insurance or Medicaid. An 267 examination may not be requested under this paragraph for the 268 purpose of obtaining a second opinion as to whether a child has 269 been sexually abused. 270 Section 4.This act shall take effect July 1, 2025.