Executives at Magellan, which helps administer the Medicaid programs for 25 states and the District of Columbia, declined to discuss Hanzman’s order.

A spokeswoman for AHCA, Michelle Dahnke, declined to discuss the order, as well, saying the agency was not a party to the proceedings Hanzman described, though his order said both AHCA and Magellan appeared at the hearing.Daniel Armstrong, a psychologist who is associate chair of pediatrics at the University of Miami, said states often “ration” health and psychological care in an effort to control costs.

But, he added, “Florida’s children in foster care are among our most vulnerable. They are in the care of the state because their parents have been unable to keep them safe and well” — sometimes inflicting dreadful abuse and neglect on them.

“As a consequence,” Armstrong said, “mental health, behavioral, and emotional disturbance should be expected, and not something that comes as a surprise.”

Much of the order concerns the plight of a 16-year-old girl, who is not being named by The Miami Herald to protect her privacy. Child protection investigators took custody of the girl from her parents after she disclosed that her birth father had been both molesting her and doing drugs near her.

But what should have been the end of the story became just another ugly chapter: The girl was adopted by her paternal grandfather, who abused her as well.

Around May 2009, the judge wrote, the Department of Children & Families’ abuse hotline received a report that the grandfather was making the girl watch pornographic movies before going into her bedroom and forcing himself on her.

Two months later, DCF took her from the grandfather and sent her to live with a family friend under a permanent guardianship. That arrangement did not last long either; the family refused to accept the girl back after she ran away, plagued by drug abuse and difficult behavior.

For much of the past two years, the girl remained missing.

In April 2011, she told authorities she hated foster care so much that she wanted to return to the grandfather who molested her. While living on the streets, records show, she remained under the sway of pimps who sold her for money.

By November, Hanzman and child welfare authorities were searching for some way to help the girl, who is diagnosed with PTSD, depression and a severe drug addiction. Therapists said she needed residential psychiatric treatment.

A psychologist with Magellan, Charles Winick, spent “only approximately 20 minutes” with the girl, and “failed to review most of her case file,” Hanzman wrote, and arrived at a different conclusion: The girl did not meet “suitability criteria” for a mental health treatment center because her real diagnosis was drug abuse.

With no other options, the girl was sent to live with another relative — and promptly ran away again — most likely, authorities believe, to her pimp. She has not been seen since.