THE BILL ITSELF
CS/CS/CS/SB 560
Child Welfare
Florida Senate - 2026 CS for CS for CS for SB 560 By the Committee on Rules; the Appropriations Committee on Health and Human Services; the Committee on Children, Families, and Elder Affairs; and Senator Garcia 595-03177-26 2026560c3
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A bill to be entitled
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An act relating to child welfare; amending s. 39.407,
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F.S.; providing that a new medical report relating to
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the provision of psychotropic medication to a child in
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the legal custody of the Department of Children and
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Families may be required only under certain
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circumstances; amending s. 39.4085, F.S.; requiring
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the department and each community-based care lead
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agency to coordinate with certain organizations and
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meet at least quarterly for a specified purpose;
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authorizing such meetings to be held in person or via
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teleconference or other electronic means; requiring
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that such meetings have a formal agenda; requiring the
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department and each community-based care lead agency
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to make certain information available on their
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respective websites; requiring, beginning in a
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specified year, the department and each community
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based care lead agency to publish on their respective
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websites a biannual report containing specified
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information; amending s. 409.175, F.S.; revising the
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definition of the terms “personnel” and “placement
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screening”; amending s. 409.912, F.S.; requiring a
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physician to provide to a pharmacy a copy of certain
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documentation, rather than a signed attestation, with
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certain prescriptions; amending s. 409.993, F.S.;
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requiring the Office of Insurance Regulation, in
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collaboration with the department and other entities,
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to review and analyze certain data; requiring the
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office to provide a certain report to the Governor and
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Legislature; requiring certain entities to respond to
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certain requests for information; authorizing the
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office and the department to levy fines upon or
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otherwise penalize insurance companies and community
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based care lead agencies and their subcontractors,
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respectively, for failure to timely reply to certain
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requests for information; limiting the amount of
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certain fines to specified amounts; requiring the
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transfer of such fines to the General Revenue Fund;
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providing for legislative review and repeal; 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 (c) of subsection (3) of section
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39.407, Florida Statutes, is amended to read:
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39.407 Medical, psychiatric, and psychological examination
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and treatment of child; physical, mental, or substance abuse
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examination of person with or requesting child custody.—
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(3)
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(c) Except as provided in paragraphs (b) and (e), the
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department must file a motion seeking the court’s authorization
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to initially provide or continue to provide psychotropic
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medication to a child in its legal custody. The motion must be
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supported by a written report prepared by the department which
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describes the efforts made to enable the prescribing physician
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or psychiatric nurse, as defined in s. 394.455, to obtain
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express and informed consent for providing the medication to the
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child and other treatments considered or recommended for the
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child. In addition, the motion must be supported by the
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prescribing physician’s or psychiatric nurse’s signed medical
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report providing:
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1. The name of the child, the name and range of the dosage
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of the psychotropic medication, and that there is a need to
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prescribe psychotropic medication to the child based upon a
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diagnosed condition for which such medication is being
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prescribed.
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2. A statement indicating that the physician or psychiatric
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nurse, as defined in s. 394.455, has reviewed all medical
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information concerning the child which has been provided.
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3. A statement indicating that the psychotropic medication,
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at its prescribed dosage, is appropriate for treating the
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child’s diagnosed medical condition, as well as the behaviors
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and symptoms the medication, at its prescribed dosage, is
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expected to address.
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4. An explanation of the nature and purpose of the
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treatment; the recognized side effects, risks, and
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contraindications of the medication; drug-interaction
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precautions; the possible effects of stopping the medication;
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and how the treatment will be monitored, followed by a statement
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indicating that this explanation was provided to the child if
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age appropriate and to the child’s caregiver.
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5. Documentation addressing whether the psychotropic
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medication will replace or supplement any other currently
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prescribed medications or treatments; the length of time the
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child is expected to be taking the medication; and any
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additional medical, mental health, behavioral, counseling, or
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other services that the prescribing physician or psychiatric
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nurse, as defined in s. 394.455, recommends.
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A new medical report may be required only when there is a change
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in the dosage or dosage range of the medication, the type of
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medication prescribed, the manner of administration of the
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medication, or the prescribing physician or psychiatric nurse.
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For purposes of this paragraph, prescribing physicians and
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psychiatric nurses belonging to the same group practice are
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considered a single prescriber.
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Section 2. Subsection (6) is added to section 39.4085,
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Florida Statutes, to read:
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39.4085 Goals for dependent children; responsibilities;
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education; Office of the Children’s Ombudsman.—
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(6)(a) The department shall coordinate with organizations
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that are focused on empowering children with lived experience.
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The department and such organizations shall meet at least
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quarterly, in person or via teleconference or other electronic
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means, to solicit input on ways to address challenges and
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opportunities for children in the child welfare system. Each
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meeting must have a formal agenda, and such agenda and the
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minutes from each meeting must be made available on the
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department’s website.
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(b) Each community-based care lead agency shall coordinate
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with organizations that are focused on empowering children with
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lived experience. The community-based care lead agency and such
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organizations shall meet at least quarterly, in person or via
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teleconference or other electronic means, to solicit input on
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ways to address challenges and opportunities for children in the
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child welfare system. Each meeting must have a formal agenda,
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and such agenda and the minutes from each meeting must be made
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available on the community-based care lead agency’s website.
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(c) By February 1 and August 1 of each year, beginning in
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2027, the department and each community-based care lead agency
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shall make publicly accessible on their respective websites a
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report that outlines how the department and the community-based
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care lead agencies have implemented the suggestions of the
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organizations based on the meetings required in paragraphs (a)
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and (b).
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Section 3. Paragraphs (j) and (k) of subsection (2) of
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section 409.175, Florida Statutes, are amended to read:
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409.175 Licensure of family foster homes, residential
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child-caring agencies, and child-placing agencies; public
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records exemption.—
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(2) As used in this section, the term:
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(j) “Personnel” means all owners, operators, employees, and
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volunteers working in a child-placing agency or residential
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child-caring agency who may be employed by or do volunteer work
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for a person, corporation, or agency that holds a license as a
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child-placing agency or a residential child-caring agency, but
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the term does not include those who do not work on the premises
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where child care is furnished and have no direct contact with a
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child or have no contact with a child outside of the presence of
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the child’s parent or guardian. For purposes of screening, the
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term includes any member, over the age of 12 years, of the
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family of the owner or operator or any person other than a
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client, a child who is found to be dependent as defined in s.
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39.01, or a child as defined in s. 39.6251(1), over the age of
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12 years, residing with the owner or operator if the agency is
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located in or adjacent to the home of the owner or operator or
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if the family member of, or person residing with, the owner or
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operator has any direct contact with the children. Members of
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the family of the owner or operator, or persons residing with
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the owner or operator, who are between the ages of 12 years and
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18 years are not required to be fingerprinted, but must be
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screened for delinquency records. For purposes of screening, the
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term also includes owners, operators, employees, and volunteers
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working in summer day camps, or summer 24-hour camps providing
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care for children. A volunteer who assists on an intermittent
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basis for less than 10 hours per month shall not be included in
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the term “personnel” for the purposes of screening if a person
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who meets the screening requirement of this section is always
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present and has the volunteer in his or her line of sight.
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(k) “Placement screening” means the act of assessing the
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background of household members in the family foster home and
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includes, but is not limited to, criminal history records checks
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as provided in s. 39.0138 using the standards for screening set
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forth in that section. The term “household member” means a
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member of the family or a person, other than the child being
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placed, a child who is found to be dependent as defined in s.
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39.01, or a child as defined in s. 39.6251(1), over the age of
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12 years who resides with the owner who operates the family
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foster home if such family member or person has any direct
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contact with the child. Household members who are between the
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ages of 12 and 18 years are not required to be fingerprinted but
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must be screened for delinquency records.
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Section 4. Subsection (13) of section 409.912, Florida
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Statutes, is amended to read:
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409.912 Cost-effective purchasing of health care.—The
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agency shall purchase goods and services for Medicaid recipients
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in the most cost-effective manner consistent with the delivery
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of quality medical care. To ensure that medical services are
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effectively utilized, the agency may, in any case, require a
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confirmation or second physician’s opinion of the correct
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diagnosis for purposes of authorizing future services under the
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Medicaid program. This section does not restrict access to
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emergency services or poststabilization care services as defined
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in 42 C.F.R. s. 438.114. Such confirmation or second opinion
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shall be rendered in a manner approved by the agency. The agency
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shall maximize the use of prepaid per capita and prepaid
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aggregate fixed-sum basis services when appropriate and other
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alternative service delivery and reimbursement methodologies,
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including competitive bidding pursuant to s. 287.057, designed
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to facilitate the cost-effective purchase of a case-managed
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continuum of care. The agency shall also require providers to
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minimize the exposure of recipients to the need for acute
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inpatient, custodial, and other institutional care and the
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inappropriate or unnecessary use of high-cost services. The
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agency shall contract with a vendor to monitor and evaluate the
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clinical practice patterns of providers in order to identify
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trends that are outside the normal practice patterns of a
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provider’s professional peers or the national guidelines of a
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provider’s professional association. The vendor must be able to
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provide information and counseling to a provider whose practice
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patterns are outside the norms, in consultation with the agency,
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to improve patient care and reduce inappropriate utilization.
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The agency may mandate prior authorization, drug therapy
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management, or disease management participation for certain
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populations of Medicaid beneficiaries, certain drug classes, or
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particular drugs to prevent fraud, abuse, overuse, and possible
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dangerous drug interactions. The Pharmaceutical and Therapeutics
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Committee shall make recommendations to the agency on drugs for
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which prior authorization is required. The agency shall inform
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the Pharmaceutical and Therapeutics Committee of its decisions
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regarding drugs subject to prior authorization. The agency is
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authorized to limit the entities it contracts with or enrolls as
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Medicaid providers by developing a provider network through
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provider credentialing. The agency may competitively bid single
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source-provider contracts if procurement of goods or services
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results in demonstrated cost savings to the state without
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limiting access to care. The agency may limit its network based
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on the assessment of beneficiary access to care, provider
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availability, provider quality standards, time and distance
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standards for access to care, the cultural competence of the
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provider network, demographic characteristics of Medicaid
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beneficiaries, practice and provider-to-beneficiary standards,
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appointment wait times, beneficiary use of services, provider
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turnover, provider profiling, provider licensure history,
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previous program integrity investigations and findings, peer
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review, provider Medicaid policy and billing compliance records,
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clinical and medical record audits, and other factors. Providers
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are not entitled to enrollment in the Medicaid provider network.
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The agency shall determine instances in which allowing Medicaid
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beneficiaries to purchase durable medical equipment and other
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goods is less expensive to the Medicaid program than long-term
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rental of the equipment or goods. The agency may establish rules
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to facilitate purchases in lieu of long-term rentals in order to
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protect against fraud and abuse in the Medicaid program as
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defined in s. 409.913. The agency may seek federal waivers
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necessary to administer these policies.
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(13) The agency may not pay for psychotropic medication
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prescribed for a child in the Medicaid program without the
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express and informed consent of the child’s parent or legal
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guardian. The physician shall document the consent in the
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child’s medical record and provide a copy of such documentation
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to the pharmacy with a signed attestation of this documentation
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with the prescription. The express and informed consent or court
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authorization for a prescription of psychotropic medication for
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a child in the custody of the Department of Children and
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Families shall be obtained pursuant to s. 39.407.
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Section 5. Subsection (5) is added to section 409.993,
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Florida Statutes, to read:
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409.993 Lead agencies and subcontractor liability.—
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(5) OFFICE OF INSURANCE REGULATION REVIEW.—
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(a) The Office of Insurance Regulation, in collaboration
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with the Department of Children and Families and community—based
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care lead agencies and their subcontracted providers, shall
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review all available, relevant, and appropriate data from the
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previous 5 fiscal years relating to liability insurance coverage
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and availability to analyze all of the following:
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1. Access to and availability of liability insurance
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through authorized insurance companies, surplus lines companies,
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and self-insurance funds.
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2. Factors affecting the ability to obtain and maintain
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liability insurance.
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3. Cost of general liability insurance based on insurance
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premium documentation.
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4. Claims data.
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5. Settlement and judicial disposition data.
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6. Community-based care lead agency operating budgets and
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expenses.
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7. Impact of insurance costs on the financial condition of
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community-based care lead agencies and their subcontractors.
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8. Consistency of statutory insurance requirements with the
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general insurance market.
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(b) The Office of Insurance Regulation shall develop a
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report on the findings of its review and analysis, including,
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but not limited to:
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1. A summary of the methods used and data obtained for
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review and analysis.
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2. Trends in insurance premium rates.
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3. Trends in claims and settlements.
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4. Trends in liability coverage affordability and
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availability.
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5. Recommendations for agency and legislative action to
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ensure affordable and available liability insurance for
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community-based care lead agencies and their subcontractors.
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(c) The report must be provided to the Governor, the
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President of the Senate, and the Speaker of the House of
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Representatives by January 1, 2027.
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(d) Insurance companies shall reply to requests for
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information received from the Office of Insurance Regulation for
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the purposes of this section. The office may levy fines upon or
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otherwise penalize an insurance company that fails to reply to a
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request for information within 30 calendar days after receipt of
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such request. A fine schedule set by the office under this
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paragraph may not exceed $500 per day for the first 3 days late
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and $1,000 per day for each late day thereafter. Fines paid to
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the office under this paragraph shall be transferred to the
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General Revenue Fund.
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(e) Community-based care lead agencies and their
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subcontracted providers shall reply to requests for information
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received from the Department of Children and Families for the
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purposes of this section. The department may levy fines upon or
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otherwise penalize a community-based care lead agency or
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subcontractor that fails to reply to a request for information
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within 30 calendar days after receipt of such request. A fine
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schedule set by the department under this paragraph may not
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exceed $500 per day for the first 3 days late and $1,000 for
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each late day thereafter. Fines paid to the department under
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this paragraph shall be transferred to the General Revenue Fund.
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(f) This subsection shall stand repealed on July 1, 2027,
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unless reviewed and saved from repeal through reenactment by the
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Legislature.
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Section 6. This act shall take effect July 1, 2026.