65C-28.003. Medical Treatment  

Effective on Sunday, May 8, 2016
  • 1(1) If a child in out-of-home care appears to be suffering from illness or injury requiring medical intervention, the 20child welfare professional, 23upon notification, 25or the 27out-of-home 28caregiver 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.

    73(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.”

    95(a) If a child is Medicaid eligible, these services shall be sought first through Medicaid providers. If a child is not Medicaid eligible, 118or if a Medicaid provider is not available or appropriate, then necessary services shall be obtained using other providers137.

    138(b) If the 141child welfare professional responsible for the case 148receives 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 171licensed out-of-home caregiver 174or relative or non-relative caregiver. 179Information 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.

    211(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 255child welfare professional 258and the 260out-of-home 261caregiver 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.

    351(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.

    403(5) Required Actions to Gain Medical Consent at Time of the Shelter Hearing. T417he 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. 449No consent is needed for treatment or medication rendered in the event of an emergency as documented by the attending physician.

    470(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.

    534(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.

    605(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.

    6811. 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 76939.407(3), F.S., 771will be followed.

    7742. 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:

    802a. Present diagnosis and known past medical interventions for the treatment of this condition;

    816b. A statement that the prescribing health care professional has reviewed all medical information concerning the child that has been provided;

    837c. The name and requested administration range for any medication requested;

    848d. A statement recommending the proposed procedure signed by the attending physician;

    860e. An analysis of the risks and benefits of the prescribed treatment for the particular child;

    876f. Alternatives to the treatment being recommended and the rationale for selecting the particular treatment recommended; and,

    893g. Interventions other than the extraordinary medical care and treatment that are or shall be ongoing in conjunction with the care and treatment.

    916(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 951child welfare professional 954shall ensure the parent and the guardian ad litem, if appointed, are notified 967no later than 48 hours from the time the child welfare professional was notified of the care and treatment. 986The 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. 1041If the parents are unable to be located 1049all attempts to 1052locate and 1054notify parents shall be documented in the child’s case file.

    1064(7) Consent for Medical Care for Children in the Custody of the Department when Parental Rights Have Been Terminated.

    1083(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 1128child welfare professional responsible for the case 1135shall provide documentation of the consent for the ordinary medical 1145care or emergency care 1149and document in FSFN.

    1153(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.

    1213(8) Required Documentation for Medical Care and Treatment.

    1221(a) During the initial removal or no later than the first court proceeding thereafter, the 1236child welfare professional responsible for the case 1243shall request the following information from the child’s parents, family members, 1254other caregivers, 1256or 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.

    1290(b) All actions taken to obtain medical history and parental consent for medical screening, treatment, medications or immunizations shall be documented in 1312FSFN and a copy provided to the out-of-home caregiver for placement in the Child’s Resource Record1328. 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 1356and available at 1359http://www.flrules.org/Gateway/reference.asp?No=Ref-06738, 1361shall be placed in the child’s case file and a copy provided to the caregiver for placement in the Child’s Resource Record, 1383as defined in Rule 138765C-30.001, 1388F.A.C1389.

    1390(c) A copy of any court orders authorizing treatment shall be 1401documented in FSFN, 1404and a copy provided to the 1410out-of-home 1411caregiver for placement in the Child’s Resource Record.

    1419(d) Any notification provided to parents or others regarding a child’s medical treatment 1432shall be documented in FSFN1437.

    1438(9) Notification of parents. The 1443child welfare professional 1446shall 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 1473within 48 hours from the time the child welfare professional was notified of the treatment1488.

    1489Rulemaking Authority 149139.012, 149239.0121(6), 1493(12), (13), 149539.407(1), 1496743.0645 FS. 1498Law Implemented 150039.407, 1501743.064 FS. 1503History–New 5-4-06, Amended 5-8-16.


Rulemaking Events:

Historical Versions(1)

Select effective date to view different version.