THE BILL ITSELF
CS/CS/SB 42
Specific Medical Diagnoses in Child Protective Investigations
Florida Senate - 2026 CS for CS for SB 42 By the Committee on Fiscal Policy; the Appropriations Committee on Health and Human Services; and Senators Sharief, Rouson, Grall, Bernard, and Garcia 594-03331-26 202642c2
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A bill to be entitled
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An act relating to specific medical diagnoses in child
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protective investigations; amending s. 39.301, F.S.;
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providing an exception to the requirement that the
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Department of Children and Families immediately
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forward certain allegations to a law enforcement
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agency; requiring that such allegations be immediately
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forwarded to a law enforcement agency upon completion
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of the department’s investigation under certain
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circumstances; requiring a child protective
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investigator to inform the subject of an investigation
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of a certain duty; requiring the department to request
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relevant medical records from a licensed health care
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professional for certain children who are the subject
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of a central abuse hotline report; conforming a cross
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reference; amending s. 39.303, F.S.; requiring Child
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Protection Teams to consult with a licensed physician
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or advanced practice registered nurse with specified
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experience when evaluating certain reports; amending
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s. 39.304, F.S.; authorizing a parent or legal
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custodian of a child who is the subject of certain
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orders to request specified medical examinations of
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the child within a specified timeframe; requiring that
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such medical examinations be paid for by the parent or
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legal custodian making the request or as otherwise
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covered by insurance; requiring the physician or
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advanced practice registered nurse who performed
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certain medical examinations to submit a written
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report to the department and certain persons within a
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specified timeframe; requiring the department to
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immediately convene a case staffing with specified
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persons under certain circumstances; amending s.
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456.057, F.S.; requiring that certain patient records
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be furnished to the Department of Children and
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Families within a specified timeframe; providing an
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effective date.
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Be It Enacted by the Legislature of the State of Florida:
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Section 1. Paragraph (a) of subsection (2), paragraph (a)
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of subsection (5), paragraph (a) of subsection (9), and
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paragraph (c) of subsection (14) of section 39.301, Florida
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Statutes, are amended to read:
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39.301 Initiation of protective investigations.—
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(2)(a) The department shall immediately forward allegations
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of criminal conduct to the municipal or county law enforcement
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agency of the municipality or county in which the alleged
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conduct has occurred. However, the department may delay
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forwarding allegations of criminal conduct to the appropriate
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law enforcement agency if the parent or legal custodian:
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1. Has alleged that the child has a preexisting medical
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diagnosis specified in s. 39.303(4); or
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2. Is requesting that the child have a medical examination
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under s. 39.304(1)(c).
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Allegations of criminal conduct which are not immediately
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forwarded to the law enforcement agency pursuant to subparagraph
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1. or subparagraph 2. must be immediately forwarded to the law
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enforcement agency upon completion of the investigation under
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this part if criminal conduct is still alleged.
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(5)(a) Upon commencing an investigation under this part,
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the child protective investigator shall inform any subject of
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the investigation of the following:
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1. The names of the investigators and identifying
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credentials from the department.
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2. The purpose of the investigation.
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3. The right to obtain his or her own attorney and ways
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that the information provided by the subject may be used.
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4. The possible outcomes and services of the department’s
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response.
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5. The right of the parent or legal custodian to be engaged
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to the fullest extent possible in determining the nature of the
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allegation and the nature of any identified problem and the
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remedy.
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6. The duty of the parent or legal custodian to report any
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change in the residence or location of the child to the
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investigator and that the duty to report continues until the
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investigation is closed.
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7. The duty of the parent or legal custodian to immediately
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report any preexisting medical diagnosis for the child specified
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in s. 39.303(4) and to provide the name and contact information
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of the licensed health care professional who made such diagnosis
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or treated the child for the diagnosed condition to the
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department within 10 days after being informed of such duty.
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(9)(a) For each report received from the central abuse
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hotline and accepted for investigation, the department shall
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perform the following child protective investigation activities
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to determine child safety:
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1. Conduct a review of all relevant, available information
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specific to the child, family, and alleged maltreatment; family
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child welfare history; local, state, and federal criminal
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records checks; and requests for law enforcement assistance
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provided by the abuse hotline. Based on a review of available
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information, including the allegations in the current report, a
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determination must shall be made as to whether immediate
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consultation should occur with law enforcement, the Child
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Protection Team, a domestic violence shelter or advocate, or a
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substance abuse or mental health professional. Such
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consultations should include discussion as to whether a joint
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response is necessary and feasible. A determination must shall
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be made as to whether the person making the report should be
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contacted before the face-to-face interviews with the child and
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family members.
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2. Conduct face-to-face interviews with the child; other
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siblings, if any; and the parents, legal custodians, or
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caregivers.
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3. Assess the child’s residence, including a determination
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of the composition of the family and household, including the
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name, address, date of birth, social security number, sex, and
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race of each child named in the report; any siblings or other
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children in the same household or in the care of the same
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adults; the parents, legal custodians, or caregivers; and any
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other adults in the same household.
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4. Determine whether there is any indication that any child
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in the family or household has been abused, abandoned, or
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neglected; the nature and extent of present or prior injuries,
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abuse, or neglect, and any evidence thereof; and a determination
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as to the person or persons apparently responsible for the
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abuse, abandonment, or neglect, including the name, address,
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date of birth, social security number, sex, and race of each
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such person.
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5. Complete assessment of immediate child safety for each
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child based on available records, interviews, and observations
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with all persons named in subparagraph 2. and appropriate
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collateral contacts, which may include other professionals, and
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continually assess the child’s safety throughout the
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investigation. The department’s child protection investigators
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are hereby designated a criminal justice agency for the purpose
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of accessing criminal justice information to be used for
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enforcing this state’s laws concerning the crimes of child
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abuse, abandonment, and neglect. This information must shall be
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used solely for purposes supporting the detection, apprehension,
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prosecution, pretrial release, posttrial release, or
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rehabilitation of criminal offenders or persons accused of the
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crimes of child abuse, abandonment, or neglect and may not be
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further disseminated or used for any other purpose.
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6. For a child who has a preexisting medical diagnosis
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specified in s. 39.303(4), as reported by the parent or legal
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custodian of the child, request the relevant medical records
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from the licensed health care professional who diagnosed or
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treated the child for such medical diagnosis.
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7. 6. Document the present and impending dangers to each
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child based on the identification of inadequate protective
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capacity through utilization of a standardized safety assessment
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instrument. If present or impending danger is identified, the
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child protective investigator must implement a safety plan or
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take the child into custody. If present danger is identified and
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the child is not removed, the child protective investigator must
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shall create and implement a safety plan before leaving the home
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or the location where there is present danger. If impending
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danger is identified, the child protective investigator must
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shall create and implement a safety plan as soon as necessary to
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protect the safety of the child. The child protective
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investigator may modify the safety plan if he or she identifies
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additional impending danger.
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a. If the child protective investigator implements a safety
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plan, the plan must be specific, sufficient, feasible, and
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sustainable in response to the realities of the present or
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impending danger. A safety plan may be an in-home plan or an
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out-of-home plan, or a combination of both. A safety plan may
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include tasks or responsibilities for a parent, caregiver, or
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legal custodian. However, a safety plan may not rely on
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promissory commitments by the parent, caregiver, or legal
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custodian who is currently not able to protect the child or on
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services that are not available or will not result in the safety
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of the child. A safety plan may not be implemented if for any
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reason the parents, guardian, or legal custodian lacks the
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capacity or ability to comply with the plan. If the department
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is not able to develop a plan that is specific, sufficient,
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feasible, and sustainable, the department must shall file a
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shelter petition. A child protective investigator must shall
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implement separate safety plans for the perpetrator of domestic
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violence, if the investigator, using reasonable efforts, can
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locate the perpetrator to implement a safety plan, and for the
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parent who is a victim of domestic violence as defined in s.
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741.28. Reasonable efforts to locate a perpetrator include, but
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are not limited to, a diligent search pursuant to the same
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requirements as in s. 39.503. If the perpetrator of domestic
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violence is not the parent, guardian, or legal custodian of any
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child in the home and if the department does not intend to file
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a shelter petition or dependency petition that will assert
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allegations against the perpetrator as a parent of a child in
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the home, the child protective investigator must shall seek
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issuance of an injunction authorized by s. 39.504 to implement a
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safety plan for the perpetrator and impose any other conditions
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to protect the child. The safety plan for the parent who is a
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victim of domestic violence may not be shared with the
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perpetrator. If any party to a safety plan fails to comply with
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the safety plan resulting in the child being unsafe, the
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department must shall file a shelter petition.
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b. The child protective investigator shall collaborate with
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the community-based care lead agency in the development of the
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safety plan as necessary to ensure that the safety plan is
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specific, sufficient, feasible, and sustainable. The child
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protective investigator shall identify services necessary for
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the successful implementation of the safety plan. The child
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protective investigator and the community-based care lead agency
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shall mobilize service resources to assist all parties in
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complying with the safety plan. The community-based care lead
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agency shall prioritize safety plan services to families who
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have multiple risk factors, including, but not limited to, two
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or more of the following:
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(I) The parent or legal custodian is of young age;
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(II) The parent or legal custodian, or an adult currently
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living in or frequently visiting the home, has a history of
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substance abuse, mental illness, or domestic violence;
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(III) The parent or legal custodian, or an adult currently
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living in or frequently visiting the home, has been previously
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found to have physically or sexually abused a child;
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(IV) The parent or legal custodian, or an adult currently
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living in or frequently visiting the home, has been the subject
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of multiple allegations by reputable reports of abuse or
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neglect;
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(V) The child is physically or developmentally disabled; or
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(VI) The child is 3 years of age or younger.
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c. The child protective investigator shall monitor the
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implementation of the plan to ensure the child’s safety until
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the case is transferred to the lead agency at which time the
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lead agency shall monitor the implementation.
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d. The department may file a petition for shelter or
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dependency without a new child protective investigation or the
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concurrence of the child protective investigator if the child is
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unsafe but for the use of a safety plan and the parent or
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caregiver has not sufficiently increased protective capacities
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within 90 days after the transfer of the safety plan to the lead
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agency.
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(14)
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(c) The department, in consultation with the judiciary,
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shall adopt by rule:
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1. Criteria that are factors requiring that the department
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take the child into custody, petition the court as provided in
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this chapter, or, if the child is not taken into custody or a
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petition is not filed with the court, conduct an administrative
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review. Such factors must include, but are not limited to,
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noncompliance with a safety plan or the case plan developed by
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the department, and the family under this chapter, and prior
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abuse reports with findings that involve the child, the child’s
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sibling, or the child’s caregiver.
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2. Requirements that if after an administrative review the
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department determines not to take the child into custody or
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petition the court, the department must shall document the
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reason for its decision in writing and include it in the
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investigative file. For all cases that were accepted by the
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local law enforcement agency for criminal investigation pursuant
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to subsection (2), the department must include in the file
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written documentation that the administrative review included
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input from law enforcement. In addition, for all cases that must
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be referred to Child Protection Teams pursuant to s. 39.303(5)
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and (6) s. 39.303(4) and (5) , the file must include written
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documentation that the administrative review included the
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results of the team’s evaluation.
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Section 2. Present subsections (4) through (10) of section
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39.303, Florida Statutes, are redesignated as subsections (5)
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through (11), respectively, a new subsection (4) is added to
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that section, and present subsections (5) and (6) of that
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section are amended, to read:
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39.303 Child Protection Teams and sexual abuse treatment
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programs; services; eligible cases.—
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(4) A Child Protection Team shall consult with a physician
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licensed under chapter 458 or chapter 459 or an advanced
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practice registered nurse licensed under chapter 464 who has
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experience treating children with the medical conditions
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specified in this subsection when evaluating a child with a
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reported preexisting medical diagnosis of any of the following:
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(a) Rickets.
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(b) Ehlers-Danlos syndrome.
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(c) Osteogenesis imperfecta.
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(d) Vitamin D deficiency.
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(6) (5) All abuse and neglect cases transmitted for
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investigation to a circuit by the hotline must be simultaneously
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transmitted to the Child Protection Team for review. For the
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purpose of determining whether a face-to-face medical evaluation
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by a Child Protection Team is necessary, all cases transmitted
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to the Child Protection Team which meet the criteria in
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subsection (5) (4) must be timely reviewed by:
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(a) A physician licensed under chapter 458 or chapter 459
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who holds board certification in pediatrics and is a member of a
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Child Protection Team;
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(b) A physician licensed under chapter 458 or chapter 459
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who holds board certification in a specialty other than
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pediatrics, who may complete the review only when working under
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the direction of the Child Protection Team medical director or a
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physician licensed under chapter 458 or chapter 459 who holds
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board certification in pediatrics and is a member of a Child
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Protection Team;
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(c) An advanced practice registered nurse licensed under
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chapter 464 who has a specialty in pediatrics or family medicine
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and is a member of a Child Protection Team;
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(d) A physician assistant licensed under chapter 458 or
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chapter 459, who may complete the review only when working under
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the supervision of the Child Protection Team medical director or
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a physician licensed under chapter 458 or chapter 459 who holds
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board certification in pediatrics and is a member of a Child
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Protection Team; or
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(e) A registered nurse licensed under chapter 464, who may
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complete the review only when working under the direct
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supervision of the Child Protection Team medical director or a
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physician licensed under chapter 458 or chapter 459 who holds
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board certification in pediatrics and is a member of a Child
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Protection Team.
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(7) (6) A face-to-face medical evaluation by a Child
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Protection Team is not necessary when:
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(a) The child was examined for the alleged abuse or neglect
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by a physician who is not a member of the Child Protection Team,
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and a consultation between the Child Protection Team medical
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director or a Child Protection Team board-certified
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pediatrician, advanced practice registered nurse, physician
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assistant working under the supervision of a Child Protection
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Team medical director or a Child Protection Team board-certified
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pediatrician, or registered nurse working under the direct
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supervision of a Child Protection Team medical director or a
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Child Protection Team board-certified pediatrician, and the
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examining physician concludes that a further medical evaluation
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is unnecessary;
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(b) The child protective investigator, with supervisory
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approval, has determined, after conducting a child safety
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assessment, that there are no indications of injuries as
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described in paragraphs (5)(a)-(h) (4)(a)-(h) as reported; or
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(c) The Child Protection Team medical director or a Child
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Protection Team board-certified pediatrician, as authorized in
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subsection (6) (5) , determines that a medical evaluation is not
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required.
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Notwithstanding paragraphs (a), (b), and (c), a Child Protection
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Team medical director or a Child Protection Team pediatrician,
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as authorized in subsection (6) (5) , may determine that a face
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to-face medical evaluation is necessary.
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Section 3. Paragraphs (c), (d), and (e) are added to
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subsection (1) of section 39.304, Florida Statutes, to read:
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39.304 Photographs, medical examinations, X rays, and
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medical treatment of abused, abandoned, or neglected child.—
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(1)
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(c) If a medical examination is performed on a child under
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paragraph (b), other than a medical examination for purposes of
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determining whether a child has been sexually abused, the parent
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or legal custodian of the child who is the subject of a
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protective investigation or shelter order may request of the
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department, no later than 10 days after such medical
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examination, that the child be examined by:
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1. A Child Protection Team if the medical examination under
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paragraph (b) was not performed by a Child Protection Team;
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2. A physician licensed under chapter 458 or chapter 459 or
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an advanced practice registered nurse licensed under chapter 464
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of the parent’s or legal custodian’s choosing who routinely
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provides medical care to pediatric patients, if the medical
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examination under paragraph (b) was performed by a Child
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Protection Team, for the purpose of obtaining a second opinion
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on diagnosis or treatment; or
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3. A physician licensed under chapter 458 or chapter 459 or
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an advanced practice registered nurse licensed under chapter 464
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of the parent’s or legal custodian’s choosing who routinely
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provides diagnosis of and medical care to pediatric patients for
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the conditions specified in s. 39.303(4) to consider a
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differential diagnosis.
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The cost of a medical examination under subparagraph 2. or
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subparagraph 3. must be borne by the parent or legal custodian,
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including through his or her health care coverage, if
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applicable.
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(d) Notwithstanding s. 39.202(6), for all medical
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examinations performed pursuant to paragraph (c), the physician
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or advanced practice registered nurse must submit within 10 days
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after the medical examination a written report that details the
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findings and conclusions of the medical examination to the
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department and the parent or legal custodian.
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(e) If the findings and conclusions of the medical
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examination conducted under paragraph (b) and the medical
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examination conducted under paragraph (c) differ, the department
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must immediately convene a case staffing to reach a consensus
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regarding the differences in the medical opinions. The case
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staffing must include the child protective investigator, the
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investigator’s supervisor, legal staff of the department,
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representatives from a Child Protection Team, and the community
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based care lead agency. If possible, the case staffing must also
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include any health care practitioners who previously treated the
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child, any health care practitioners who are currently treating
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the child, and the physician or advanced practice registered
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nurse who conducted the medical examination under paragraph (c).
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Section 4. Paragraph (a) of subsection (7) of section
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456.057, Florida Statutes, is amended to read:
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456.057 Ownership and control of patient records; report or
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copies of records to be furnished; disclosure of information.—
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(7)(a) Except as otherwise provided in this section and in
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s. 440.13(4)(c), such records may not be furnished to, and the
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medical condition of a patient may not be discussed with, any
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person other than the patient, the patient’s legal
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representative, or other health care practitioners and providers
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involved in the patient’s care or treatment, except upon written
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authorization from the patient. However, such records may be
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furnished without written authorization under the following
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circumstances:
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1. To any person, firm, or corporation that has procured or
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furnished such care or treatment with the patient’s consent.
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2. When compulsory physical examination is made pursuant to
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Rule 1.360, Florida Rules of Civil Procedure, in which case
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copies of the medical records shall be furnished to both the
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defendant and the plaintiff.
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3. In any civil or criminal action, unless otherwise
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prohibited by law, upon the issuance of a subpoena from a court
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of competent jurisdiction and proper notice to the patient or
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the patient’s legal representative by the party seeking such
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records.
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4. For statistical and scientific research, provided the
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information is abstracted in such a way as to protect the
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identity of the patient or provided written permission is
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received from the patient or the patient’s legal representative.
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5. To a regional poison control center for purposes of
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treating a poison episode under evaluation, case management of
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poison cases, or compliance with data collection and reporting
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requirements of s. 395.1027 and the professional organization
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that certifies poison control centers in accordance with federal
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law.
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6. To the Department of Children and Families, its agent,
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or its contracted entity, for the purpose of investigations of
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or services for cases of abuse, neglect, or exploitation of
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children or vulnerable adults. Records requested by the
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Department of Children and Families pursuant to s. 39.301(9)(a)
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must be furnished to the Department of Children and Families
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within 14 days after such request.
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Section 5. This act shall take effect July 1, 2026.