HB 47 — Specific Medical Diagnoses in Child Protective Investigations

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hb47-02-c2hb47-01-c1 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/CS/HBCS/HB 47 2026 (e)(7)(6) A registeredface-to-face nursemedical licensedevaluation underby chaptera 464, who may complete the review only when working under the direct supervision of the Child Protection Team medical director or a physician licensed under chapter 458 or chapter 459 who holds board certification in pediatrics and is anot membernecessary ofwhen: a Child Protection Team.

(7)(6) A face-to-face medical evaluation by a Child Protection Team is not necessary when:

or (c) The Child Protection Team medical director or a Child PageProtection 7Team ofboard-certified 13pediatrician, CODING:as authorized in subsection (6) (5), determines that a medical evaluation is not required.

Notwithstanding paragraphs (a), (b), and (c), a Child Protection Team medical director or a Child Protection Team pediatrician, Page 7 of 10 CODING:

hb47-02-c2hb47-01-c1 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/CS/HBCS/HB 47 2026 Protection Team board-certified pediatrician, as authorized in subsection (6) (5), determinesmay determine that a face- to-face medical evaluation is notnecessary. required.

Notwithstanding paragraphs (a), (b), and (c), a Child Protection Team medical director or a Child Protection Team pediatrician, as authorized in subsection (6) (5), may determine that a face- to-face medical evaluation is necessary.

SubsectionParagraphs (c), (d), and (e) are added to subsection (1) of section 39.304, Florida Statutes, is amended to read:

39.304 Photographs, medical evaluations or examinations, X rays, and medical treatment of abused, abandoned, or neglected child.— (1)(a)(1) Any(c) personIf requiredan toexamination investigateis casesperformed ofon suspecteda child abuse,under abandonment,paragraph or(b), neglectother maythan takean orexamination causefor topurposes beof takendetermining photographswhether ofa child has been sexually abused, the areasparent ofor traumalegal visiblecustodian onof athe child who is the subject of a report.protective investigation or shelter order may request of the department, no later than 5 days after such medical examination, that the child be examined:

Any Child Protection Team that evaluates or examines a child who is the subject of a report must take, or cause to be taken, photographs of any areas of trauma visible on the child.

Photographs of physical abuse injuries, or duplicates thereof, shall be provided to the department for inclusion in the investigative file and shall become part of that file.

Photographs of sexual abuse trauma shall be made part of the Child Protection Team medical record.

(b) If the areas of trauma visible on a child indicate a Page 8 of 13 CODING:

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hb47-02-c2 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/CS/HB 47 2026 need for a medical evaluation or examination, or if the child verbally complains or otherwise exhibits distress as a result of injury through suspected child abuse, abandonment, or neglect, or is alleged to have been sexually abused, the person required to investigate may cause the child to be referred for diagnosis to a licensed physician or an emergency department in a hospital without the consent of the child's parents or legal custodian.

Such evaluation or examination may be performed by any licensed physician or an advanced practice registered nurse licensed pursuant to part I of chapter 464.

Any licensed physician or advanced practice registered nurse licensed pursuant to part I of chapter 464 who has reasonable cause to suspect that an injury was the result of child abuse, abandonment, or neglect may authorize a radiological examination to be performed on the child without the consent of the child's parent or legal custodian.

(c) If an evaluation or examination is performed on a child under paragraph (b), other than an evaluation or examination for purposes of determining whether a child has been sexually abused, the parent or legal custodian of the child who is the subject of a protective investigation or shelter order may request of the department, no later than 10 days after such medical evaluation or examination, that the child be evaluated or examined by:

ABy a Child Protection Team if the medical evaluationexamination orunder Pageparagraph 9(b) ofwas 13not CODING:performed by a Child Protection Team;

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hb47-02-c2 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/CS/HB 47 2026 examination under paragraph (b) was not performed by a Child Protection Team;

ABy a physician licensed under chapter 458 or chapter 459 or an advanced practice registered nurse licensed under chapter 464 of the parent's or legal custodian's choosing who routinely provides medical care to pediatric patients, if the medical evaluation or examination pursuant to paragraph (b) was performed by a Child Protection Team, for the purpose of obtaining a second opinion on diagnosis or treatment;

ABy a physician licensed under chapter 458 or chapter 459Page or8 an advanced practice registered nurse licensed under chapter 464 of the10 parent'sCODING: or legal custodian's choosing who routinely provides diagnosis of and medical care to pediatric patients for the conditions specified in s.

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hb47-01-c1 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/HB 47 2026 459 or an advanced practice registered nurse licensed under chapter 464 of the parent's or legal custodian's choosing who routinely provides diagnosis of and medical care to pediatric patients for the conditions specified in s.

The cost of an evaluation or examination under subparagraph 2.

(d) For all medical evaluations or examinations performed pursuant to paragraph (c), the physician or advanced practice registered nurse must submit within 5 days after the evaluation or examination a written report that details the findings and conclusions of the medical evaluation or examination to the Pagedepartment 10and ofthe 13parent CODING:or legal custodian.

(e) If the findings and conclusions of the medical examination conducted under paragraph (b) and the examination conducted under paragraph (c) differ, the department must immediately convene a case staffing to reach a consensus regarding the differences in the medical opinions.

The case staffing must include the child protective investigator, the investigator's supervisor, legal staff of the department, representatives from a Child Protection Team, and the community- based care lead agency.

If possible, the case staffing shall also include any health care practitioners who previously treated the child, any health care practitioners who are Page 9 of 10 CODING:

hb47-02-c2hb47-01-c1 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/CS/HBCS/HB 47 2026 departmentcurrently treating the child, and the parentphysician or legaladvanced custodian.practice registered nurse who conducted the examination under paragraph (c).

(e) If the findings and conclusions of the medical evaluation or examination conducted under paragraph (b) and the evaluation or examination conducted under paragraph (c) differ, the department must immediately convene a case staffing to reach a consensus regarding the differences in the medical opinions.

The case staffing must include the child protective investigator, the investigator's supervisor, legal staff of the department, representatives from a Child Protection Team, and the community-based care lead agency.

If possible, the case staffing shall also include any health care practitioners who previously treated the child, any health care practitioners who are currently treating the child, and the physician or advanced practice registered nurse who conducted the evaluation or examination under paragraph (c).

Paragraph (a) of subsection (7) of section 456.057, Florida Statutes, is amended to read:

456.057 Ownership and control of patient records;

report or copies of records to be furnished;

disclosure of information.— (7)(a) Except as otherwise provided in this section and in s.

440.13(4)(c), such records may not be furnished to, and the medical condition of a patient may not be discussed with, any person other than the patient, the patient's legal representative, or other health care practitioners and providers Page 11 of 13 CODING:

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hb47-02-c2 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/CS/HB 47 2026 involved in the patient's care or treatment, except upon written authorization from the patient.

However, such records may be furnished without written authorization under the following circumstances:

1.

To any person, firm, or corporation that has procured or furnished such care or treatment with the patient's consent.

2.

When compulsory physical examination is made pursuant to Rule 1.360, Florida Rules of Civil Procedure, in which case copies of the medical records shall be furnished to both the defendant and the plaintiff.

3.

In any civil or criminal action, unless otherwise prohibited by law, upon the issuance of a subpoena from a court of competent jurisdiction and proper notice to the patient or the patient's legal representative by the party seeking such records.

4.

For statistical and scientific research, provided the information is abstracted in such a way as to protect the identity of the patient or provided written permission is received from the patient or the patient's legal representative.

5.

To a regional poison control center for purposes of treating a poison episode under evaluation, case management of poison cases, or compliance with data collection and reporting requirements of s.

395.1027 and the professional organization that certifies poison control centers in accordance with federal law.

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hb47-02-c2 F L O R I D A H O U S E O F R E P R E S E N T A T I V E S CS/CS/HB 47 2026 6.

To the Department of Children and Families, its agent, or its contracted entity, within 14 days after receipt of a request for such records, for the purpose of investigations of or services for cases of abuse, neglect, or exploitation of children or vulnerable adults.

Section 5.

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