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F L O R I D A H O U S E O F R E P R E S E N T A T I VE S
1
An act relating to specific medical diagnoses in child 2
protective investigations; amending s. 39.301, F.S.; 3
providing an exception to the requirement that the 4
Department of Children and Families immediately 5
forward certain allegations to a law enforcement 6
agency; requiring such allegations to be immediately 7
forwarded to a law enforcement agency upon completion 8
of the department's investigation; requiring a child 9
protective investigator to inform the subject of an 10
investigation of a certain duty; requiring the 11
department to request medical records of certain 12
children from certain licensed health care 13
professionals; conforming a cross-reference; amending 14
s. 39.303, F.S.; requiring Child Protection Teams to 15
consult with a licensed physician or advanced practice 16
registered nurse with certain experience when 17
evaluating certain reports; conforming cross-18
references; amending s. 39.304, F.S.; authorizing a 19
parent or legal custodian of a child who is the 20
subject of a protective investigation or shelter order 21
to request specified medical examinations of the child 22
within a specified timeframe; requiring that certain 23
medical examinations be paid for by the parent or 24
legal custodian making the request or as otherwise 25
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covered by insurance; requiring the physician or 26
advanced practice registered nurse who performed 27
certain medical examinations to submit a written 28
report to the department and certain persons within a 29
specified timeframe; requiring the department to 30
immediately convene a case staffing with specified 31
persons under certain circumstances; amending s. 32
456.057, F.S.; requiring certain records be provided 33
to the department within a specified timeframe; 34
providing an effective date. 35
36
Be It Enacted by the Legislature of the State of Florida: 37
38
Section 1. Paragraph (a) of subsection (2), paragraph (a) 39
of subsection (5), paragraph (a) of subsection (9), and 40
paragraph (c) of subsection (14) of section 39.301, Florida 41
Statutes, are amended to read: 42
39.301 Initiation of protective investigations.— 43
(2)(a) The department shall immediately forward 44
allegations of criminal conduct to the municipal or county law 45
enforcement agency of the municipality or county in which the 46
alleged conduct has occurred. However, the department may delay 47
forwarding allegations of criminal conduct to the appropriate 48
law enforcement agency if the parent or legal custodian: 49
1. Has alleged that the child has a preexisting medical 50
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diagnosis specified in s. 39.303(4); or 51
2. Is requesting that the child have a medical examination 52
under s. 39.304(1)(c). 53
54
Allegations of criminal conduct which are not immediately 55
forwarded to the law enforcement agency pursuant to subparagraph 56
1. or subparagraph 2. must be immediately forwarded to the law 57
enforcement agency upon completion of the investigation under 58
this part if criminal conduct is still alleged. 59
(5)(a) Upon commencing an investigation under this part, 60
the child protective investigator shall inform any subject of 61
the investigation of the following: 62
1. The names of the investigators and identifying 63
credentials from the department. 64
2. The purpose of the investigation. 65
3. The right to obtain his or her own attorney and ways 66
that the information provided by the subject may be used. 67
4. The possible outcomes and services of the department's 68
response. 69
5. The right of the parent or legal custodian to be 70
engaged to the fullest extent possible in determining the nature 71
of the allegation and the nature of any identified problem and 72
the remedy. 73
6. The duty of the parent or legal custodian to report any 74
change in the residence or location of the child to the 75
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investigator and that the duty to report continues until the 76
investigation is closed. 77
7. The duty of the parent or legal custodian to 78
immediately report any preexisting medical diagnosis for the 79
child specified in s. 39.303(4) and to provide the name and 80
contact information of the licensed health care professional who 81
made such diagnosis or treated the child for the diagnosed 82
condition to the department within 10 days after being informed 83
of such duty. 84
(9)(a) For each report received from the central abuse 85
hotline and accepted for investigation, the department shall 86
perform the following child protective investigation activities 87
to determine child safety: 88
1. Conduct a review of all relevant, available information 89
specific to the child, family, and alleged maltreatment; family 90
child welfare history; local, state, and federal criminal 91
records checks; and requests for law enforcement assistance 92
provided by the abuse hotline. Based on a review of available 93
information, including the allegations in the current report, a 94
determination must shall be made as to whether immediate 95
consultation should occur with law enforcement, the Child 96
Protection Team, a domestic violence shelter or advocate, or a 97
substance abuse or mental health professional. Such 98
consultations should include discussion as to whether a joint 99
response is necessary and feasible. A determination must shall 100
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be made as to whether the person making the report should be 101
contacted before the face-to-face interviews with the child and 102
family members. 103
2. Conduct face-to-face interviews with the child; other 104
siblings, if any; and the parents, legal custodians, or 105
caregivers. 106
3. Assess the child's residence, including a determination 107
of the composition of the family and household, including the 108
name, address, date of birth, social security number, sex, and 109
race of each child named in the report; any siblings or other 110
children in the same household or in the care of the same 111
adults; the parents, legal custodians, or caregivers; and any 112
other adults in the same household. 113
4. Determine whether there is any indication that any 114
child in the family or household has been abused, abandoned, or 115
neglected; the nature and extent of present or prior injuries, 116
abuse, or neglect, and any evidence thereof; and a determination 117
as to the person or persons apparently responsible for the 118
abuse, abandonment, or neglect, including the name, address, 119
date of birth, social security number, sex, and race of each 120
such person. 121
5. Complete assessment of immediate child safety for each 122
child based on available records, interviews, and observations 123
with all persons named in subparagraph 2. and appropriate 124
collateral contacts, which may include other professionals, and 125
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continually assess the child's safety throughout the 126
investigation. The department's child protection investigators 127
are hereby designated a criminal justice agency for the purpose 128
of accessing criminal justice information to be used for 129
enforcing this state's laws concerning the crimes of child 130
abuse, abandonment, and neglect. This information must shall be 131
used solely for purposes supporting the detection, apprehension, 132
prosecution, pretrial release, posttrial release, or 133
rehabilitation of criminal offenders or persons accused of the 134
crimes of child abuse, abandonment, or neglect and may not be 135
further disseminated or used for any other purpose. 136
6. For a child who has a preexisting medical diagnosis 137
specified in s. 39.303(4), as reported by the parent or legal 138
custodian of the child, request the relevant medical records 139
from the licensed health care professional who diagnosed or 140
treated the child for such medical diagnosis. 141
7.6. Document the present and impending dangers to each 142
child based on the identification of inadequate protective 143
capacity through utilization of a standardized safety assessment 144
instrument. If present or impending danger is identified, the 145
child protective investigator must implement a safety plan or 146
take the child into custody. If present danger is identified and 147
the child is not removed, the child protective investigator must 148
shall create and implement a safety plan before leaving the home 149
or the location where there is present danger. If impending 150
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danger is identified, the child protective investigator must 151
shall create and implement a safety plan as soon as necessary to 152
protect the safety of the child. The child protective 153
investigator may modify the safety plan if he or she identifies 154
additional impending danger. 155
a. If the child protective investigator implements a 156
safety plan, the plan must be specific, sufficient, feasible, 157
and sustainable in response to the realities of the present or 158
impending danger. A safety plan may be an in-home plan or an 159
out-of-home plan, or a combination of both. A safety plan may 160
include tasks or responsibilities for a parent, caregiver, or 161
legal custodian. However, a safety plan may not rely on 162
promissory commitments by the parent, caregiver, or legal 163
custodian who is currently not able to protect the child or on 164
services that are not available or will not result in the safety 165
of the child. A safety plan may not be implemented if for any 166
reason the parents, guardian, or legal custodian lacks the 167
capacity or ability to comply with the plan. If the department 168
is not able to develop a plan that is specific, sufficient, 169
feasible, and sustainable, the department must shall file a 170
shelter petition. A child protective investigator must shall 171
implement separate safety plans for the perpetrator of domestic 172
violence, if the investigator, using reasonable efforts, can 173
locate the perpetrator to implement a safety plan, and for the 174
parent who is a victim of domestic violence as defined in s. 175
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741.28. Reasonable efforts to locate a perpetrator include, but 176
are not limited to, a diligent search pursuant to the same 177
requirements as in s. 39.503. If the perpetrator of domestic 178
violence is not the parent, guardian, or legal custodian of any 179
child in the home and if the department does not intend to file 180
a shelter petition or dependency petition that will assert 181
allegations against the perpetrator as a parent of a child in 182
the home, the child protective investigator must shall seek 183
issuance of an injunction authorized by s. 39.504 to implement a 184
safety plan for the perpetrator and impose any other conditions 185
to protect the child. The safety plan for the parent who is a 186
victim of domestic violence may not be shared with the 187
perpetrator. If any party to a safety plan fails to comply with 188
the safety plan resulting in the child being unsafe, the 189
department must shall file a shelter petition. 190
b. The child protective investigator shall collaborate 191
with the community-based care lead agency in the development of 192
the safety plan as necessary to ensure that the safety plan is 193
specific, sufficient, feasible, and sustainable. The child 194
protective investigator shall identify services necessary for 195
the successful implementation of the safety plan. The child 196
protective investigator and the community-based care lead agency 197
shall mobilize service resources to assist all parties in 198
complying with the safety plan. The community-based care lead 199
agency shall prioritize safety plan services to families who 200
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have multiple risk factors, including, but not limited to, two 201
or more of the following: 202
(I) The parent or legal custodian is of young age; 203
(II) The parent or legal custodian, or an adult currently 204
living in or frequently visiting the home, has a history of 205
substance abuse, mental illness, or domestic violence; 206
(III) The parent or legal custodian, or an adult currently 207
living in or frequently visiting the home, has been previously 208
found to have physically or sexually abused a child; 209
(IV) The parent or legal custodian, or an adult currently 210
living in or frequently visiting the home, has been the subject 211
of multiple allegations by reputable reports of abuse or 212
neglect; 213
(V) The child is physically or developmentally disabled; 214
or 215
(VI) The child is 3 years of age or younger. 216
c. The child protective investigator shall monitor the 217
implementation of the plan to ensure the child's safety until 218
the case is transferred to the lead agency at which time the 219
lead agency shall monitor the implementation. 220
d. The department may file a petition for shelter or 221
dependency without a new child protective investigation or the 222
concurrence of the child protective investigator if the child is 223
unsafe but for the use of a safety plan and the parent or 224
caregiver has not sufficiently increased protective capacities 225
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within 90 days after the transfer of the safety plan to the lead 226
agency. 227
(14) 228
(c) The department, in consultation with the judiciary, 229
shall adopt by rule: 230
1. Criteria that are factors requiring that the department 231
take the child into custody, petition the court as provided in 232
this chapter, or, if the child is not taken into custody or a 233
petition is not filed with the court, conduct an administrative 234
review. Such factors must include, but are not limited to, 235
noncompliance with a safety plan or the case plan developed by 236
the department, and the family under this chapter, and prior 237
abuse reports with findings that involve the child, the child's 238
sibling, or the child's caregiver. 239
2. Requirements that if after an administrative review the 240
department determines not to take the child into custody or 241
petition the court, the department must shall document the 242
reason for its decision in writing and include it in the 243
investigative file. For all cases that were accepted by the 244
local law enforcement agency for criminal investigation pursuant 245
to subsection (2), the department must include in the file 246
written documentation that the administrative review included 247
input from law enforcement. In addition, for all cases that must 248
be referred to Child Protection Teams pursuant to s. 39.303(5) 249
and (6) s. 39.303(4) and (5), the file must include written 250
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documentation that the administrative review included the 251
results of the team's evaluation. 252
Section 2. Subsections (4) through (10) of section 39.303, 253
Florida Statutes, are renumbered as subsections (5) through 254
(11), respectively, present subsections (5) and (6) of that 255
section are amended, and a new subsection (4) is added to that 256
section, to read: 257
39.303 Child Protection Teams and sexual abuse treatment 258
programs; services; eligible cases.— 259
(4) A Child Protection Team shall consult with a physician 260
licensed under chapter 458 or chapter 459 or an advanced 261
practice registered nurse licensed under chapter 464 who has 262
experience treating children with the medical conditions 263
specified in this subsection when evaluating a child with a 264
reported preexisting medical diagnosis of any of the following: 265
(a) Rickets. 266
(b) Ehlers-Danlos syndrome. 267
(c) Osteogenesis imperfecta. 268
(d) Vitamin D deficiency. 269
(6)(5) All abuse and neglect cases transmitted for 270
investigation to a circuit by the hotline must be simultaneously 271
transmitted to the Child Protection Team for review. For the 272
purpose of determining whether a face-to-face medical evaluation 273
by a Child Protection Team is necessary, all cases transmitted 274
to the Child Protection Team which meet the criteria in 275
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subsection (5) (4) must be timely reviewed by: 276
(a) A physician licensed under chapter 458 or chapter 459 277
who holds board certification in pediatrics and is a member of a 278
Child Protection Team; 279
(b) A physician licensed under chapter 458 or chapter 459 280
who holds board certification in a specialty other than 281
pediatrics, who may complete the review only when working under 282
the direction of the Child Protection Team medical director or a 283
physician licensed under chapter 458 or chapter 459 who holds 284
board certification in pediatrics and is a member of a Child 285
Protection Team; 286
(c) An advanced practice registered nurse licensed under 287
chapter 464 who has a specialty in pediatrics or family medicine 288
and is a member of a Child Protection Team; 289
(d) A physician assistant licensed under chapter 458 or 290
chapter 459, who may complete the review only when working under 291
the supervision of the Child Protection Team medical director or 292
a physician licensed under chapter 458 or chapter 459 who holds 293
board certification in pediatrics and is a member of a Child 294
Protection Team; or 295
(e) A registered nurse licensed under chapter 464, who may 296
complete the review only when working under the direct 297
supervision of the Child Protection Team medical director or a 298
physician licensed under chapter 458 or chapter 459 who holds 299
board certification in pediatrics and is a member of a Child 300
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Protection Team. 301
(7)(6) A face-to-face medical evaluation by a Child 302
Protection Team is not necessary when: 303
(a) The child was examined for the alleged abuse or 304
neglect by a physician who is not a member of the Child 305
Protection Team, and a consultation between the Child Protection 306
Team medical director or a Child Protection Team board-certified 307
pediatrician, advanced practice registered nurse, physician 308
assistant working under the supervision of a Child Protection 309
Team medical director or a Child Protection Team board-certified 310
pediatrician, or registered nurse working under the direct 311
supervision of a Child Protection Team medical director or a 312
Child Protection Team board-certified pediatrician, and the 313
examining physician concludes that a further medical evaluation 314
is unnecessary; 315
(b) The child protective investigator, with supervisory 316
approval, has determined, after conducting a child safety 317
assessment, that there are no indications of injuries as 318
described in paragraphs (5)(a)-(h) (4)(a)-(h) as reported; or 319
(c) The Child Protection Team medical director or a Child 320
Protection Team board-certified pediatrician, as authorized in 321
subsection (6) (5), determines that a medical evaluation is not 322
required. 323
324
Notwithstanding paragraphs (a), (b), and (c), a Child Protection 325
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Team medical director or a Child Protection Team pediatrician, 326
as authorized in subsection (6) (5), may determine that a face-327
to-face medical evaluation is necessary. 328
Section 3. Paragraphs (c), (d), and (e) are added to 329
subsection (1) of section 39.304, Florida Statutes, to read: 330
39.304 Photographs, medical examinations, X rays, and 331
medical treatment of abused, abandoned, or neglected child.— 332
(1) 333
(c) If a medical examination is performed on a child under 334
paragraph (b), other than a medical examination for purposes of 335
determining whether a child has been sexually abused, the parent 336
or legal custodian of the child who is the subject of a 337
protective investigation or shelter order may request of the 338
department, no later than 10 days after such medical 339
examination, that the child be examined by: 340
1. A Child Protection Team if the medical examination 341
under paragraph (b) was not performed by a Child Protection 342
Team; 343
2. A physician licensed under chapter 458 or chapter 459 344
or an advanced practice registered nurse licensed under chapter 345
464 of the parent's or legal custodian's choosing who routinely 346
provides medical care to pediatric patients, if the medical 347
examination under paragraph (b) was performed by a Child 348
Protection Team, for the purpose of obtaining a second opinion 349
on diagnosis or treatment; or 350
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3. A physician licensed under chapter 458 or chapter 459 351
or an advanced practice registered nurse licensed under chapter 352
464 of the parent's or legal custodian's choosing who routinely 353
provides diagnosis of and medical care to pediatric patients for 354
the conditions specified in s. 39.303(4) to consider a 355
differential diagnosis. 356
357
The cost of a medical examination under subparagraph 2. or 358
subparagraph 3. must be borne by the parent or legal custodian, 359
including through his or her health care coverage, if 360
applicable. 361
(d) Notwithstanding s. 39.202(6), for all medical 362
examinations performed pursuant to paragraph (c), the physician 363
or advanced practice registered nurse must submit within 10 days 364
after the medical examination a written report that details the 365
findings and conclusions of the medical examination to the 366
department and the parent or legal custodian. 367
(e) If the findings and conclusions of the medical 368
examination conducted under paragraph (b) and the medical 369
examination conducted under paragraph (c) differ, the department 370
must immediately convene a case staffing to reach a consensus 371
regarding the differences in the medical opinions. The case 372
staffing must include the child protective investigator, the 373
investigator's supervisor, legal staff of the department, 374
representatives from a Child Protection Team, and the community-375
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based care lead agency. If possible, the case staffing must also 376
include any health care practitioners who previously treated the 377
child, any health care practitioners who are currently treating 378
the child, and the physician or advanced practice registered 379
nurse who conducted the medical examination under paragraph (c). 380
Section 4. Paragraph (a) of subsection (7) of section 381
456.057, Florida Statutes, is amended to read: 382
456.057 Ownership and control of patient records; report 383
or copies of records to be furnished; disclosure of 384
information.— 385
(7)(a) Except as otherwise provided in this section and in 386
s. 440.13(4)(c), such records may not be furnished to, and the 387
medical condition of a patient may not be discussed with, any 388
person other than the patient, the patient's legal 389
representative, or other health care practitioners and providers 390
involved in the patient's care or treatment, except upon written 391
authorization from the patient. However, such records may be 392
furnished without written authorization under the following 393
circumstances: 394
1. To any person, firm, or corporation that has procured 395
or furnished such care or treatment with the patient's consent. 396
2. When compulsory physical examination is made pursuant 397
to Rule 1.360, Florida Rules of Civil Procedure, in which case 398
copies of the medical records shall be furnished to both the 399
defendant and the plaintiff. 400
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3. In any civil or criminal action, unless otherwise 401
prohibited by law, upon the issuance of a subpoena from a court 402
of competent jurisdiction and proper notice to the patient or 403
the patient's legal representative by the party seeking such 404
records. 405
4. For statistical and scientific research, provided the 406
information is abstracted in such a way as to protect the 407
identity of the patient or provided written permission is 408
received from the patient or the patient's legal representative. 409
5. To a regional poison control center for purposes of 410
treating a poison episode under evaluation, case management of 411
poison cases, or compliance with data collection and reporting 412
requirements of s. 395.1027 and the professional organization 413
that certifies poison control centers in accordance with federal 414
law. 415
6. To the Department of Children and Families, its agent, 416
or its contracted entity, for the purpose of investigations of 417
or services for cases of abuse, neglect, or exploitation of 418
children or vulnerable adults. Records requested by the 419
Department of Children and Families pursuant to s. 39.301(9)(a) 420
must be furnished to the Department of Children and Families 421
within 14 days after such request. 422
Section 5. This act shall take effect July 1, 2026. 423