Amendment SSA1-SB82

SB82-SSA1,28,15 AUTHORIZATION TO CONSENT TO HEALTH SERVICES

SB82-SSA1,28,19 I, .... (print name of parent), hereby authorize my child's caregiver .... (print name of caregiver), who currently resides with or is providing care for (cross out "currently resides with or" or "or is providing care for," if inapplicable) my child, .... (print name and date of birth of child), to do the following for my child:

SB82-SSA1,28,20 A. Health Services Consent and Exclusions:

SB82-SSA1,28,24 Provide consent for emergency and nonemergency health services for my child, .... (print name of child), including medical and dental examinations and prescribed treatments, including surgery, with the following exceptions: (If there are no exceptions, write "none.")

SB82-SSA1,29,1 ........................................................................................................................................

SB82-SSA1,29,2 ........................................................................................................................................

SB82-SSA1,29,4 All health services will be provided under the direction of a licensed dental care provider or physician or other licensed health care provider as appropriate.

SB82-SSA1,29,7 B. Child's Health Care Records. Provide consent to the release of the patient health care records of my child, .... (print name of child), with the following exceptions: (If there are no exceptions, write "none.")

SB82-SSA1,29,8 ........................................................................................................................................

SB82-SSA1,29,9 ........................................................................................................................................

SB82-SSA1,29,13 The authority granted under this health services consent form shall remain in effect until .... (print date), unless revoked or made invalid earlier. (The parent may specify any date agreed to between the parent and caregiver up to one year after the date on which the form is signed.)

SB82-SSA1,29,14 Signature of parent .... Date ....

SB82-SSA1,29,15 Name of parent (print) ....

SB82-SSA1,29,16 STATEMENT OF CAREGIVER

SB82-SSA1,29,22 I understand that .... (name of parent) has authorized me to make health services decisions for .... (name of child). I agree to make health services decisions for the above-named child consistent with what I and the child's health care providers believe is in the child's best interest, consistent with the authority granted in this form, and consistent with any other wishes or beliefs of the child's parent of which I am aware.

SB82-SSA1,29,23 Signature of Caregiver .... Date ....

SB82-SSA1,29,24 CONTACT INFORMATION

SB82-SSA1,29,25 A. Parent:

SB82-SSA1,30,1 Name (print) ....

SB82-SSA1,30,2 Home address .... Home telephone number ....

SB82-SSA1,30,3 Work address .... Work telephone number ....

SB82-SSA1,30,4 Other address (specify) .... Other telephone number ....

SB82-SSA1,30,5 B. Caregiver:

SB82-SSA1,30,6 Name (print) ....

SB82-SSA1,30,7 Home address .... Home telephone number ....

SB82-SSA1,30,8 Work address .... Work telephone number ....

SB82-SSA1,30,9 Other address (specify) .... Other telephone number ....

SB82-SSA1,30,11 (4) Revocation of health services form. (a) A parent may revoke a health services consent form at any time by doing any of the following:

SB82-SSA1,30,13 1. Canceling, defacing, obliterating, burning, tearing, or otherwise destroying the health services consent form.

SB82-SSA1,30,15 2. Executing a statement, in writing, that is signed and dated by the parent, expressing the parent's intent to revoke the health services consent form.

SB82-SSA1,30,16 3. Executing a subsequent health services consent form.

SB82-SSA1,30,19 (b) A health services consent form is not valid if the child no longer resides with the caregiver or if the caregiver is no longer providing temporary or permanent care and supervision for the child.

SB82-SSA1,30,23 (c) If a caregiver knows that the instrument that authorized him or her to make health services decisions for a child has been revoked or is no longer valid, the caregiver shall communicate this fact to any health care provider for the child that the caregiver knows has a copy of the health services consent form.

SB82-SSA1,31,2 (d) The child's health care provider shall, upon notification of revocation or invalidity of the health services consent form, record in the child's medical record the time, date, and place of the notification to the health care provider of the revocation or invalidity.

SB82-SSA1,31,6 (5) Duties and immunities. (a) No health care facility or health care provider may be charged with a crime, held civilly liable, or charged with unprofessional conduct for any of the following in providing health services under a health services consent form:

SB82-SSA1,31,10 1. Complying, in the absence of actual knowledge of a revocation, with the terms of a health services consent form that is in compliance with this section or the decision of a caregiver that is made under a health services consent form that is in compliance with this section.

SB82-SSA1,31,13 2. Acting contrary to or failing to act on a revocation of a health services consent form, unless the health care facility or health care provider has actual knowledge of the revocation.

SB82-SSA1,31,17 3. Acting contrary to or failing to act on the health services decision of a parent who is not currently denied periods of physical placement with the child, unless the health care facility or health care provider has actual knowledge of the parent's health services decision.

SB82-SSA1,31,21 (b) In the absence of actual notice to the contrary, a health care facility or health care provider may presume that a parent was authorized to execute the health services consent form under the requirements of this section and that the form is valid.

SB82-SSA1,31,24 (c) No caregiver may be charged with a crime or held civilly liable for making a decision in good faith under a health services consent form that is in compliance with this section.

SB82-SSA1,32,4 (6) Penalties. (a) Whoever knowingly falsifies or forges a health services consent form with intent to create the false impression that a person other than the caregiver has been designated to consent to health services for a child is subject to a forfeiture not to exceed $200.

SB82-SSA1,32,11 (b) Whoever gives or attempts to give consent for health services based on a health services consent form that the individual knows has been executed without the voluntary consent of the parent, that the individual knows has been forged or substantially altered without the authorization of the child's parent, or that the individual knows has been revoked, with the intent to act contrary to the parent's wishes may be fined not more than $500 or imprisoned for not more than 30 days or both.

SB82-SSA1, s. 38 Section 38 . 49.155 (5) of the statutes is renumbered 49.155 (5) (a) and amended to read:

SB82-SSA1,32,16 49.155 (5) (a) An individual is liable for the percentage of the cost of the child care specified by the department in a printed copayment schedule except as provided in pars. (b), (c), and (d).

SB82-SSA1,32,21 (b) An individual who is under the age of 20 and is attending high school or participating in a course of study meeting the standards established under s. 115.29 (4) for the granting of a declaration of equivalency to high school graduation may not be determined liable for more than the minimum copayment amount for the type of child care received and the number of children receiving child care.

SB82-SSA1, s. 39 Section 39 . 49.155 (5) (c) and (d) of the statutes are created to read:

SB82-SSA1,32,25 49.155 (5) (c) An individual who is eligible to receive payments under s. 48.57 (3m) or (3n) for providing care and maintenance for a child is not liable for a copayment for the child.

SB82-SSA1,33,2 (d) An individual who the department specifies, by rule, is not liable for a copayment.

SB82-SSA1, s. 40 Section 40 . 880.08 (3) (am) (intro.) of the statutes is amended to read:

SB82-SSA1,33,6 880.08 (3) (am) (intro.) When the proposed ward is a minor, notice shall be given as provided in s. 879.05 to all of the following persons, if applicable, except that notice required to be given by publication shall be published as a class 1 notice:

SB82-SSA1, s. 41 Section 41 . Nonstatutory provisions.

SB82-SSA1,33,13 (1) Guardianship and legal custody of children. The joint legislative council is requested to study state laws regarding guardianship and legal custody of children and the rights and responsibilities of guardians and legal custodians of children. If the joint legislative council conducts the study, the joint legislative council shall report its findings, conclusions, and recommendations to the legislature in the manner provided under section 13.172 (2) of the statutes by January 1, 2005.

SB82-SSA1,33,19 (2) Kinship care funding management. The department of health and family services shall study methods to manage the funding appropriated for kinship care payments in order to minimize the need for waiting lists for kinship care payments. The department shall submit a report summarizing the results of the study to the appropriate standing committees of the legislature in the manner provided under section 13.172 (3) of the statutes by June 30, 2004.

SB82-SSA1,33,20 (End)