Photographs, medical examinations, X rays, and medical treatment of abused, abandoned, or neglected child.

(1)(a) Any person required to investigate cases of suspected child abuse, abandonment, or neglect may take or cause to be taken photographs of the areas of trauma visible on a child who is the subject of a report. Any Child Protection Team that 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 need for a medical 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 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 a medical examination is performed on a child under paragraph (b), other than a medical 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 examination, that the child be examined by:

1. A Child Protection Team if the medical examination under paragraph (b) was not performed by a Child Protection Team;

2. 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 examination under paragraph (b) was performed by a Child Protection Team, for the purpose of obtaining a second opinion on diagnosis or treatment; or

3. 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 diagnosis of and medical care to pediatric patients for the conditions specified in s. 39.303(4) to consider a differential diagnosis.

The cost of a medical examination under subparagraph 2. or subparagraph 3. must be borne by the parent or legal custodian, including through his or her health care coverage, if applicable.

(d) Notwithstanding s. 39.202(6), for all medical examinations performed pursuant to paragraph (c), the physician or advanced practice registered nurse must submit within 10 days after the medical examination a written report that details the findings and conclusions of the medical examination to the department and the parent or legal custodian.

(e) If the findings and conclusions of the medical examination conducted under paragraph (b) and the medical 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 must 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 medical examination under paragraph (c).

(2) Consent for any medical treatment shall be obtained in the following manner.

(a)1. Consent to medical treatment shall be obtained from a parent or legal custodian of the child; or

2. A court order for such treatment shall be obtained.

(b) If a parent or legal custodian of the child is unavailable and his or her whereabouts cannot be reasonably ascertained, and it is after normal working hours so that a court order cannot reasonably be obtained, an authorized agent of the department shall have the authority to consent to necessary medical treatment for the child. The authority of the department to consent to medical treatment in this circumstance shall be limited to the time reasonably necessary to obtain court authorization.

(c) If a parent or legal custodian of the child is available but refuses to consent to the necessary treatment, a court order shall be required unless the situation meets the definition of an emergency in s. 743.064 or the treatment needed is related to suspected abuse, abandonment, or neglect of the child by a parent or legal custodian. In such case, the department shall have the authority to consent to necessary medical treatment. This authority is limited to the time reasonably necessary to obtain court authorization.

In no case shall the department consent to sterilization, abortion, or termination of life support.

(3) Any facility licensed under chapter 395 shall provide to the department, its agent, or a Child Protection Team that contracts with the department any photograph or report on examinations made or X rays taken pursuant to this section, or copies thereof, for the purpose of investigation or assessment of cases of abuse, abandonment, neglect, or exploitation of children.

(4) Any photograph or report on examinations made or X rays taken pursuant to this section, or copies thereof, shall be sent to the department as soon as possible and shall be preserved in permanent form in records held by the department.

(5) The county in which the child is a resident shall bear the initial costs of the examination of the allegedly abused, abandoned, or neglected child; however, the parents or legal custodian of the child shall be required to reimburse the county for the costs of such examination, other than an initial forensic physical examination as provided in s. 960.28, and to reimburse the department for the cost of the photographs taken pursuant to this section. A medical provider may not bill a child victim, directly or indirectly, for the cost of an initial forensic physical examination.