THE BILL ITSELF
CS/HB 475
Out-of-home Placement Providers and Treatment Facilities
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A bill to be entitled
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An act relating to out-of-home placement providers and
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treatment facilities; amending s. 39.523, F.S.;
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requiring the Department of Children and Families, the
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Department of Health, the Agency for Persons with
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Disabilities, and the Agency for Health Care
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Administration to provide certain data to community-
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based care lead agencies on a specified schedule;
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requiring the Office of Program Policy Analysis and
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Government Accountability to conduct an analysis of
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this state's capacity to care for high-acuity children
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in out-of-home placements and treatment facilities;
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providing definitions; specifying requirements for the
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analysis; requiring the office to submit to the
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Legislature, by specified dates, interim and final
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reports of its findings and recommendations; providing
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an effective date.
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Be It Enacted by the Legislature of the State of Florida:
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Section 1. Paragraph (g) is added to subsection (2) of
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section 39.523, Florida Statutes, to read:
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39.523 Placement in out-of-home care.—
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(2) ASSESSMENT AND PLACEMENT.—When any child is removed
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from a home and placed in out-of-home care, a comprehensive
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placement assessment process shall be completed in accordance
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with s. 39.4022 to determine the level of care needed by the
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child and match the child with the most appropriate placement.
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(g) The department, the Department of Health, the Agency
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for Persons with Disabilities, and the Agency for Health Care
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Administration must provide to each community-based care lead
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agency, as defined in s. 409.986(3):
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1. A detailed list of each licensed out-of-home placement
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provider and treatment facility within the lead agency's
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respective region, including, but not limited to:
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a. Therapeutic and medical foster homes licensed under s.
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409.175.
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b. Residential treatment centers for children and
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adolescents as provided in s. 394.875.
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c. Therapeutic group homes as defined in s. 39.407(6)(a).
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d. Qualified residential treatment programs licensed by
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the Agency for Health Care Administration.
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e. Behavioral qualified residential treatment programs
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licensed by the department.
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f. Professional foster care programs as provided in s.
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409.996.
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g. Group homes and foster care facilities licensed by the
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Agency for Persons with Disabilities.
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h. Statewide inpatient psychiatric programs licensed by
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the Agency for Health Care Administration.
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2. On a weekly basis, the current number of available beds
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in each licensed out-of-home placement provider and treatment
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facility listed under subparagraph 1.
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Section 2. Out-of-home placement provider and treatment
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facility analysis.—
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(1) The Office of Program Policy Analysis and Government
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Accountability shall conduct a comprehensive analysis of this
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state's capacity to care for high-acuity children in out-of-home
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placements and treatment facilities.
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(2) For purposes of this multipart analysis, the term:
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(a) "High-acuity" means a child from birth to 18 years of
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age who presents with intensive and complex medical,
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developmental, behavioral health, or disability needs across
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multiple areas of functioning.
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(b) "Specialized placement" means licensed out-of-home
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care settings, including, but not limited to, family foster
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homes licensed as level IV or level V, qualified residential
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treatment programs, behavioral qualified residential treatment
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programs, therapeutic group homes, residential treatment centers
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for children and adolescents, and professional foster care
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programs, as well as foster care facilities and group homes
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licensed by the Agency for Persons with Disabilities.
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(c) "Treatment facility" means a medical facility that
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treats a child and does not constitute an out-of-home placement,
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including, but not limited to, the statewide inpatient
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psychiatric program.
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(3) The Office of Program Policy Analysis and Government
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Accountability shall review the roles and responsibilities of
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the Department of Children and Families, the Department of
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Health, the Agency for Persons with Disabilities, the Agency for
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Health Care Administration, and community-based care lead
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agencies regarding recruitment and retention at all specialized
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placements and treatment facilities.
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(4) The Office of Program Policy Analysis and Government
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Accountability shall conduct a comprehensive review and gap
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analysis of the use of specialized placements and treatment
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facilities by the Department of Children and Families, the
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Department of Health, the Agency for Persons with Disabilities,
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and the Agency for Health Care Administration for children in
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out-of-home care who are identified as high acuity or diagnosed
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with co-occurring disorders. Specifically, the office shall
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compile data for the last 3 fiscal years and evaluate the
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sufficiency of current bed capacity relative to the demonstrated
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need across all community-based care lead agency regions, sorted
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by community-based care lead agency, as follows:
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(a) The total number of licensed beds, the average daily
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census, and the percentage of capacity used each month for each
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specialized placement and treatment facility that is reviewed;
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any identified need for increased bed capacity in any of such
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specialized placements and treatment facilities; and, for
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specialized placements and treatment facilities that also care
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for nonchild welfare children, data on the case mix.
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(b) An aggregate list of referred diagnoses, ranked in
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descending order from most common to least common, associated
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with children referred to or placed in each specialized
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placement or treatment facility.
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(c) The total number of requests, orders, or referrals for
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specialized placements and treatment facilities; the number of
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placements made; the specific reasons placements were not made;
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the number of alternative services provided, such as step-down
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or in-lieu-of-services; and, for placements made in a county
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other than the county in which the child's residence is located,
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the distance between the placement and the child's residence.
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(d) The number of out-of-state specialized placements, the
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reasons for such out-of-state placements, and the community-
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based care lead agency region of origin.
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(e) The average number of days required for qualified
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evaluators to complete suitability assessments and whether there
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is a shortage of qualified evaluators.
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(f) The average number of days from the determination of
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clinical need until the actual admission or placement of the
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child.
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(g) The average length of stay per specialized placement
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and treatment facility type, sorted by the primary behavioral or
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medical condition treated.
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(h) The prevalence of courts disregarding specialized
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placement or treatment facility recommendations made by the
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Department of Children and Families and the reasons therefor.
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(5) The Office of Program Policy Analysis and Government
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Accountability shall review the Department of Health's process
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for establishing, screening, and placing children into medical
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foster homes, including, but not limited to, the involvement of
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a Child Protection Team.
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(6) The Office of Program Policy Analysis and Government
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Accountability shall review the methods the Department of
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Children and Families, the Department of Health, the Agency for
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Persons with Disabilities, and the Agency for Health Care
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Administration use to communicate the availability of beds in
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specialized placements and treatment facilities to community-
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based care lead agencies.
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(7) The Office of Program Policy Analysis and Government
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Accountability shall assess the quality and uniformity of
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training provided to case managers by community-based care lead
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agencies to support high-acuity children, specialized
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placements, and treatment facilities and shall identify a model
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training if one is identified through the review of existing
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community-based care lead agency case manager trainings.
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(8) The Office of Program Policy Analysis and Government
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Accountability shall submit an interim report of its findings
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and recommendations to the President of the Senate and the
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Speaker of the House of Representatives by October 1, 2026, and
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a final report of its findings and recommendations by December
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1, 2026.
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Section 3. This act shall take effect July 1, 2026.