SB 1748 — Child Welfare

409.16765, or a hospital licensed under chapter 395.

2. “Least restrictive alternative” means the treatment and conditions of treatment that, separately and in combination, are no more intrusive or restrictive of freedom than reasonably necessary to achieve a substantial therapeutic benefit or to protect the child or adolescent or others from physical injury.

3. “Suitable for residential treatment” or “suitability” means a determination concerning a child or adolescent with an emotional disturbance as defined in s.

394.492(5) or a serious emotional disturbance as defined in s.

394.492(6) that each of the following criteria is met:

a. The child requires residential treatment.

b. The child is in need of a residential treatment program and is expected to benefit from mental health treatment.

c. An appropriate, less restrictive alternative to residential treatment is unavailable.

4. “Qualifying assessment” means a determination by a department-approved functional assessment concerning a child or adolescent who has an emotional disturbance or a serious emotional disturbance or mental illness, as those terms are defined in s.

394.492, for recommended placement in a qualified residential treatment program under s.

409.16765.

(b)1. If Whenever the department believes that a child in its legal custody is emotionally disturbed and may need residential treatment, an examination and suitability assessment must be conducted by a qualified evaluator who is appointed by the Agency for Health Care Administration.

This suitability assessment must be completed before the placement of the child in a residential treatment center for emotionally disturbed children and adolescents or a hospital.

The qualified evaluator must be a psychiatrist or a psychologist licensed in Florida who has at least 3 years of experience in the diagnosis and treatment of serious emotional disturbances in children and adolescents and who has no actual or perceived conflict of interest with any inpatient facility or residential treatment center or program.

This paragraph does not apply to a child who may need placement in a qualified residential treatment program.

2.(c) Before a child is admitted under this paragraph subsection, the child must shall be assessed for suitability for residential treatment by a qualified evaluator who has conducted a personal examination and assessment of the child and has made written findings that:

a.1. The child appears to have an emotional disturbance serious enough to require residential treatment and is reasonably likely to benefit from the treatment.

b.2. The child has been provided with a clinically appropriate explanation of the nature and purpose of the treatment.

c.3. All available modalities of treatment less restrictive than residential treatment have been considered, and a less restrictive alternative that would offer comparable benefits to the child is unavailable.

3. A copy of the written findings of the evaluation and suitability assessment must be provided to the department, to the guardian ad litem, and, if the child is a member of a Medicaid managed care plan, to the plan that is financially responsible for the child’s care in residential treatment, all of whom must be provided with the opportunity to discuss the findings with the evaluator.

(c)1. If the department believes that a child in its legal custody has a serious emotional or behavioral disorder or disturbance and may need placement in a qualified residential treatment program, a qualifying assessment must be conducted by a qualified evaluator who is a trained professional with a master’s degree in human services, has at least 3 years’ experience working with children or adolescents involved in the child welfare system of care, and has no actual or perceived conflict of interest with any inpatient facility or residential treatment center or program.

The qualifying assessment must be completed no later than 30 days after placement of the child in a qualified residential treatment program.

2. A copy of the qualifying assessment must be provided to the department;

to the guardian ad litem;

and, if the child is a member of a Medicaid managed care plan, to the plan that is financially responsible for the child’s care in residential treatment, all of whom must be provided with the opportunity to discuss the placement recommendations with the evaluator.

(d) Immediately upon placing a child in a residential treatment program under this section, the department must notify the guardian ad litem and the court having jurisdiction over the child and must provide the guardian ad litem and the court with a copy of the suitability or qualifying assessment by the qualified evaluator.

(e) Within 10 days after the admission of a child to a residential treatment program, the director of the residential treatment program or the director’s designee must ensure that an individualized plan of treatment has been prepared by the program and has been explained to the child, to the department, and to the guardian ad litem, and submitted to the department.

The child must be involved in the preparation of the plan to the maximum feasible extent consistent with his or her ability to understand and participate, and the guardian ad litem and the child’s foster parents must be involved to the maximum extent consistent with the child’s treatment needs.

The plan must include a preliminary plan for residential treatment and aftercare upon completion of residential treatment.

The plan must include specific behavioral and emotional goals against which the success of the residential treatment may be measured.

A copy of the plan must be provided to the child, to the guardian ad litem, and to the department.

(f) Within 30 days after admission, the residential treatment program must review the appropriateness and suitability of the child’s placement in the program.

The residential treatment program must determine whether the child is receiving benefit toward the treatment goals and whether the child could be treated in a less restrictive treatment program.

The residential treatment program shall prepare a written report of its findings and submit the report to the guardian ad litem and to the department.

The department must submit the report to the court.

The report must include a discharge plan for the child.

The residential treatment program must continue to evaluate the child’s treatment progress every 30 days thereafter and must include its findings in a written report submitted to the department and the guardian ad litem.

The department must submit the report to the court.

The department may not reimburse a facility until the facility has submitted every written report that is due.

(g)1. The department must submit, at the beginning of each month, to the court having jurisdiction over the child, a written report regarding the child’s progress toward achieving the goals specified in the individualized plan of treatment.

2. The court must conduct a hearing to review the status of the child’s residential treatment plan no later than 60 days after the child’s admission to the residential treatment program.

An independent review of the child’s progress toward achieving the goals and objectives of the treatment plan must be completed by a qualified evaluator and submitted to the court before its 60-day review.

3. For any child in residential treatment at the time a judicial review is held under pursuant to s.

39.701, the child’s continued placement in residential treatment must be a subject of the judicial review.

4. If at any time the court determines that the child is not suitable for continued residential treatment, the court shall order the department to place the child in the least restrictive setting that is best suited to meet his or her needs.

(h) After the initial 60-day review, the court must conduct a review of the child’s residential treatment plan every 90 days.

(i) In addition to the requirements of paragraphs (g) and (h), within 60 days after initial placement in a qualified residential treatment program, the court must approve or disapprove the placement based on the qualified assessment, determination, and documentation made by the qualified evaluator, as well as any other factors the court deems fit.

(j)1.(i) The department must adopt rules for implementing timeframes for the completion of suitability and qualifying assessments by qualified evaluators and a procedure that includes timeframes for completing the 60-day independent review by the qualified evaluators of the child’s progress toward achieving the goals and objectives of the treatment plan which review must be submitted to the court.

The Agency for Health Care Administration must adopt rules for the registration of qualified evaluators, the procedure for selecting the evaluators to conduct the reviews required under this section, and a reasonable, cost-efficient fee schedule for qualified evaluators.

2. The department may adopt rules relating to the assessment tool, the placement recommendations from the assessment, and the training criteria for qualified evaluators in order to administer this section.

Section 5. Subsections (6) through (9) of section 39.6011, Florida Statutes, are redesignated as subsections (7) through (10), respectively, and a new subsection (6) is added to that section, to read:

409.16765,409.1676, a copy of the signed approval of such placement by the department must be included in the case plan.

Section 6. Paragraph5. Paragraph (a) of subsection (1) of section 39.6221, Florida Statutes, is amended to read:

(a) The child has been in the placement for not less than the preceding 6 months, or the preceding 3 months if the caregiver has been named as the successor guardian on the child’s Guardianshipguardianship Assistanceassistance Agreement.agreement.

Section 7. Paragraph6. Paragraph (a) of subsection (4) of section 39.6251, Florida Statutes, is amended to read:

Section 8. Paragraph7. Paragraph (a) of subsection (1) of section 61.30, Florida Statutes, is amended, and paragraph (d) is added to that subsection, to read:

Section 9. Paragraph8. Paragraph (e) of subsection (2) and paragraph (f) of subsection (4) of section 409.145, Florida Statutes, are amended, and a new paragraph (h) is added to subsection (4) of that section, to read:

(e) Employees caregiversof Caregivers employed by residential group homes.—All employees, including persons who do not work directly with children, of a residential group home must meet the background screening requirements under s.

39.0138 and the level 2 standards for screening under chapter 435.435 All caregivers in residential group homes shall meet the same education, training, and background and other screening requirements as foster parents.

All caregivers in residential group homes must shall meet, at a minimum, the same education and, training, and background and other screening requirements as foster parents.

Section 10. Section9. Section 409.1676, Florida Statutes, is repealed.amended to read:

Section409.1676 Comprehensive 11. Sectionresidential 409.16765,group Floridacare Statutes,services to children who have extraordinary needs.— (1) It is createdthe intent of the Legislature to read:provide comprehensive residential group care services, including residential care, case management, and other services, to children in the child protection system who have extraordinary needs.

409.16765 QualifiedThese residentialservices treatmentare programs.—to (1) Asbe usedprovided in thisa section, the term “qualified residential treatmentgroup program”care meanssetting by a residentialnot-for-profit groupcorporation homeor environmenta thatlocal providesgovernment careentity forunder a childcontract whowith hasthe anDepartment emotionalof disturbanceChildren orand aFamilies seriousor emotionalby disturbancea orlead mentalagency illness, as thosedescribed terms are defined in s.

394.492.409.987.

(2) AThese qualifiedcontracts residentialshould treatmentbe programdesigned shall,to subjectprovide an identified number of children with access to availablea resources,full meetarray theof followingservices requirements:for a fixed price.

(a) ProvideFurther, ait safeis andthe therapeuticintent environmentof tailoredthe toLegislature that the needsDepartment of Children and Families and the Department of Juvenile Justice establish an interagency agreement by December 1, 2002, which describes respective agency responsibilities for referral, placement, service provision, and service coordination for children withunder emotionalthe orcare behavioraland healthsupervision problems.of the department dependent and delinquent youth who are referred to these residential group care facilities.

(b) UseThe aagreement modelmust require interagency collaboration in the development of treatmentterms, thatconditions, includesand aperformance strength-basedoutcomes for residential group care contracts serving the youth referred who are under the care and trauma-informedsupervision approach.of the department and delinquent have been adjudicated both dependent and delinquent.

(c) Be(2) As licensedused asin athis residentialsection, child-caringthe agencyterm: as defined in s.

409.175.(a) “Child with extraordinary needs” means a dependent child who has serious behavioral problems or who has been determined to be without the options of either reunification with family or adoption.

(d) Be(b) “Residential accreditedgroup bycare” anmeans accreditinga organizationliving environment for children who are under s.the care and supervision of the department have been adjudicated dependent and are expected to be in foster care for at least 6 months with 24-hour-awake staff or live-in group home parents or staff.

472(k)(4)(g)Each offacility themust Socialbe Securityappropriately Act.licensed in this state as a residential child caring agency as defined in s.

(e) Have409.175(2)(l) available, 24 hours a day, registered or licensed nursing and clinicalmust staffbe basedaccredited onby theJuly child’s1, treatment2005. plan.

(f) ProvideA aftercareresidential servicesgroup orcare supportsfacility toserving all children whohaving area dischargedserious frombehavioral problem as defined in this section must have available staff or contract personnel with the program.clinical expertise, credentials, and training to provide services identified in subsection (4).

(3) The(c) “Serious community-basedbehavioral careproblems” leadmeans agencybehaviors shall:of children who have been assessed by a licensed master’s-level human-services professional to need at a minimum intensive services but who do not meet the criteria of s.

(a) Ensure394.492(7). each child who is placed in a qualified residential treatment program receives a qualifying assessment, as defined in s.

39.407,A nochild laterwith thanan 30emotional daysdisturbance afteras placementdefined in thes. program.

(b) Maintain394.492(5) documentationor of(6) amay child’sbe placementserved in residential group care unless a qualifieddetermination residentialis treatmentmade programby asa specifiedmental inhealth s.professional that such a setting is inappropriate.

A child having a serious behavioral problem must have been determined in the assessment to have at least one of the following risk factors:

1. An adjudication of delinquency and be on conditional release status with the Department of Juvenile Justice.

2. A history of physical aggression or violent behavior toward self or others, animals, or property within the past year.

3. A history of setting fires within the past year.

4. A history of multiple episodes of running away from home or placements within the past year.

5. A history of sexual aggression toward other youth.

(b) “Qualifying assessment” is a department-approved functional assessment administered by a qualified individual to recommend or affirm placement in a qualified residential treatment program.

(c) “Qualified individual” means a trained professional with experience working with children or adolescents involved in the child welfare system and who is not employed by the department or lead agency and has no actual or perceived conflict of interest with any placement setting or program.

(d) “Qualified residential treatment program” has the same meaning as provided in 42 U.S.C.

s.

672.

(3) The department, in accordance with a specific appropriation for this program, shall contract with a not-for profit corporation, a local government entity, or the lead agency that has been established in accordance with s.

409.987 for the performance of residential group care services described in this section.

A lead agency that is currently providing residential care may provide this service directly with the approval of the local community alliance.

The department or a lead agency may contract for more than one site in a county if that is determined to be the most effective way to achieve the goals set forth in this section.

(4) The lead agency, the contracted not-for-profit corporation, or the local government entity is responsible for a comprehensive assessment, a qualifying assessment, residential care, transportation, access to behavioral health services, recreational activities, clothing, supplies, and miscellaneous expenses associated with caring for these children;

for necessary arrangement for or provision of educational services;

and for assuring necessary and appropriate health and dental care.

(5) The department may transfer all casework responsibilities for children served under this program to the entity that provides this service, including case management and development and implementation of a case plan in accordance with current standards for child protection services.

When the department establishes this program in a community that has a lead agency as described in s.

409.987, the casework responsibilities must be transferred to the lead agency.

(5)(6) This section does not prohibit any provider of these services from appropriately billing Medicaid for services rendered, from contracting with a local school district for educational services, or from earning federal or local funding for services provided, as long as two or more funding sources do not pay for the same specific service that has been provided to a child.

(6)(7) The lead agency, not-for-profit corporation, or local government entity has the legal authority for children served under this program, as provided in chapter 39 or this chapter, as appropriate, to enroll the child in school, to sign for a driver license for the child, to cosign loans and insurance for the child, to sign for medical treatment, and to authorize other such activities.

(7) For children placed in a qualified residential treatment program, the lead agency shall:

(a) Ensure each child receives a qualifying assessment no later than 30 days after placement in the program.

(b) Maintain documentation of a child’s placement as specified in s.

(4) The(d) Provide departmenta shallcopy adoptof rulesthe necessaryqualifying assessment to administerthe thisdepartment; section.

Sectionthe 12. Paragraphguardian (c)ad oflitem; subsection (2) of section 409.1678, Florida Statutes, is amended to read:

and, if the child is a member of a Medicaid managed care plan, to the plan that is financially responsible for the child’s care in residential treatment.

(8) Within 60 days after initial placement, the court must approve or disapprove the placement based on the qualified assessment, determination, and documentation made by the qualified evaluator, as well as any other factors the court deems fit.

(9)(8) The department shall provide technical assistance as requested and contract management services.

(9) The provisions of this section shall be implemented to the extent of available appropriations contained in the annual General Appropriations Act for such purpose.

(10) The department may adopt rules necessary to administer this section.

Section 10. Paragraph (c) of subsection (2) of section 409.1678, Florida Statutes, is amended to read:

Section 13. Section11. Section 409.1679, Florida Statutes, is repealed.

Section 14. Paragraphs12. Paragraphs (l) and (m) of subsection (2) of section 409.175, Florida Statutes, are amended to read:

409.16765,409.1676, human trafficking safe houses as defined in s.

Section 15. Paragraph13. Paragraph (a) of subsection (14) of section 39.301, Florida Statutes, is amended to read:

Section 16. Paragraph14. Paragraph (b) of subsection (7) of section 39.302, Florida Statutes, is amended to read:

Section 17. Subsection15. Subsection (15) of section 39.402, Florida Statutes, is amended to read:

Section 18. Paragraph16. Paragraph (d) of subsection (3) of section 39.501, Florida Statutes, is amended to read:

617530 If the department is the petitioner, it shall provide all safety plans as defined in s.

Section 19. Subsection17. Subsection (8) of section 39.6013, Florida Statutes, is amended to read:

Section 20. This18. This act shall take effect July 1, 2020.