Bill Text: FL S1670 | 2014 | Regular Session | Introduced
Bill Title: Medically Complex Children
Spectrum: Bipartisan Bill
Status: (Failed) 2014-05-02 - Died in Appropriations Subcommittee on Health and Human Services, companion bill(s) passed, see CS/SB 1666 (Ch. 2014-224) [S1670 Detail]
Download: Florida-2014-S1670-Introduced.html
Florida Senate - 2014 SB 1670 By the Committee on Children, Families, and Elder Affairs; and Senator Grimsley 586-02452-14 20141670__ 1 A bill to be entitled 2 An act relating to medically complex children; 3 amending s. 39.001, F.S.; revising the purposes of ch. 4 39, F.S.; providing for the provision of services for 5 medically complex children; conforming cross 6 references; amending s. 39.01, F.S.; defining the term 7 “medical neglect”; conforming cross-references; 8 amending s. 39.303, F.S.; revising legislative intent; 9 providing requirements for a child protection team 10 that evaluates a report of medical neglect and 11 assesses the health care needs of a medically complex 12 child; creating s. 39.3068, F.S.; providing 13 requirements for an investigation of medical neglect; 14 amending s. 409.165, F.S.; revising provisions 15 relating to the cost of services; requiring the 16 Department of Children and Families to work with the 17 Department of Health and the Agency for Health Care 18 Administration to care for medically complex children; 19 allowing the Department of Children and Families to 20 place children in a medical foster home; conforming 21 provisions to changes made by the act; amending s. 22 409.962, F.S.; redefining the term “provider service 23 network”; amending s. 409.967, F.S.; requiring 24 Medicaid managed care plans to provide specified 25 information on children under the care of the 26 Department of Children and Families; amending s. 27 409.974, F.S.; providing for contracting with eligible 28 plans; revising provisions relating to negotiation 29 with a provider service network; providing 30 requirements for termination of a contract with a 31 provider service network; amending ss. 39.302, 39.524, 32 316.613, 409.1678, and 960.065, F.S.; conforming 33 cross-references; providing an effective date. 34 35 Be It Enacted by the Legislature of the State of Florida: 36 37 Section 1. Paragraph (o) is added to subsection (1) of 38 section 39.001, Florida Statutes, and paragraph (k) of that 39 subsection is amended, present paragraphs (f) through (h) of 40 subsection (3) of that section are redesignated as paragraphs 41 (g) through (i), respectively, and a new paragraph (f) is added 42 to that subsection, and present subsections (4) through (11) of 43 that section are redesignated as subsections (5) through (12), 44 respectively, a new subsection (4) is added to that section, and 45 paragraph (c) of present subsection (8) and paragraph (b) of 46 present subsection (10) of that section are amended, to read: 47 39.001 Purposes and intent; personnel standards and 48 screening.— 49 (1) PURPOSES OF CHAPTER.—The purposes of this chapter are: 50 (k) To make every possible effort, ifwhentwo or more 51 children who are in the care or under the supervision of the 52 department are siblings, to place the siblings in the same home; 53 and in the event of permanent placement of the siblings, to 54 place them in the same adoptive home or, if the siblings are 55 separated while under the care or supervision of the department 56 or in a permanent placement, to keep them in contact with each 57 other. 58 (o) To preserve and strengthen families who are caring for 59 medically complex children. 60 (3) GENERAL PROTECTIONS FOR CHILDREN.—It is a purpose of 61 the Legislature that the children of this state be provided with 62 the following protections: 63 (f) Access to sufficient home and community-based support 64 for medically complex children to allow them to remain in the 65 least restrictive and most nurturing environment, which includes 66 sufficient home and community-based services in an amount and 67 scope comparable to those the child would receive in out-of-home 68 care placement. 69 (4) SERVICES FOR MEDICALLY COMPLEX CHILDREN.—The department 70 shall maintain a program of family-centered services and 71 supports for medically complex children. The purpose of the 72 program is to prevent abuse and neglect of medically complex 73 children while enhancing the capacity of families to provide for 74 their children’s needs. Program services must include outreach, 75 early intervention, and provision of home and community-based 76 services such as care coordination, respite care, and direct 77 home care. The department shall work with the Agency for Health 78 Care Administration and the Department of Health to provide 79 needed services. 80 (9)(8)OFFICE OF ADOPTION AND CHILD PROTECTION.— 81 (c) The office is authorized and directed to: 82 1. Oversee the preparation and implementation of the state 83 plan established under subsection (10)(9)and revise and update 84 the state plan as necessary. 85 2. Provide for or make available continuing professional 86 education and training in the prevention of child abuse and 87 neglect. 88 3. Work to secure funding in the form of appropriations, 89 gifts, and grants from the state, the Federal Government, and 90 other public and private sources in order to ensure that 91 sufficient funds are available for the promotion of adoption, 92 support of adoptive families, and child abuse prevention 93 efforts. 94 4. Make recommendations pertaining to agreements or 95 contracts for the establishment and development of: 96 a. Programs and services for the promotion of adoption, 97 support of adoptive families, and prevention of child abuse and 98 neglect. 99 b. Training programs for the prevention of child abuse and 100 neglect. 101 c. Multidisciplinary and discipline-specific training 102 programs for professionals with responsibilities affecting 103 children, young adults, and families. 104 d. Efforts to promote adoption. 105 e. Postadoptive services to support adoptive families. 106 5. Monitor, evaluate, and review the development and 107 quality of local and statewide services and programs for the 108 promotion of adoption, support of adoptive families, and 109 prevention of child abuse and neglect and shall publish and 110 distribute an annual report of its findings on or before January 111 1 of each year to the Governor, the Speaker of the House of 112 Representatives, the President of the Senate, the head of each 113 state agency affected by the report, and the appropriate 114 substantive committees of the Legislature. The report shall 115 include: 116 a. A summary of the activities of the office. 117 b. A summary of the adoption data collected and reported to 118 the federal Adoption and Foster Care Analysis and Reporting 119 System (AFCARS) and the federal Administration for Children and 120 Families. 121 c. A summary of the child abuse prevention data collected 122 and reported to the National Child Abuse and Neglect Data System 123 (NCANDS) and the federal Administration for Children and 124 Families. 125 d. A summary detailing the timeliness of the adoption 126 process for children adopted from within the child welfare 127 system. 128 e. Recommendations, by state agency, for the further 129 development and improvement of services and programs for the 130 promotion of adoption, support of adoptive families, and 131 prevention of child abuse and neglect. 132 f. Budget requests, adoption promotion and support needs, 133 and child abuse prevention program needs by state agency. 134 6. Work with the direct-support organization established 135 under s. 39.0011 to receive financial assistance. 136 (11)(10)FUNDING AND SUBSEQUENT PLANS.— 137 (b) The office and the other agencies and organizations 138 listed in paragraph (10)(a)(9)(a)shall readdress the state 139 plan and make necessary revisions every 5 years, at a minimum. 140 Such revisions shall be submitted to the Speaker of the House of 141 Representatives and the President of the Senate no later than 142 June 30 of each year divisible by 5. At least biennially, the 143 office shall review the state plan and make any necessary 144 revisions based on changing needs and program evaluation 145 results. An annual progress report shall be submitted to update 146 the state plan in the years between the 5-year intervals. In 147 order to avoid duplication of effort, these required plans may 148 be made a part of or merged with other plans required by either 149 the state or Federal Government, so long as the portions of the 150 other state or Federal Government plan that constitute the state 151 plan for the promotion of adoption, support of adoptive 152 families, and prevention of child abuse, abandonment, and 153 neglect are clearly identified as such and are provided to the 154 Speaker of the House of Representatives and the President of the 155 Senate as required above. 156 Section 2. Present subsections (42) through (76) of section 157 39.01, Florida Statutes, are redesignated as subsections (43) 158 through (77), respectively, a new subsection (42) is added to 159 that section, and subsections (10) and (33) are amended, to 160 read: 161 39.01 Definitions.—When used in this chapter, unless the 162 context otherwise requires: 163 (10) “Caregiver” means the parent, legal custodian, 164 permanent guardian, adult household member, or other person 165 responsible for a child’s welfare as defined in subsection (48) 166(47). 167 (33) “Institutional child abuse or neglect” means 168 situations of known or suspected child abuse or neglect in which 169 the person allegedly perpetrating the child abuse or neglect is 170 an employee of a private school, public or private day care 171 center, residential home, institution, facility, or agency or 172 any other person at such institution responsible for the child’s 173 care as defined in subsection (48)(47). 174 (42) “Medical neglect” means the failure to provide or to 175 allow needed care as recommended by a health care practitioner 176 for a physical injury, illness, medical condition, or 177 impairment, or the failure to seek timely and appropriate 178 medical care for a serious health problem that a reasonable 179 person would have recognized as requiring professional medical 180 attention. Medical neglect does not occur if: 181 (a) The parent or legal custodian of the child has made 182 reasonable attempts to obtain necessary health care services or 183 the immediate health condition giving rise to the allegation of 184 neglect is a known and expected complication of the child’s 185 diagnosis or treatment; and 186 (b) The recommended care offers limited net benefit to the 187 child and the morbidity or other side effects of the treatment 188 may be considered to be greater than the anticipated benefit. 189 Section 3. Section 39.303, Florida Statutes, is amended to 190 read: 191 39.303 Child protection teams; services; eligible cases. 192 The Children’s Medical Services Program in the Department of 193 Health shall develop, maintain, and coordinate the services of 194 one or more multidisciplinary child protection teams in each of 195 the service districts of the Department of Children and Family 196 Services. Such teams may be composed of appropriate 197 representatives of school districts and appropriate health, 198 mental health, social service, legal service, and law 199 enforcement agencies.The Legislature finds that optimal200coordination of child protection teams and sexual abuse201treatment programs requires collaboration betweenThe Department 202 of Health and the Department of Children and FamiliesFamily203Services. The two departmentsshall maintain an interagency 204 agreement that establishes protocols for oversight and 205 operations of child protection teams and sexual abuse treatment 206 programs. The State Surgeon General and the Deputy Secretary for 207 Children’s Medical Services, in consultation with the Secretary 208 of Children and Family Services, shall maintain the 209 responsibility for the screening, employment, and, if necessary, 210 the termination of child protection team medical directors, at 211 headquarters and in the 15 districts. Child protection team 212 medical directors shall be responsible for oversight of the 213 teams in the districts. 214 (1) The Department of Health shall useutilizeand convene 215 the teams to supplement the assessment and protective 216 supervision activities of the family safety and preservation 217 program of the Department of Children and FamiliesFamily218Services.Nothing inThis section does notshall be construed to219 remove or reduce the duty and responsibility of any person to 220 report pursuant to this chapter all suspected or actual cases of 221 child abuse, abandonment, or neglect or sexual abuse of a child. 222 The role of the teams shall be to support activities of the 223 program and to provide services deemed by the teams to be 224 necessary and appropriate to abused, abandoned, and neglected 225 children upon referral. The specialized diagnostic assessment, 226 evaluation, coordination, consultation, and other supportive 227 services that a child protection team shall be capable of 228 providing include, but are not limited to, the following: 229 (a) Medical diagnosis and evaluation services, including 230 provision or interpretation of X rays and laboratory tests, and 231 related services, as needed, and documentation of related 232 findingsrelative thereto. 233 (b) Telephone consultation services in emergencies and in 234 other situations. 235 (c) Medical evaluation related to abuse, abandonment, or 236 neglect, as defined by policy or rule of the Department of 237 Health. 238 (d) Such psychological and psychiatric diagnosis and 239 evaluation services for the child or the child’s parent or 240 parents, legal custodian or custodians, or other caregivers, or 241 any other individual involved in a child abuse, abandonment, or 242 neglect case, as the team may determine to be needed. 243 (e) Expert medical, psychological, and related professional 244 testimony in court cases. 245 (f) Case staffings to develop treatment plans for children 246 whose cases have been referred to the team. A child protection 247 team may provide consultation with respect to a child who is 248 alleged or is shown to be abused, abandoned, or neglected. The,249whichconsultation shall be provided at the request of a 250 representative of the family safety and preservation program or 251 at the request of any other professional involved with a child 252 or the child’s parent or parents, legal custodian or custodians, 253 or other caregivers. In every such child protection team case 254 staffing, consultation, or staff activity involving a child, a 255 family safety and preservation program representative shall 256 attend and participate. 257 (g) Case service coordination and assistance, including the 258 location of services available from other public and private 259 agencies in the community. 260 (h) Such training services for program and other employees 261 of the Department of Children and FamiliesFamily Services, 262 employees of the Department of Health, and other medical 263 professionals as is deemed appropriate to enable them to develop 264 and maintain their professional skills and abilities in handling 265 child abuse, abandonment, and neglect cases. 266 (i) Educational and community awareness campaigns on child 267 abuse, abandonment, and neglect in an effort to enable citizens 268 more successfully to prevent, identify, and treat child abuse, 269 abandonment, and neglect in the community. 270 (j) Child protection team assessments that include, as 271 appropriate, medical evaluations, medical consultations, family 272 psychosocial interviews, specialized clinical interviews, or 273 forensic interviews. 274 275 All medical personnel participating on a child protection team 276 must successfully complete the required child protection team 277 training curriculum as set forth in protocols determined by the 278 Deputy Secretary for Children’s Medical Services and the 279 Statewide Medical Director for Child Protection. A child 280 protection team that is evaluating a report of medical neglect 281 and assessing the health care needs of a medically complex child 282 shall consult with a physician who has experience in treating 283 children with the same condition. 284 (2) The child abuse, abandonment, and neglect reports that 285 must be referred by the department to child protection teams of 286 the Department of Health for an assessment and other appropriate 287 available support services as set forth in subsection (1) must 288 include cases involving: 289 (a) Injuries to the head, bruises to the neck or head, 290 burns, or fractures in a child of any age. 291 (b) Bruises anywhere on a child 5 years of age or under. 292 (c) Any report alleging sexual abuse of a child. 293 (d) Any sexually transmitted disease in a prepubescent 294 child. 295 (e) Reported malnutrition of a child and failure of a child 296 to thrive. 297 (f) Reported medical neglect of a child. 298 (g) Any family in which one or more children have been 299 pronounced dead on arrival at a hospital or other health care 300 facility, or have been injured and later died, as a result of 301 suspected abuse, abandonment, or neglect, when any sibling or 302 other child remains in the home. 303 (h) Symptoms of serious emotional problems in a child when 304 emotional or other abuse, abandonment, or neglect is suspected. 305 (3) All abuse and neglect cases transmitted for 306 investigation to a district by the hotline must be 307 simultaneously transmitted to the Department of Health child 308 protection team for review. For the purpose of determining 309 whether face-to-face medical evaluation by a child protection 310 team is necessary, all cases transmitted to the child protection 311 team which meet the criteria in subsection (2) must be timely 312 reviewed by: 313 (a) A physician licensed under chapter 458 or chapter 459 314 who holds board certification in pediatrics and is a member of a 315 child protection team; 316 (b) A physician licensed under chapter 458 or chapter 459 317 who holds board certification in a specialty other than 318 pediatrics, who may complete the review only when working under 319 the direction of a physician licensed under chapter 458 or 320 chapter 459 who holds board certification in pediatrics and is a 321 member of a child protection team; 322 (c) An advanced registered nurse practitioner licensed 323 under chapter 464 who has a specialtyspecialityin pediatrics 324 or family medicine and is a member of a child protection team; 325 (d) A physician assistant licensed under chapter 458 or 326 chapter 459, who may complete the review only when working under 327 the supervision of a physician licensed under chapter 458 or 328 chapter 459 who holds board certification in pediatrics and is a 329 member of a child protection team; or 330 (e) A registered nurse licensed under chapter 464, who may 331 complete the review only when working under the direct 332 supervision of a physician licensed under chapter 458 or chapter 333 459 who holds certification in pediatrics and is a member of a 334 child protection team. 335 (4) A face-to-face medical evaluation by a child protection 336 team is not necessary when: 337 (a) The child was examined for the alleged abuse or neglect 338 by a physician who is not a member of the child protection team, 339 and a consultation between the child protection team board 340 certified pediatrician, advanced registered nurse practitioner, 341 physician assistant working under the supervision of a child 342 protection team board-certified pediatrician, or registered 343 nurse working under the direct supervision of a child protection 344 team board-certified pediatrician, and the examining physician 345 concludes that a further medical evaluation is unnecessary; 346 (b) The child protective investigator, with supervisory 347 approval, has determined, after conducting a child safety 348 assessment, that there are no indications of injuries as 349 described in paragraphs (2)(a)-(h) as reported; or 350 (c) The child protection team board-certified pediatrician, 351 as authorized in subsection (3), determines that a medical 352 evaluation is not required. 353 354 Notwithstanding paragraphs (a), (b), and (c), a child protection 355 team pediatrician, as authorized in subsection (3), may 356 determine that a face-to-face medical evaluation is necessary. 357 (5) In all instances in which a child protection team is 358 providing certain services to abused, abandoned, or neglected 359 children, other offices and units of the Department of Health, 360 and offices and units of the Department of Children and Families 361Family Services, shall avoid duplicating the provision of those 362 services. 363 (6) The Department of Health child protection team quality 364 assurance program and the Department of Children and Families’ 365Family Services’Family Safety Program Office quality assurance 366 program shall collaborate to ensure referrals and responses to 367 child abuse, abandonment, and neglect reports are appropriate. 368 Each quality assurance program shall include a review of records 369 in which there are no findings of abuse, abandonment, or 370 neglect, and the findings of these reviews shall be included in 371 each department’s quality assurance reports. 372 Section 4. Section 39.3068, Florida Statutes, is created to 373 read: 374 39.3068 Reports of medical neglect.— 375 (1) A report of medical neglect as defined in s. 39.01 must 376 be investigated by staff who have specialized training in 377 medical neglect and medically complex children. 378 (2) The investigation must identify any immediate medical 379 needs of the child and must use a family-centered approach to 380 assess the capacity of the family to meet those needs. 381 (3) A family-centered approach is intended to increase 382 independence on the part of the family, accessibility to 383 programs and services within the community, and collaboration 384 between families and their service providers. The ethnic, 385 cultural, economic, racial, social, and religious diversity of 386 families must be respected and considered in the development and 387 provision of services. 388 (4) An investigation of cases involving medically complex 389 children must include determination of Medicaid coverage for 390 needed services and coordination with the Agency for Health Care 391 Administration to secure such covered services. 392 Section 5. Section 409.165, Florida Statutes, is amended to 393 read: 394 409.165 Alternate care for children.— 395 (1) Within funds appropriated, the department shall 396 establish and supervise a program of emergency shelters, runaway 397 shelters, foster homes, group homes, agency-operated group 398 treatment homes, nonpsychiatric residential group care 399 facilities, psychiatric residential treatment facilities, and 400 other appropriate facilities to provide shelter and care for 401 dependent children who must be placed away from their families. 402 The department, in accordance with outcomeestablishedgoals 403 established in s. 409.986, shall contract for the provision of 404 such shelter and care by counties, municipalities, nonprofit 405 corporations, and other entities capable of providing needed 406 services if: 407 (a) The services so provided comply with all department 408 standards, policies, and proceduresare available; 409 (b) The services can besoprovided at a reasonable cost 410are more cost-effective than those provided by the department; 411 and 412 (c) Unless otherwise provided by law, such providers of 413 shelter and care are licensed by the department. 414 415It is the legislative intent that the416 (2) Funds appropriated for the alternate care of children 417 as described in this section may be used to meet the needs of 418 children in their own homes or those of relatives if the 419 children can be safely served in such settingstheir own homes,420or the homes of relatives, and the expenditure of funds in such 421 manner is equal to or less than the cost of out-of-home 422 placementcalculated by the department to be an eventual cost423savings over placement of children. 424 (3)(2)The department shallmaycooperate with all child 425 service institutions or agencies within the state which meet the 426 department’s standards in order to maintain a comprehensive, 427 coordinated, and inclusive system for promoting and protecting 428 the well-being of children, consistent with the goals 429 established in s. 409.986rules for proper care and supervision430prescribed by the department for the well-being of children. 431 (a) The department shall work with the Department of Health 432 in the development, utilization, and monitoring of medical 433 foster homes for medically complex children. 434 (b) The department shall work with the Agency for Health 435 Care Administration to provide such home and community-based 436 services as may be necessary to maintain medically complex 437 children in the least restrictive and most nurturing 438 environment. 439 (4)(3)With the written consent of parents, custodians, or 440 guardians, or in accordance with those provisions in chapter 39 441 that relate to dependent children, the department, under rules 442 properly adopted, may place a child: 443 (a) With a relative; 444 (b) With an adult nonrelative approved by the court for 445 long-term custody; 446 (c) With a person who is considering the adoption of a 447 child in the manner provided for by law; 448 (d) When limited, except as provided in paragraph (b), to 449 temporary emergency situations, with a responsible adult 450 approved by the court; 451 (e) With a person or family approved by the department to 452 serve as a medical foster home; 453 (f)(e)With a person or agency licensed by the department 454 in accordance with s. 409.175; or 455 (g)(f)In a subsidized independent living situation, 456 subject to the provisions of s. 409.1451(4)(c), 457 458 under such conditions as are determined to be for the best 459 interests or the welfare of the child. Any child placed in an 460 institution or in a family home by the department or its agency 461 may be removed by the department or its agency, and such other 462 disposition may be made as is for the best interest of the 463 child, including transfer of the child to another institution, 464 another home, or the home of the child. Expenditure of funds 465 appropriated for out-of-home care can be used to meet the needs 466 of a child in the child’s own home or the home of a relative if 467 the child can be safely served in the child’s own home or that 468 of a relative if placement can be avoided by the expenditure of 469 such funds, and if the expenditure of such funds in this manner 470 is equal to or less than the cost of out-of-home placement 471calculated by the department to be a potential cost savings. 472 Section 6. Subsection (13) of section 409.962, Florida 473 Statutes, is amended to read: 474 409.962 Definitions.—As used in this part, except as 475 otherwise specifically provided, the term: 476 (13) “Provider service network” means an entity qualified 477 pursuant to s. 409.912(4)(d) of which a controlling interest is 478 owned by a health care provider, or group ofaffiliated479 providers affiliated for the purpose of providing health care, 480 or a public agency or entity that delivers health services. 481 Health care providers include Florida-licensed health care 482 professionals or licensed health care facilities, federally 483 qualified health care centers, and home health care agencies. 484 Section 7. Paragraph (c) of subsection (2) of section 485 409.967, Florida Statutes, is amended to read: 486 409.967 Managed care plan accountability.— 487 (2) The agency shall establish such contract requirements 488 as are necessary for the operation of the statewide managed care 489 program. In addition to any other provisions the agency may deem 490 necessary, the contract must require: 491 (c) Access.— 492 1. The agency shall establish specific standards for the 493 number, type, and regional distribution of providers in managed 494 care plan networks to ensure access to care for both adults and 495 children. Each plan must maintain a regionwide network of 496 providers in sufficient numbers to meet the access standards for 497 specific medical services for all recipients enrolled in the 498 plan. The exclusive use of mail-order pharmacies may not be 499 sufficient to meet network access standards. Consistent with the 500 standards established by the agency, provider networks may 501 include providers located outside the region. A plan may 502 contract with a new hospital facility before the date the 503 hospital becomes operational if the hospital has commenced 504 construction, will be licensed and operational by January 1, 505 2013, and a final order has issued in any civil or 506 administrative challenge. Each plan shall establish and maintain 507 an accurate and complete electronic database of contracted 508 providers, including information about licensure or 509 registration, locations and hours of operation, specialty 510 credentials and other certifications, specific performance 511 indicators, and such other information as the agency deems 512 necessary. The database must be available online to both the 513 agency and the public and have the capability to compare the 514 availability of providers to network adequacy standards and to 515 accept and display feedback from each provider’s patients. Each 516 plan shall submit quarterly reports to the agency identifying 517 the number of enrollees assigned to each primary care provider. 518 2. Each managed care plan must publish any prescribed drug 519 formulary or preferred drug list on the plan’s website in a 520 manner that is accessible to and searchable by enrollees and 521 providers. The plan must update the list within 24 hours after 522 making a change. Each plan must ensure that the prior 523 authorization process for prescribed drugs is readily accessible 524 to health care providers, including posting appropriate contact 525 information on its website and providing timely responses to 526 providers. For Medicaid recipients diagnosed with hemophilia who 527 have been prescribed anti-hemophilic-factor replacement 528 products, the agency shall provide for those products and 529 hemophilia overlay services through the agency’s hemophilia 530 disease management program. 531 3. Managed care plans, and their fiscal agents or 532 intermediaries, must accept prior authorization requests for any 533 service electronically. 534 4. Managed care plans serving children in the care and 535 custody of the Department of Children and Families must maintain 536 complete medical, dental, and behavioral health information and 537 provide such information to the department for inclusion in the 538 state’s child welfare data system. Using such documentation, the 539 agency and the department shall determine the plan’s compliance 540 with standards for access to medical, dental, and behavioral 541 health services, the use of psychotropic medications, and 542 followup on all medically necessary services recommended as a 543 result of early and periodic screening diagnosis and treatment. 544 Section 8. Subsection (1) of section 409.974, Florida 545 Statutes, is amended to read: 546 409.974 Eligible plans.— 547 (1) ELIGIBLE PLAN SELECTION AND CONTRACTING.—The agency 548 shall select eligible plans through the procurement process 549 described in s. 409.966. The agency shall notice invitations to 550 negotiate no later than January 1, 2013. 551 (a) The agency shall procure and contract with two plans 552 for Region 1. At least one plan shall be a provider service 553 network if any provider service networks submit a responsive 554 bid. 555 (b) The agency shall procure and contract with two plans 556 for Region 2. At least one plan shall be a provider service 557 network if any provider service networks submit a responsive 558 bid. 559 (c) The agency shall procure and contract with at least 560 three plans and up to five plans for Region 3. At least one plan 561 must be a provider service network if any provider service 562 networks submit a responsive bid. 563 (d) The agency shall procure and contract with at least 564 three plans and up to five plans for Region 4. At least one plan 565 must be a provider service network if any provider service 566 networks submit a responsive bid. 567 (e) The agency shall procure and contract with at least two 568 plans and up to four plans for Region 5. At least one plan must 569 be a provider service network if any provider service networks 570 submit a responsive bid. 571 (f) The agency shall procure and contract with at least 572 four plans and up to seven plans for Region 6. At least one plan 573 must be a provider service network if any provider service 574 networks submit a responsive bid. 575 (g) The agency shall procure and contract with at least 576 three plans and up to six plans for Region 7. At least one plan 577 must be a provider service network if any provider service 578 networks submit a responsive bid. 579 (h) The agency shall procure and contract with at least two 580 plans and up to four plans for Region 8. At least one plan must 581 be a provider service network if any provider service networks 582 submit a responsive bid. 583 (i) The agency shall procure and contract with at least two 584 plans and up to four plans for Region 9. At least one plan must 585 be a provider service network if any provider service networks 586 submit a responsive bid. 587 (j) The agency shall procure and contract with at least two 588 plans and up to four plans for Region 10. At least one plan must 589 be a provider service network if any provider service networks 590 submit a responsive bid. 591 (k) The agency shall procure and contract with at least 592 five plans and up to 10 plans for Region 11. At least one plan 593 must be a provider service network if any provider service 594 networks submit a responsive bid. 595 596 If no provider service network submits a responsive bid, the 597 agency shall procure and contract with no more than one less 598 than the maximum number of eligible plans permitted in that 599 region, and, within the next. Within12 monthsafter the initial600invitation to negotiate, the agency shall issue an invitation to 601 negotiate in orderattemptto procure and contract with a 602 provider service network. The agency shall terminate the 603 contract and provide notice for another invitation to negotiate 604 when changes in the corporate ownership and structure of the 605 onlywithprovider service networknetworksin a region causes 606 the managed care plan to no longer meet the definition of a 607 provider service network under s. 409.962(13)thoseregions608where no provider service network has been selected. 609 Section 9. Subsection (1) of section 39.302, Florida 610 Statutes, is amended to read: 611 39.302 Protective investigations of institutional child 612 abuse, abandonment, or neglect.— 613 (1) The department shall conduct a child protective 614 investigation of each report of institutional child abuse, 615 abandonment, or neglect. Upon receipt of a report that alleges 616 that an employee or agent of the department, or any other entity 617 or person covered by s. 39.01(33) or (48)(47), acting in an 618 official capacity, has committed an act of child abuse, 619 abandonment, or neglect, the department shall initiate a child 620 protective investigation within the timeframe established under 621 s. 39.201(5) and notify the appropriate state attorney, law 622 enforcement agency, and licensing agency, which shall 623 immediately conduct a joint investigation, unless independent 624 investigations are more feasible. When conducting investigations 625 or having face-to-face interviews with the child, investigation 626 visits shall be unannounced unless it is determined by the 627 department or its agent that unannounced visits threaten the 628 safety of the child. If a facility is exempt from licensing, the 629 department shall inform the owner or operator of the facility of 630 the report. Each agency conducting a joint investigation is 631 entitled to full access to the information gathered by the 632 department in the course of the investigation. A protective 633 investigation must include an interview with the child’s parent 634 or legal guardian. The department shall make a full written 635 report to the state attorney within 3 working days after making 636 the oral report. A criminal investigation shall be coordinated, 637 whenever possible, with the child protective investigation of 638 the department. Any interested person who has information 639 regarding the offenses described in this subsection may forward 640 a statement to the state attorney as to whether prosecution is 641 warranted and appropriate. Within 15 days after the completion 642 of the investigation, the state attorney shall report the 643 findings to the department and shall include in the report a 644 determination of whether or not prosecution is justified and 645 appropriate in view of the circumstances of the specific case. 646 Section 10. Subsection (1) of section 39.524, Florida 647 Statutes, is amended to read: 648 39.524 Safe-harbor placement.— 649 (1) Except as provided in s. 39.407 or s. 985.801, a 650 dependent child 6 years of age or older who has been found to be 651 a victim of sexual exploitation as defined in s. 39.01(68)(g)s.65239.01(67)(g)must be assessed for placement in a safe house as 653 provided in s. 409.1678. The assessment shall be conducted by 654 the department or its agent and shall incorporate and address 655 current and historical information from any law enforcement 656 reports; psychological testing or evaluation that has occurred; 657 current and historical information from the guardian ad litem, 658 if one has been assigned; current and historical information 659 from any current therapist, teacher, or other professional who 660 has knowledge of the child and has worked with the child; and 661 any other information concerning the availability and 662 suitability of safe-house placement. If such placement is 663 determined to be appropriate as a result of this assessment, the 664 child may be placed in a safe house, if one is available. As 665 used in this section, the term “available” as it relates to a 666 placement means a placement that is located within the circuit 667 or otherwise reasonably accessible. 668 Section 11. Subsection (6) of section 316.613, Florida 669 Statutes, is amended to read: 670 316.613 Child restraint requirements.— 671 (6) The child restraint requirements imposed by this 672 section do not apply to a chauffeur-driven taxi, limousine, 673 sedan, van, bus, motor coach, or other passenger vehicle if the 674 operator and the motor vehicle are hired and used for the 675 transportation of persons for compensation. It is the obligation 676 and responsibility of the parent, guardian, or other person 677 responsible for a child’s welfare,as defined in s. 39.01(47),678 to comply with the requirements of this section. 679 Section 12. Paragraph (d) of subsection (1) of section 680 409.1678, Florida Statutes, is amended to read: 681 409.1678 Safe harbor for children who are victims of sexual 682 exploitation.— 683 (1) As used in this section, the term: 684 (d) “Sexually exploited child” means a dependent child who 685 has suffered sexual exploitation as defined in s. 39.01(68)(g) 686s. 39.01(67)(g)and is ineligible for relief and benefits under 687 the federal Trafficking Victims Protection Act, 22 U.S.C. ss. 688 7101 et seq. 689 Section 13. Subsection (5) of section 960.065, Florida 690 Statutes, is amended to read: 691 960.065 Eligibility for awards.— 692 (5) A person is not ineligible for an award pursuant to 693 paragraph (2)(a), paragraph (2)(b), or paragraph (2)(c) if that 694 person is a victim of sexual exploitation of a child as defined 695 in s. 39.01(68)(g)s. 39.01(67)(g). 696 Section 14. This act shall take effect July 1, 2014.