Current through Reg. 50, No. 187; September 24, 2024
(1) If a child in
out-of-home care appears to be suffering from illness or injury requiring
medical intervention, the child welfare professional, upon notification, or the
out-of-home caregiver shall take the child to the child's health care provider
for a health care screening or treatment. If there is a medical emergency or an
urgent need for medical attention, the child shall be taken to the nearest
available health care provider or hospital.
(2) Ongoing health care and treatment shall
include physical, dental and vision examinations as required by Rule Chapter
59G-4, F.A.C., "Medicaid Services."
(a) If a
child is Medicaid eligible, these services shall be sought first through
Medicaid providers. If a child is not Medicaid eligible, or if a Medicaid
provider is not available or appropriate, then necessary services shall be
obtained using other providers.
(b)
If the child welfare professional responsible for the case receives a notice
for a scheduled child health check-up, he or she shall immediately send copies
to the child's custodial parent, the child's licensed out-of-home caregiver or
relative or non-relative caregiver. Information pertaining to the child's
health check-up shall be documented in FSFN by the child welfare professional
responsible for the case within 48 hours of notification of completion of the
medical appointment.
(3)
The parents shall remain financially responsible for the medical care and
treatment of a child in out-of-home care when that medical care and treatment
is not covered by Medicaid. For children who are not covered by Medicaid but
have private insurance coverage, the child welfare professional and the
out-of-home caregiver shall cooperate with the child's health insurance
provider in identifying medical providers that will accept the insurance
coverage. Unless the child is Medicaid eligible, the parent is responsible for
payment in all situations in which the child receives a medical examination or
treatment, irrespective of the parent's consent to such examination or
treatment. However, the inability or failure of the parent to meet this payment
responsibility shall not delay the receipt of a medical exam or treatment. The
financial responsibility of the parent ends when parental rights are
terminated.
(4) The child welfare
professional and licensed caregivers shall receive training in regard to and
comply with the federal Health Insurance Portability and Accountability Act
which provides procedures regarding the management and protection of personal
health information. The child welfare professional shall inform relative and
non-relative caregivers regarding the requirements of HIPAA.
(5) Required Actions to Gain Medical Consent
at Time of the Shelter Hearing. The Children's Legal Services attorney shall
request a blanket court order authorizing the custodian, as named in the order,
to give consent for ordinary medical treatment and medication on an ongoing
basis. No consent is needed for treatment or medication rendered in the event
of an emergency as documented by the attending physician.
(6) Consent for Medical Care of Children in
Out-of-Home Care When Parental Rights Have Not Been Terminated. There are three
types of medical care and treatment, each of which requires its own method to
obtain consent for medical treatment. This may include a relative or
non-relative who has been granted custody by the court. The attending physician
shall determine the type of care needed.
(a)
Ordinary Medical Care and Treatment. After a child is adjudicated dependent,
the contracted service provider may delegate authority to consent to ordinary
medical care and treatment to the out-of-home caregiver if the child remains in
the custody of the Department. Children's Legal Services shall request the
court order placing the child in out-of-home care specify individuals who are
authorized to consent to ordinary medical care and treatment for the
child.
(b) Extraordinary Medical
Care and Treatment. If the health care provider determines that an illness or
injury requires medical treatment beyond ordinary medical care and treatment,
but is not an emergency, the express and informed consent of the child's parent
for the treatment shall be sought. If a parent provides express and informed
consent for any extraordinary medical procedure, the form and content of the
consent shall be as directed by the prescribing health care professional.
1. If the parent is unavailable, unwilling or
unable to provide informed consent for the proposed medical care, the child
welfare professional shall consult with the medical provider to determine if
the treatment should be required. If consultation with the medical provider
results in a determination that the treatment should be required, the child
welfare professional shall seek and obtain an order of the court authorizing
the treatment prior to the treatment being rendered. In cases when the child is
prescribed psychotropic medications, the procedures established in Section
39.407(3),
F.S., will be followed.
2. If a
court order is required to obtain authorization for any extraordinary medical
procedure, the following information shall be included in the request for a
court order:
a. Present diagnosis and known
past medical interventions for the treatment of this condition,
b. A statement that the prescribing health
care professional has reviewed all medical information concerning the child
that has been provided,
c. The name
and requested administration range for any medication requested,
d. A statement recommending the proposed
procedure signed by the attending physician,
e. An analysis of the risks and benefits of
the prescribed treatment for the particular child,
f. Alternatives to the treatment being
recommended and the rationale for selecting the particular treatment
recommended; and,
g. Interventions
other than the extraordinary medical care and treatment that are or shall be
ongoing in conjunction with the care and
treatment.
(c)
Emergency Medical Care and Treatment. Although parents shall be involved
whenever possible, obtaining consent is not required for emergency care and
treatment. If the emergency care and treatment is provided without parental
consent, the child welfare professional shall ensure the parent and the
guardian ad litem, if appointed, are notified no later than 48 hours from the
time the child welfare professional was notified of the care and treatment. The
child's case file shall contain a statement signed by the attending physician
that the situation was an emergency and the care was needed to ensure the
child's health or physical well-being. The case file shall also contain
documentation that the parent and guardian ad litem, if appointed, were
notified after the treatment was administered. If the parents are unable to be
located all attempts to locate and notify parents shall be documented in the
child's case file.
(7)
Consent for Medical Care for Children in the Custody of the Department when
Parental Rights Have Been Terminated.
(a)
Ordinary and Emergency Medical Care and Treatment. When a child is placed in
the custody of the Department following the termination of parental rights, the
Department or contracted service provider shall provide consent for ordinary
medical care or emergency care of the child. The child welfare professional
responsible for the case shall provide documentation of the consent for the
ordinary medical care or emergency care and document in FSFN.
(b) Extraordinary Medical Care and Treatment.
When a child is placed in the custody of the Department following the
termination of parental rights, the Department or contracted service provider
shall not provide consent for extraordinary medical care or treatment.
Authorization for the extraordinary medical care or treatment shall be obtained
by the Department or contracted service provider from the
court.
(8) Required
Documentation for Medical Care and Treatment.
(a) During the initial removal or no later
than the first court proceeding thereafter, the child welfare professional
responsible for the case shall request the following information from the
child's parents, family members, other caregivers, or health care providers:
medical history of the child; medical history of the child's family and medical
consents from the child's parent or guardian. This information shall be placed
in the Child's Resource Record.
(b)
All actions taken to obtain medical history and parental consent for medical
screening, treatment, medications or immunizations shall be documented in FSFN
and a copy provided to the out-of-home caregiver for placement in the Child's
Resource Record. If parental consent is received, a copy of the "Consent for
Treatment and Release of Medical Information, " CF-FSP 4006, Oct 2005, which is
incorporated by reference and available at
http://www.flrules.org/Gateway/reference.asp?No=Ref-06738,
shall be placed in the child's case file and a copy provided to the caregiver
for placement in the Child's Resource Record, as defined in Rule
65C-30.001, F.A.C.
(c) A copy of any court orders authorizing
treatment shall be documented in FSFN, and a copy provided to the out-of-home
caregiver for placement in the Child's Resource Record.
(d) Any notification provided to parents or
others regarding a child's medical treatment shall be documented in
FSFN.
(9) Notification of
parents. The child welfare professional shall ensure that the child's parent is
notified of any medical treatment of the child where the parent was not
involved in providing consent for the treatment within 48 hours from the time
the child welfare professional was notified of the
treatment.
Rulemaking Authority
39.012,
39.0121(6), (12),
(13),
39.407 (1),
743.0645 FS. Law Implemented
39.407,
743.064 FS.
New 5-4-06, Amended
5-8-16.
