CS for CS for SB 304 First Engrossed (ntc) 2025304e1 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. However, the department need not 33 immediately forward allegations of criminal conduct to the 34 appropriate law enforcement agency if the parent or legal 35 custodian: 36 1.Has alleged that the child has a preexisting diagnosis 37 specified in s. 39.303(4)(b); or 38 2.Is requesting that the child have an examination under 39 s. 39.304(1)(c). 40 41 Allegations of criminal conduct that are not immediately 42 forwarded to the law enforcement agency pursuant to subparagraph 43 1. or subparagraph 2. must be immediately forwarded to the law 44 enforcement agency upon completion of the investigation under 45 this part if criminal conduct is still alleged. 46 (5)(a)Upon commencing an investigation under this part, 47 the child protective investigator shall inform any subject of 48 the investigation of the following: 49 1.The names of the investigators and identifying 50 credentials from the department. 51 2.The purpose of the investigation. 52 3.The right to obtain his or her own attorney and ways 53 that the information provided by the subject may be used. 54 4.The possible outcomes and services of the departments 55 response. 56 5.The right of the parent or legal custodian to be engaged 57 to the fullest extent possible in determining the nature of the 58 allegation and the nature of any identified problem and the 59 remedy. 60 6.The duty of the parent or legal custodian to report any 61 change in the residence or location of the child to the 62 investigator and that the duty to report continues until the 63 investigation is closed. 64 7.The duty of the parent or legal custodian to report any 65 preexisting diagnosis for the child which is specified in s. 66 39.303(4)(b) and provide any medical records that support that 67 diagnosis in a timely manner. 68 (14) 69 (c)The department, in consultation with the judiciary, 70 shall adopt by rule: 71 1.Criteria that are factors requiring that the department 72 take the child into custody, petition the court as provided in 73 this chapter, or, if the child is not taken into custody or a 74 petition is not filed with the court, conduct an administrative 75 review. Such factors must include, but are not limited to, 76 noncompliance with a safety plan or the case plan developed by 77 the department, and the family under this chapter, and prior 78 abuse reports with findings that involve the child, the childs 79 sibling, or the childs caregiver. 80 2.Requirements that if after an administrative review the 81 department determines not to take the child into custody or 82 petition the court, the department shall document the reason for 83 its decision in writing and include it in the investigative 84 file. For all cases that were accepted by the local law 85 enforcement agency for criminal investigation pursuant to 86 subsection (2), the department must include in the file written 87 documentation that the administrative review included input from 88 law enforcement. In addition, for all cases that must be 89 referred to Child Protection Teams pursuant to s. 39.303(5) and 90 (6) s. 39.303(4) and (5), the file must include written 91 documentation that the administrative review included the 92 results of the teams evaluation. 93 Section 2.Present subsections (4) through (10) of section 94 39.303, Florida Statutes, are redesignated as subsections (5) 95 through (11), respectively, a new subsection (4) is added to 96 that section, and subsection (3) and present subsections (5) and 97 (6) of that section are amended, to read: 98 39.303Child Protection Teams and sexual abuse treatment 99 programs; services; eligible cases. 100 (3)The Department of Health shall use and convene the 101 Child Protection Teams to supplement the assessment and 102 protective supervision activities of the family safety and 103 preservation program of the Department of Children and Families. 104 This section does not remove or reduce the duty and 105 responsibility of any person to report pursuant to this chapter 106 all suspected or actual cases of child abuse, abandonment, or 107 neglect or sexual abuse of a child. The role of the Child 108 Protection Teams is to support activities of the program and to 109 provide services deemed by the Child Protection Teams to be 110 necessary and appropriate to abused, abandoned, and neglected 111 children upon referral. The specialized diagnostic assessment, 112 evaluation, coordination, consultation, and other supportive 113 services that a Child Protection Team must be capable of 114 providing include, but are not limited to, the following: 115 (a)Medical diagnosis and evaluation services, including 116 provision or interpretation of X rays and laboratory tests, and 117 related services, as needed, and documentation of related 118 findings. 119 (b)Telephone consultation services in emergencies and in 120 other situations. 121 (c)Medical evaluation related to abuse, abandonment, or 122 neglect, as defined by policy or rule of the Department of 123 Health. 124 (d)Such psychological and psychiatric diagnosis and 125 evaluation services for the child or the childs parent or 126 parents, legal custodian or custodians, or other caregivers, or 127 any other individual involved in a child abuse, abandonment, or 128 neglect case, as the team may determine to be needed. 129 (e)Expert medical, psychological, and related professional 130 testimony in court cases. 131 (f)Case staffings to develop treatment plans for children 132 whose cases have been referred to the team. A Child Protection 133 Team may provide consultation with respect to a child who is 134 alleged or is shown to be abused, abandoned, or neglected, which 135 consultation shall be provided at the request of a 136 representative of the family safety and preservation program or 137 at the request of any other professional involved with a child 138 or the childs parent or parents, legal custodian or custodians, 139 or other caregivers. In every such Child Protection Team case 140 staffing, consultation, or staff activity involving a child, a 141 family safety and preservation program representative shall 142 attend and participate. 143 (g)Case service coordination and assistance, including the 144 location of services available from other public and private 145 agencies in the community. 146 (h)Such training services for program and other employees 147 of the Department of Children and Families, employees of the 148 Department of Health, and other medical professionals as is 149 deemed appropriate to enable them to develop and maintain their 150 professional skills and abilities in handling child abuse, 151 abandonment, and neglect cases. The training service must 152 include training in the recognition of and appropriate responses 153 to head trauma and brain injury in a child under 6 years of age 154 as required by ss. 402.402(2) and 409.988. 155 (i)Educational and community awareness campaigns on child 156 abuse, abandonment, and neglect in an effort to enable citizens 157 more successfully to prevent, identify, and treat child abuse, 158 abandonment, and neglect in the community. 159 (j)Child Protection Team assessments that include, as 160 appropriate, medical evaluations, medical consultations, family 161 psychosocial interviews, specialized clinical interviews, or 162 forensic interviews. 163 164 A Child Protection Team that is evaluating a report of medical 165 neglect and assessing the health care needs of a medically 166 complex child shall consult with a physician who has experience 167 in treating children with the same condition. 168 (4)A Child Protection Team shall consult with a physician 169 licensed under chapter 458 or chapter 459 or an advanced 170 practice registered nurse licensed under chapter 464 who has 171 experience in and routinely provides medical care to pediatric 172 patients when evaluating a report of: 173 (a)Medical neglect and assessing the needs of a medically 174 complex child; or 175 (b)A child with a reported preexisting diagnosis of any of 176 the following: 177 1.Rickets. 178 2.Ehlers-Danlos syndrome. 179 3.Osteogenesis imperfecta. 180 4.Vitamin D deficiency. 181 5.Any other medical condition known to appear to be caused 182 by, or known to be misdiagnosed as, abuse. 183 (6)(5)All abuse and neglect cases transmitted for 184 investigation to a circuit by the hotline must be simultaneously 185 transmitted to the Child Protection Team for review. For the 186 purpose of determining whether a face-to-face medical evaluation 187 by a Child Protection Team is necessary, all cases transmitted 188 to the Child Protection Team which meet the criteria in 189 subsection (5) (4) must be timely reviewed by: 190 (a)A physician licensed under chapter 458 or chapter 459 191 who holds board certification in pediatrics and is a member of a 192 Child Protection Team; 193 (b)A physician licensed under chapter 458 or chapter 459 194 who holds board certification in a specialty other than 195 pediatrics, who may complete the review only when working under 196 the direction of the Child Protection Team medical director or a 197 physician licensed under chapter 458 or chapter 459 who holds 198 board certification in pediatrics and is a member of a Child 199 Protection Team; 200 (c)An advanced practice registered nurse licensed under 201 chapter 464 who has a specialty in pediatrics or family medicine 202 and is a member of a Child Protection Team; 203 (d)A physician assistant licensed under chapter 458 or 204 chapter 459, who may complete the review only when working under 205 the supervision of the Child Protection Team medical director or 206 a physician licensed under chapter 458 or chapter 459 who holds 207 board certification in pediatrics and is a member of a Child 208 Protection Team; or 209 (e)A registered nurse licensed under chapter 464, who may 210 complete the review only when working under the direct 211 supervision of the Child Protection Team medical director or a 212 physician licensed under chapter 458 or chapter 459 who holds 213 board certification in pediatrics and is a member of a Child 214 Protection Team. 215 (7)(6)A face-to-face medical evaluation by a Child 216 Protection Team is not necessary when: 217 (a)The child was examined for the alleged abuse or neglect 218 by a physician who is not a member of the Child Protection Team, 219 and a consultation between the Child Protection Team medical 220 director or a Child Protection Team board-certified 221 pediatrician, advanced practice registered nurse, physician 222 assistant working under the supervision of a Child Protection 223 Team medical director or a Child Protection Team board-certified 224 pediatrician, or registered nurse working under the direct 225 supervision of a Child Protection Team medical director or a 226 Child Protection Team board-certified pediatrician, and the 227 examining physician concludes that a further medical evaluation 228 is unnecessary; 229 (b)The child protective investigator, with supervisory 230 approval, has determined, after conducting a child safety 231 assessment, that there are no indications of injuries as 232 described in paragraphs (5)(a)-(h) (4)(a)-(h) as reported; or 233 (c)The Child Protection Team medical director or a Child 234 Protection Team board-certified pediatrician, as authorized in 235 subsection (6) (5), determines that a medical evaluation is not 236 required. 237 238 Notwithstanding paragraphs (a), (b), and (c), a Child Protection 239 Team medical director or a Child Protection Team pediatrician, 240 as authorized in subsection (6) (5), may determine that a face 241 to-face medical evaluation is necessary. 242 Section 3.Paragraph (c) is added to subsection (1) of 243 section 39.304, Florida Statutes, to read: 244 39.304Photographs, medical examinations, X rays, and 245 medical treatment of abused, abandoned, or neglected child. 246 (1) 247 (c)If an examination is performed on a child under 248 paragraph (b), the parent or legal custodian from whom the child 249 was removed pursuant to s. 39.401 may: 250 1.If the initial examination was not performed by the 251 Child Protection Team, request that the child be examined by the 252 Child Protection Team as soon as practicable; 253 2.If the initial examination was performed by the Child 254 Protection Team, for the purpose of obtaining a second opinion 255 on diagnosis or treatment, request that the child be examined by 256 a physician licensed under chapter 458 or chapter 459 or an 257 advanced practice registered nurse licensed under chapter 464 of 258 his or her choosing who routinely provides medical care to 259 pediatric patients; or 260 3.For the purpose of ruling out a differential diagnosis, 261 request that the child be examined by a physician licensed under 262 chapter 458 or chapter 459 or an advanced practice registered 263 nurse licensed under chapter 464 who routinely provides 264 diagnosis of and medical care to pediatric patients for the 265 conditions specified in s. 39.303(4)(b). 266 267 An examination requested under subparagraph 2. or subparagraph 268 3. must be paid for by the parent or legal custodian making such 269 request or as otherwise covered by insurance or Medicaid. An 270 examination may not be requested under this paragraph for the 271 purpose of obtaining a second opinion as to whether a child has 272 been sexually abused. 273 Section 4.This act shall take effect July 1, 2025.