The Florida Senate

381.001  Legislative intent; public health system.

381.0011  Duties and powers of the Department of Health.

381.0012  Enforcement authority.

381.0013  Eminent domain.

381.0014  Regulations and ordinances superseded.

381.0015  Presumptions.

381.0016  Municipal regulations and ordinances.

381.0017  Purchase, lease, and sale of real property.

381.0018  Application for and acceptance of gifts or grants.

381.0019  Disposition of equipment and material; transfers to county health departments.

381.002  Grant of title to prescriptive medical personal property to client.

381.0021  Client welfare accounts.

381.0022  Sharing confidential or exempt information.

381.0025  Penalties.

381.003  Communicable disease and AIDS prevention and control.

381.0031  Report of diseases of public health significance to department.

381.00315  Public health advisories; public health emergencies.

381.0032  Epidemiological research.

381.00325  Hepatitis A awareness program.

381.0034  Requirement for instruction on HIV and AIDS.

381.0035  Educational course on HIV and AIDS; employees and clients of certain health care facilities.

381.0036  Planning for implementation of educational requirements concerning HIV and AIDS for specified applicants for professional licensure.

381.0037  Findings; intent.

381.0038  Education.

381.0039  Oversight of AIDS education programs.

381.004  HIV testing.

381.0041  Donation and transfer of human tissue; testing requirements.

381.0042  Patient care for persons with HIV infection.

381.0045  Targeted outreach for pregnant women.

381.0046  Statewide HIV and AIDS prevention campaign.

381.005  Primary and preventive health services.

381.0051  Family planning.

381.0052  Dental health.

381.0053  Comprehensive nutrition program.

381.0055  Confidentiality and quality assurance activities.

381.0056  School health services program.

381.0057  Funding for school health services.

381.0059  Background screening requirements for school health services personnel.

381.00591  Department of Health; National Environmental Laboratory accreditation; application; rules.

381.00593  Public school volunteer health care practitioner program.

381.006  Environmental health.

381.0061  Administrative fines.

381.0062  Supervision; private and certain public water systems.

381.0063  Drinking water funds.

381.0064  Continuing education courses for persons installing or servicing septic tanks.

381.0065  Onsite sewage treatment and disposal systems; regulation.

381.00655  Connection of existing onsite sewage treatment and disposal systems to central sewerage system; requirements.

381.0066  Onsite sewage treatment and disposal systems; fees.

381.0067  Corrective orders; private and certain public water systems and onsite sewage treatment and disposal systems.

381.0068  Technical review and advisory panel.

381.0072  Food service protection.

381.0075  Regulation of body-piercing salons.

381.008  Definitions of terms used in ss. 381.008-381.00897.

381.0081  Permit required to operate a migrant labor camp or residential migrant housing; penalties for unlawful establishment or operation; allocation of proceeds.

381.0082  Application for permit to operate migrant labor camp or residential migrant housing.

381.0083  Permit for migrant labor camp or residential migrant housing.

381.0084  Application fees for migrant labor camps and residential migrant housing.

381.0085  Revocation of permit to operate migrant labor camp or residential migrant housing.

381.0086  Rules; variances; penalties.

381.0087  Enforcement; citations.

381.0088  Right of entry.

381.00893  Complaints by aggrieved parties.

381.00895  Prohibited acts; application.

381.00896  Nondiscrimination.

381.00897  Access to migrant labor camps and residential migrant housing.

381.009  Toilets required by department regulations; charge for use of prohibited.

381.0091  Separate restrooms and separate dressing rooms for males and females.

381.0098  Biomedical waste.

381.0101  Environmental health professionals.

381.0201  Technical and support services.

381.0202  Laboratory services.

381.0203  Pharmacy services.

381.0204  Vital statistics.

381.0205  Emergency medical services.

381.026  Florida Patient's Bill of Rights and Responsibilities.

381.0261  Summary of patient's bill of rights; distribution; penalty.

381.0301  Education and resource development.

381.0302  Florida Health Services Corps.

381.0303  Health practitioner recruitment for special needs shelters.

381.0402  Area health education center network.

381.0403  The Community Hospital Education Act.

381.0404  Center for Health Technologies.

381.0405  Office of Rural Health.

381.0406  Rural health networks.

381.04065  Rural health network cooperative agreements.

381.0407  Managed care and publicly funded primary care program coordination.

381.045  Hepatitis B or HIV carriers.

381.0601  Self-derived and directed-donor blood programs.

381.06015  Public Cord Blood Tissue Bank.

381.0602  Organ Transplant Advisory Council; membership; responsibilities.

381.0605  Survey of state hospital facilities; Agency for Health Care Administration.

381.1001  Short title; Florida Community Health Protection Act.

381.1015  Community Environmental Health Program; creation; purposes.

381.102  Community Health pilot projects.

381.103  Community Health Pilot Projects; duties of department.

381.6021  Certification of organizations engaged in the practice of cadaveric organ and tissue procurement.

381.6022  Certification of organ procurement organizations, tissue banks, and eye banks.

381.60225  Background screening.

381.6023  Organ and Tissue Procurement and Transplantation Advisory Board; creation; duties.

381.6024  Fees; Florida Organ and Tissue Donor Education and Procurement Trust Fund.

381.6025  Physician supervision of cadaveric organ and tissue procurement coordinators.

381.6026  Procurement of cadaveric organs for transplant by out-of-state physicians.

381.731  Strategic planning.

381.732  Short title; Healthy Communities, Healthy People Act.

381.733  Definitions relating to Healthy Communities, Healthy People Act.

381.734  Healthy Communities, Healthy People Program.

381.7351  Short title; Closing the Gap Act.

381.7352  Legislative findings and intent.

381.7353  Reducing Racial and Ethnic Health Disparities: Closing the Gap grant program; administration; department duties.

381.7354  Eligibility.

381.7355  Project requirements; review criteria.

381.7356  Local matching funds; grant awards.

381.739  Short title; Charlie Mack Overstreet Brain or Spinal Cord Injuries Act.

381.7395  Legislative intent.

381.74  Establishment and maintenance of a central registry.

381.745  Definitions; ss. 381.739-381.79.

381.75  Duties and responsibilities of the department, of transitional living facilities, and of residents.

381.755  Benefits not assignable.

381.76  Eligibility for the brain and spinal cord injury program.

381.765  Retention of title to and disposal of equipment.

381.77  Nursing home residents, age 55 and under; annual survey.

381.775  Applicant and recipient records; confidential and privileged.

381.78  Advisory council on brain and spinal cord injuries.

381.785  Recovery of third-party payments for funded services.

381.79  Brain and Spinal Cord Injury Program Trust Fund.

381.795  Long-term community-based supports.

381.815  Sickle-cell program.

381.83  Trade secrets; confidentiality.

381.85  Biomedical and social research.

381.87  Osteoporosis prevention and education program.

381.88  Insect sting emergency treatment.

381.89  Regulation of tanning facilities.

381.895  Standards for compressed air used for recreational diving.

381.90  Health Information Systems Council; legislative intent; creation, appointment, duties.

381.91  Jessie Trice Cancer Prevention Program.

381.93  Breast and cervical cancer early detection program.

381.931  Annual report on Medicaid expenditures.

381.95  Medical facility information maintained for terrorism response purposes; confidentiality.

381.001  Legislative intent; public health system.--

(1)  It is the intent of the Legislature that the Department of Health be responsible for the state's public health system which shall be designed to promote, protect, and improve the health of all people in the state. The mission of the state's public health system is to foster the conditions in which people can be healthy, by assessing state and community health needs and priorities through data collection, epidemiologic studies, and community participation; by developing comprehensive public health policies and objectives aimed at improving the health status of people in the state; and by ensuring essential health care and an environment which enhances the health of the individual and the community. The Legislature recognizes that the state's public health system must be founded on an active partnership between federal, state, and local government and between the public and private sectors, and, therefore, assessment, policy development, and service provision must be shared by all of these entities to achieve its mission.

(2)  It is the intent of the Legislature that the department, in carrying out the mission of public health, focus attention on identifying, assessing, and controlling the presence and spread of communicable diseases; on monitoring and regulating factors in the environment which may impair the public's health, with particular attention to preventing contamination of drinking water, the air people breathe, and the food people consume; and ensuring availability of and access to preventive and primary health care, including, but not limited to, acute and episodic care, prenatal and postpartum care, child health, family planning, school health, chronic disease prevention, child and adult immunization, dental health, nutrition, and health education and promotion services.

(3)  It is, furthermore, the intent of the Legislature that the public health system include comprehensive planning, data collection, technical support, and health resource development functions. These functions include, but are not limited to, state laboratory and pharmacy services, the state vital statistics system, the State Center for Health Statistics, emergency medical services coordination and support, and recruitment, retention, and development of preventive and primary health care professionals and managers.

(4)  It is, furthermore, the intent of the Legislature that the department provide public health services through the 67 county health departments in partnership with county governments, as specified in part I of chapter 154, and in so doing make every attempt possible to solicit the support and involvement of private and not-for-profit health care agencies in fulfilling the public health mission.

History.--s. 2, ch. 91-297; s. 28, ch. 97-101.

381.0011  Duties and powers of the Department of Health.--It is the duty of the Department of Health to:

(1)  Assess the public health status and needs of the state through statewide data collection and other appropriate means, with special attention to future needs that may result from population growth, technological advancements, new societal priorities, or other changes.

(2)  Formulate general policies affecting the public health of the state.

(3)  Include in the department's strategic plan developed under ¹s. 186.021 a summary of all aspects of the public health mission and health status objectives to direct the use of public health resources with an emphasis on prevention.

(4)  Administer and enforce laws and rules relating to sanitation, control of communicable diseases, illnesses and hazards to health among humans and from animals to humans, and the general health of the people of the state.

(5)  Cooperate with and accept assistance from federal, state, and local officials for the prevention and suppression of communicable and other diseases, illnesses, injuries, and hazards to human health.

(6)  Declare, enforce, modify, and abolish quarantine of persons, animals, and premises as the circumstances indicate for controlling communicable diseases or providing protection from unsafe conditions that pose a threat to public health, except as provided in ss. 384.28 and 392.545-392.60.

(a)  The department shall adopt rules to specify the conditions and procedures for imposing and releasing a quarantine. The rules must include provisions related to:

1.  The closure of premises.

2.  The movement of persons or animals exposed to or infected with a communicable disease.

3.  The tests or treatment, including vaccination, for communicable disease required prior to employment or admission to the premises or to comply with a quarantine.

4.  Testing or destruction of animals with or suspected of having a disease transmissible to humans.

5.  Access by the department to quarantined premises.

6.  The disinfection of quarantined animals, persons, or premises.

7.  Methods of quarantine.

(b)  Any health regulation that restricts travel or trade within the state may not be adopted or enforced in this state except by authority of the department.

(7)  Provide for a thorough investigation and study of the incidence, causes, modes of propagation and transmission, and means of prevention, control, and cure of diseases, illnesses, and hazards to human health.

(8)  Provide for the dissemination of information to the public relative to the prevention, control, and cure of diseases, illnesses, and hazards to human health. The department shall conduct a workshop before issuing any health alert or advisory relating to food-borne illness or communicable disease in public lodging or food service establishments in order to inform persons, trade associations, and businesses of the risk to public health and to seek the input of affected persons, trade associations, and businesses on the best methods of informing and protecting the public, except in an emergency, in which case the workshop must be held within 14 days after the issuance of the emergency alert or advisory.

(9)  Act as registrar of vital statistics.

(10)  Cooperate with and assist federal health officials in enforcing public health laws and regulations.

(11)  Cooperate with other departments, local officials, and private boards and organizations for the improvement and preservation of the public health.

(12)  Cooperate with other departments, local officials, and private organizations in developing and implementing a statewide injury control program.

(13)  Adopt rules pursuant to ss. 120.536(1) and 120.54 to implement the provisions of law conferring duties upon it. This subsection does not authorize the department to require a permit or license unless such requirement is specifically provided by law.

(14)  Perform any other duties prescribed by law.

History.--s. 3, ch. 91-297; s. 13, ch. 93-53; s. 29, ch. 97-101; s. 2, ch. 98-151; s. 94, ch. 98-200; s. 6, ch. 2000-367; s. 1, ch. 2002-269.

¹Note.--"Strategic plans" in s. 186.021 were redesignated "long-range program plans" by s. 42, ch. 2000-371.

381.0012  Enforcement authority.--

(1)  The department may commence and maintain all proper and necessary actions and proceedings to enforce the rules adopted pursuant to this chapter and may defend all actions and proceedings involving the department's powers and duties.

(2)  The department may apply for an injunction to the proper circuit court, and the judge of that court upon hearing and for cause shown may grant a temporary or permanent injunction, or both, restraining any person from violating or continuing to violate any of the provisions of this chapter or from failing or refusing to comply with the requirements of this chapter. A permanent injunction may be issued without bond. However, a temporary injunction may not be issued without bond except after a hearing of which the respondent has been given not less than 7 days' prior notice. A temporary injunction may not be issued without bond which limits or prevents operations of an industrial, manufacturing, or processing plant, unless at the hearing, it is shown by clear, certain, and convincing evidence that irreparable injury will result to the public from the failure to issue the temporary injunction. If a temporary injunction or restraining order is improperly or erroneously granted, the state is liable in damages and to the extent provided for in chapter 768.

(3)  The department may commence and maintain all proper and necessary actions and proceedings to compel the performance of any act specifically required of any person, officer, or board by any law of this state relating to public health.

(4)  The department may appear before any magistrate empowered to issue warrants in criminal cases and request the issuance of a warrant. The magistrate shall issue a warrant directed to any sheriff, deputy, or police officer to assist in any way to carry out the purpose and intent of this chapter.

(5)  It shall be the duty of every state and county attorney, sheriff, police officer, and other appropriate city and county officials upon request to assist the department or any of its agents in enforcing the state health laws and the rules adopted under this chapter.

History.--s. 4, ch. 91-297.

381.0013  Eminent domain.--Whenever the department shall find it necessary to acquire private property for the use of the department and to be occupied by the department, the department may exercise the power of eminent domain and to proceed to condemn the property in the manner provided by chapter 73.

History.--s. 1, ch. 57-232; ss. 19, 35, ch. 69-106; s. 5, ch. 91-297.

Note.--Former s. 381.062.

381.0014  Regulations and ordinances superseded.--The rules adopted by the department under the provisions of this chapter shall, as to matters of public health, supersede all rules enacted by other state departments, boards or commissions, or ordinances and regulations enacted by municipalities, except that this chapter does not alter or supersede any of the provisions set forth in chapters 502 and 503 or any rule adopted under the authority of those chapters.

History.--s. 2, ch. 29834, 1955; ss. 19, 35, ch. 69-106; s. 1, ch. 76-235; s. 56, ch. 77-147; s. 6, ch. 91-297; s. 189, ch. 99-13.

Note.--Former s. 381.071.

381.0015  Presumptions.--The authority, action, and proceedings of the department in enforcing the rules adopted by it under the provisions of this chapter shall be regarded as judicial in nature and treated as prima facie just and legal.

History.--s. 2, ch. 29834, 1955; ss. 19, 35, ch. 69-106; s. 57, ch. 77-147; s. 7, ch. 91-297.

Note.--Former s. 381.081.

381.0016  Municipal regulations and ordinances.--Any municipality may enact, in a manner prescribed by law, health regulations and ordinances not inconsistent with state public health laws and rules adopted by the department.

History.--s. 2, ch. 29834, 1955; ss. 19, 35, ch. 69-106; s. 59, ch. 77-147; s. 8, ch. 91-297.

Note.--Former s. 381.101.

381.0017  Purchase, lease, and sale of real property.--

(1)  The department may purchase, lease, or otherwise acquire land and buildings and take a deed thereto in the name of the state, for the use and benefit of the department, subject to available appropriations therefor, when the acquisition is necessary to the efficient accomplishment of the purposes of this chapter.

(2)  The department may sell, lease, or convey in the name of the state for the use and benefit of the department any land and buildings owned by the state for the use and benefit of the department, which lands and buildings are no longer necessary for carrying out the purposes of this chapter.

(3)  Title is confirmed in the department to any real estate which has heretofore been conveyed or attempted to be conveyed to the former Division of Health of the department.

History.--s. 2, ch. 29834, 1955; ss. 19, 35, ch. 69-106; s. 64, ch. 77-147; s. 9, ch. 91-297.

Note.--Former s. 381.171.

381.0018  Application for and acceptance of gifts or grants.--The department may apply for and accept any funds, grants, gifts, or services made available to it by any agency or department of the Federal Government or any other agency or private individual in aid of any present or future health program undertaken, maintained, or proposed. All moneys received under the provision of this section shall be deposited in the State Treasury and shall be disbursed in the same manner as other funds of the department.

History.--s. 2, ch. 29834, 1955; ss. 19, 35, ch. 69-106; s. 65, ch. 77-147; s. 10, ch. 91-297.

Note.--Former s. 381.201.

381.0019  Disposition of equipment and material; transfers to county health departments.--When the department purchases equipment and materials in furtherance of its public health programs from state or federal or state and federal funds for primary use and location in a county health department of this state, it is authorized to transfer title to such equipment and materials to the board of county commissioners of the county where the county health department is located, unless otherwise prohibited by federal or state law, rule, or regulation. All property so transferred shall be accounted for as provided in chapter 274.

History.--s. 2, ch. 29834, 1955; s. 2, ch. 61-46; ss. 19, 35, ch. 69-106; s. 127, ch. 77-104; s. 11, ch. 91-297; s. 30, ch. 97-101.

Note.--Former s. 381.211.

381.002  Grant of title to prescriptive medical personal property to client.--Legal title to prescriptive medical personal property purchased by the department for the use or benefit of a particular client of the department may, pursuant to rules adopted by the department, be granted to such client. Such property is not subject to the requirements of chapter 273.

History.--s. 1, ch. 85-186; s. 12, ch. 91-297.

Note.--Former s. 381.213.

381.0021  Client welfare accounts.--The Department of Health may establish one or more client welfare accounts in any bank, savings and loan association, or credit union. If one account is created, separate revenue and expense accounts shall be maintained in the department's accounting system for each client, program, facility, or institution. Funds to be deposited in the account shall consist of client funds, private donations, and revenue from any auxiliary, canteen, or similar endeavor in a department program, facility, or institution. The interest or increment accruing on such funds shall be the property of the client when such funds are deposited on behalf of a client. Nonclient funds shall be used for the benefit, education, and general welfare of clients. The general welfare of clients includes, but is not limited to, the establishment of, maintenance of, employment of personnel for, and the purchase of items for resale at canteens or through vending machines maintained by a department program, facility, or institution and for programs and activities that benefit clients such as canteens; hobby shops; recreational, entertainment, or activity centers; or similar programs.

History.--s. 18, ch. 97-237.

381.0022  Sharing confidential or exempt information.--

(1)  Notwithstanding any other provision of law to the contrary, the Department of Health and the Department of Children and Family Services may share confidential information or information exempt from disclosure under chapter 119 on any individual who is or has been the subject of a program within the jurisdiction of each agency. Information so exchanged remains confidential or exempt as provided by law.

(2)  Notwithstanding any other provision of law to the contrary, the Department of Health may share confidential information or information exempt from disclosure under chapter 119 on any individual who is or has been a Medicaid recipient and is or was the subject of a program within the jurisdiction of the Department of Health, for the purpose of requesting, receiving, or auditing payment for services. Information so exchanged remains confidential or exempt as provided by law.

History.--s. 18, ch. 98-191; s. 55, ch. 99-397.

381.0025  Penalties.--

(1)  Any person who violates any of the provisions of this chapter, any quarantine, or any rule adopted by the department under the provisions of this chapter is guilty of a misdemeanor of the second degree, punishable as provided in s. 775.082 or s. 775.083.

(2)  Any person who interferes with, hinders, or opposes any employee of the department in the discharge of his or her duties pursuant to the provisions of this chapter, chapter 386, chapter 513, or chapter 514, or who impersonates an employee of the department, is guilty of a misdemeanor of the second degree, punishable as provided in s. 775.082 or s. 775.083.

(3)  Any person who maliciously disseminates any false rumor or report concerning the existence of any infectious or contagious disease is guilty of a misdemeanor of the second degree, punishable as provided in s. 775.082 or s. 775.083.

History.--s. 2, ch. 29834, 1955; ss. 19, 35, ch. 69-106; s. 330, ch. 71-136; s. 5, ch. 79-12; s. 98, ch. 86-220; s. 1, ch. 88-177; s. 13, ch. 91-297; s. 648, ch. 95-148; s. 7, ch. 96-293.

Note.--Former s. 381.411.

381.003  Communicable disease and AIDS prevention and control.--

(1)  The department shall conduct a communicable disease prevention and control program as part of fulfilling its public health mission. A communicable disease is any disease caused by transmission of a specific infectious agent, or its toxic products, from an infected person, an infected animal, or the environment to a susceptible host, either directly or indirectly. The communicable disease program must include, but need not be limited to:

(a)  Programs for the prevention and control of tuberculosis in accordance with chapter 392.

(b)  Programs for the prevention and control of human immunodeficiency virus infection and acquired immune deficiency syndrome in accordance with chapter 384 and this chapter.

(c)  Programs for the prevention and control of sexually transmissible diseases in accordance with chapter 384.

(d)  Programs for the prevention, control, and reporting of diseases of public health significance as provided for in this chapter.

(e)  Programs for the prevention and control of vaccine-preventable diseases, including programs to immunize school children as required by s. 1003.22(3)-(11) and the development of an automated, electronic, and centralized database or registry of immunizations. The department shall ensure that all children in this state are immunized against vaccine-preventable diseases. The immunization registry shall allow the department to enhance current immunization activities for the purpose of improving the immunization of all children in this state.

1.  Except as provided in subparagraph 2., the department shall include all children born in this state in the immunization registry by using the birth records from the Office of Vital Statistics. The department shall add other children to the registry as immunization services are provided.

2.  The parent or guardian of a child may refuse to have the child included in the immunization registry by signing a form obtained from the department, or from the health care practitioner or entity that provides the immunization, which indicates that the parent or guardian does not wish to have the child included in the immunization registry. The decision to not participate in the immunization registry must be noted in the registry.

3.  The immunization registry shall allow for immunization records to be electronically transferred to entities that are required by law to have such records, including schools, licensed child care facilities, and any other entity that is required by law to obtain proof of a child's immunizations.

4.  Any health care practitioner licensed under chapter 458, chapter 459, or chapter 464 in this state who complies with rules adopted by the department to access the immunization registry may, through the immunization registry, directly access immunization records and update a child's immunization history or exchange immunization information with another authorized practitioner, entity, or agency involved in a child's care. The information included in the immunization registry must include the child's name, date of birth, address, and any other unique identifier necessary to correctly identify the child; the immunization record, including the date, type of administered vaccine, and vaccine lot number; and the presence or absence of any adverse reaction or contraindication related to the immunization. Information received by the department for the immunization registry retains its status as confidential medical information and the department must maintain the confidentiality of that information as otherwise required by law. A health care practitioner or other agency that obtains information from the immunization registry must maintain the confidentiality of any medical records in accordance with s. 456.057 or as otherwise required by law.

(2)  The department may adopt, repeal, and amend rules related to the prevention and control of communicable diseases and the administration of the immunization registry. Such rules may include procedures for investigating disease, timeframes for reporting disease, definitions, procedures for managing specific diseases, requirements for followup reports of known or suspected exposure to disease, and procedures for providing access to confidential information necessary for disease investigations. For purposes of the immunization registry, the rules may include procedures for a health care practitioner to obtain authorization to use the immunization registry, methods for a parent or guardian to elect not to participate in the immunization registry, and procedures for a health care practitioner licensed under chapter 458, chapter 459, or chapter 464 to access and share electronic immunization records with other entities allowed by law to have access to the records.

History.--s. 14, ch. 91-297; s. 3, ch. 98-151; s. 3, ch. 2000-242; s. 7, ch. 2000-367; s. 16, ch. 2001-62; s. 974, ch. 2002-387.

381.0031  Report of diseases of public health significance to department.--

(1)  Any practitioner licensed in this state to practice medicine, osteopathic medicine, chiropractic medicine, naturopathy, or veterinary medicine; any hospital licensed under part I of chapter 395; or any laboratory licensed under chapter 483 that diagnoses or suspects the existence of a disease of public health significance shall immediately report the fact to the Department of Health.

(2)  Periodically the department shall issue a list of infectious or noninfectious diseases determined by it to be a threat to public health and therefore of significance to public health and shall furnish a copy of the list to the practitioners listed in subsection (1).

(3)  Reports required by this section must be in accordance with methods specified by rule of the department.

(4)  Information submitted in reports required by this section is confidential, exempt from the provisions of s. 119.07(1), and is to be made public only when necessary to public health. A report so submitted is not a violation of the confidential relationship between practitioner and patient.

(5)  The department may obtain and inspect copies of medical records, records of laboratory tests, and other medical-related information for reported cases of diseases of public health significance described in subsection (2). The department shall examine the records of a person who has a disease of public health significance only for purposes of preventing and eliminating outbreaks of disease and making epidemiological investigations of reported cases of diseases of public health significance, notwithstanding any other law to the contrary. Health care practitioners, licensed health care facilities, and laboratories shall allow the department to inspect and obtain copies of such medical records and medical-related information, notwithstanding any other law to the contrary. Release of medical records and medical-related information to the department by a health care practitioner, licensed health care facility, or laboratory, or by an authorized employee or agent thereof, does not constitute a violation of the confidentiality of patient records. A health care practitioner, health care facility, or laboratory, or any employee or agent thereof, may not be held liable in any manner for damages and is not subject to criminal penalties for providing patient records to the department as authorized by this section.

(6)  The department may adopt rules related to reporting diseases of significance to public health, which must specify the information to be included in the report, who is required to report, the method and time period for reporting, requirements for enforcement, and required followup activities by the department which are necessary to protect public health.

This section does not affect s. 384.25.

History.--s. 2, ch. 29834, 1955; ss. 19, 35, ch. 69-106; s. 67, ch. 77-147; s. 4, ch. 89-311; s. 2, ch. 90-347; s. 15, ch. 91-297; s. 2, ch. 95-188; s. 184, ch. 96-406; s. 175, ch. 97-101; s. 4, ch. 98-151; s. 252, ch. 98-166; s. 8, ch. 2000-367.

Note.--Former s. 381.231.

381.00315  Public health advisories; public health emergencies.--The State Health Officer is responsible for declaring public health emergencies and issuing public health advisories.

(1)  As used in this section, the term:

(a)  "Public health advisory" means any warning or report giving information to the public about a potential public health threat. Prior to issuing any public health advisory, the State Health Officer must consult with any state or local agency regarding areas of responsibility which may be affected by such advisory. Upon determining that issuing a public health advisory is necessary to protect the public health and safety, and prior to issuing the advisory, the State Health Officer must notify each county health department within the area which is affected by the advisory of the State Health Officer's intent to issue the advisory. The State Health Officer is authorized to take any action appropriate to enforce any public health advisory.

(b)  "Public health emergency" means any occurrence, or threat thereof, whether natural or man made, which results or may result in substantial injury or harm to the public health from infectious disease, chemical agents, nuclear agents, biological toxins, or situations involving mass casualties or natural disasters. Prior to declaring a public health emergency, the State Health Officer shall, to the extent possible, consult with the Governor and shall notify the Chief of Domestic Security Initiatives as created in s. 943.03. The declaration of a public health emergency shall continue until the State Health Officer finds that the threat or danger has been dealt with to the extent that the emergency conditions no longer exist and he or she terminates the declaration. However, a declaration of a public health emergency may not continue for longer than 60 days unless the Governor concurs in the renewal of the declaration. The State Health Officer, upon declaration of a public health emergency, may take actions that are necessary to protect the public health. Such actions include, but are not limited to:

1.  Directing manufacturers of prescription drugs or over-the-counter drugs who are permitted under chapter 499 and wholesalers of prescription drugs located in this state who are permitted under chapter 499 to give priority to the shipping of specified drugs to pharmacies and health care providers within geographic areas that have been identified by the State Health Officer. The State Health Officer must identify the drugs to be shipped. Manufacturers and wholesalers located in the state must respond to the State Health Officer's priority shipping directive before shipping the specified drugs.

2.  Notwithstanding chapters 465 and 499 and rules adopted thereunder, directing pharmacists employed by the department to compound bulk prescription drugs and provide these bulk prescription drugs to physicians and nurses of county health departments or any qualified person authorized by the State Health Officer for administration to persons as part of a prophylactic or treatment regimen.

3.  Notwithstanding s. 456.036, temporarily reactivating the inactive license of the following health care practitioners, when such practitioners are needed to respond to the public health emergency: physicians licensed under chapter 458 or chapter 459; physician assistants licensed under chapter 458 or chapter 459; licensed practical nurses, registered nurses, and advanced registered nurse practitioners licensed under part I of chapter 464; respiratory therapists licensed under part V of chapter 468; and emergency medical technicians and paramedics certified under part III of chapter 401. Only those health care practitioners specified in this paragraph who possess an unencumbered inactive license and who request that such license be reactivated are eligible for reactivation. An inactive license that is reactivated under this paragraph shall return to inactive status when the public health emergency ends or prior to the end of the public health emergency if the State Health Officer determines that the health care practitioner is no longer needed to provide services during the public health emergency. Such licenses may only be reactivated for a period not to exceed 90 days without meeting the requirements of s. 456.036 or chapter 401, as applicable.

4.  Ordering an individual to be examined, tested, vaccinated, treated, or quarantined for communicable diseases that have significant morbidity or mortality and present a severe danger to public health. Individuals who are unable or unwilling to be examined, tested, vaccinated, or treated for reasons of health, religion, or conscience may be subjected to quarantine.

a.  Examination, testing, vaccination, or treatment may be performed by any qualified person authorized by the State Health Officer.

b.  If the individual poses a danger to the public health, the State Health Officer may subject the individual to quarantine. If there is no practical method to quarantine the individual, the State Health Officer may use any means necessary to vaccinate or treat the individual.

Any order of the State Health Officer given to effectuate this paragraph shall be immediately enforceable by a law enforcement officer under s. 381.0012.

(2)  Individuals who assist the State Health Officer at his or her request on a volunteer basis during a public health emergency are entitled to the benefits specified in s. 110.504(2), (3), (4), and (5).

History.--s. 16, ch. 96-403; s. 63, ch. 97-100; s. 2, ch. 2002-269.

381.0032  Epidemiological research.--

(1)  The department may conduct studies concerning the epidemiology of diseases of public health significance, such as acquired immune deficiency syndrome and other diseases in Florida. These studies may not duplicate national studies but shall be designed to provide special insight and understanding into Florida-specific problems given this state's unique climate and geography, demographic mix, and high rate of immigration.

(2)  Epidemiological studies designed by the department shall emphasize practical applications and utility in the control of diseases of public health significance, such as acute or chronic diseases caused by infectious agents, host factors, or toxic substances. These studies shall, to the maximum extent possible, use state and local public health workers as field teams, study design team members, reviewers, and co-authors. Epidemiological studies conducted pursuant to this section shall be directed by the State Health Officer or his or her designee.

(3)  The department shall work with the various universities and colleges in this state, including, but not limited to, the College of Public Health at the University of South Florida, when it deems it appropriate and necessary in carrying out such studies.

History.--s. 23, ch. 88-380; s. 16, ch. 91-297; s. 649, ch. 95-148.

Note.--Former s. 381.614.

381.00325  Hepatitis A awareness program.--The Department of Health shall develop a Hepatitis A awareness program. This program shall include information regarding the appropriate education of the public and information regarding the availability of Hepatitis A vaccine. The department shall work with private businesses and associations in developing the program and in disseminating the information.

History.--s. 36, ch. 2000-367.

381.0034  Requirement for instruction on HIV and AIDS.--

(1)  As of July 1, 1991, the Department of Health shall require each person licensed or certified under chapter 401, chapter 467, part IV of chapter 468, or chapter 483, as a condition of biennial relicensure, to complete an educational course approved by the department on the modes of transmission, infection control procedures, clinical management, and prevention of human immunodeficiency virus and acquired immune deficiency syndrome. Such course shall include information on current Florida law on acquired immune deficiency syndrome and its impact on testing, confidentiality of test results, and treatment of patients. Each such licensee or certificateholder shall submit confirmation of having completed said course, on a form provided by the department, when submitting fees or application for each biennial renewal.

(2)  Failure to complete the requirements of this section shall be grounds for disciplinary action contained in the chapters specified in subsection (1). In addition to discipline by the department, the licensee or certificateholder shall be required to complete said course.

(3)  The department shall require, as a condition of granting a license under the chapters specified in subsection (1), that an applicant making initial application for licensure complete an educational course acceptable to the department on human immunodeficiency virus and acquired immune deficiency syndrome. An applicant who has not taken a course at the time of licensure shall, upon an affidavit showing good cause, be allowed 6 months to complete this requirement.

(4)  The department shall have the authority to adopt rules to carry out the provisions of this section.

(5)  Any professional holding two or more licenses or certificates subject to the provisions of this section shall be permitted to show proof of having taken one department-approved course on human immunodeficiency virus and acquired immune deficiency syndrome, for purposes of relicensure or recertification for the additional licenses.

History.--s. 68, ch. 91-297; s. 40, ch. 95-196; s. 31, ch. 97-101.

381.0035  Educational course on HIV and AIDS; employees and clients of certain health care facilities.--

(1)  The Department of Health shall require all employees and clients of facilities licensed under chapters 393, 394, and 397 and employees of facilities licensed under chapter 395 and parts II, III, IV, and VI of chapter 400 to complete, biennially, a continuing educational course on the modes of transmission, infection control procedures, clinical management, and prevention of human immunodeficiency virus and acquired immune deficiency syndrome with an emphasis on appropriate behavior and attitude change. Such instruction shall include information on current Florida law and its impact on testing, confidentiality of test results, and treatment of patients and any protocols and procedures applicable to human immunodeficiency counseling and testing, reporting, the offering of HIV testing to pregnant women, and partner notification issues pursuant to ss. 381.004 and 384.25.

(2)  New employees shall be required to complete a course on human immunodeficiency virus and acquired immune deficiency syndrome, with instruction to include information on current Florida law and its impact on testing, confidentiality of test results, and treatment of patients.

(3)  Facilities licensed under chapters 393, 394, 395, 397, and parts II, III, IV, and VI of chapter 400 shall maintain a record of employees and dates of attendance at human immunodeficiency virus and acquired immune deficiency syndrome educational courses.

(4)  The department shall have the authority to review the records of each facility to determine compliance with the requirements of this section. The department may adopt rules to carry out the provisions of this section.

History.--s. 8, ch. 88-380; ss. 17, 69, ch. 91-297; s. 63, ch. 92-289; s. 32, ch. 97-101; s. 1, ch. 98-171; s. 190, ch. 99-13.

Note.--Former s. 381.043.

381.0036  Planning for implementation of educational requirements concerning HIV and AIDS for specified applicants for professional licensure.--The Department of Business and Professional Regulation and the Department of Health are hereby directed to begin planning for the implementation of the sections of this act which require, as a part of initial licensure, applicants for certain specified professions to complete an educational course on the transmission, control, treatment, and prevention of human immunodeficiency virus and acquired immune deficiency syndrome. Such planning shall include collecting information from the facilities and programs which educate and train the licensed professionals affected by the licensure requirements of this act and shall also include developing rules for the implementation of the licensure requirements.

History.--s. 6, ch. 88-380; s. 17, ch. 91-297; s. 37, ch. 94-218; s. 33, ch. 97-101.

Note.--Former s. 381.044.

381.0037  Findings; intent.--The Legislature finds that acquired immune deficiency syndrome, otherwise known as AIDS, constitutes a serious and unique danger to the public health and welfare. The Legislature finds that acquired immune deficiency syndrome is transmitted by sexual activity, by intravenous drug use, or from an infected mother to a fetus and that public fear of contagion from casual contact is not supported by any scientific evidence. The Legislature finds that acquired immune deficiency syndrome is transmitted by a retrovirus which makes the possibility of development of an immunization or cure highly unlikely in the near future. The Legislature finds that, once infected, there is a high probability that an individual will develop acquired immune deficiency syndrome or a related syndrome and die a premature death as a result but may live productively for years in a communicable state without showing any signs or symptoms of illness. The Legislature finds the unique methods of transmission of this disease and its inevitably fatal course have raised public fears; changed the attitudes of employers, insurers, educators, law enforcement personnel, and health and medical providers about dealing with the disease; and unexpectedly raised the medical costs of this state. The Legislature intends to establish programs and requirements related to acquired immune deficiency syndrome which carefully balance medical necessity, the right to privacy, and protection of the public from harm and which establish public programs for the care and treatment of persons with acquired immune deficiency syndrome and related conditions.

History.--s. 1, ch. 88-380; s. 17, ch. 91-297.

Note.--Former s. 381.607.

381.0038  Education.--The Department of Health shall establish a program to educate the public about the threat of acquired immune deficiency syndrome.

(1)  The acquired immune deficiency syndrome education program shall:

(a)  Be designed to reach all segments of Florida's population;

(b)  Contain special components designed to reach non-English-speaking and other minority groups within the state;

(c)  Impart knowledge to the public about methods of transmission of acquired immune deficiency syndrome and methods of prevention;

(d)  Educate the public about transmission risks in social, employment, and educational situations;

(e)  Educate health care workers and health facility employees about methods of transmission and prevention in their unique workplace environments;

(f)  Contain special components designed to reach persons who may frequently engage in behaviors placing them at a high risk for acquiring acquired immune deficiency syndrome;

(g)  Provide information and consultation to state agencies to educate all state employees; and

(h)  Provide information and consultation to state and local agencies to educate law enforcement and correctional personnel and inmates.

(i)  Provide information and consultation to local governments to educate local government employees.

(j)  Make information available to private employers and encourage them to distribute this information to their employees.

(k)  Contain special components which emphasize appropriate behavior and attitude change.

(l)  Contain components that include information about domestic violence and the risk factors associated with domestic violence and AIDS.

(2)  The program designed by the Department of Health shall utilize all forms of the media and shall place emphasis on the design of educational materials that can be used by businesses, schools, and health care providers in the regular course of their business.

(3)  The department may contract with other persons in the design, development, and distribution of the components of the education program.

History.--s. 2, ch. 88-380; s. 17, ch. 91-297; s. 1, ch. 95-187; s. 34, ch. 97-101.

Note.--Former s. 381.608.

381.0039  Oversight of AIDS education programs.--The Department of Education, the Department of Health, and the Department of Business and Professional Regulation are directed to establish an interagency agreement to oversee the quality and cost efficiency of acquired immune deficiency syndrome education programs being administered in the state pursuant to chapters 381, 456, 943, and 945. The interagency agreement shall also include development, where appropriate, of methods for coordinating educational programs for various professional groups.

History.--s. 16, ch. 89-350; s. 17, ch. 91-297; s. 38, ch. 94-218; s. 35, ch. 97-101; s. 19, ch. 98-166; s. 9, ch. 2000-160.

Note.--Former s. 381.6081.

381.004  HIV testing.--

(1)  LEGISLATIVE INTENT.--The Legislature finds that the use of tests designed to reveal a condition indicative of human immunodeficiency virus infection can be a valuable tool in protecting the public health. The Legislature finds that despite existing laws, regulations, and professional standards which require or promote the informed, voluntary, and confidential use of tests designed to reveal human immunodeficiency virus infection, many members of the public are deterred from seeking such testing because they misunderstand the nature of the test or fear that test results will be disclosed without their consent. The Legislature finds that the public health will be served by facilitating informed, voluntary, and confidential use of tests designed to detect human immunodeficiency virus infection.

(2)  DEFINITIONS.--As used in this section:

(a)  "HIV test" means a test ordered after July 6, 1988, to determine the presence of the antibody or antigen to human immunodeficiency virus or the presence of human immunodeficiency virus infection.

(b)  "HIV test result" means a laboratory report of a human immunodeficiency virus test result entered into a medical record on or after July 6, 1988, or any report or notation in a medical record of a laboratory report of a human immunodeficiency virus test. As used in this section, the term "HIV test result" does not include test results reported to a health care provider by a patient.

(c)  "Significant exposure" means:

1.  Exposure to blood or body fluids through needlestick, instruments, or sharps;

2.  Exposure of mucous membranes to visible blood or body fluids, to which universal precautions apply according to the National Centers for Disease Control and Prevention, including, without limitations, the following body fluids:

a.  Blood.

b.  Semen.

c.  Vaginal secretions.

d.  Cerebro-spinal fluid (CSF).

e.  Synovial fluid.

f.  Pleural fluid.

g.  Peritoneal fluid.

h.  Pericardial fluid.

i.  Amniotic fluid.

j.  Laboratory specimens that contain HIV (e.g., suspensions of concentrated virus); or

3.  Exposure of skin to visible blood or body fluids, especially when the exposed skin is chapped, abraded, or afflicted with dermatitis or the contact is prolonged or involving an extensive area.

(d)  "Preliminary HIV test" means an antibody screening test, such as the enzyme-linked immunosorbent assays (ELISAs) or the Single-Use Diagnostic System (SUDS).

(e)  "Test subject" or "subject of the test" means the person upon whom an HIV test is performed, or the person who has legal authority to make health care decisions for the test subject.

(3)  HUMAN IMMUNODEFICIENCY VIRUS TESTING; INFORMED CONSENT; RESULTS; COUNSELING; CONFIDENTIALITY.--

(a)  No person in this state shall order a test designed to identify the human immunodeficiency virus, or its antigen or antibody, without first obtaining the informed consent of the person upon whom the test is being performed, except as specified in paragraph (h). Informed consent shall be preceded by an explanation of the right to confidential treatment of information identifying the subject of the test and the results of the test to the extent provided by law. Information shall also be provided on the fact that a positive HIV test result will be reported to the county health department with sufficient information to identify the test subject and on the availability and location of sites at which anonymous testing is performed. As required in paragraph (4)(c), each county health department shall maintain a list of sites at which anonymous testing is performed, including the locations, phone numbers, and hours of operation of the sites. Consent need not be in writing provided there is documentation in the medical record that the test has been explained and the consent has been obtained.

(b)  Except as provided in paragraph (h), informed consent must be obtained from a legal guardian or other person authorized by law when the person:

1.  Is not competent, is incapacitated, or is otherwise unable to make an informed judgment; or

2.  Has not reached the age of majority, except as provided in s. 384.30.

(c)  The person ordering the test or that person's designee shall ensure that all reasonable efforts are made to notify the test subject of his or her test result. Notification of a person with a positive test result shall include information on the availability of appropriate medical and support services, on the importance of notifying partners who may have been exposed, and on preventing transmission of HIV. Notification of a person with a negative test result shall include, as appropriate, information on preventing the transmission of HIV. When testing occurs in a hospital emergency department, detention facility, or other facility and the test subject has been released before being notified of positive test results, informing the county health department for that department to notify the test subject fulfills this responsibility.

(d)  No test result shall be determined as positive, and no positive test result shall be revealed to any person, without corroborating or confirmatory tests being conducted except in the following situations:

1.  Preliminary test results may be released to licensed physicians or the medical or nonmedical personnel subject to the significant exposure for purposes of subparagraphs (h)10., 11., and 12.

2.  Preliminary test results may be released to health care providers and to the person tested when decisions about medical care or treatment of, or recommendation to, the person tested and, in the case of an intrapartum or postpartum woman, when care, treatment, or recommendations regarding her newborn, cannot await the results of confirmatory testing. Positive preliminary HIV test results shall not be characterized to the patient as a diagnosis of HIV infection. Justification for the use of preliminary test results must be documented in the medical record by the health care provider who ordered the test. This subparagraph does not authorize the release of preliminary test results for the purpose of routine identification of HIV-infected individuals or when HIV testing is incidental to the preliminary diagnosis or care of a patient. Corroborating or confirmatory testing must be conducted as followup to a positive preliminary test. Results shall be communicated to the patient according to statute regardless of the outcome. Except as provided in this section, test results are confidential and exempt from the provisions of s. 119.07(1).

(e)  Except as provided in this section, the identity of any person upon whom a test has been performed and test results are confidential and exempt from the provisions of s. 119.07(1). No person who has obtained or has knowledge of a test result pursuant to this section may disclose or be compelled to disclose the identity of any person upon whom a test is performed, or the results of such a test in a manner which permits identification of the subject of the test, except to the following persons:

1.  The subject of the test or the subject's legally authorized representative.

2.  Any person, including third-party payors, designated in a legally effective release of the test results executed prior to or after the test by the subject of the test or the subject's legally authorized representative. The test subject may in writing authorize the disclosure of the test subject's HIV test results to third party payors, who need not be specifically identified, and to other persons to whom the test subject subsequently issues a general release of medical information. A general release without such prior written authorization is not sufficient to release HIV test results.

3.  An authorized agent or employee of a health facility or health care provider if the health facility or health care provider itself is authorized to obtain the test results, the agent or employee participates in the administration or provision of patient care or handles or processes specimens of body fluids or tissues, and the agent or employee has a need to know such information. The department shall adopt a rule defining which persons have a need to know pursuant to this subparagraph.

4.  Health care providers consulting between themselves or with health care facilities to determine diagnosis and treatment. For purposes of this subparagraph, health care providers shall include licensed health care professionals employed by or associated with state, county, or municipal detention facilities when such health care professionals are acting exclusively for the purpose of providing diagnoses or treatment of persons in the custody of such facilities.

5.  The department, in accordance with rules for reporting and controlling the spread of disease, as otherwise provided by state law.

6.  A health facility or health care provider which procures, processes, distributes, or uses:

a.  A human body part from a deceased person, with respect to medical information regarding that person; or

b.  Semen provided prior to July 6, 1988, for the purpose of artificial insemination.

7.  Health facility staff committees, for the purposes of conducting program monitoring, program evaluation, or service reviews pursuant to chapters 395 and 766.

8.  Authorized medical or epidemiological researchers who may not further disclose any identifying characteristics or information.

9.  A person allowed access by a court order which is issued in compliance with the following provisions:

a.  No court of this state shall issue such order unless the court finds that the person seeking the test results has demonstrated a compelling need for the test results which cannot be accommodated by other means. In assessing compelling need, the court shall weigh the need for disclosure against the privacy interest of the test subject and the public interest which may be disserved by disclosure which deters blood, organ, and semen donation and future human immunodeficiency virus-related testing or which may lead to discrimination. This paragraph shall not apply to blood bank donor records.

b.  Pleadings pertaining to disclosure of test results shall substitute a pseudonym for the true name of the subject of the test. The disclosure to the parties of the subject's true name shall be communicated confidentially in documents not filed with the court.

c.  Before granting any such order, the court shall provide the individual whose test result is in question with notice and a reasonable opportunity to participate in the proceedings if he or she is not already a party.

d.  Court proceedings as to disclosure of test results shall be conducted in camera, unless the subject of the test agrees to a hearing in open court or unless the court determines that a public hearing is necessary to the public interest and the proper administration of justice.

e.  Upon the issuance of an order to disclose test results, the court shall impose appropriate safeguards against unauthorized disclosure which shall specify the persons who may have access to the information, the purposes for which the information shall be used, and appropriate prohibitions on future disclosure.

10.  A person allowed access by order of a judge of compensation claims of the Division of Administrative Hearings. A judge of compensation claims shall not issue such order unless he or she finds that the person seeking the test results has demonstrated a compelling need for the test results which cannot be accommodated by other means.

11.  Those employees of the department or of child-placing or child-caring agencies or of family foster homes, licensed pursuant to s. 409.175, who are directly involved in the placement, care, control, or custody of such test subject and who have a need to know such information; adoptive parents of such test subject; or any adult custodian, any adult relative, or any person responsible for the child's welfare, if the test subject was not tested under subparagraph (b)2. and if a reasonable attempt has been made to locate and inform the legal guardian of a test result. The department shall adopt a rule to implement this subparagraph.

12.  Those employees of residential facilities or of community-based care programs that care for developmentally disabled persons, pursuant to chapter 393, who are directly involved in the care, control, or custody of such test subject and who have a need to know such information.

13.  A health care provider involved in the delivery of a child can note the mother's HIV test results in the child's medical record.

14.  Medical personnel or nonmedical personnel who have been subject to a significant exposure during the course of medical practice or in the performance of professional duties, or individuals who are the subject of the significant exposure as provided in subparagraphs (h)10.-12.

15.  The medical examiner shall disclose positive HIV test results to the department in accordance with rules for reporting and controlling the spread of disease.

(f)  Except as provided in this section, the identity of a person upon whom a test has been performed is confidential and exempt from the provisions of s. 119.07(1). No person to whom the results of a test have been disclosed may disclose the test results to another person except as authorized by this subsection and by ss. 951.27 and 960.003. Whenever disclosure is made pursuant to this subsection, it shall be accompanied by a statement in writing which includes the following or substantially similar language: "This information has been disclosed to you from records whose confidentiality is protected by state law. State law prohibits you from making any further disclosure of such information without the specific written consent of the person to whom such information pertains, or as otherwise permitted by state law. A general authorization for the release of medical or other information is NOT sufficient for this purpose." An oral disclosure shall be accompanied by oral notice and followed by a written notice within 10 days, except that this notice shall not be required for disclosures made pursuant to subparagraphs (e)3. and 4.

(g)  Human immunodeficiency virus test results contained in the medical records of a hospital licensed under chapter 395 may be released in accordance with s. 395.3025 without being subject to the requirements of subparagraph (e)2., subparagraph (e)9., or paragraph (f); provided the hospital has obtained written informed consent for the HIV test in accordance with provisions of this section.

(h)  Notwithstanding the provisions of paragraph (a), informed consent is not required:

1.  When testing for sexually transmissible diseases is required by state or federal law, or by rule including the following situations:

a.  HIV testing pursuant to s. 796.08 of persons convicted of prostitution or of procuring another to commit prostitution.

b.  HIV testing of inmates pursuant to s. 945.355 prior to their release from prison by reason of parole, accumulation of gain-time credits, or expiration of sentence.

c.  Testing for HIV by a medical examiner in accordance with s. 406.11.

2.  Those exceptions provided for blood, plasma, organs, skin, semen, or other human tissue pursuant to s. 381.0041.

3.  For the performance of an HIV-related test by licensed medical personnel in bona fide medical emergencies when the test results are necessary for medical diagnostic purposes to provide appropriate emergency care or treatment to the person being tested and the patient is unable to consent, as supported by documentation in the medical record. Notification of test results in accordance with paragraph (c) is required.

4.  For the performance of an HIV-related test by licensed medical personnel for medical diagnosis of acute illness where, in the opinion of the attending physician, obtaining informed consent would be detrimental to the patient, as supported by documentation in the medical record, and the test results are necessary for medical diagnostic purposes to provide appropriate care or treatment to the person being tested. Notification of test results in accordance with paragraph (c) is required if it would not be detrimental to the patient. This subparagraph does not authorize the routine testing of patients for HIV infection without informed consent.

5.  When HIV testing is performed as part of an autopsy for which consent was obtained pursuant to s. 872.04.

6.  For the performance of an HIV test upon a defendant pursuant to the victim's request in a prosecution for any type of sexual battery where a blood sample is taken from the defendant voluntarily, pursuant to court order for any purpose, or pursuant to the provisions of s. 775.0877, s. 951.27, or s. 960.003; however, the results of any HIV test performed shall be disclosed solely to the victim and the defendant, except as provided in ss. 775.0877, 951.27, and 960.003.

7.  When an HIV test is mandated by court order.

8.  For epidemiological research pursuant to s. 381.0032, for research consistent with institutional review boards created by 45 C.F.R. part 46, or for the performance of an HIV-related test for the purpose of research, if the testing is performed in a manner by which the identity of the test subject is not known and may not be retrieved by the researcher.

9.  When human tissue is collected lawfully without the consent of the donor for corneal removal as authorized by s. 765.5185 or enucleation of the eyes as authorized by s. 765.519.

10.  For the performance of an HIV test upon an individual who comes into contact with medical personnel in such a way that a significant exposure has occurred during the course of employment or within the scope of practice and where a blood sample is available that was taken from that individual voluntarily by medical personnel for other purposes. The term "medical personnel" includes a licensed or certified health care professional; an employee of a health care professional or health care facility; employees of a laboratory licensed under chapter 483; personnel of a blood bank or plasma center; a medical student or other student who is receiving training as a health care professional at a health care facility; and a paramedic or emergency medical technician certified by the department to perform life-support procedures under s. 401.23.

a.  Prior to performance of an HIV test on a voluntarily obtained blood sample, the individual from whom the blood was obtained shall be requested to consent to the performance of the test and to the release of the results. The individual's refusal to consent and all information concerning the performance of an HIV test and any HIV test result shall be documented only in the medical personnel's record unless the individual gives written consent to entering this information on the individual's medical record.

b.  Reasonable attempts to locate the individual and to obtain consent shall be made, and all attempts must be documented. If the individual cannot be found, an HIV test may be conducted on the available blood sample. If the individual does not voluntarily consent to the performance of an HIV test, the individual shall be informed that an HIV test will be performed, and counseling shall be furnished as provided in this section. However, HIV testing shall be conducted only after a licensed physician documents, in the medical record of the medical personnel, that there has been a significant exposure and that, in the physician's medical judgment, the information is medically necessary to determine the course of treatment for the medical personnel.

c.  Costs of any HIV test of a blood sample performed with or without the consent of the individual, as provided in this subparagraph, shall be borne by the medical personnel or the employer of the medical personnel. However, costs of testing or treatment not directly related to the initial HIV tests or costs of subsequent testing or treatment shall not be borne by the medical personnel or the employer of the medical personnel.

d.  In order to utilize the provisions of this subparagraph, the medical personnel must either be tested for HIV pursuant to this section or provide the results of an HIV test taken within 6 months prior to the significant exposure if such test results are negative.

e.  A person who receives the results of an HIV test pursuant to this subparagraph shall maintain the confidentiality of the information received and of the persons tested. Such confidential information is exempt from s. 119.07(1).

f.  If the source of the exposure will not voluntarily submit to HIV testing and a blood sample is not available, the medical personnel or the employer of such person acting on behalf of the employee may seek a court order directing the source of the exposure to submit to HIV testing. A sworn statement by a physician licensed under chapter 458 or chapter 459 that a significant exposure has occurred and that, in the physician's medical judgment, testing is medically necessary to determine the course of treatment constitutes probable cause for the issuance of an order by the court. The results of the test shall be released to the source of the exposure and to the person who experienced the exposure.

11.  For the performance of an HIV test upon an individual who comes into contact with medical personnel in such a way that a significant exposure has occurred during the course of employment or within the scope of practice of the medical personnel while the medical personnel provides emergency medical treatment to the individual; or who comes into contact with nonmedical personnel in such a way that a significant exposure has occurred while the nonmedical personnel provides emergency medical assistance during a medical emergency. For the purposes of this subparagraph, a medical emergency means an emergency medical condition outside of a hospital or health care facility that provides physician care. The test may be performed only during the course of treatment for the medical emergency.

a.  An individual who is capable of providing consent shall be requested to consent to an HIV test prior to the testing. The individual's refusal to consent, and all information concerning the performance of an HIV test and its result, shall be documented only in the medical personnel's record unless the individual gives written consent to entering this information on the individual's medical record.

b.  HIV testing shall be conducted only after a licensed physician documents, in the medical record of the medical personnel or nonmedical personnel, that there has been a significant exposure and that, in the physician's medical judgment, the information is medically necessary to determine the course of treatment for the medical personnel or nonmedical personnel.

c.  Costs of any HIV test performed with or without the consent of the individual, as provided in this subparagraph, shall be borne by the medical personnel or the employer of the medical personnel or nonmedical personnel. However, costs of testing or treatment not directly related to the initial HIV tests or costs of subsequent testing or treatment shall not be borne by the medical personnel or the employer of the medical personnel or nonmedical personnel.

d.  In order to utilize the provisions of this subparagraph, the medical personnel or nonmedical personnel shall be tested for HIV pursuant to this section or shall provide the results of an HIV test taken within 6 months prior to the significant exposure if such test results are negative.

e.  A person who receives the results of an HIV test pursuant to this subparagraph shall maintain the confidentiality of the information received and of the persons tested. Such confidential information is exempt from s. 119.07(1).

f.  If the source of the exposure will not voluntarily submit to HIV testing and a blood sample was not obtained during treatment for the medical emergency, the medical personnel, the employer of the medical personnel acting on behalf of the employee, or the nonmedical personnel may seek a court order directing the source of the exposure to submit to HIV testing. A sworn statement by a physician licensed under chapter 458 or chapter 459 that a significant exposure has occurred and that, in the physician's medical judgment, testing is medically necessary to determine the course of treatment constitutes probable cause for the issuance of an order by the court. The results of the test shall be released to the source of the exposure and to the person who experienced the exposure.

12.  For the performance of an HIV test by the medical examiner or attending physician upon an individual who expired or could not be resuscitated while receiving emergency medical assistance or care and who was the source of a significant exposure to medical or nonmedical personnel providing such assistance or care.

a.  HIV testing may be conducted only after a licensed physician documents in the medical record of the medical personnel or nonmedical personnel that there has been a significant exposure and that, in the physician's medical judgment, the information is medically necessary to determine the course of treatment for the medical personnel or nonmedical personnel.

b.  Costs of any HIV test performed under this subparagraph may not be charged to the deceased or to the family of the deceased person.

c.  For the provisions of this subparagraph to be applicable, the medical personnel or nonmedical personnel must be tested for HIV under this section or must provide the results of an HIV test taken within 6 months before the significant exposure if such test results are negative.

d.  A person who receives the results of an HIV test pursuant to this subparagraph shall comply with paragraph (e).

13.  For the performance of an HIV-related test medically indicated by licensed medical personnel for medical diagnosis of a hospitalized infant as necessary to provide appropriate care and treatment of the infant when, after a reasonable attempt, a parent cannot be contacted to provide consent. The medical records of the infant shall reflect the reason consent of the parent was not initially obtained. Test results shall be provided to the parent when the parent is located.

14.  For the performance of HIV testing conducted to monitor the clinical progress of a patient previously diagnosed to be HIV positive.

15.  For the performance of repeated HIV testing conducted to monitor possible conversion from a significant exposure.

(4)  COUNTY HEALTH DEPARTMENT NETWORK OF VOLUNTARY HUMAN IMMUNODEFICIENCY VIRUS TESTING PROGRAMS.--

(a)  The Department of Health shall establish a network of voluntary human immunodeficiency virus testing programs in every county in the state. These programs shall be conducted in each health department established under the provisions of part I of chapter 154. Additional programs may be contracted to other private providers to the extent that finances permit and local circumstances dictate.

(b)  Each county health department shall have the ability to provide counseling and testing for human immunodeficiency virus to each patient who receives services and shall offer such testing on a voluntary basis to each patient who presents himself or herself for services in a public health program designated by the State Health Officer by rule.

(c)  Each county health department shall provide a program of counseling and testing for human immunodeficiency virus infection, on both an anonymous and confidential basis. Counseling provided to a patient tested on both an anonymous and confidential basis shall include informing the patient of the availability of partner-notification services, the benefits of such services, and the confidentiality protections available as part of such services. The Department of Health or its designated agent shall continue to provide for anonymous testing through an alternative testing site program with sites throughout all areas of the state. Each county health department shall maintain a list of anonymous testing sites. The list shall include the locations, phone numbers, and hours of operation of the sites and shall be disseminated to all persons and programs offering human immunodeficiency virus testing within the service area of the county health department, including physicians licensed under chapter 458 or chapter 459. Except as provided in this section, the identity of a person upon whom a test has been performed and test results are confidential and exempt from the provisions of s. 119.07(1).

(d)  The result of a serologic test conducted under the auspices of the Department of Health shall not be used to determine if a person may be insured for disability, health, or life insurance or to screen or determine suitability for, or to discharge a person from, employment. Any person who violates the provisions of this subsection is guilty of a misdemeanor of the first degree, punishable as provided in s. 775.082 or s. 775.083.

(5)  HUMAN IMMUNODEFICIENCY VIRUS TESTING REQUIREMENTS; REGISTRATION WITH THE DEPARTMENT OF HEALTH; EXEMPTIONS FROM REGISTRATION.--No county health department and no other person in this state shall conduct or hold themselves out to the public as conducting a testing program for acquired immune deficiency syndrome or human immunodeficiency virus status without first registering with the Department of Health, reregistering each year, complying with all other applicable provisions of state law, and meeting the following requirements:

(a)  The program must be directed by a person with a minimum number of contact hours of experience in the counseling of persons with acquired immune deficiency syndrome or human immunodeficiency virus infection, as established by the Department of Health by rule.

(b)  The program must have all medical care supervised by a physician licensed under the provisions of chapter 458 or chapter 459.

(c)  The program shall have all laboratory procedures performed in a laboratory licensed under the provisions of chapter 483.

(d)  The program must meet all the informed consent criteria contained in subsection (3).

(e)  The program must provide the opportunity for pretest counseling on the meaning of a test for human immunodeficiency virus, including medical indications for the test; the possibility of false positive or false negative results; the potential need for confirmatory testing; the potential social, medical, and economic consequences of a positive test result; and the need to eliminate high-risk behavior.

(f)  The program must provide supplemental corroborative testing on all positive test results before the results of any positive test are provided to the patient. Except as provided in this section, the identity of any person upon whom a test has been performed and test results are confidential and exempt from the provisions of s. 119.07(1).

(g)  The program must provide the opportunity for face-to-face posttest counseling on the meaning of the test results; the possible need for additional testing; the social, medical, and economic consequences of a positive test result; and the need to eliminate behavior which might spread the disease to others.

(h)  Each person providing posttest counseling to a patient with a positive test result shall receive specialized training, to be specified by rule of the department, about the special needs of persons with positive results, including recognition of possible suicidal behavior, and shall refer the patient for further health and social services as appropriate.

(i)  When services are provided for a charge during pretest counseling, testing, supplemental testing, and posttest counseling, the program must provide a complete list of all such charges to the patient and the Department of Health.

(j)  Nothing in this subsection shall be construed to require a facility licensed under chapter 483 or a person licensed under the provisions of chapter 457, chapter 458, chapter 459, chapter 460, chapter 461, chapter 466, or chapter 467 to register with the Department of Health if he or she does not advertise or hold himself or herself out to the public as conducting testing programs for human immunodeficiency virus infection or specializing in such testing.

(k)  The department shall deny, suspend, or revoke the registration of any person or agency that violates this section, or any rule adopted under this section, constituting an emergency affecting the immediate health, safety, and welfare of a person receiving service.

(6)  PENALTIES.--

(a)  Any violation of this section by a facility or licensed health care provider shall be a ground for disciplinary action contained in the facility's or professional's respective licensing chapter.

(b)  Any person who violates the confidentiality provisions of this section and s. 951.27 commits a misdemeanor of the first degree, punishable as provided in s. 775.082 or s. 775.083.

(c)  Any person who obtains information that identifies an individual who has a sexually transmissible disease including human immunodeficiency virus or acquired immunodeficiency syndrome, who knew or should have known the nature of the information and maliciously, or for monetary gain, disseminates this information or otherwise makes this information known to any other person, except by providing it either to a physician or nurse employed by the department or to a law enforcement agency, commits a felony of the third degree, punishable as provided in s. 775.082 or s. 775.083.

(7)  EXEMPTIONS.--Except as provided in paragraph (4)(d) and ss. 627.429 and 641.3007, insurers and others participating in activities related to the insurance application and underwriting process shall be exempt from this section.

(8)  MODEL PROTOCOL FOR COUNSELING AND TESTING FOR HUMAN IMMUNODEFICIENCY VIRUS.--The Department of Health shall develop, by rule, a model protocol consistent with the provisions of this section for counseling and testing persons for the human immunodeficiency virus. The protocol shall include criteria for evaluating a patient's risk for human immunodeficiency virus infection and for offering human immunodeficiency virus testing, on a voluntary basis, as a routine part of primary health care or admission to a health care facility. The Department of Health shall ensure that the protocols developed under this section are made available to health care providers.

(9)  FEES.--

(a)  Each person or private organization registered as an AIDS or HIV testing site shall pay the department a fee which shall be set by rule of the department.

(b)  Fees established pursuant to paragraph (a) shall be an amount sufficient to meet all costs incurred by the department in carrying out its registration, data collection, complaint monitoring, and administrative responsibilities under this section, for all private AIDS or HIV testing sites, but shall not exceed $100.

(c)  No other fees shall be charged by other governmental agencies for these purposes.

(10)  RULES.--The Department of Health may adopt rules to implement this section, including definitions of terms, procedures for accessing confidential information, requirements for testing, and requirements for registered testing sites.

(11)  TESTING AS A CONDITION OF TREATMENT OR ADMISSION.--

(a)  It is unlawful for any facility the operation of which, or for any person engaged in an occupation the practice of which, requires a license by the Agency for Health Care Administration, the Department of Health, or the Department of Business and Professional Regulation, to require any person to take or submit to a human immunodeficiency virus-related test as a condition of admission to any such facility or as a condition of purchasing or obtaining any service or product for which the license is required. This subsection shall not be construed to prohibit any physician in good faith from declining to provide a particular treatment requested by a patient if the appropriateness of that treatment can only be determined through a human immunodeficiency virus-related test.

(b)  The Agency for Health Care Administration, the Department of Health, and the Department of Business and Professional Regulation shall adopt rules implementing this subsection.

(c)  Any violation of this subsection or the rules implementing it shall be punishable as provided in subsection (6).

History.--s. 21, ch. 88-380; s. 2, ch. 89-289; s. 6, ch. 89-350; s. 3, ch. 90-210; s. 3, ch. 90-292; s. 3, ch. 90-344; ss. 17, 67, ch. 91-297; s. 12, ch. 92-33; s. 2, ch. 92-171; s. 64, ch. 92-289; s. 10, ch. 93-227; s. 3, ch. 93-230; s. 4, ch. 93-264; s. 39, ch. 94-218; s. 94, ch. 95-143; s. 1032, ch. 95-148; s. 1, ch. 95-308; s. 1, ch. 95-387; s. 1, ch. 96-179; s. 185, ch. 96-406; s. 64, ch. 97-100; s. 176, ch. 97-101; s. 2, ch. 98-171; s. 20, ch. 98-191; s. 191, ch. 99-13; s. 8, ch. 99-397; s. 4, ch. 2000-242; s. 9, ch. 2000-367; s. 17, ch. 2001-62; s. 6, ch. 2001-91; s. 76, ch. 2001-226; s. 4, ch. 2002-292.

Note.--Former s. 381.609.

381.0041  Donation and transfer of human tissue; testing requirements.--

(1)  Every donation of blood, plasma, organs, skin, or other human tissue for transfusion or transplantation to another shall be tested prior to transfusion or other use for human immunodeficiency virus infection and other communicable diseases specified by rule of the Department of Health. Tests for the human immunodeficiency virus infection shall be performed only after obtaining written, informed consent from the potential donor or the donor's legal representative. Such consent may be given by a minor pursuant to s. 743.06. Obtaining consent shall include a fair explanation of the procedures to be followed and the meaning and use of the test results. Such explanation shall include a description of the confidential nature of the test as described in s. 381.004(3). If consent for testing is not given, then the person shall not be accepted as a donor except as otherwise provided in subsection (3).

(2)  Notwithstanding the provisions of subsection (1), written, informed consent to perform testing shall not be required:

(a)  When the blood, plasma, organ, skin, or other human tissue is received for processing or testing from an out-of-state blood bank;

(b)  When blood or tissue is received from a health care facility or health care provider for reference testing or processing and the results of such test are reported back to the facility or provider; or

(c)  When an unrevoked anatomical gift has been made pursuant to s. 765.514, by will or other written instrument, and the donor is deceased or incompetent.

(3)  No person shall collect any blood, organ, skin, or other human tissue from one human being and hold it for, or actually perform, any implantation, transplantation, transfusion, grafting, or any other method of transfer to another human being without first testing such tissue for the human immunodeficiency virus and other communicable diseases specified by rule of the Department of Health, or without performing another process approved by rule of the Department of Health capable of killing the causative agent of those diseases specified by rule. Such testing shall not be required:

(a)  When there is insufficient time to perform testing because of a life-threatening emergency circumstance and the blood is transferred with the recipient's informed consent.

(b)  For a donation of semen made by the spouse of a recipient for the purposes of artificial insemination or other reproductive procedure.

(c)  When there is insufficient time to obtain the results of a confirmatory test for any tissue or organ which is to be transplanted, notwithstanding the provisions of s. 381.004(3)(d). In such circumstances, the results of preliminary screening tests may be released to the potential recipient's treating physician for use in determining organ or tissue suitability.

(4)  All human blood, organs, skin, or other human tissue which is to be transfused or transplanted to another and is found positive for human immunodeficiency virus or other communicable disease specified by rule of the Department of Health shall be rendered noncommunicable by the person holding the tissue or shall be destroyed, unless the human tissue is specifically labeled to identify the human immunodeficiency virus and:

(a)  Is used for research purposes; or

(b)  Is used to save the life of another and is transferred with the recipient's informed consent.

(5)  Each person who collects human blood, organs, skin, or other human tissue who finds evidence after confirmatory testing of human immunodeficiency virus in the donor shall notify the donor of the presence of the virus. When notifying the donor pursuant to this requirement, the donor shall be provided the following information:

(a)  The meaning of the test results;

(b)  Measures for the prevention of the transmission of the human immunodeficiency virus;

(c)  The availability in the geographic area of any appropriate health care services, including mental health care, and appropriate social and support services;

(d)  The benefits of locating and counseling any individual by whom the infected individual may have been exposed to human immunodeficiency virus and any individual whom the infected individual may have exposed to the virus; and

(e)  The availability, if any, of the services of public health authorities with respect to locating and counseling any individual described in paragraph (d).

(6)  Human immunodeficiency virus tests performed pursuant to autologous blood donations which have not been confirmed as positive by confirmatory testing may be revealed to the donor's treating physician when such test results may be necessary for the diagnosis, treatment, or care of the donor.

(7)  Any blood donor who tests positive for human immunodeficiency virus based upon confirmatory testing shall be notified in the following manner:

(a)  The donor shall be sent written notification by certified mail that abnormal test results exist with respect to his or her blood donation, and the blood bank shall offer the opportunity to discuss the nature and significance of the findings by telephone or in person.

(b)  If the blood bank does not receive a response from the donor within 30 days, it shall send the actual test results and the information required by subsection (5) to the donor by certified mail.

(8)  The Department of Health shall develop, in conjunction with persons who collect human tissue, a model protocol for providing the information required in subsection (5).

(9)  All blood banks shall be governed by the confidentiality provisions of s. 381.004(3).

(10)  The Department of Health is authorized to adopt rules to implement this section. In adopting rules pertaining to this section, the department shall consider the rules of the United States Food and Drug Administration and shall conform to those rules to the extent feasible without jeopardizing the public health.

(11)(a)  Any person who fails to test blood, plasma, organs, skin, or other human tissue which is to be transfused or transplanted, or violates the confidentiality provisions required by this section, is guilty of a misdemeanor of the first degree, punishable as provided in s. 775.082 or s. 775.083.

(b)  Any person who has human immunodeficiency virus infection, who knows he or she is infected with human immunodeficiency virus, and who has been informed that he or she may communicate this disease by donating blood, plasma, organs, skin, or other human tissue who donates blood, plasma, organs, skin, or other human tissue is guilty of a felony of the third degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084.

(12)  Prior to the transplant of an organ or artificial insemination, the institution or physician responsible for overseeing the procedure must provide the prospective recipient a warning as to the risks of contracting human immunodeficiency virus.

History.--s. 22, ch. 88-380; s. 7, ch. 89-350; s. 4, ch. 90-292; s. 4, ch. 90-344; s. 17, ch. 91-297; s. 67, ch. 95-143; s. 650, ch. 95-148; s. 186, ch. 96-406; s. 177, ch. 97-101; s. 77, ch. 2001-226.

Note.--Former s. 381.6105.

381.0042  Patient care for persons with HIV infection.--The department may establish acquired immune deficiency syndrome patient care networks in each region of the state where the numbers of cases of acquired immune deficiency syndrome and other human immunodeficiency virus infections justifies the establishment of cost-effective regional patient care networks. Such networks shall be delineated by rule of the department which shall take into account natural trade areas and centers of medical excellence that specialize in the treatment of acquired immune deficiency syndrome, as well as available federal, state, and other funds. Each patient care network shall include representation of persons with human immunodeficiency virus infection; health care providers; business interests; the department, including, but not limited to, county health departments; and local units of government. Each network shall plan for the care and treatment of persons with acquired immune deficiency syndrome and acquired immune deficiency syndrome related complex in a cost-effective, dignified manner which emphasizes outpatient and home care. Once each year, beginning April 1989, each network shall make its recommendations concerning the needs for patient care to the department.

History.--s. 39, ch. 88-380; s. 17, ch. 91-297; s. 36, ch. 97-101.

Note.--Former s. 381.612.

381.0045  Targeted outreach for pregnant women.--

(1)  This section may be cited as the "Targeted Outreach for Pregnant Women Act of 1998."

(2)  It is the purpose of this section to establish a targeted outreach program for high-risk pregnant women who may not seek proper prenatal care, who suffer from substance abuse problems, or who are infected with human immunodeficiency virus (HIV), and to provide these women with links to much needed services and information.

(3)  The department shall:

(a)  Conduct outreach programs through contracts with, grants to, or other working relationships with persons or entities where the target population is likely to be found.

(b)  Provide outreach that is peer-based, culturally sensitive, and performed in a nonjudgmental manner.

(c)  Encourage high-risk pregnant women of unknown status to be tested for HIV.

(d)  Educate women not receiving prenatal care as to the benefits of such care.

(e)  Provide HIV-infected pregnant women with information so they can make an informed decision about the use of Zidovudine (AZT).

(f)  Link women with substance abuse treatment, when available, and act as a liaison with Healthy Start coalitions, children's medical services, Ryan White-funded providers, and other services of the Department of Health.

(g)  Provide continued oversight to HIV-exposed newborns.

(4)  The types of entities the department is encouraged to contract with, provide grants to, or enter into other working relationships with may include, but are not limited to, faith-based organizations, academic institutions, religious organizations, nonprofit community centers, and other social-services-related entities.

History.--s. 1, ch. 98-307; s. 18, ch. 2001-62.

381.0046  Statewide HIV and AIDS prevention campaign.--

(1)  The Department of Health shall develop and implement a statewide HIV and AIDS prevention campaign that is directed towards minorities who are at risk of HIV infection. The campaign shall include television, radio, and outdoor advertising; public service announcements; and peer-to-peer outreach. Each campaign message and concept shall be evaluated with members of the target group to ensure its effectiveness. The campaign shall provide information on the risk of HIV and AIDS infection and strategies to follow for prevention, early detection, and treatment. The campaign shall use culturally sensitive literature and educational materials and promote the development of individual skills for behavior modification.

(2)  The Department of Health shall establish four positions within the department for HIV and AIDS regional minority coordinators and one position for a statewide HIV and AIDS minority coordinator. The coordinators shall facilitate statewide efforts to implement and coordinate HIV and AIDS prevention and treatment programs. The statewide coordinator shall report directly to the chief of the Bureau of HIV and AIDS within the Department of Health.

(3)  The Department of Health shall, with assistance from the Minority HIV and AIDS Task Force and the statewide coordinator, plan and conduct a statewide Black Leadership Conference on HIV and AIDS by January 2000. The conference shall provide workshops for minority organizations in building skills and improving an organization's capacity to conduct HIV and AIDS prevention and treatment programs.

History.--s. 201, ch. 99-397.

381.005  Primary and preventive health services.--

(1)  The department shall conduct a primary and preventive health care program as part of fulfilling its public health mission. This program shall include, but is not limited to:

(a)  Acute and episodic care in accordance with chapter 154.

(b)  Prenatal and postpartum care in accordance with chapters 154 and 383.

(c)  Child health services in accordance with chapters 154 and 383.

(d)  School health services in accordance with chapters 1003 and 1006.

(e)  Dental health services in accordance with chapter 154 and this chapter.

(f)  Nutrition services in accordance with chapter 154.

(g)  Chronic diseases prevention in accordance with chapter 385.

(h)  Family planning services in accordance with this chapter.

(i)  Childhood immunizations.

(j)  Health education and promotion.

(k)  Regulation of the practice of midwifery.

(2)  The department may adopt, repeal, and amend rules related to the services discussed in this section.

History.--s. 18, ch. 91-297; s. 975, ch. 2002-387.

381.0051  Family planning.--

(1)  SHORT TITLE.--This section shall be known as the "Comprehensive Family Planning Act."

(2)  LEGISLATIVE INTENT.--It is the intent of the Legislature to make available to citizens of the state of childbearing age comprehensive medical knowledge, assistance, and services relating to the planning of families and maternal health care.

(3)  ACCESS TO SERVICES; PROHIBITIONS.--Except as otherwise provided in this section, no medical agency or institution of this state or unit of local government shall interfere with the right of any patient or physician to use medically acceptable contraceptive procedures, supplies, or information or to restrict the physician-patient relationship.

(4)  AUTHORITY AND POWERS.--

(a)  The Department of Health shall implement a comprehensive family planning program which shall be designed to include, but not be limited to, the following:

1.  Comprehensive family planning education and counseling programs.

2.  Prescription for and provision of all medically recognized methods of contraception.

3.  Medical evaluation, including cytological examination and other appropriate laboratory studies.

4.  Treatment of physical complications other than pregnancy resulting from the use of contraceptive methods.

5.  Provision of services at locations and times readily available to the population served.

6.  Emphasis and stress on service to postpartum mothers.

(b)  Services shall be available to all persons desirous of such services, subject to the provisions of this section, at a cost based on a fee schedule prepared and published by the Department of Health. Fees shall be based on the cost of service and ability to pay.

(5)  MINORS; PROVISION OF MATERNAL HEALTH AND CONTRACEPTIVE INFORMATION AND SERVICES.--

(a)  Maternal health and contraceptive information and services of a nonsurgical nature may be rendered to any minor by persons licensed to practice medicine under the provisions of chapter 458 or chapter 459, as well as by the Department of Health through its family planning program, provided the minor:

1.  Is married;

2.  Is a parent;

3.  Is pregnant;

4.  Has the consent of a parent or legal guardian; or

5.  May, in the opinion of the physician, suffer probable health hazards if such services are not provided.

(b)  Application of nonpermanent internal contraceptive devices shall not be deemed a surgical procedure.

(6)  REFUSAL FOR RELIGIOUS OR MEDICAL REASONS.--The provisions of this section shall not be interpreted so as to prevent a physician or other person from refusing to furnish any contraceptive or family planning service, supplies, or information for medical or religious reasons; and the physician or other person shall not be held liable for such refusal.

(7)  RULES.--The Department of Health may adopt rules to implement this section, including rules regarding definitions of terms and requirements for eligibility, informed-consent services, revisits, temporary contraceptive methods, voluntary sterilization, and infertility services.

History.--ss. 1, 2, 3, 4, 5, 6, ch. 72-132; s. 19, ch. 91-297; s. 37, ch. 97-101; s. 9, ch. 99-397; s. 5, ch. 2000-242.

Note.--Former s. 381.382.

381.0052  Dental health.--

(1)  This section shall be known as the "Public Health Dental Program Act."

(2)  It is the intent of the Legislature to make available dental preventive and educational services to the citizens of the state and treatment services to indigent persons.

(3)  The department shall implement a comprehensive dental program which shall be designed to include, but not be limited to:

(a)  Comprehensive preventive and educational programs.

(b)  Comprehensive treatment services, including diagnostic, basic restorative, surgical, pulpal therapy, prophylaxis, and limited prosthetic services.

(4)  Services shall be available to eligible persons in accordance with eligibility criteria developed by the department. Fees for treatment shall be determined by the department.

(5)  The department may adopt rules to implement this section.

History.--s. 20, ch. 91-297.

381.0053  Comprehensive nutrition program.--

(1)  It is the intent of the Legislature to make available nutrition information to promote health and prevent disease for the citizens of the state and to provide nutrition assessment and diet counseling services to improve the nutritional status of indigent persons.

(2)  The department shall implement a comprehensive nutrition program which shall include, but not be limited to, the following:

(a)  Nutritional assessment and diet counseling for persons with nutritional risk factors who are provided health services through public health programs.

(b)  Nutrition education to promote optimum health of the citizens of the state.

(c)  Consultative nutrition services to group care facilities that promote the provision of safe and nutritionally adequate diets.

(3)  Services shall be available to eligible persons in accordance with eligibility criteria adopted by the department. Fees for services shall be developed by the department.

(4)  The department may promulgate rules to implement the provisions of this section.

History.--s. 66, ch. 91-297.

381.0055  Confidentiality and quality assurance activities.--

(1)  All information which is confidential by operation of law and which is obtained by the Department of Health, a county health department, healthy start coalition, or certified rural health network, or a panel or committee assembled by the department, a county health department, healthy start coalition, or certified rural health network pursuant to this section, shall retain its confidential status and be exempt from the provisions of s. 119.07(1) and s. 24(a), Art. I of the State Constitution.

(2)  All information which is confidential by operation of law and which is obtained by a hospital or health care provider from the department, a county health department, healthy start coalition, or certified rural health network, or a panel or committee assembled by the department, a county health department, healthy start coalition, or certified rural health network pursuant to this section, shall retain its confidential status and be exempt from the provisions of s. 119.07(1) and s. 24(a), Art. I of the State Constitution.

(3)  Portions of meetings, proceedings, reports, and records of the department, a county health department, healthy start coalition, or certified rural health network, or a panel or committee assembled by the department, a county health department, healthy start coalition, or certified rural health network pursuant to this section, which relate solely to patient care quality assurance and where specific persons or incidents are discussed are confidential and exempt from the provisions of s. 286.011, and s. 24(b), Art. I of the State Constitution and are confidential and exempt from the provisions of s. 119.07(1) and s. 24(a), Art. I of the State Constitution, respectively.

History.--s. 7, ch. 94-260; s. 187, ch. 96-406; s. 178, ch. 97-101; s. 19, ch. 97-237.

381.0056  School health services program.--

(1)  This section may be cited as the "School Health Services Act."

(2)  The Legislature finds that health services conducted as a part of the total school health program should be carried out to appraise, protect, and promote the health of students. School health services supplement, rather than replace, parental responsibility and are designed to encourage parents to devote attention to child health, to discover health problems, and to encourage use of the services of their physicians, dentists, and community health agencies.

(3)  When used in or for purposes of this section:

(a)  "Emergency health needs" means onsite management and aid for illness or injury pending the student's return to the classroom or release to a parent, guardian, designated friend, or designated health care provider.

(b)  "Entity" or "health care entity" means a unit of local government or a political subdivision of the state; a hospital licensed under chapter 395; a health maintenance organization certified under chapter 641; a health insurer authorized under the Florida Insurance Code; a community health center; a migrant health center; a federally qualified health center; an organization that meets the requirements for nonprofit status under s. 501(c)(3) of the Internal Revenue Code; a private industry or business; or a philanthropic foundation that agrees to participate in a public-private partnership with a county health department, local school district, or school in the delivery of school health services, and agrees to the terms and conditions for the delivery of such services as required by this section and as documented in the local school health services plan.

(c)  "Invasive screening" means any screening procedure in which the skin or any body orifice is penetrated.

(d)  "Physical examination" means a thorough evaluation of the health status of an individual.

(e)  "School health services plan" means the document that describes the services to be provided, the responsibility for provision of the services, the anticipated expenditures to provide the services, and evidence of cooperative planning by local school districts and county health departments.

(f)  "Screening" means presumptive identification of unknown or unrecognized diseases or defects by the application of tests that can be given with ease and rapidity to apparently healthy persons.

(4)  The Department of Health shall have the responsibility, in cooperation with the Department of Education, to supervise the administration of the school health services program and perform periodic program reviews. However, the principal of each school shall have immediate supervisory authority over the health personnel working in the school.

(5)  Each county health department shall develop, jointly with the district school board and the local school health advisory committee, a school health services plan; and the plan shall include, at a minimum, provisions for:

(a)  Health appraisal;

(b)  Records review;

(c)  Nurse assessment;

(d)  Nutrition assessment;

(e)  A preventive dental program;

(f)  Vision screening;

(g)  Hearing screening;

(h)  Scoliosis screening;

(i)  Growth and development screening;

(j)  Health counseling;

(k)  Referral and followup of suspected or confirmed health problems by the local county health department;

(l)  Meeting emergency health needs in each school;

(m)  County health department personnel to assist school personnel in health education curriculum development;

(n)  Referral of students to appropriate health treatment, in cooperation with the private health community whenever possible;

(o)  Consultation with a student's parent or guardian regarding the need for health attention by the family physician, dentist, or other specialist when definitive diagnosis or treatment is indicated;

(p)  Maintenance of records on incidents of health problems, corrective measures taken, and such other information as may be needed to plan and evaluate health programs; except, however, that provisions in the plan for maintenance of health records of individual students must be in accordance with s. 1002.22;

(q)  Health information which will be provided by the school health nurses, when necessary, regarding the placement of students in exceptional student programs and the reevaluation at periodic intervals of students placed in such programs; and

(r)  Notification to the local nonpublic schools of the school health services program and the opportunity for representatives of the local nonpublic schools to participate in the development of the cooperative health services plan.

(6)  A nonpublic school may request to participate in the school health services program. A nonpublic school voluntarily participating in the school health services program shall:

(a)  Cooperate with the county health department and district school board in the development of the cooperative health services plan;

(b)  Make available adequate physical facilities for health services;

(c)  Provide inservice health training to school personnel;

(d)  Cooperate with public health personnel in the implementation of the school health services plan;

(e)  Be subject to health service program reviews by the Department of Health and the Department of Education; and

(f)  At the beginning of each school year, inform parents or guardians in writing that their children who are students in the school will receive specified health services as provided for in the district health services plan. A student will be exempt from any of these services if his or her parent or guardian requests such exemption in writing. This paragraph shall not be construed to authorize invasive screening; if there is a need for such procedure, the consent of the student's parent or guardian shall be obtained in writing prior to performing the screening. However, the laws and rules relating to contagious or communicable diseases and sanitary matters shall not be violated.

(7)  The district school board shall:

(a)  Include health services and health education as part of the comprehensive plan for the school district;

(b)  Provide inservice health training for school personnel;

(c)  Make available adequate physical facilities for health services; and

(d)  At the beginning of each school year, inform parents or guardians in writing that their children who are students in the district schools will receive specified health services as provided for in the district health services plan. A student will be exempt from any of these services if his or her parent or guardian requests such exemption in writing. This paragraph shall not be construed to authorize invasive screening; if there is a need for such procedure, the consent of the student's parent or guardian shall be obtained in writing prior to performing the screening. However, the laws and rules relating to contagious or communicable diseases and sanitary matters shall not be violated.

(8)  The Department of Health, in cooperation with the Department of Education, may adopt rules necessary to implement this section. The rules may include standards and requirements for developing school health services plans, conducting school health screening, meeting emergency health needs, maintaining school health records, and coordinating with education programs for exceptional students.

(9)  In the absence of negligence, no person shall be liable for any injury caused by an act or omission in the administration of school health services.

(10)  Any health care entity that provides school health services under contract with the department pursuant to a school health services plan developed under this section, and as part of a school nurse services public-private partnership, is deemed to be a corporation acting primarily as an instrumentality of the state solely for the purpose of limiting liability pursuant to s. 768.28(5). The limitations on tort actions contained in s. 768.28(5) shall apply to any action against the entity with respect to the provision of school health services, if the entity is acting within the scope of and pursuant to guidelines established in the contract or by rule of the department. The contract must require the entity, or the partnership on behalf of the entity, to obtain general liability insurance coverage, with any additional endorsement necessary to insure the entity for liability assumed by its contract with the department. The Legislature intends that insurance be purchased by entities, or by partnerships on behalf of the entity, to cover all liability claims, and under no circumstances shall the state or the department be responsible for payment of any claims or defense costs for claims brought against the entity or its subcontractor for services performed under the contract with the department. This subsection does not preclude consideration by the Legislature for payment by the state of any claims bill involving an entity contracting with the department pursuant to this section.

(11)  School health programs funded by health care districts or entities defined in subsection (3) must be supplementary to and consistent with the requirements of this section and ss. 381.0057 and 381.0059.

History.--ss. 1, 2, 3, 4, 5, 6, 7, 9, ch. 74-356; s. 1, ch. 77-174; s. 2, ch. 78-245; s. 15, ch. 79-288; s. 1, ch. 81-18; s. 21, ch. 84-317; s. 50, ch. 85-81; s. 1, ch. 90-344; s. 812, ch. 95-148; s. 101, ch. 97-101; s. 48, ch. 97-237; s. 28, ch. 99-5; s. 1, ch. 99-214; s. 6, ch. 2000-242; s. 5, ch. 2001-53; s. 976, ch. 2002-387.

Note.--Former s. 402.32.

381.0057  Funding for school health services.--

(1)  It is the intent of the Legislature that funds in addition to those provided under the School Health Services Act be provided to those school districts and schools where there is a high incidence of medically underserved high-risk children, low birthweight babies, infant mortality, or teenage pregnancy. The purpose of this funding is to phase in those programs which offer the greatest potential for promoting the health of students and reducing teenage pregnancy.

(2)  The Secretary of Health, or his or her designee, in cooperation with the Commissioner of Education, or his or her designee, shall publicize the availability of funds, targeting those school districts or schools which have a high incidence of medically underserved high-risk children, low birthweight babies, infant mortality, or teenage pregnancy.

(3)  The Secretary of Health, or his or her designees, in cooperation with the Commissioner of Education, or his or her designees, in equal representation, shall form a joint committee to evaluate and select the school districts or schools to be funded.

(4)  Any school district, school, or laboratory school which desires to receive state funding under the provisions of this section shall submit a proposal to the joint committee established in subsection (3). The proposal shall state the goals of the program, provide specific plans for reducing teenage pregnancy, and describe all of the health services to be available to students with funds provided pursuant to this section, including a combination of initiatives such as health education, counseling, extracurricular, and self-esteem components. School health services shall not promote elective termination of pregnancy as a part of counseling services. Only those program proposals which have been developed jointly by county health departments and local school districts or schools, and which have community and parental support, shall be eligible for funding. Funding shall be available specifically for implementation of one of the following programs:

(a)  School health improvement pilot project.--The program shall include basic health care to an elementary school, middle school, and high school feeder system. Program services shall include, but not be limited to:

1.  Planning, implementing, and evaluating school health services. Staffing shall include a full-time, trained school health aide in each elementary, middle, and high school; one full-time nurse to supervise the aides in the elementary and middle schools; and one full-time nurse in each high school.

2.  Providing student health appraisals and identification of actual or potential health problems by screenings, nursing assessments, and record reviews.

3.  Expanding screening activities.

4.  Improving the student utilization of school health services.

5.  Coordinating health services for students with parents or guardians and other agencies in the community.

(b)  Student support services team program.--The program shall include a multidisciplinary team composed of a psychologist, social worker, and nurse whose responsibilities are to provide basic support services and to assist, in the school setting, children who exhibit mild to severely complex health, behavioral, or learning problems affecting their school performance. Support services shall include, but not be limited to: evaluation and treatment for minor illnesses and injuries, referral and followup for serious illnesses and emergencies, onsite care and consultation, referral to a physician, and followup care for pregnancy or chronic diseases and disorders as well as emotional or mental problems. Services also shall include referral care for drug and alcohol abuse and sexually transmitted diseases, sports and employment physicals, immunizations, and in addition, effective preventive services aimed at delaying early sexual involvement and aimed at pregnancy, acquired immune deficiency syndrome, sexually transmitted diseases, and destructive lifestyle conditions, such as alcohol and drug abuse. Moneys for this program shall be used to fund three teams, each consisting of one half-time psychologist, one full-time nurse, and one full-time social worker. Each team shall provide student support services to an elementary school, middle school, and high school that are a part of one feeder school system and shall coordinate all activities with the school administrator and guidance counselor at each school. A program which places all three teams in middle schools or high schools may also be proposed.

(c)  Full service schools.--The full-service schools shall integrate the services of the Department of Health that are critical to the continuity-of-care process. The department shall provide services to students on the school grounds. Department personnel shall provide their specialized services as an extension of the educational environment. Such services may include nutritional services, medical services, aid to dependent children, parenting skills, counseling for abused children, and education for the students' parents or guardians.

Funding may also be available for any other program that is comparable to a program described in this subsection but is designed to meet the particular needs of the community.

(5)  In addition to the merits of a proposal, selection shall be based on those school districts or schools that most closely meet the following criteria:

(a)  Have evidence of a comprehensive inservice staff development plan to ensure delivery of appropriate curriculum.

(b)  Have evidence of a cooperative working relationship between the county health department and the school district or school and have community as well as parental support.

(c)  Have a high percentage of subsidized school lunches.

(d)  Have a high incidence of medically underserved high-risk children, low birthweight babies, infant mortality, or teenage pregnancy.

(6)  Each school district or school program that is funded through the provisions of this section shall provide a mechanism through which a parent may, by written request, exempt a child from all or certain services provided by a school health services program described in subsection (4).

(7)  The services provided by a comprehensive school health program must focus attention on promoting the health of students, reducing risk-taking behavior, and reducing teen pregnancy. Services provided under this section are in addition to the services provided under s. 381.0056 and are intended to supplement, rather than supplant, those services.

History.--s. 6, ch. 90-358; s. 21, ch. 95-146; s. 813, ch. 95-148; s. 102, ch. 97-101; s. 49, ch. 97-237; s. 7, ch. 2000-242.

Note.--Former s. 402.321.

381.0059  Background screening requirements for school health services personnel.--

(1)  Pursuant to the provisions of chapter 435, any person who provides services under a school health services plan pursuant to s. 381.0056 must meet level 2 screening requirements as described in s. 435.04. A person may satisfy the requirements of this subsection by submitting proof of compliance with the requirements of level 2 screening conducted within 12 months before the date that person initially provides services under a school health services plan.

(2)  A person may provide services under a school health services plan pursuant to s. 381.0056 prior to the completion of level 2 screening. However, pending the results of the screening, such person may not be alone with a minor.

(3)  As provided in s. 435.07, the Department of Health may grant an exemption from disqualification to provide services under a school health services plan pursuant to s. 381.0056.

(4)  Under penalty of perjury, each person who provides services under a school health plan pursuant to s. 381.0056 must attest to meeting the level 2 screening requirements for participation under the plan and agree to inform his or her employer immediately if convicted of any disqualifying offense while providing services under a plan.

(5)  As used in this section, the term "person who provides services under a school health services plan" includes unpaid volunteers, except for an unpaid volunteer who lectures students in group settings on health education topics.

History.--s. 2, ch. 99-214; s. 58, ch. 2000-349; s. 10, ch. 2000-367; s. 6, ch. 2001-53.

381.00591  Department of Health; National Environmental Laboratory accreditation; application; rules.--The Department of Health may apply for and become a National Environmental Laboratory Accreditation Program accrediting authority. The department, as an accrediting entity, may adopt rules pursuant to ss. 120.536(1) and 120.54, to implement standards of the National Environmental Laboratory Accreditation Program, including requirements for proficiency testing providers and other rules that are not inconsistent with this section, including rules pertaining to fees, application procedures, standards applicable to environmental or public water supply laboratories, and compliance.

History.--s. 54, ch. 99-397.

381.00593  Public school volunteer health care practitioner program.--

(1)  This section may be cited as the "Public School Volunteer Health Care Practitioner Act."

(2)  The purpose of this section is to establish a public school volunteer health care practitioner program with incentives and coordinate the program with the "School Health Services Act," pursuant to s. 381.0056, in order to encourage health care practitioners to provide their services, without compensation, in the public schools; and such program is intended to complement other programs designed to provide health services or increase the level of health care in the public schools.

(3)  For purposes of this section, the term "health care practitioner" means a physician licensed under chapter 458; an osteopathic physician licensed under chapter 459; a chiropractic physician licensed under chapter 460; a podiatric physician licensed under chapter 461; an optometrist licensed under chapter 463; an advanced registered nurse practitioner, registered nurse, or licensed practical nurse licensed under part I of chapter 464; a pharmacist licensed under chapter 465; a dentist or dental hygienist licensed under chapter 466; a midwife licensed under chapter 467; a speech-language pathologist or audiologist licensed under part I of chapter 468; or a physical therapist licensed under chapter 486.

(4)(a)  Notwithstanding any provision of chapter 458, chapter 459, chapter 460, chapter 461, chapter 463, part I of chapter 464, chapter 465, chapter 466, chapter 467, part I of chapter 468, or chapter 486 to the contrary, any health care practitioner who participates in the program established in this section and thereby agrees to provide his or her services, without compensation, in a public school for at least 80 hours a year for each school year during the biennial licensure period, or, if the health care practitioner is retired, for at least 400 hours a year for each school year during the licensure period, upon providing sufficient proof from the applicable school district that the health care practitioner has completed such hours at the time of license renewal under procedures specified by the Department of Health, shall be eligible for the following:

1.  Waiver of the biennial license renewal fee for an active license; and

2.  Fulfillment of a maximum of 25 percent of the continuing education hours required for license renewal, pursuant to s. 456.013(9).

The school district may establish a schedule for health care practitioners who participate in the program.

(b)  A health care practitioner must complete all forms and procedures for participation in the program prior to the applicable license renewal date.

(5)  To participate in the program, a health care practitioner must:

(a)  Have a valid, active license to practice his or her profession in this state.

(b)  Submit fingerprints and have a background screening in accordance with the requirements of s. 381.0059, unless already provided and completed for practitioner licensing, profiling, or credentialing purposes.

(6)  The school district, through its self-insurance program, shall bear the cost of any increase in premiums for liability protection for health care practitioners participating in the program other than those employed by the school or school district.

(7)(a)  The Department of Health shall have the responsibility to supervise the program and perform periodic program reviews as provided in s. 381.0056(4).

(b)  The Department of Health, in cooperation with the Department of Education, shall publicize the availability of the program and its benefits.

(8)  The Department of Health, in cooperation with the Department of Education, may adopt rules necessary to implement this section. The rules shall include the forms to be completed and procedures to be followed by applicants and school personnel under the program.

(9)  The provisions of this section shall be implemented to the extent of specific appropriations contained in the annual General Appropriations Act for such purpose.

History.--s. 9, ch. 2002-230.

381.006  Environmental health.--The department shall conduct an environmental health program as part of fulfilling the state's public health mission. The purpose of this program is to detect and prevent disease caused by natural and manmade factors in the environment. The environmental health program shall include, but not be limited to:

(1)  A drinking water function.

(2)  An environmental health surveillance function which shall collect, compile, and correlate information on public health and exposure to hazardous substances through sampling and testing of water, air, or foods. Environmental health surveillance shall include a comprehensive assessment of drinking water under the department's supervision and an indoor air quality testing and monitoring program to assess health risks from exposure to chemical, physical, and biological agents in the indoor environment.

(3)  A toxicology and hazard assessment function which shall conduct toxicological and human health risk assessments of exposure to toxic agents, for the purposes of:

(a)  Supporting determinations by the State Health Officer of safe levels of contaminants in water, air, or food if applicable standards or criteria have not been adopted. These determinations shall include issuance of health advisories to protect the health and safety of the public at risk from exposure to toxic agents.

(b)  Provision of human toxicological health risk assessments to the public and other governmental agencies to characterize the risks to the public from exposure to contaminants in air, water, or food.

(c)  Consultation and technical assistance to the Department of Environmental Protection and other governmental agencies on actions necessary to ameliorate exposure to toxic agents, including the emergency provision by the Department of Environmental Protection of drinking water in cases of drinking water contamination that present an imminent and substantial threat to the public's health, as required by s. 376.30(3)(c)1.a.

(d)  Monitoring and reporting the body burden of toxic agents to estimate past exposure to these toxic agents, predict future health effects, and decrease the incidence of poisoning by identifying and eliminating exposure.

(4)  A sanitary nuisance function, as that term is defined in chapter 386.

(5)  A migrant labor function.

(6)  A public facilities function, including sanitary practices relating to state, county, municipal, and private institutions serving the public; jointly with the Department of Education, publicly and privately owned schools; all places used for the incarceration of prisoners and inmates of state institutions for the mentally ill; toilets and washrooms in all public places and places of employment; any other condition, place, or establishment necessary for the control of disease or the protection and safety of public health.

(7)  An onsite sewage treatment and disposal function.

(8)  A biohazardous waste control function.

(9)  A function to control diseases transmitted from animals to humans, including the segregation, quarantine, and destruction of domestic pets and wild animals having or suspected of having such diseases.

(10)  An environmental epidemiology function which shall investigate food-borne disease, waterborne disease, and other diseases of environmental causation, whether of chemical, radiological, or microbiological origin. A $10 surcharge for this function shall be assessed upon all persons permitted under chapter 500. This function shall include an educational program for physicians and health professionals designed to promote surveillance and reporting of environmental diseases, and to further the dissemination of knowledge about the relationship between toxic substances and human health which will be useful in the formulation of public policy and will be a source of information for the public.

(11)  Mosquito and pest control functions as provided in chapters 388 and 482.

(12)  A radiation control function as provided in chapter 404 and part IV of chapter 468.

(13)  A public swimming and bathing facilities function as provided in chapter 514.

(14)  A mobile home park, lodging park, recreational vehicle park, and recreational camp function as provided in chapter 513.

(15)  A sanitary facilities function, which shall include minimum standards for the maintenance and sanitation of sanitary facilities; public access to sanitary facilities; and fixture ratios for special or temporary events and for homeless shelters.

(16)  A group-care-facilities function, where a group-care facility means any public or private school, housing, building or buildings, section of a building, or distinct part of a building or other place, whether operated for profit or not, which undertakes, through its ownership or management, to provide one or more personal services, care, protection, and supervision to persons who require such services and who are not related to the owner or administrator. The department may adopt rules necessary to protect the health and safety of residents, staff, and patrons of group-care facilities, such as child care facilities, family day-care homes, assisted-living facilities, adult day-care centers, adult family-care homes, hospices, residential treatment facilities, crisis-stabilization units, pediatric extended-care centers, intermediate-care facilities for the developmentally disabled, group-care homes, and, jointly with the Department of Education, private and public schools. These rules may include definitions of terms; provisions relating to operation and maintenance of facilities, buildings, grounds, equipment, furnishings, and occupant-space requirements; lighting; heating, cooling, and ventilation; food service; water supply and plumbing; sewage; sanitary facilities; insect and rodent control; garbage; safety; personnel health, hygiene, and work practices; and other matters the department finds are appropriate or necessary to protect the safety and health of the residents, staff, or patrons. The department may not adopt rules that conflict with rules adopted by the licensing or certifying agency. The department may enter and inspect at reasonable hours to determine compliance with applicable statutes or rules. In addition to any sanctions that the department may impose for violations of rules adopted under this section, the department shall also report such violations to any agency responsible for licensing or certifying the group-care facility. The licensing or certifying agency may also impose any sanction based solely on the findings of the department.

The department may adopt rules to carry out the provisions of this section.

History.--s. 21, ch. 91-297; s. 1, ch. 92-180; s. 27, ch. 93-150; s. 4, ch. 93-151; s. 351, ch. 94-356; s. 5, ch. 98-151; s. 10, ch. 99-397; s. 17, ch. 2000-141; s. 8, ch. 2000-242; s. 34, ch. 2001-186; s. 3, ch. 2001-372.

381.0061  Administrative fines.--

(1)  In addition to any administrative action authorized by chapter 120 or by other law, the department may impose a fine, which shall not exceed $500 for each violation, for a violation of s. 381.006(16), s. 381.0065, s. 381.0066, s. 381.0072, or part III of chapter 489, for a violation of any rule adopted under this chapter, or for a violation of any of the provisions of chapter 386. Notice of intent to impose such fine shall be given by the department to the alleged violator. Each day that a violation continues may constitute a separate violation.

(2)  In determining the amount of fine to be imposed, if any, for a violation, the following factors shall be considered:

(a)  The gravity of the violation, including the probability that death or serious physical or emotional harm to any person will result or has resulted, the severity of the actual or potential harm, and the extent to which the provisions of the applicable statutes or rules were violated.

(b)  Actions taken by the owner or operator to correct violations.

(c)  Any previous violations.

(3)  All amounts collected under this section shall be deposited into an appropriate trust fund of the department.

History.--s. 4, ch. 80-351; s. 2, ch. 85-300; s. 13, ch. 89-324; s. 22, ch. 91-297; s. 7, ch. 92-180; s. 11, ch. 99-397.

Note.--Former s. 381.112.

381.0062  Supervision; private and certain public water systems.--

(1)  LEGISLATIVE INTENT.--It is the intent of the Legislature to protect the public's health by establishing standards for the construction, modification, and operation of public and private water systems to assure consumers that the water provided by those systems is potable.

(2)  DEFINITIONS.--As used in this section:

(a)  "Contaminant" means any physical, biological, chemical, or radiological substance or matter in water.

(b)  "Department" means the Department of Health, including the county health departments.

(c)  "Florida Safe Drinking Water Act" means part VI of chapter 403.

(d)  "Health hazard" means any condition, contaminant, device, or practice in a water system or its operation which will create or has the potential to create an acute or chronic threat to the health and well-being of the water consumer.

(e)  "Limited use commercial public water system" means a public water system not covered or included in the Florida Safe Drinking Water Act, which serves one or more nonresidential establishments and provides piped water.

(f)  "Limited use community public water system" means a public water system not covered or included in the Florida Safe Drinking Water Act, which serves five or more residences or two or more rental residences, and provides piped water.

(g)  "Maximum contaminant level" means the maximum permissible level of a contaminant in potable water delivered to consumers.

(h)  "Multifamily water system" means a water system that provides piped water to three or four residences, one of which may be a rental residence.

(i)  "Person" means an individual, public or private corporation, company, association, partnership, municipality, agency of the state, district, federal, or any other legal entity, or its legal representative, agent, or assignee.

(j)  "Potable water" means water that is satisfactory for human consumption, dermal contact, culinary purposes, or dishwashing as approved by the department.

(k)  "Private water system" means a water system that provides piped water for one or two residences, one of which may be a rental residence.

(l)  "Public consumption" means oral ingestion or physical contact with water by a person for any purpose other than cleaning work areas or simple handwashing. Examples of public consumption include, when making food or beverages available to the general public, water used for washing food, cooking utensils, or food service areas and water used for preparing food or beverages; washing surfaces accessed by children as in a child care center or similar setting; washing medical instruments or surfaces accessed by a patient; any water usage in health care facilities; emergency washing devices such as eye washing sinks; washing in food processing plants or establishments like slaughterhouses and packinghouses; and water used in schools.

(m)  "Public water system" means a water system that is not included or covered under the Florida Safe Drinking Water Act, provides piped water to the public, and is not a private or multifamily water system. For purposes of this section, public water systems are classified as limited use community or limited use commercial.

(n)  "Supplier of water" means the person, company, or corporation that owns or operates a limited use community or limited use commercial public water system, a multifamily water system, or a private water system.

(o)  "Variance" means a sanction from the department affording a supplier of water an extended time to correct a maximum contaminant level violation caused by the raw water or to deviate from construction standards established by rule of the department.

(3)  SUPERVISION.--The department and its agents shall have general supervision and control over all private water systems, multifamily water systems, and public water systems not covered or included in the Florida Safe Drinking Water Act (part VI of chapter 403), and over those aspects of the public water supply program for which it has the duties and responsibilities provided for in part VI of chapter 403. The department shall:

(a)  Administer and enforce the provisions of this section and all rules and orders adopted or issued under this section, including water quality and monitoring standards.

(b)  Require any person wishing to construct, modify, or operate a limited use community or limited use commercial public water system or a multifamily water system to first make application to and obtain approval from the department on forms adopted by rule of the department.

(c)  Review and act upon any application for the construction, modification, operation, or change of ownership of, and conduct surveillance, enforcement, and compliance investigations of, limited use community and limited use commercial public water systems, and multifamily water systems.

(d)  Require a fee from the supplier of water in an amount sufficient to cover the costs of reviewing and acting upon any application for the construction, modification, or operation of a limited use community and limited use commercial public water system, of not less than $10 or more than $90 annually.

(e)  Require a fee from the supplier of water in an amount sufficient to cover the costs of reviewing and acting upon any application for the construction or change of ownership of a multifamily water system, of not less than $10 or more than $90.

(f)  Require a fee from the supplier of water in an amount sufficient to cover the costs of sample collection, review of analytical results, health-risk interpretations, and coordination with other agencies when such work is not included in paragraphs (b) and (c) and is requested by the supplier of water, of not less than $10 or more than $90.

(g)  Require suppliers of water to collect samples of water, to submit such samples to a department-certified drinking water laboratory for contaminant analysis, and to keep sampling records as required by rule of the department.

(h)  Require all fees collected by the department in accordance with the provisions of this section to be deposited in an appropriate trust fund of the department, and used exclusively for the payment of costs incurred in the administration of this section.

(i)  Prohibit any supplier of water from, intentionally or otherwise, introducing any contaminant which poses a health hazard into a drinking water system.

(j)  Require suppliers of water to give public notice of water problems and corrective measures under the conditions specified by rule of the department.

(k)  Require a fee to cover the cost of reinspection of any system regulated under this section, which may not be less than $25 or more than $40.

(4)  RIGHT OF ENTRY.--For purposes of this section, department personnel may enter, at any reasonable time and if they have reasonable cause to believe a violation of this section is occurring or about to occur, upon any and all parts of the premises of such limited use public and multifamily drinking water systems, to make an examination and investigation to determine the sanitary and safety conditions of such systems. Any person who interferes with, hinders, or opposes any employee of the department in the discharge of his or her duties pursuant to the provisions of this section is subject to the penalties provided in s. 381.0025.

(5)  ENFORCEMENT AND PENALTIES.--

(a)  Any person who constructs, modifies, or operates a limited use community or limited use commercial public water system, a multifamily water system, or a private water system, without first complying with the requirements of this section, who operates a water system in violation of department order, or who maintains or operates a water system after revocation of the permit is guilty of a misdemeanor of the second degree, punishable as provided in s. 775.082 or s. 775.083.

(b)  This section and rules adopted pursuant to this section may be enforced by injunction or restraining order granted by a circuit court as provided in s. 381.0012(2).

(c)  Additional remedies available to county health department staff through any county or municipal ordinance may be applied, over and above the penalties set forth in this section, to any violation of this section or the rules adopted pursuant to this section.

(6)  VARIANCES AND EXEMPTIONS.--

(a)  The department may grant variances and exemptions from the rules adopted under this section through procedures set forth by the rule of the department.

(b)  Any establishment with a limited use commercial public water system which does not make tap water available for public consumption and meets the water quality standards and installation requirements established by the department shall be exempt from obtaining an annual operating permit from the department, if the supplier of water:

1.  Registers with the department; if the establishment changes ownership or business activity, it must register; and pay a $15 registration fee; and

2.  Performs an initial water quality clearance of the water supply system.

A system exempt under this subsection may, in order to retain potable water status, conduct annual testing for bacteria in the form of one satisfactory microbiological sample per calendar year.

History.--s. 2, ch. 29834, 1955; ss. 19, 35, ch. 69-106; s. 69, ch. 77-147; s. 16, ch. 77-337; s. 68, ch. 90-331; s. 23, ch. 91-297; s. 1, ch. 93-50; s. 651, ch. 95-148; s. 14, ch. 96-303; s. 179, ch. 97-101; s. 20, ch. 97-237; s. 6, ch. 98-151; s. 12, ch. 99-397; s. 9, ch. 2000-242.

Note.--Former s. 381.261.

381.0063  Drinking water funds.--All fees and penalties received from suppliers of water pursuant to ss. 403.860(5) and 403.861(8) shall be deposited in the appropriate County Health Department Trust Fund to be used by the department to pay the costs of expenditures required pursuant to ss. 381.0062 and 403.862(1)(c).

History.--s. 69, ch. 90-331; s. 24, ch. 91-297; s. 21, ch. 91-305; s. 38, ch. 97-101.

Note.--Former s. 381.2615.

381.0064  Continuing education courses for persons installing or servicing septic tanks.--

(1)  The Department of Health shall establish a program for continuing education which meets the purposes of ss. 381.0101 and 489.554 regarding the public health and environmental effects of onsite sewage treatment and disposal systems and any other matters the department determines desirable for the safe installation and use of onsite sewage treatment and disposal systems. The department may charge a fee to cover the cost of such program.

(2)  The department shall by rule establish criteria for the approval of continuing education courses and providers, including requirements relating to the content of courses and standards for approval of providers, and may by rule establish criteria for accepting alternative nonclassroom continuing education on an hour-for-hour basis.

(3)  Septic tank contractors and master septic tank contractors registered under part III of chapter 489 shall meet the continuing education requirements set forth in s. 489.554.

History.--ss. 1, 2, 3, ch. 85-314; s. 59, ch. 91-224; s. 25, ch. 91-297; s. 5, ch. 93-151; s. 9, ch. 96-303; s. 180, ch. 97-101; s. 1, ch. 98-420.

Note.--Former s. 381.262.

381.0065  Onsite sewage treatment and disposal systems; regulation.--

(1)  LEGISLATIVE INTENT.--It is the intent of the Legislature that where a publicly owned or investor-owned sewerage system is not available, the department shall issue permits for the construction, installation, modification, abandonment, or repair of onsite sewage treatment and disposal systems under conditions as described in this section and rules adopted under this section. It is further the intent of the Legislature that the installation and use of onsite sewage treatment and disposal systems not adversely affect the public health or significantly degrade the groundwater or surface water.

(2)  DEFINITIONS.--As used in ss. 381.0065-381.0067, the term:

(a)  "Available," as applied to a publicly owned or investor-owned sewerage system, means that the publicly owned or investor-owned sewerage system is capable of being connected to the plumbing of an establishment or residence, is not under a Department of Environmental Protection moratorium, and has adequate permitted capacity to accept the sewage to be generated by the establishment or residence; and:

1.  For a residential subdivision lot, a single-family residence, or an establishment, any of which has an estimated sewage flow of 1,000 gallons per day or less, a gravity sewer line to maintain gravity flow from the property's drain to the sewer line, or a low pressure or vacuum sewage collection line in those areas approved for low pressure or vacuum sewage collection, exists in a public easement or right-of-way that abuts the property line of the lot, residence, or establishment.

2.  For an establishment with an estimated sewage flow exceeding 1,000 gallons per day, a sewer line, force main, or lift station exists in a public easement or right-of-way that abuts the property of the establishment or is within 50 feet of the property line of the establishment as accessed via existing rights-of-way or easements.

3.  For proposed residential subdivisions with more than 50 lots, for proposed commercial subdivisions with more than 5 lots, and for areas zoned or used for an industrial or manufacturing purpose or its equivalent, a sewerage system exists within one-fourth mile of the development as measured and accessed via existing easements or rights-of-way.

4.  For repairs or modifications within areas zoned or used for an industrial or manufacturing purpose or its equivalent, a sewerage system exists within 500 feet of an establishment's or residence's sewer stub-out as measured and accessed via existing rights-of-way or easements.

(b)  "Blackwater" means that part of domestic sewage carried off by toilets, urinals, and kitchen drains.

(c)  "Domestic sewage" means human body waste and wastewater, including bath and toilet waste, residential laundry waste, residential kitchen waste, and other similar waste from appurtenances at a residence or establishment.

(d)  "Graywater" means that part of domestic sewage that is not blackwater, including waste from the bath, lavatory, laundry, and sink, except kitchen sink waste.

(e)  "Florida Keys" means those islands of the state located within the boundaries of Monroe County.

(f)  "Injection well" means an open vertical hole at least 90 feet in depth, cased and grouted to at least 60 feet in depth which is used to dispose of effluent from an onsite sewage treatment and disposal system.

(g)  "Innovative system" means an onsite sewage treatment and disposal system that, in whole or in part, employs materials, devices, or techniques that are novel or unique and that have not been successfully field-tested under sound scientific and engineering principles under climatic and soil conditions found in this state.

(h)  "Lot" means a parcel or tract of land described by reference to recorded plats or by metes and bounds, or the least fractional part of subdivided lands having limited fixed boundaries or an assigned number, letter, or any other legal description by which it can be identified.

(i)  "Mean annual flood line" means the elevation determined by calculating the arithmetic mean of the elevations of the highest yearly flood stage or discharge for the period of record, to include at least the most recent 10-year period. If at least 10 years of data is not available, the mean annual flood line shall be as determined based upon the data available and field verification conducted by a certified professional surveyor and mapper with experience in the determination of flood water elevation lines or, at the option of the applicant, by department personnel. Field verification of the mean annual flood line shall be performed using a combination of those indicators listed in subparagraphs 1.-7. that are present on the site, and that reflect flooding that recurs on an annual basis. In those situations where any one or more of these indicators reflect a rare or aberrant event, such indicator or indicators shall not be utilized in determining the mean annual flood line. The indicators that may be considered are:

1.  Water stains on the ground surface, trees, and other fixed objects;

2.  Hydric adventitious roots;

3.  Drift lines;

4.  Rafted debris;

5.  Aquatic mosses and liverworts;

6.  Moss collars; and

7.  Lichen lines.

(j)  "Onsite sewage treatment and disposal system" means a system that contains a standard subsurface, filled, or mound drainfield system; an aerobic treatment unit; a graywater system tank; a laundry wastewater system tank; a septic tank; a grease interceptor; a pump tank; a solids or effluent pump; a waterless, incinerating, or organic waste-composting toilet; or a sanitary pit privy that is installed or proposed to be installed beyond the building sewer on land of the owner or on other land to which the owner has the legal right to install a system. The term includes any item placed within, or intended to be used as a part of or in conjunction with, the system. This term does not include package sewage treatment facilities and other treatment works regulated under chapter 403.

(k)  "Permanent nontidal surface water body" means a perennial stream, a perennial river, an intermittent stream, a perennial lake, a submerged marsh or swamp, a submerged wooded marsh or swamp, a spring, or a seep, as identified on the most recent quadrangle map, 7.5 minute series (topographic), produced by the United States Geological Survey. "Permanent nontidal surface water body" shall also mean an artificial surface water body that does not have an impermeable bottom and side and that is designed to hold, or does hold, visible standing water for at least 180 days of the year. However, a nontidal surface water body that is drained, either naturally or artificially, where the intent or the result is that such drainage be temporary, shall be considered a permanent nontidal surface water body. A nontidal surface water body that is drained of all visible surface water, where the lawful intent or the result of such drainage is that such drainage will be permanent, shall not be considered a permanent nontidal surface water body. The boundary of a permanent nontidal surface water body shall be the mean annual flood line.

(l)  "Potable water line" means any water line that is connected to a potable water supply source, but the term does not include an irrigation line with any of the following types of backflow devices:

1.  For irrigation systems into which chemicals are not injected, any atmospheric or pressure vacuum breaker or double check valve or any detector check assembly.

2.  For irrigation systems into which chemicals such as fertilizers, pesticides, or herbicides are injected, any reduced pressure backflow preventer.

(m)  "Septage" means a mixture of sludge, fatty materials, human feces, and wastewater removed during the pumping of an onsite sewage treatment and disposal system.

(n)  "Subdivision" means, for residential use, any tract or plot of land divided into two or more lots or parcels of which at least one is 1 acre or less in size for sale, lease, or rent. A subdivision for commercial or industrial use is any tract or plot of land divided into two or more lots or parcels of which at least one is 5 acres or less in size and which is for sale, lease, or rent. A subdivision shall be deemed to be proposed until such time as an application is submitted to the local government for subdivision approval or, in those areas where no local government subdivision approval is required, until such time as a plat of the subdivision is recorded.

(o)  "Tidally influenced surface water body" means a body of water that is subject to the ebb and flow of the tides and has as its boundary a mean high-water line as defined by s. 177.27(15).

(p)  "Toxic or hazardous chemical" means a substance that poses a serious danger to human health or the environment.

(3)  DUTIES AND POWERS OF THE DEPARTMENT OF HEALTH.--The department shall:

(a)  Adopt rules to administer ss. 381.0065-381.0067, including definitions that are consistent with the definitions in this section, decreases to setback requirements where no health hazard exists, increases for the lot-flow allowance for performance-based systems, requirements for separation from water table elevation during the wettest season, requirements for the design and construction of any component part of an onsite sewage treatment and disposal system, application and permit requirements for persons who maintain an onsite sewage treatment and disposal system, requirements for maintenance and service agreements for aerobic treatment units and performance-based treatment systems, and recommended standards, including disclosure requirements, for voluntary system inspections to be performed by individuals who are authorized by law to perform such inspections and who shall inform a person having ownership, control, or use of an onsite sewage treatment and disposal system of the inspection standards and of that person's authority to request an inspection based on all or part of the standards.

(b)  Perform application reviews and site evaluations, issue permits, and conduct inspections and complaint investigations associated with the construction, installation, maintenance, modification, abandonment, operation, use, or repair of an onsite sewage treatment and disposal system for a residence or establishment with an estimated domestic sewage flow of 10,000 gallons or less per day, or an estimated commercial sewage flow of 5,000 gallons or less per day, which is not currently regulated under chapter 403.

(c)  Develop a comprehensive program to ensure that onsite sewage treatment and disposal systems regulated by the department are sized, designed, constructed, installed, repaired, modified, abandoned, used, operated, and maintained in compliance with this section and rules adopted under this section to prevent groundwater contamination and surface water contamination and to preserve the public health. The department is the final administrative interpretive authority regarding rule interpretation. In the event of a conflict regarding rule interpretation, the Division Director for Environmental Health of the department, or his or her designee, shall timely assign a staff person to resolve the dispute.

(d)  Grant variances in hardship cases under the conditions prescribed in this section and rules adopted under this section.

(e)  Permit the use of a limited number of innovative systems for a specific period of time, when there is compelling evidence that the system will function properly and reliably to meet the requirements of this section and rules adopted under this section.

(f)  Issue annual operating permits under this section.

(g)  Establish and collect fees as established under s. 381.0066 for services provided with respect to onsite sewage treatment and disposal systems.

(h)  Conduct enforcement activities, including imposing fines, issuing citations, suspensions, revocations, injunctions, and emergency orders for violations of this section, part I of chapter 386, or part III of chapter 489 or for a violation of any rule adopted under this section, part I of chapter 386, or part III of chapter 489.

(i)  Provide or conduct education and training of department personnel, service providers, and the public regarding onsite sewage treatment and disposal systems.

(j)  Supervise research on, demonstration of, and training on the performance, environmental impact, and public health impact of onsite sewage treatment and disposal systems within this state. Research fees collected under s. 381.0066(2)(k) must be used to develop and fund hands-on training centers designed to provide practical information about onsite sewage treatment and disposal systems to septic tank contractors, master septic tank contractors, contractors, inspectors, engineers, and the public and must also be used to fund research projects which focus on improvements of onsite sewage treatment and disposal systems, including use of performance-based standards and reduction of environmental impact. Research projects shall be initially approved by the technical advisory panel and shall be applicable to and reflect the soil conditions specific to Florida. Such projects shall be awarded through competitive negotiation, using the procedures provided in s. 287.055, to public or private entities that have experience in onsite sewage treatment and disposal systems in Florida and that are principally located in Florida. Research projects shall not be awarded to firms or entities that employ or are associated with persons who serve on either the technical advisory panel or the research review and advisory committee.

(k)  Approve the installation of individual graywater disposal systems in which blackwater is treated by a central sewerage system.

(l)  Regulate and permit the sanitation, handling, treatment, storage, reuse, and disposal of byproducts from any system regulated under this chapter and not regulated by the Department of Environmental Protection.

(m)  Permit and inspect portable or temporary toilet services and holding tanks. The department shall review applications, perform site evaluations, and issue permits for the temporary use of holding tanks, privies, portable toilet services, or any other toilet facility that is intended for use on a permanent or nonpermanent basis, including facilities placed on construction sites when workers are present. The department may specify standards for the construction, maintenance, use, and operation of any such facility for temporary use.

(n)  Regulate and permit maintenance entities for performance-based treatment systems and aerobic treatment unit systems. To ensure systems are maintained and operated according to manufacturer's specifications and designs, the department shall establish by rule minimum qualifying criteria for maintenance entities. The criteria shall include: training, access to approved spare parts and components, access to manufacturer's maintenance and operation manuals, and service response time. The maintenance entity shall employ a contractor licensed under s. 489.105(3)(m), or part III of chapter 489, or a state-licensed wastewater plant operator, who is responsible for maintenance and repair of all systems under contract.

(4)  PERMITS; INSTALLATION; AND CONDITIONS.--A person may not construct, repair, modify, abandon, or operate an onsite sewage treatment and disposal system without first obtaining a permit approved by the department. The department may issue permits to carry out this section, but shall not make the issuance of such permits contingent upon prior approval by the Department of Environmental Protection. A construction permit is valid for 18 months from the issuance date and may be extended by the department for one 90-day period under rules adopted by the department. A repair permit is valid for 90 days from the date of issuance. An operating permit must be obtained prior to the use of any aerobic treatment unit or if the establishment generates commercial waste. Buildings or establishments that use an aerobic treatment unit or generate commercial waste shall be inspected by the department at least annually to assure compliance with the terms of the operating permit. The operating permit for a commercial wastewater system is valid for 1 year from the date of issuance and must be renewed annually. The operating permit for an aerobic treatment unit is valid for 2 years from the date of issuance and must be renewed every 2 years. If all information pertaining to the siting, location, and installation conditions or repair of an onsite sewage treatment and disposal system remains the same, a construction or repair permit for the onsite sewage treatment and disposal system may be transferred to another person, if the transferee files, within 60 days after the transfer of ownership, an amended application providing all corrected information and proof of ownership of the property. There is no fee associated with the processing of this supplemental information. A person may not contract to construct, modify, alter, repair, service, abandon, or maintain any portion of an onsite sewage treatment and disposal system without being registered under part III of chapter 489. A property owner who personally performs construction, maintenance, or repairs to a system serving his or her own owner-occupied single-family residence is exempt from registration requirements for performing such construction, maintenance, or repairs on that residence, but is subject to all permitting requirements. A municipality or political subdivision of the state may not issue a building or plumbing permit for any building that requires the use of an onsite sewage treatment and disposal system unless the owner or builder has received a construction permit for such system from the department. A building or structure may not be occupied and a municipality, political subdivision, or any state or federal agency may not authorize occupancy until the department approves the final installation of the onsite sewage treatment and disposal system. A municipality or political subdivision of the state may not approve any change in occupancy or tenancy of a building that uses an onsite sewage treatment and disposal system until the department has reviewed the use of the system with the proposed change, approved the change, and amended the operating permit.

(a)  Subdivisions and lots in which each lot has a minimum area of at least one-half acre and either a minimum dimension of 100 feet or a mean of at least 100 feet of the side bordering the street and the distance formed by a line parallel to the side bordering the street drawn between the two most distant points of the remainder of the lot may be developed with a water system regulated under s. 381.0062 and onsite sewage treatment and disposal systems, provided the projected daily sewage flow does not exceed an average of 1,500 gallons per acre per day, and provided satisfactory drinking water can be obtained and all distance and setback, soil condition, water table elevation, and other related requirements of this section and rules adopted under this section can be met.

(b)  Subdivisions and lots using a public water system as defined in s. 403.852 may use onsite sewage treatment and disposal systems, provided there are no more than four lots per acre, provided the projected daily sewage flow does not exceed an average of 2,500 gallons per acre per day, and provided that all distance and setback, soil condition, water table elevation, and other related requirements that are generally applicable to the use of onsite sewage treatment and disposal systems are met.

(c)  Notwithstanding the provisions of paragraphs (a) and (b), for subdivisions platted of record on or before October 1, 1991, when a developer or other appropriate entity has previously made or makes provisions, including financial assurances or other commitments, acceptable to the Department of Health, that a central water system will be installed by a regulated public utility based on a density formula, private potable wells may be used with onsite sewage treatment and disposal systems until the agreed-upon densities are reached. The department may consider assurances filed with the Department of Business and Professional Regulation under chapter 498 in determining the adequacy of the financial assurance required by this paragraph. In a subdivision regulated by this paragraph, the average daily sewage flow may not exceed 2,500 gallons per acre per day. This section does not affect the validity of existing prior agreements. After October 1, 1991, the exception provided under this paragraph is not available to a developer or other appropriate entity.

(d)  Paragraphs (a) and (b) do not apply to any proposed residential subdivision with more than 50 lots or to any proposed commercial subdivision with more than 5 lots where a publicly owned or investor-owned sewerage system is available. It is the intent of this paragraph not to allow development of additional proposed subdivisions in order to evade the requirements of this paragraph. The department shall report to the Legislature by February 1 of each odd-numbered year concerning the success in meeting this intent.

(e)  Onsite sewage treatment and disposal systems must not be placed closer than:

1.  Seventy-five feet from a private potable well.

2.  Two hundred feet from a public potable well serving a residential or nonresidential establishment having a total sewage flow of greater than 2,000 gallons per day.

3.  One hundred feet from a public potable well serving a residential or nonresidential establishment having a total sewage flow of less than or equal to 2,000 gallons per day.

4.  Fifty feet from any nonpotable well.

5.  Ten feet from any storm sewer pipe, to the maximum extent possible, but in no instance shall the setback be less than 5 feet.

6.  Seventy-five feet from the mean high-water line of a tidally influenced surface water body.

7.  Seventy-five feet from the normal annual flood line of a permanent nontidal surface water body.

8.  Fifteen feet from the design high-water line of retention areas, detention areas, or swales designed to contain standing or flowing water for less than 72 hours after a rainfall or the design high-water level of normally dry drainage ditches or normally dry individual lot stormwater retention areas.

(f)  Except as provided under paragraphs (e) and (t), no limitations shall be imposed by rule, relating to the distance between an onsite disposal system and any area that either permanently or temporarily has visible surface water.

(g)  All provisions of this section and rules adopted under this section relating to soil condition, water table elevation, distance, and other setback requirements must be equally applied to all lots, with the following exceptions:

1.  Any residential lot that was platted and recorded on or after January 1, 1972, or that is part of a residential subdivision that was approved by the appropriate permitting agency on or after January 1, 1972, and that was eligible for an onsite sewage treatment and disposal system construction permit on the date of such platting and recording or approval shall be eligible for an onsite sewage treatment and disposal system construction permit, regardless of when the application for a permit is made. If rules in effect at the time the permit application is filed cannot be met, residential lots platted and recorded or approved on or after January 1, 1972, shall, to the maximum extent possible, comply with the rules in effect at the time the permit application is filed. At a minimum, however, those residential lots platted and recorded or approved on or after January 1, 1972, but before January 1, 1983, shall comply with those rules in effect on January 1, 1983, and those residential lots platted and recorded or approved on or after January 1, 1983, shall comply with those rules in effect at the time of such platting and recording or approval. In determining the maximum extent of compliance with current rules that is possible, the department shall allow structures and appurtenances thereto which were authorized at the time such lots were platted and recorded or approved.

2.  Lots platted before 1972 are subject to a 50-foot minimum surface water setback and are not subject to lot size requirements. The projected daily flow for onsite sewage treatment and disposal systems for lots platted before 1972 may not exceed:

a.  Two thousand five hundred gallons per acre per day for lots served by public water systems as defined in s. 403.852.

b.  One thousand five hundred gallons per acre per day for lots served by water systems regulated under s. 381.0062.

(h)1.  The department may grant variances in hardship cases which may be less restrictive than the provisions specified in this section. If a variance is granted and the onsite sewage treatment and disposal system construction permit has been issued, the variance may be transferred with the system construction permit, if the transferee files, within 60 days after the transfer of ownership, an amended construction permit application providing all corrected information and proof of ownership of the property and if the same variance would have been required for the new owner of the property as was originally granted to the original applicant for the variance. There is no fee associated with the processing of this supplemental information. A variance may not be granted under this section until the department is satisfied that:

a.  The hardship was not caused intentionally by the action of the applicant;

b.  No reasonable alternative, taking into consideration factors such as cost, exists for the treatment of the sewage; and

c.  The discharge from the onsite sewage treatment and disposal system will not adversely affect the health of the applicant or the public or significantly degrade the groundwater or surface waters.

Where soil conditions, water table elevation, and setback provisions are determined by the department to be satisfactory, special consideration must be given to those lots platted before 1972.

2.  The department shall appoint and staff a variance review and advisory committee, which shall meet monthly to recommend agency action on variance requests. The committee shall make its recommendations on variance requests at the meeting in which the application is scheduled for consideration, except for an extraordinary change in circumstances, the receipt of new information that raises new issues, or when the applicant requests an extension. The committee shall consider the criteria in subparagraph 1. in its recommended agency action on variance requests and shall also strive to allow property owners the full use of their land where possible. The committee consists of the following:

a.  The Division Director for Environmental Health of the department or his or her designee.

b.  A representative from the county health departments.

c.  A representative from the home building industry recommended by the Florida Home Builders Association.

d.  A representative from the septic tank industry recommended by the Florida Onsite Wastewater Association.

e.  A representative from the Department of Environmental Protection.

f.  A representative from the real estate industry who is also a developer in this state who develops lots using onsite sewage treatment and disposal systems, recommended by the Florida Association of Realtors.

g.  A representative from the engineering profession recommended by the Florida Engineering Society.

Members shall be appointed for a term of 3 years, with such appointments being staggered so that the terms of no more than two members expire in any one year. Members shall serve without remuneration, but if requested, shall be reimbursed for per diem and travel expenses as provided in s. 112.061.

(i)  A construction permit may not be issued for an onsite sewage treatment and disposal system in any area zoned or used for industrial or manufacturing purposes, or its equivalent, where a publicly owned or investor-owned sewage treatment system is available, or where a likelihood exists that the system will receive toxic, hazardous, or industrial waste. An existing onsite sewage treatment and disposal system may be repaired if a publicly owned or investor-owned sewerage system is not available within 500 feet of the building sewer stub-out and if system construction and operation standards can be met. This paragraph does not require publicly owned or investor-owned sewerage treatment systems to accept anything other than domestic wastewater.

1.  A building located in an area zoned or used for industrial or manufacturing purposes, or its equivalent, when such building is served by an onsite sewage treatment and disposal system, must not be occupied until the owner or tenant has obtained written approval from the department. The department shall not grant approval when the proposed use of the system is to dispose of toxic, hazardous, or industrial wastewater or toxic or hazardous chemicals.

2.  Each person who owns or operates a business or facility in an area zoned or used for industrial or manufacturing purposes, or its equivalent, or who owns or operates a business that has the potential to generate toxic, hazardous, or industrial wastewater or toxic or hazardous chemicals, and uses an onsite sewage treatment and disposal system that is installed on or after July 5, 1989, must obtain an annual system operating permit from the department. A person who owns or operates a business that uses an onsite sewage treatment and disposal system that was installed and approved before July 5, 1989, need not obtain a system operating permit. However, upon change of ownership or tenancy, the new owner or operator must notify the department of the change, and the new owner or operator must obtain an annual system operating permit, regardless of the date that the system was installed or approved.

3.  The department shall periodically review and evaluate the continued use of onsite sewage treatment and disposal systems in areas zoned or used for industrial or manufacturing purposes, or its equivalent, and may require the collection and analyses of samples from within and around such systems. If the department finds that toxic or hazardous chemicals or toxic, hazardous, or industrial wastewater have been or are being disposed of through an onsite sewage treatment and disposal system, the department shall initiate enforcement actions against the owner or tenant to ensure adequate cleanup, treatment, and disposal.

(j)  An onsite sewage treatment and disposal system for a single-family residence that is designed by a professional engineer registered in the state and certified by such engineer as complying with performance criteria adopted by the department must be approved by the department subject to the following:

1.  The performance criteria applicable to engineer-designed systems must be limited to those necessary to ensure that such systems do not adversely affect the public health or significantly degrade the groundwater or surface water. Such performance criteria shall include consideration of the quality of system effluent, the proposed total sewage flow per acre, wastewater treatment capabilities of the natural or replaced soil, water quality classification of the potential surface-water-receiving body, and the structural and maintenance viability of the system for the treatment of domestic wastewater. However, performance criteria shall address only the performance of a system and not a system's design.

2.  The technical review and advisory panel shall assist the department in the development of performance criteria applicable to engineer-designed systems. Workshops on the development of the rules delineating such criteria shall commence not later than September 1, 1996, and the department shall advertise such rules for public hearing no later than October 1, 1997.

3.  A person electing to utilize an engineer-designed system shall, upon completion of the system design, submit such design, certified by a registered professional engineer, to the county health department. The county health department may utilize an outside consultant to review the engineer-designed system, with the actual cost of such review to be borne by the applicant. Within 5 working days after receiving an engineer-designed system permit application, the county health department shall request additional information if the application is not complete. Within 15 working days after receiving a complete application for an engineer-designed system, the county health department either shall issue the permit or, if it determines that the system does not comply with the performance criteria, shall notify the applicant of that determination and refer the application to the department for a determination as to whether the system should be approved, disapproved, or approved with modification. The department engineer's determination shall prevail over the action of the county health department. The applicant shall be notified in writing of the department's determination and of the applicant's rights to pursue a variance or seek review under the provisions of chapter 120.

4.  The owner of an engineer-designed performance-based system must maintain a current maintenance service agreement with a maintenance entity permitted by the department. The maintenance entity shall obtain a biennial system operating permit from the department for each system under service contract. The department shall inspect the system at least annually, or on such periodic basis as the fee collected permits, and may collect system-effluent samples if appropriate to determine compliance with the performance criteria. The fee for the biennial operating permit shall be collected beginning with the second year of system operation. The maintenance entity shall inspect each system at least twice each year and shall report quarterly to the department on the number of systems inspected and serviced.

5.  If an engineer-designed system fails to properly function or fails to meet performance standards, the system shall be re-engineered, if necessary, to bring the system into compliance with the provisions of this section.

(k)  An innovative system may be approved in conjunction with an engineer-designed site-specific system which is certified by the engineer to meet the performance-based criteria adopted by the department.

(l)  For the Florida Keys, the department shall adopt a special rule for the construction, installation, modification, operation, repair, maintenance, and performance of onsite sewage treatment and disposal systems which considers the unique soil conditions and which considers water table elevations, densities, and setback requirements. On lots where a setback distance of 75 feet from surface waters, saltmarsh, and buttonwood association habitat areas cannot be met, an injection well, approved and permitted by the department, may be used for disposal of effluent from onsite sewage treatment and disposal systems.

(m)  No product sold in the state for use in onsite sewage treatment and disposal systems may contain any substance in concentrations or amounts that would interfere with or prevent the successful operation of such system, or that would cause discharges from such systems to violate applicable water quality standards. The department shall publish criteria for products known or expected to meet the conditions of this paragraph. In the event a product does not meet such criteria, such product may be sold if the manufacturer satisfactorily demonstrates to the department that the conditions of this paragraph are met.

(n)  Evaluations for determining the seasonal high-water table elevations or the suitability of soils for the use of a new onsite sewage treatment and disposal system shall be performed by department personnel, professional engineers registered in the state, or such other persons with expertise, as defined by rule, in making such evaluations. Evaluations for determining mean annual flood lines shall be performed by those persons identified in paragraph (2)(i). The department shall accept evaluations submitted by professional engineers and such other persons as meet the expertise established by this section or by rule unless the department has a reasonable scientific basis for questioning the accuracy or completeness of the evaluation.

(o)  The department shall appoint a research review and advisory committee, which shall meet at least semiannually. The committee shall advise the department on directions for new research, review and rank proposals for research contracts, and review draft research reports and make comments. The committee is comprised of:

1.  A representative of the Division of Environmental Health of the Department of Health.

2.  A representative from the septic tank industry.

3.  A representative from the home building industry.

4.  A representative from an environmental interest group.

5.  A representative from the State University System, from a department knowledgeable about onsite sewage treatment and disposal systems.

6.  A professional engineer registered in this state who has work experience in onsite sewage treatment and disposal systems.

7.  A representative from the real estate profession.

8.  A representative from the restaurant industry.

9.  A consumer.

Members shall be appointed for a term of 3 years, with the appointments being staggered so that the terms of no more than four members expire in any one year. Members shall serve without remuneration, but are entitled to reimbursement for per diem and travel expenses as provided in s. 112.061.

(p)  An application for an onsite sewage treatment and disposal system permit shall be completed in full, signed by the owner or the owner's authorized representative, or by a contractor licensed under chapter 489, and shall be accompanied by all required exhibits and fees. No specific documentation of property ownership shall be required as a prerequisite to the review of an application or the issuance of a permit. The issuance of a permit does not constitute determination by the department of property ownership.

(q)  The department may not require any form of subdivision analysis of property by an owner, developer, or subdivider prior to submission of an application for an onsite sewage treatment and disposal system.

(r)  Nothing in this section limits the power of a municipality or county to enforce other laws for the protection of the public health and safety.

(s)  In the siting of onsite sewage treatment and disposal systems, including drainfields, shoulders, and slopes, guttering shall not be required on single-family residential dwelling units for systems located greater than 5 feet from the roof drip line of the house. If guttering is used on residential dwelling units, the downspouts shall be directed away from the drainfield.

(t)  Notwithstanding the provisions of subparagraph (g)1., onsite sewage treatment and disposal systems located in floodways of the Suwannee and Aucilla Rivers must adhere to the following requirements:

1.  The absorption surface of the drainfield shall not be subject to flooding based on 10-year flood elevations. Provided, however, for lots or parcels created by the subdivision of land in accordance with applicable local government regulations prior to January 17, 1990, if an applicant cannot construct a drainfield system with the absorption surface of the drainfield at an elevation equal to or above 10-year flood elevation, the department shall issue a permit for an onsite sewage treatment and disposal system within the 10-year floodplain of rivers, streams, and other bodies of flowing water if all of the following criteria are met:

a.  The lot is at least one-half acre in size;

b.  The bottom of the drainfield is at least 36 inches above the 2-year flood elevation; and

c.  The applicant installs either: a waterless, incinerating, or organic waste composting toilet and a graywater system and drainfield in accordance with department rules; an aerobic treatment unit and drainfield in accordance with department rules; a system approved by the State Health Office that is capable of reducing effluent nitrate by at least 50 percent; or a system approved by the county health department pursuant to department rule other than a system using alternative drainfield materials. The United States Department of Agriculture Soil Conservation Service soil maps, State of Florida Water Management District data, and Federal Emergency Management Agency Flood Insurance maps are resources that shall be used to identify flood-prone areas.

2.  The use of fill or mounding to elevate a drainfield system out of the 10-year floodplain of rivers, streams, or other bodies of flowing water shall not be permitted if such a system lies within a regulatory floodway of the Suwannee and Aucilla Rivers. In cases where the 10-year flood elevation does not coincide with the boundaries of the regulatory floodway, the regulatory floodway will be considered for the purposes of this subsection to extend at a minimum to the 10-year flood elevation.

(u)  The owner of an aerobic treatment unit system shall maintain a current maintenance service agreement with an aerobic treatment unit maintenance entity permitted by the department. The maintenance entity shall obtain a system operating permit from the department for each aerobic treatment unit under service contract. The maintenance entity shall inspect each aerobic treatment unit system at least twice each year and shall report quarterly to the department on the number of aerobic treatment unit systems inspected and serviced. The owner shall allow the department to inspect during reasonable hours each aerobic treatment unit system at least annually, and such inspection may include collection and analysis of system-effluent samples for performance criteria established by rule of the department.

(5)  ENFORCEMENT; RIGHT OF ENTRY; CITATIONS.--

(a)  Department personnel who have reason to believe noncompliance exists, may at any reasonable time, enter the premises permitted under ss. 381.0065-381.0066, or the business premises of any septic tank contractor or master septic tank contractor registered under part III of chapter 489, or any premises that the department has reason to believe is being operated or maintained not in compliance, to determine compliance with the provisions of this section, part I of chapter 386, or part III of chapter 489 or rules or standards adopted under ss. 381.0065-381.0067, part I of chapter 386, or part III of chapter 489. As used in this paragraph, the term "premises" does not include a residence or private building. To gain entry to a residence or private building, the department must obtain permission from the owner or occupant or secure an inspection warrant from a court of competent jurisdiction.

(b)1.  The department may issue citations that may contain an order of correction or an order to pay a fine, or both, for violations of ss. 381.0065-381.0067, part I of chapter 386, or part III of chapter 489 or the rules adopted by the department, when a violation of these sections or rules is enforceable by an administrative or civil remedy, or when a violation of these sections or rules is a misdemeanor of the second degree. A citation issued under ss. 381.0065-381.0067, part I of chapter 386, or part III of chapter 489 constitutes a notice of proposed agency action.

2.  A citation must be in writing and must describe the particular nature of the violation, including specific reference to the provisions of law or rule allegedly violated.

3.  The fines imposed by a citation issued by the department may not exceed $500 for each violation. Each day the violation exists constitutes a separate violation for which a citation may be issued.

4.  The department shall inform the recipient, by written notice pursuant to ss. 120.569 and 120.57, of the right to an administrative hearing to contest the citation within 21 days after the date the citation is received. The citation must contain a conspicuous statement that if the recipient fails to pay the fine within the time allowed, or fails to appear to contest the citation after having requested a hearing, the recipient has waived the recipient's right to contest the citation and must pay an amount up to the maximum fine.

5.  The department may reduce or waive the fine imposed by the citation. In determining whether to reduce or waive the fine, the department must consider the gravity of the violation, the person's attempts at correcting the violation, and the person's history of previous violations including violations for which enforcement actions were taken under ss. 381.0065-381.0067, part I of chapter 386, part III of chapter 489, or other provisions of law or rule.

6.  Any person who willfully refuses to sign and accept a citation issued by the department commits a misdemeanor of the second degree, punishable as provided in s. 775.082 or s. 775.083.

7.  The department, pursuant to ss. 381.0065-381.0067, part I of chapter 386, or part III of chapter 489, shall deposit any fines it collects in the county health department trust fund for use in providing services specified in those sections.

8.  This section provides an alternative means of enforcing ss. 381.0065-381.0067, part I of chapter 386, and part III of chapter 489. This section does not prohibit the department from enforcing ss. 381.0065-381.0067, part I of chapter 386, or part III of chapter 489, or its rules, by any other means. However, the department must elect to use only a single method of enforcement for each violation.

History.--ss. 1, 2, 3, 4, 5, 6, ch. 75-145; s. 72, ch. 77-147; s. 1, ch. 77-174; ss. 1, 2, ch. 77-308; s. 1, ch. 78-430; s. 1, ch. 79-45; s. 1, ch. 82-10; s. 37, ch. 83-218; ss. 43, 46, ch. 83-310; s. 1, ch. 84-119; s. 4, ch. 85-314; s. 5, ch. 86-220; s. 14, ch. 89-324; s. 26, ch. 91-297; ss. 1, 10, 11, ch. 93-151; s. 40, ch. 94-218; s. 352, ch. 94-356; s. 1033, ch. 95-148; ss. 1, 3, ch. 96-303; s. 116, ch. 96-410; s. 181, ch. 97-101; s. 21, ch. 97-237; s. 7, ch. 98-151; s. 2, ch. 98-420; s. 192, ch. 99-13; ss. 1, 7, ch. 99-395; s. 10, ch. 2000-242; s. 19, ch. 2001-62; s. 1, ch. 2001-234.

Note.--Former s. 381.272.

381.00655  Connection of existing onsite sewage treatment and disposal systems to central sewerage system; requirements.--

(1)(a)  The owner of a properly functioning onsite sewage treatment and disposal system, excluding an approved onsite graywater system, must connect the system or the building's plumbing to an available publicly owned or investor-owned sewerage system within 365 days after written notification by the owner of the publicly owned or investor-owned sewerage system that the system is available for connection. The publicly owned or investor-owned sewerage system must notify the owner of the onsite sewage treatment and disposal system of the availability of the central sewerage system. No less than 1 year prior to the date the sewerage system will become available, the publicly owned or investor-owned sewerage system shall notify the affected owner of the onsite sewage treatment and disposal system of the anticipated availability of the sewerage system and shall also notify the owner that the owner will be required to connect to the sewerage system within 1 year of the actual availability. The owner shall have the option of prepaying the amortized value of required connection charges in equal monthly installments over a period not to exceed 2 years from the date of the initial notification of anticipated availability. Nothing in this section shall operate to impair contracts or other binding obligations relating to payment schedules in existence as of October 1, 1993. Nothing in this paragraph limits the power of a municipality or county to enforce other laws for the protection of the public health and safety.

(b)  The owner of an onsite sewage treatment and disposal system that needs repair or modification to function in a sanitary manner or to comply with the requirements of ss. 381.0065-381.0067 or rules adopted under those sections must connect to an available publicly owned or investor-owned sewerage system within 90 days after written notification from the department. In hardship cases, upon request of the owner, the department may approve an extension of not more than 90 days for sewerage connection. The department may approve only one extension. This paragraph does not authorize the owner of the onsite sewage treatment and disposal system to create or maintain a sanitary nuisance.

(2)  The provisions of subsection (1) or any other provision of law to the contrary notwithstanding:

(a)  The local governing body of the jurisdiction in which the owner of the onsite sewage treatment and disposal system resides may provide that any connection fee charged under this section by an investor-owned sewerage system may be paid without interest in monthly installments, over a period of time not to exceed 5 years from the date the sewerage system becomes available if it determines that the owner has demonstrated a financial hardship. The local governing body shall establish criteria for making this determination which take into account the owner's net worth, income, and financial needs.

(b)  A publicly owned or investor-owned sewerage system may, with the approval of the department, waive the requirement of mandatory onsite sewage disposal connection if it determines that such connection is not required in the public interest due to public health considerations.

History.--s. 2, ch. 93-151.

381.0066  Onsite sewage treatment and disposal systems; fees.--

(1)  The department may collect fees for services provided with respect to onsite sewage treatment and disposal systems. The total fees assessed under this section must be sufficient to meet the cost of administering this section and ss. 381.0065 and 381.00655.

(2)  The minimum fees in the following fee schedule apply until changed by rule by the department within the following limits:

(a)  Application review, permit issuance, or system inspection, including repair of a subsurface, mound, filled, or other alternative system or permitting of an abandoned system: a fee of not less than $25, or more than $125.

(b)  Site evaluation, site reevaluation, evaluation of a system previously in use, or a per annum septage disposal site evaluation: a fee of not less than $40, or more than $115.

(c)  Biennial Operating permit for aerobic treatment units or performance-based treatment systems: a fee of not more than $100.

(d)  Annual operating permit for systems located in areas zoned for industrial manufacturing or equivalent uses or where the system is expected to receive wastewater which is not domestic in nature: a fee of not less than $150, or more than $300.

(e)  Innovative technology: a fee not to exceed $25,000.

(f)  Septage disposal service, septage stabilization facility, portable or temporary toilet service, tank manufacturer inspection: a fee of not less than $25, or more than $200, per year.

(g)  Application for variance: a fee of not less than $150, or more than $300.

(h)  Annual operating permit for waterless, incinerating, or organic waste composting toilets: a fee of not less than $50, or more than $150.

(i)  Aerobic treatment unit or performance-based treatment system maintenance entity permit: a fee of not less than $25, or more than $150, per year.

(j)  Reinspection fee per visit for site inspection after system construction approval or for noncompliant system installation per site visit: a fee of not less than $25, or more than $100.

¹(k)  Research: An additional $5 fee shall be added to each new system construction permit issued during fiscal years 1996-2003 to be used for onsite sewage treatment and disposal system research, demonstration, and training projects. Five dollars from any repair permit fee collected under this section shall be used for funding the hands-on training centers described in s. 381.0065(3)(j).

(l)  Annual operating permit, including annual inspection and any required sampling and laboratory analysis of effluent, for an engineer-designed performance-based system: a fee of not less than $150, or more than $300.

The funds collected pursuant to this subsection must be deposited in a trust fund administered by the department, to be used for the purposes stated in this section and ss. 381.0065 and 381.00655.

History.--ss. 44, 46, ch. 83-310; s. 39, ch. 85-81; s. 2, ch. 88-89; s. 27, ch. 91-297; ss. 3, 10, 11, ch. 93-151; ss. 2, 3, ch. 96-303; s. 2, ch. 99-395; s. 2, ch. 2001-234; s. 16, ch. 2002-402.

¹Note.--Section 16, ch. 2002-402, amended paragraph (2)(k) "[i]n order to implement Specific Appropriation 558 of the 2002-2003 General Appropriations Act."

Note.--Former s. 381.273.

381.0067  Corrective orders; private and certain public water systems and onsite sewage treatment and disposal systems.--When the department or its agents, through investigation, find that any private water system, public water system not covered or included in the Florida Safe Drinking Water Act (part VI of chapter 403) or onsite sewage treatment and disposal system constitutes a nuisance or menace to the public health, it may issue an order requiring the owner to correct the improper condition.

History.--s. 2, ch. 29834, 1955; ss. 19, 35, ch. 69-106; s. 74, ch. 77-147; s. 17, ch. 77-337; s. 28, ch. 91-297; s. 6, ch. 93-151.

Note.--Former s. 381.291.

381.0068  Technical review and advisory panel.--

(1)  The Department of Health shall, by July 1, 1996, establish and staff a technical review and advisory panel to assist the department with rule adoption.

(2)  The primary purpose of the panel is to assist the department in rulemaking and decisionmaking by drawing on the expertise of representatives from several groups that are affected by onsite sewage treatment and disposal systems. The panel may also review and comment on any legislation or any existing or proposed state policy or issue related to onsite sewage treatment and disposal systems. If requested by the panel, the chair will advise any affected person or member of the Legislature of the panel's position on the legislation or any existing or proposed state policy or issue. The chair may also take such other action as is appropriate to allow the panel to function. At a minimum, the panel shall consist of a soil scientist; a professional engineer registered in this state who is recommended by the Florida Engineering Society and who has work experience in onsite sewage treatment and disposal systems; two representatives from the home-building industry recommended by the Florida Home Builders Association, including one who is a developer in this state who develops lots using onsite sewage treatment and disposal systems; a representative from the county health departments who has experience permitting and inspecting the installation of onsite sewage treatment and disposal systems in this state; a representative from the real estate industry who is recommended by the Florida Association of Realtors; a consumer representative with a science background; two representatives of the septic tank industry recommended by the Florida Septic Tank Association, including one who is a manufacturer of onsite sewage treatment and disposal systems; and a representative from the environmental health profession who is recommended by the Florida Environmental Health Association and who is not employed by a county health department. Members are to be appointed for a term of 2 years. The panel may also, as needed, be expanded to include ad hoc, nonvoting representatives who have topic-specific expertise. All rules proposed by the department which relate to onsite sewage treatment and disposal systems must be presented to the panel for review and comment prior to adoption. The panel's position on proposed rules shall be made a part of the rulemaking record that is maintained by the agency. The panel shall select a chair, who shall serve for a period of 1 year and who shall direct, coordinate, and execute the duties of the panel. The panel shall also solicit input from the department's variance review and advisory committee before submitting any comments to the department concerning proposed rules. The panel's comments must include any dissenting points of view concerning proposed rules. The panel shall hold meetings as it determines necessary to conduct its business, except that the chair, a quorum of the voting members of the panel, or the department may call meetings. The department shall keep minutes of all meetings of the panel. Panel members shall serve without remuneration, but, if requested, shall be reimbursed for per diem and travel expenses as provided in s. 112.061.

History.--s. 9, ch. 93-151; s. 4, ch. 96-303; s. 182, ch. 97-101; s. 3, ch. 98-420; s. 193, ch. 99-13.

381.0072  Food service protection.--It shall be the duty of the Department of Health to adopt and enforce sanitation rules consistent with law to ensure the protection of the public from food-borne illness. These rules shall provide the standards and requirements for the storage, preparation, serving, or display of food in food service establishments as defined in this section and which are not permitted or licensed under chapter 500 or chapter 509.

(1)  DEFINITIONS.--As used in this section, the term:

(a)  "Department" means the Department of Health or its representative county health department.

(b)  "Food service establishment" means any facility, as described in this paragraph, where food is prepared and intended for individual portion service, and includes the site at which individual portions are provided. The term includes any such facility regardless of whether consumption is on or off the premises and regardless of whether there is a charge for the food. The term includes detention facilities, child care facilities, schools, institutions, civic or fraternal organizations, bars and lounges and facilities used at temporary food events, mobile food units, and vending machines at any facility regulated under this section. The term does not include private homes where food is prepared or served for individual family consumption; nor does the term include churches, synagogues, or other not-for-profit religious organizations as long as these organizations serve only their members and guests and do not advertise food or drink for public consumption, or any facility or establishment permitted or licensed under chapter 500 or chapter 509; nor does the term include any theater, if the primary use is as a theater and if patron service is limited to food items customarily served to the admittees of theaters; nor does the term include a research and development test kitchen limited to the use of employees and which is not open to the general public.

(c)  "Operator" means the owner, operator, keeper, proprietor, lessee, manager, assistant manager, agent, or employee of a food service establishment.

(2)  DUTIES.--

(a)  The department shall adopt rules, including definitions of terms which are consistent with law prescribing minimum sanitation standards and manager certification requirements as prescribed in s. 509.039, and which shall be enforced in food service establishments as defined in this section. The sanitation standards must address the construction, operation, and maintenance of the establishment; lighting, ventilation, laundry rooms, lockers, use and storage of toxic materials and cleaning compounds, and first-aid supplies; plan review; design, construction, installation, location, maintenance, sanitation, and storage of food equipment and utensils; employee training, health, hygiene, and work practices; food supplies, preparation, storage, transportation, and service, including access to the areas where food is stored or prepared; and sanitary facilities and controls, including water supply and sewage disposal; plumbing and toilet facilities; garbage and refuse collection, storage, and disposal; and vermin control. Public and private schools, hospitals licensed under chapter 395, nursing homes licensed under part II of chapter 400, child care facilities as defined in s. 402.301, and residential facilities colocated with a nursing home or hospital if all food is prepared in a central kitchen that complies with nursing or hospital regulations shall be exempt from the rules developed for manager certification. The department shall administer a comprehensive inspection, monitoring, and sampling program to ensure such standards are maintained. With respect to food service establishments permitted or licensed under chapter 500 or chapter 509, the department shall assist the Division of Hotels and Restaurants of the Department of Business and Professional Regulation and the Department of Agriculture and Consumer Services with rulemaking by providing technical information.

(b)  The department shall carry out all provisions of this chapter and all other applicable laws and rules relating to the inspection or regulation of food service establishments as defined in this section, for the purpose of safeguarding the public's health, safety, and welfare.

(c)  The department shall inspect each food service establishment as often as necessary to ensure compliance with applicable laws and rules. The department shall have the right of entry and access to these food service establishments at any reasonable time. In inspecting food service establishments as provided under this section, the department shall provide each inspected establishment with the food recovery brochure developed under s. 570.0725.

(d)  The department or other appropriate regulatory entity may inspect theaters exempted in subsection (1) to ensure compliance with applicable laws and rules pertaining to minimum sanitation standards. A fee for inspection shall be prescribed by rule, but the aggregate amount charged per year per theater establishment shall not exceed $300, regardless of the entity providing the inspection.

(3)  LICENSES REQUIRED.--

(a)  Licenses; annual renewals.--Each food service establishment regulated under this section shall obtain a license from the department annually. Food service establishment licenses shall expire annually and shall not be transferable from one place or individual to another. However, those facilities licensed by the department's Office of Licensure and Certification, the Child Care Services Program Office, or the Developmental Disabilities Program Office are exempt from this subsection. It shall be a misdemeanor of the second degree, punishable as provided in s. 381.0061, s. 775.082, or s. 775.083, for such an establishment to operate without this license. The department may refuse a license, or a renewal thereof, to any establishment that is not constructed or maintained in accordance with law and with the rules of the department. Annual application for renewal shall not be required.

(b)  Application for license.--Each person who plans to open a food service establishment not regulated under chapter 500 or chapter 509 shall apply for and receive a license prior to the commencement of operation.

(4)  LICENSE; INSPECTION; FEES.--

(a)  The department is authorized to collect fees from establishments licensed under this section and from those facilities exempted from licensure under paragraph (3)(a). It is the intent of the Legislature that the total fees assessed under this section be in an amount sufficient to meet the cost of carrying out the provisions of this section.

(b)  The fee schedule for food service establishments licensed under this section shall be prescribed by rule, but the aggregate license fee per establishment shall not exceed $300.

(c)  The license fees shall be prorated on a quarterly basis. Annual licenses shall be renewed as prescribed by rule.

(5)  FINES; SUSPENSION OR REVOCATION OF LICENSES; PROCEDURE.--

(a)  The department may impose fines against the establishment or operator regulated under this section for violations of sanitary standards, in accordance with s. 381.0061. All amounts collected shall be deposited to the credit of the County Health Department Trust Fund administered by the department.

(b)  The department may suspend or revoke the license of any food service establishment licensed under this section that has operated or is operating in violation of any of the provisions of this section or the rules adopted under this section. Such food service establishment shall remain closed when its license is suspended or revoked.

(c)  The department may suspend or revoke the license of any food service establishment licensed under this section when such establishment has been deemed by the department to be an imminent danger to the public's health for failure to meet sanitation standards or other applicable regulatory standards.

(d)  No license shall be suspended under this section for a period of more than 12 months. At the end of such period of suspension, the establishment may apply for reinstatement or renewal of the license. A food service establishment which has had its license revoked may not apply for another license for that location prior to the date on which the revoked license would have expired.

(6)  IMMINENT DANGERS; STOP-SALE ORDERS.--

(a)  In the course of epidemiological investigations or for those establishments regulated under this chapter, the department, to protect the public from food that is unwholesome or otherwise unfit for human consumption, may examine, sample, seize, and stop the sale or use of food to determine its condition. The department may stop the sale and supervise the proper destruction of food when the State Health Officer or his or her designee determines that such food represents a threat to the public health.

(b)  The department may determine that a food service establishment regulated under this section is an imminent danger to the public health and require its immediate closure when such establishment fails to comply with applicable sanitary and safety standards and, because of such failure, presents an imminent threat to the public's health, safety, and welfare. The department may accept inspection results from state and local building and firesafety officials and other regulatory agencies as justification for such actions. Any facility so deemed and closed shall remain closed until allowed by the department or by judicial order to reopen.

(7)  MISREPRESENTING FOOD OR FOOD PRODUCTS.--No operator of any food service establishment regulated under this section shall knowingly and willfully misrepresent the identity of any food or food product to any of the patrons of such establishment. Food used by food establishments shall be identified, labeled, and advertised in accordance with the provisions of chapter 500.

History.--ss. 31, 59, 60, ch. 91-297; ss. 4, 5, ch. 91-429; s. 4, ch. 92-180; s. 14, ch. 93-53; s. 3, ch. 93-267; s. 41, ch. 94-218; s. 1034, ch. 95-148; s. 1, ch. 95-314; s. 39, ch. 97-101; s. 8, ch. 98-151; s. 3, ch. 98-283; s. 44, ch. 2000-139; s. 11, ch. 2000-242.

381.0075  Regulation of body-piercing salons.--

(1)  LEGISLATIVE INTENT.--It is the intent of the Legislature to protect the health, safety, and welfare of the public from the spread of infectious diseases from practices that prick, pierce, or scar the skin and therefore, to that end, to regulate body-piercing salons.

(2)  DEFINITIONS.--As used in this section:

(a)  "Body piercing" means for commercial purposes the act of penetrating the skin to make, generally permanent in nature, a hole, mark, or scar. "Body piercing" does not include the use of a mechanized, presterilized ear-piercing system that penetrates the outer perimeter or lobe of the ear or both.

(b)  "Body-piercing salon" means a place where body piercing occurs.

(c)  "Department" means the Department of Health.

(d)  "Establishment" means a body-piercing salon as defined in this section.

(e)  "Jewelry" means any personal ornament inserted into a pierced area other than the outer perimeter or lobe of the ear.

(f)  "Licensee" means any person licensed under this section who is responsible for compliance with this section and the rules adopted under this section.

(g)  "Operator" means an individual designated by a licensee to control the operation of an establishment.

(h)  "Person" means any individual, partnership, corporation, or association.

(i)  "Safe level" means not more than 50 colonies of microorganisms per 4 square inches of equipment or device surface.

(j)  "Sanitization" means the effective bactericidal treatment of surfaces of equipment and devices by a product registered by the United States Environmental Protection Agency which provides a sufficient concentration of chemicals and enough time to reduce the bacterial count, including pathogens, to a safe level.

(k)  "Sterilization" means the use of procedures that destroy all microbial life, including viruses, on the equipment or device.

(l)  "Stop-use order" means a written notice from the department to a licensee requiring the licensee to remove a piece of equipment or cease conducting a particular procedure because the equipment is not being operated or the procedure conducted in accordance with the requirements of this section or any rule adopted pursuant thereto.

(m)  "Temporary establishment" means a body-piercing establishment that operates at a fixed location for a period of time of not more than 14 consecutive days in conjunction with a single event or celebration.

(3)  EXEMPTIONS.--This section does not apply to the practice of any licensed health care professional under the regulatory jurisdiction of the department as long as the person does not hold himself or herself out as a body-piercing establishment.

(4)  LICENSE REQUIRED.--

(a)  A person may not operate an establishment unless it is licensed under this section.

(b)  Any person operating an establishment must obtain a license from the department annually.

(c)  A license for an establishment is not transferable from one place or person to another.

(d)  A license automatically expires on September 30 of each year unless renewed by the department upon the request of the licensee.

(e)  A current license must be displayed in a public area of the establishment.

(f)  A person operating a temporary establishment must receive a temporary license from the department prior to operation. The department must be contacted at least 7 days prior to commencement of operation of the establishment and must conduct an inspection of the establishment to ensure compliance with licensing requirements prior to issuing the temporary license.

(5)  LICENSE APPLICATION.--

(a)  A person must apply to the department for an establishment license prior to commencement of operation and must apply for annual renewal of the license in order to continue operation.

(b)  Application for an initial license or the renewal of a license must be on a form provided by the department and must be accompanied by the annual or prorated fee required in this section.

(c)  The licensee must report any change in the application information to the department before the change may be put into operation.

(6)  FEES.--

(a)  Fees assessed under this section shall be reasonably calculated to cover the cost of regulation under this section, may be used only to meet the costs of carrying out the requirements of this section, and are nonrefundable.

(b)  A person applying for initial licensure or reactivation of an expired license at the beginning of the licensing period or for renewal of a license shall pay the full fee. All other applicants, whether for initial licensure or reactivation of an expired license, shall pay a prorated fee based on the number of quarters left until September 30.

(c)  Fees must be received by the department within 30 days after receipt of written notification from the department that a fee is due. Failure to pay timely will result in the assessment of a late fee. Fees are payable to the county health department in the county where the establishment is located.

(d)  The fees assessed under this section are, unless prorated, as follows:

1.  The annual license fee, or license renewal fee, for a body-piercing salon is $150.

2.  Each late fee is $100.

3.  The fee for a temporary establishment license is $75.

(7)  MINORS.--A person may not perform body piercing on a minor without the written notarized consent of the minor's parent or legal guardian, and an establishment may not perform body piercing on a minor under the age of 16 unless the minor is accompanied by a parent or legal guardian.

(8)  PROHIBITED ACTS; PENALTIES; INJUNCTION.--

(a)  Each of the following acts constitutes a felony of the third degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084:

1.  Owning, operating, or soliciting business as an establishment in this state without first procuring a license from the department, unless specifically exempted by this section.

2.  Obtaining or attempting to obtain a license to operate an establishment by means of fraud, misrepresentation, or concealment.

(b)  Each of the following acts constitutes a misdemeanor of the second degree, punishable as provided in s. 775.082 or s. 775.083:

1.  Failing to maintain the records required by this section or knowingly making false entries in such records.

2.  Failing to comply with the requirements regarding minors set forth in subsection (7).

(c)  In addition to any other punishment provided for, the court may suspend or revoke the license of any licensee under this section who has been found guilty of any violation of paragraph (a) or paragraph (b).

(d)  If the department or any state attorney has probable cause to believe that an establishment or person has violated any provision of paragraph (a), an action may be brought by the department or the state attorney to enjoin such establishment or person from continuing such violation, or engaging therein or doing any acts in furtherance thereof, and the court may provide any other relief it deems appropriate.

(9)  ENFORCEMENT.--

(a)  The department shall inspect or investigate an establishment as necessary, but at least annually, to ensure compliance with this section. Department personnel may, at any reasonable time, enter any establishment licensed under this section or any premises the department has reason to believe is being operated or maintained in violation of this section, to determine compliance with this section or any rule adopted under this section.

(b)  The department may impose an administrative fine, not to exceed $1,000 per violation per day, for the violation of any provision of this section, any rule adopted under this section, or any term or condition of any license issued under this section by the department.

(c)  In determining the amount of fine to be levied for a violation, as provided in paragraph (b), the following factors shall be considered:

1.  The severity of the violation and the extent to which the provisions of this section, the rules adopted under this section, or any terms or conditions of any license issued under this section were violated.

2.  Actions taken by the licensee to correct the violation.

3.  Any previous violations by the licensee.

(d)  The department may issue a stop-use order, or institute legal action for injunctive or other relief, to enforce any provision of this section.

(e)  The department may cancel, revoke, or suspend a license to operate an establishment if the licensee:

1.  Fails to pay any fee required by this section;

2.  Obtains or attempts to obtain a license under this section by fraud, misrepresentation, or concealment; or

3.  Violates any provision of this section or any rule adopted under this section.

(f)1.  The department may issue a citation that contains an order of correction or an order to pay a fine, or both, for any violation of this section or the rules adopted under this section, when the violation of the section or rule is enforceable by an administrative or civil remedy or when the violation of the section or rule is a misdemeanor of the second degree. A citation constitutes a notice of proposed agency action.

2.  A citation must be in writing and must describe the particular nature of the violation, including specific reference to the provision of law or rule allegedly violated.

3.  The fines imposed by a citation may not exceed $1,000 for each violation. Each day the violation exists constitutes a separate violation for which a citation may be issued.

4.  The department shall inform the recipient of a citation, by written notice pursuant to ss. 120.569 and 120.57, of the right to an administrative hearing to contest the citation within 21 days after the date the citation is received. The citation must contain a conspicuous statement that if the recipient fails to pay any fine levied against the recipient within the time allowed or fails to appear to contest the citation after having requested a hearing, the recipient has waived the recipient's right to contest the citation and must pay the maximum fine.

5.  The department may reduce or waive any fine imposed by a citation. In determining whether to reduce or waive a fine, the department must consider the gravity of the violation, the person's attempts at correcting the violation, and the person's history of previous violations for which enforcement actions were taken under this section.

6.  Any person who willingly refuses to sign and accept a citation issued by the department commits a misdemeanor of the second degree, punishable as provided in s. 775.082 or s. 775.083.

7.  This paragraph provides an alternative means of enforcing this section, but does not prohibit the department from enforcing this section or the rules adopted under this section by any other means. However, the department may use only a single method of enforcement for each violation.

(g)  The department shall deposit all fines it collects under this section in the County Health Department Trust Fund for use in providing services specified in this section.

(10)  RULES.--The department has authority to adopt rules to implement this section. Such rules may include sanitation practices, sterilization requirements and procedures, patient record content requirements, personnel record retention requirements, patient notification requirements and procedures, physical plant requirements, light requirements, and enforcement procedures.

(11)  BODY-PIERCING SALONS; SPECIFIC REQUIREMENTS.--

(a)  A body-piercing salon must:

1.  Properly sterilize all instruments that pierce the skin, directly aid in piercing the skin, or may come in contact with instruments that pierce the skin, through such means as storage in trays with other instruments or contact with forceps, in accordance with the sterilization procedures in this section.

2.  Sanitize all equipment indirectly used in body piercing, including any beds, tables, headrests, armrests, legrests, or handrails.

3.  Use protective infection barriers such as gloves and masks when serving a customer. If the protective barriers are contaminated, they must be properly disposed of immediately. Protective barriers may only be used once and only for one customer.

4.  To the degree possible, thoroughly cleanse the area to be pierced with an antiseptic solution before and after the piercing.

5.  Use only jewelry that is made of implant grade high-quality stainless steel, solid gold of at least 14K weight, niobium, titanium, platinum, a dense, low-porosity plastic, or silver and that is free of nicks, scratches, or irregular surfaces.

6.  Provide each customer with written instructions on the proper care of the pierced area so as to prevent infection.

7.  Maintain a record of each customer's visit for a period of not less than 2 years, including, but not limited to, the customer's name, date of visit, and area pierced and the name of the person performing the piercing.

8.  Report any injury or any complaint of injury to the department on forms prescribed by the department and provide a copy of the report to the complainant.

(b)  Sterilization procedures must include the following:

1.  Proper autoclaving must be done according to the autoclave manufacturer's instructions.

2.  There must be a sterilization indicator in each autoclaving to monitor the sterilization procedure. The indicator must indicate exposure to steam and 250° Fahrenheit.

3.  Contaminated instruments must be sterilized in the following manner:

a.  The contaminated instruments must be thoroughly cleansed with an antiseptic solution, according to the instructions for the antiseptic solution, and hot water.

b.  The contaminated instruments and all other instruments, must be packaged properly and loaded correctly into the autoclave.

c.  The contaminated instruments must be sterilized by autoclave.

4.  All sterilized instruments must be stored and handled in a manner that maintains sterility.

5.  Autoclaves must be cleaned regularly and serviced at least once a year.

6.  Each body-piercing salon utilizing autoclave sterilization techniques must post the sterilization procedures and ensure that personnel responsible for performing the sterilization procedures are adequately trained.

7.  All staff must be trained in proper infection-control procedures.

8.  Presterilized, prewrapped, disposable instruments may be used, but must be used in accordance with the manufacturer's instructions.

(c)  The body-piercing salon must be in compliance with s. 381.0098.

History.--s. 1, ch. 99-176.

381.008  Definitions of terms used in ss. 381.008-381.00897.--As used in ss. 381.008-381.00897, the following words and phrases mean:

(1)  "Common areas"--That portion of a migrant labor camp or residential migrant housing not included within private living quarters and where migrant labor camp or residential migrant housing residents generally congregate.

(2)  "Department"--The Department of Health and its representative county health departments.

(3)  "Invited guest"--Any person who is invited by a resident to a migrant labor camp or residential migrant housing to visit that resident.

(4)  "Migrant farmworker"--A person who is or has been employed in hand labor operations in planting, cultivating, or harvesting agricultural crops within the last 12 months and who has changed residence for purposes of employment in agriculture within the last 12 months.

(5)  "Migrant labor camp"--One or more buildings, structures, barracks, or dormitories, and the land appertaining thereto, constructed, established, operated, or furnished as an incident of employment as living quarters for seasonal or migrant farmworkers whether or not rent is paid or reserved in connection with the use or occupancy of such premises. The term does not include a single-family residence that is occupied by a single family.

(6)  "Other authorized visitors"--Any person, other than an invited guest, who is:

(a)  A federal, state, or county government official;

(b)  A physician or other health care provider whose sole purpose is to provide medical care or medical information;

(c)  A representative of a bona fide religious organization who, during the visit, is engaged in the vocation or occupation of a religious professional or worker such as a minister, priest, or nun;

(d)  A representative of a nonprofit legal services organization, who must comply with the Code of Professional Conduct of The Florida Bar; or

(e)  Any other person who provides services for farmworkers which are funded in whole or in part by local, state, or federal funds but who does not conduct or attempt to conduct solicitations.

(7)  "Private living quarters"--A building or portion of a building, dormitory, or barracks, including its bathroom facilities, or a similar type of sleeping and bathroom area, which is a home, residence, or sleeping place for a resident of a migrant labor camp. The term includes residential migrant housing.

(8)  "Residential migrant housing"--A building, structure, mobile home, barracks, or dormitory, and any combination thereof on adjacent property which is under the same ownership, management, or control, and the land appertaining thereto, that is rented or reserved for occupancy by five or more migrant farmworkers, except:

(a)  Housing furnished as an incident of employment.

(b)  A single-family residence or mobile home dwelling unit that is not under the same ownership, management, or control as other farmworker housing to which it is adjacent or contiguous.

(c)  A hotel, motel, or resort condominium, as defined in chapter 509, that is furnished for transient occupancy.

(d)  Any housing owned or operated by a public housing authority except for housing which is specifically provided for persons whose principal income is derived from agriculture.

(9)  "Personal hygiene facilities"--Adequate facilities for providing hot water at a minimum of 110 degrees Fahrenheit for bathing and dishwashing purposes, and an adequate and convenient approved supply of potable water available at all times in each migrant labor camp and residential migrant housing for drinking, culinary, bathing, dishwashing, and laundry purposes.

(10)  "Lighting"--At least one ceiling-type light fixture capable of providing 20 foot-candles of light at a point 30 inches from the floor, and at least one separate double electric wall outlet in each habitable room in a migrant labor camp or residential migrant housing.

(11)  "Sewage disposal"--Approved facilities for satisfactory disposal and treatment of human excreta and liquid waste.

(12)  "Garbage disposal"--Watertight receptacles of impervious material which are provided with tight-fitting covers suitable to protect the contents from flies, insects, rodents, and other animals.

History.--s. 1, ch. 59-476; ss. 19, 35, ch. 69-106; s. 144, ch. 71-377; s. 1, ch. 72-176; s. 3, ch. 76-168; s. 84, ch. 77-147; s. 1, ch. 77-457; ss. 2, 3, ch. 81-318; ss. 1, 9, 10, ch. 83-249; s. 32, ch. 91-297; ss. 1, 15, ch. 93-133; s. 40, ch. 97-101; s. 9, ch. 98-151.

Note.--Former s. 381.422.

381.0081  Permit required to operate a migrant labor camp or residential migrant housing; penalties for unlawful establishment or operation; allocation of proceeds.--

(1)  MIGRANT LABOR CAMP; PERMIT REQUIREMENT.--A person who establishes, maintains, or operates a migrant labor camp in this state without first having obtained a permit from the department and who fails to post such permit and keep such permit posted in the camp to which it applies at all times during maintenance or operation of the camp commits a misdemeanor of the first degree, punishable as provided in s. 775.082 or s. 775.083.

(2)  RESIDENTIAL MIGRANT HOUSING; PERMIT REQUIREMENT.--A person who establishes, maintains, or operates any residential migrant housing in this state without first having obtained a permit from the department commits a misdemeanor of the first degree, punishable as provided in s. 775.082 or s. 775.083.

(3)  RESIDENTIAL MIGRANT HOUSING; HEALTH AND SANITATION.--A person who establishes, maintains, or operates any residential migrant housing or migrant labor camp in this state without providing adequate personal hygiene facilities, lighting, sewage disposal, and garbage disposal, and without first having obtained the required permit from the department, commits a felony of the third degree, punishable as provided in s. 775.082, s. 775.083, or s. 775.084.

(4)  FINE.--The department may impose a fine of up to $1,000 for each violation of this section. If the owner of land on which a violation of this section occurs is other than the person committing the violation and the owner knew or should have known upon reasonable inquiry that this section was being violated on the land, the fine may be applied against such owner. In determining the amount of the fine to be imposed, the department shall consider any corrective actions taken by the violator and any previous violations.

(5)  SEIZURE.--

(a)  In addition to other penalties provided by this section, the buildings, personal property, and land used in connection with a felony violation of this section may be seized and forfeited pursuant to the Contraband Forfeiture Act.

(b)  After satisfying any liens on the property, the remaining proceeds from the sale of the property seized under this section shall be allocated as follows if the department participated in the inspection or investigation leading to seizure and forfeiture under this section:

1.  One-third of the proceeds shall be allocated to the law enforcement agency involved in the seizure, to be used as provided in s. 932.7055.

2.  One-third of the proceeds shall be allocated to the department, to be used for purposes of enforcing the provisions of this section.

3.  One-third of the proceeds shall be deposited in the State Apartment Incentive Loan Fund, to be used for the purpose of providing funds to sponsors who provide housing for farmworkers.

(c)  After satisfying any liens on the property, the remaining proceeds from the sale of the property seized under this section shall be allocated equally between the law enforcement agency involved in the seizure and the State Apartment Incentive Loan Fund if the department did not participate in the inspection or investigation leading to seizure and forfeiture.

History.--s. 2, ch. 59-476; ss. 19, 35, ch. 69-106; s. 3, ch. 76-168; s. 85, ch. 77-147; s. 1, ch. 77-457; ss. 2, 3, ch. 81-318; ss. 2, 9, 10, ch. 83-249; s. 33, ch. 91-297; ss. 2, 15, ch. 93-133; s. 44, ch. 97-167.

Note.--Former s. 381.432.

381.0082  Application for permit to operate migrant labor camp or residential migrant housing.--Application for a permit to establish, operate, or maintain a migrant labor camp or residential migrant housing must be made to the department in writing on a form and under rules prescribed by the department. The application must state the location of the existing or proposed migrant labor camp or residential migrant housing; the approximate number of persons to be accommodated; the probable duration of use, and any other information the department requires.

History.--s. 3, ch. 59-476; ss. 19, 35, ch. 69-106; s. 3, ch. 76-168; s. 86, ch. 77-147; s. 1, ch. 77-457; ss. 2, 3, ch. 81-318; ss. 3, 9, 10, ch. 83-249; s. 34, ch. 91-297; ss. 4, 15, ch. 93-133.

Note.--Former s. 381.442.

381.0083  Permit for migrant labor camp or residential migrant housing.--Any person who is planning to construct, enlarge, remodel, use, or occupy a migrant labor camp or residential migrant housing or convert property for use as a migrant labor camp or residential migrant housing must give written notice to the department of the intent to do so at least 45 days before beginning such construction, enlargement, or renovation. If the department is satisfied, after causing an inspection to be made, that the camp or the residential migrant housing meets the minimum standards of construction, sanitation, equipment, and operation required by rules issued under s. 381.0086 and that the applicant has paid the application fees required by s. 381.0084, it shall issue in the name of the department the necessary permit in writing on a form to be prescribed by the department. The permit, unless sooner revoked, shall expire on September 30 next after the date of issuance, and it shall not be transferable. An application for a permit shall be filed with the department 30 days prior to operation. When there is a change in ownership of a currently permitted migrant labor camp or residential migrant housing, the new owner must file an application with the department at least 15 days before the change. In the case of a facility owned or operated by a public housing authority, an annual satisfactory sanitation inspection of the living units by the Farmers Home Administration or the Department of Housing and Urban Development shall substitute for the pre-permitting inspection required by the department.

History.--s. 4, ch. 59-476; ss. 19, 35, ch. 69-106; s. 3, ch. 76-168; s. 87, ch. 77-147; s. 1, ch. 77-457; ss. 2, 3, ch. 81-318; ss. 5, 9, 10, ch. 83-249; s. 35, ch. 91-297; ss. 5, 15, ch. 93-133; s. 10, ch. 98-151.

Note.--Former s. 381.452.

381.0084  Application fees for migrant labor camps and residential migrant housing.--

(1)  Each migrant labor camp operator or owner of residential migrant housing who is subject to s. 381.0081 shall pay to the department the following annual application fees:

(a)  Camps or residential migrant housing that have capacity for 5 to 50 occupants: $125.

(b)  Camps or residential migrant housing that have capacity for 51 to 100 occupants: $225.

(c)  Camps or residential migrant housing that have capacity for 101 or more occupants: $500.

(2)  The department shall deposit fees collected under this section in the County Health Department Trust Fund for use in the migrant labor camp program and shall use those fees solely for actual costs incurred in enforcing ss. 381.008-381.00895.

(3)  Any existing migrant labor camp or residential migrant housing that is substantially renovated or newly constructed is exempt from the annual application fee described in this section for the next annual permit after the renovations or construction occurred.

(4)  Any existing migrant labor camp or residential migrant housing that, during any permit year, has no major deficiencies cited by the department, no uncorrected deficiencies, and no administrative action taken against it is exempt from the annual application fee described in this section for the next annual permit period.

History.--ss. 4, 10, ch. 83-249; s. 36, ch. 91-297; ss. 6, 15, ch. 93-133; s. 41, ch. 97-101.

Note.--Former s. 381.455.

381.0085  Revocation of permit to operate migrant labor camp or residential migrant housing.--The department may revoke a permit authorizing the operation of a migrant labor camp or residential migrant housing if it finds the holder has failed to comply with any provision of this law or any rule adopted hereunder. To reinstate a permit for migrant labor camp or residential migrant housing from which a permit has been revoked, the operator shall submit another application with the appropriate fee and satisfy the department that he or she is in compliance with all applicable rules.

History.--s. 5, ch. 59-476; ss. 19, 35, ch. 69-106; s. 3, ch. 76-168; s. 88, ch. 77-147; s. 1, ch. 77-457; ss. 2, 3, ch. 81-318; ss. 6, 9, 10, ch. 83-249; s. 37, ch. 91-297; s. 15, ch. 93-133; s. 652, ch. 95-148.

Note.--Former s. 381.462.

381.0086  Rules; variances; penalties.--

(1)  The department shall adopt rules necessary to protect the health and safety of migrant farm workers and other migrant labor camp or residential migrant housing occupants, including rules governing field sanitation facilities. These rules must include definitions of terms, provisions relating to plan review of the construction of new, expanded, or remodeled camps, sites, buildings and structures, personal hygiene facilities, lighting, sewage disposal, safety, minimum living space per occupant, bedding, food equipment, food storage and preparation, insect and rodent control, garbage, heating equipment, water supply, maintenance and operation of the camp, housing, or roads, and such other matters as the department finds to be appropriate or necessary to protect the life and health of the occupants. Housing operated by a public housing authority is exempt from the provisions of any administrative rule that conflicts with or is more stringent than the federal standards applicable to the housing.

(2)  An owner or operator may apply for a permanent structural variance from the department's rules by filing a written application and paying a fee set by the department, not to exceed $100. This application must:

(a)  Clearly specify the standard from which the variance is desired;

(b)  Provide adequate justification that the variance is necessary to obtain a beneficial use of an existing facility and to prevent a practical difficulty or unnecessary hardship; and

(c)  Clearly set forth the specific alternative measures that the owner or operator has taken to protect the health and safety of occupants and adequately show that the alternative measures have achieved the same result as the standard from which the variance is sought.

(3)  Any variance granted by the department must be in writing, must state the standard involved, and must state as conditions of the variance the specific alternative measures taken to protect the health and safety of the occupants. In denying the request, the department must provide written notice under ss. 120.569 and 120.57 of the applicant's right to an administrative hearing to contest the denial within 21 days after the date of receipt of the notice.

(4)  A person who violates any provision of ss. 381.008-381.00895 or rules adopted under such sections is subject either to the penalties provided in ss. 381.0012, 381.0025, and 381.0061 or to the penalties provided in s. 381.0087.

(5)  Notwithstanding any other provision of this chapter, any housing that is furnished as a condition of employment so as to subject it to the requirements of the Occupational Health and Safety Act of 1970, 29 U.S.C. s. 655, shall only be inspected under the temporary labor camp standards at 42 C.F.R. s. 1910.142.

History.--s. 6, ch. 59-476; ss. 19, 35, ch. 69-106; s. 2, ch. 72-176; s. 3, ch. 76-168; s. 1, ch. 76-252; s. 89, ch. 77-147; s. 1, ch. 77-457; ss. 2, 3, ch. 81-318; ss. 7, 9, 10, ch. 83-249; s. 41, ch. 85-81; s. 19, ch. 87-287; s. 38, ch. 91-297; ss. 7, 15, ch. 93-133; s. 117, ch. 96-410; s. 11, ch. 98-151; s. 12, ch. 2000-242.

Note.--Former s. 381.472.

381.0087  Enforcement; citations.--

(1)  Department personnel or crew chief compliance officers employed by the Bureau of Compliance of the Florida Department of Labor and Employment Security may issue citations that contain an order of correction or an order to pay a fine, or both, for violations of ss. 381.008-381.00895 or the field sanitation facility rules adopted by the department when a violation of those sections or rules is enforceable by an administrative or civil remedy, or when a violation of those sections or rules is a misdemeanor of the second degree. A citation issued under this section constitutes a notice of proposed agency action. The recipient of a citation for a major deficiency, as defined by rule of the department, will be given a maximum of 48 hours to make satisfactory correction or demonstrate that provisions for correction are satisfactory.

(2)  Citations must be in writing and must describe the particular nature of the violation, including specific reference to the provision of statute or rule allegedly violated. Continual or repeat violations of the same requirement will result in the issuance of a citation.

(3)  The fines imposed by a citation issued by the department may not exceed $500 for each violation. Each day the violation exists constitutes a separate violation for which a citation may be issued.

(4)  The citing official shall inform the recipient, by written notice pursuant to ss. 120.569 and 120.57, of the right to an administrative hearing to contest the citation of the agency within 21 days after the date of receipt of the citation. The citation must contain a conspicuous statement that if the citation recipient fails to pay the fine within the time allowed, or fails to appear to contest the citation after having requested a hearing, the recipient is deemed to have waived the right to contest the citation and must pay an amount up to the maximum fine or penalty.

(5)  The department may reduce or waive the fine imposed by the citation. In determining whether to reduce or waive the fine, the department must give due consideration to such factors as the gravity of the violation, the good faith of the person who has allegedly committed the violation, and the person's history of previous violations, including violations for which enforcement actions were taken under this section or other provisions of state law.

(6)  Any person who willfully refuses to sign and accept a citation issued by the department or the Department of Labor and Employment Security is guilty of a misdemeanor of the second degree, punishable as provided in s. 775.082 or s. 775.083.

(7)  The department shall deposit all fines collected under ss. 381.008-381.00895 in the County Health Department Trust Fund for use of the migrant labor camp inspection program and shall use such fines to improve migrant labor camp and residential migrant housing as described in s. 381.0086.

(8)  The provisions of this section are an alternative means of enforcing ss. 381.008-381.00895 and the field sanitation facility rules. This section does not prohibit the department from enforcing those sections or rules by any other means. However, the agency shall elect to use only the procedure for enforcement under this section or another method of civil or administrative enforcement for a single violation.

History.--s. 39, ch. 91-297; s. 8, ch. 93-133; s. 118, ch. 96-410; s. 183, ch. 97-101; s. 12, ch. 98-151.

381.0088  Right of entry.--The department or its inspectors may enter and inspect migrant labor camps or residential migrant housing at reasonable hours and investigate such facts, conditions, and practices or matters, as are necessary or appropriate to determine whether any person has violated any provisions of applicable statutes or rules adopted pursuant thereto by the department. The right of entry extends to any premises that the department has reason to believe is being established, maintained, or operated as a migrant labor camp or residential migrant housing without a permit, but such entry may not be made without the permission of the owner, person in charge, or resident thereof, unless an inspection warrant is first obtained from the circuit court authorizing the entry. Any application for a permit made under s. 381.0082 constitutes permission for, and complete acquiescence in, any entry or inspection of the premises for which the permit is sought, to verify the information submitted on or in connection with the application; to discover, investigate, and determine the existence of any violation of ss. 381.008-381.00895 or rules adopted thereunder; or to elicit, receive, respond to, and resolve complaints. Any current valid permit constitutes unconditional permission for, and complete acquiescence in, any entry or inspection of the premises by authorized personnel. The department may from time to time publish the reports of such inspections.

History.--s. 7, ch. 59-476; ss. 19, 35, ch. 69-106; s. 3, ch. 76-168; s. 90, ch. 77-147; s. 1, ch. 77-457; ss. 2, 3, ch. 81-318; ss. 8, 9, 10, ch. 83-249; s. 40, ch. 91-297; ss. 9, 15, ch. 93-133.

Note.--Former s. 381.482.

381.00893  Complaints by aggrieved parties.--Any person who believes that the housing violates any provision of ss. 381.008-381.00895 or rules adopted thereunder may file a complaint with the department. Upon receipt of the complaint, if the department finds there are reasonable grounds to believe that a violation exists and that the nature of the alleged violation could pose a serious and immediate threat to public health, the department shall conduct an inspection as soon as practicable. In all other cases where the department finds there are reasonable grounds to believe that a violation exists, the department shall notify the owner and the operator of the housing that a complaint has been received and the nature of the complaint. The department shall also advise the owner and the operator that the alleged violation must be remedied within 3 business days. The department shall conduct an inspection as soon as practicable following such 3-day period. The department shall notify the owner or the operator of the housing and the complainant in writing of the results of the inspection and the action taken. Upon request of the complainant, the department shall conduct the inspection so as to protect the confidentiality of the complainant. The department shall adopt rules by January 1, 1994, to implement this section.

History.--s. 11, ch. 93-133.

381.00895  Prohibited acts; application.--

(1)  An owner or operator of housing subject to the provisions of ss. 381.008-381.00897 may not, for the purpose of retaliating against a resident of that housing, discriminatorily terminate or discriminatorily modify a tenancy by increasing the resident's rent; decreasing services to the resident; bringing or threatening to bring against the resident an action for eviction or possession or another civil action; refusing to renew the resident's tenancy; or intimidating, threatening, restraining, coercing, blacklisting, or discharging the resident. Examples of conduct for which the owner or operator may not retaliate include, but are not limited to, situations in which:

(a)  The resident has complained in good faith, orally or in writing, to the owner or operator of the housing, the employer, or any government agency charged with the responsibility of enforcing the provisions of ss. 381.008-381.00897.

(b)  The resident has exercised any legal right provided in this chapter with respect to the housing.

(2)  A resident who brings an action for or raises a defense of retaliatory conduct must have acted in good faith.

(3)  This section does not apply if the owner or operator of housing proves that the eviction or other action is for good cause, including, without limitation, a good faith action for nonpayment of rent, a violation of the resident's rental or employment agreement, a violation of reasonable rules of the owner or operator of the housing or of the employer, or a violation of this chapter or the Florida Residential Landlord and Tenant Act.

History.--s. 12, ch. 93-133; s. 653, ch. 95-148.

381.00896  Nondiscrimination.--

(1)  The Legislature declares that it is the policy of this state that each county and municipality must permit and encourage the development and use of a sufficient number and sufficient types of farmworker housing facilities to meet local needs. The Legislature further finds that discriminatory practices that inhibit the development of farmworker housing are a matter of state concern.

(2)  Any owner or developer of farmworker housing which has qualified for a permit to operate, or who would qualify for a permit based upon plans submitted to the department, or the residents or intended residents of such housing may invoke the provisions of this section.

(3)  A municipality or county may not enact or administer local land use ordinances to prohibit or discriminate against the development and use of farmworker housing facilities because of the occupation, race, sex, color, religion, national origin, or income of the intended residents.

(4)  This section does not prohibit the imposition of local property taxes, water service and garbage collection fees, normal inspection fees, local bond assessments, or other fees, charges, or assessments to which other dwellings of the same type in the same zone are subject.

(5)  This section does not prohibit a municipality or county from extending preferential treatment to farmworker housing, including, without limitation, fee reductions or waivers or changes in architectural requirements, site development or property line requirements, or vehicle parking requirements that reduce the development costs of farmworker housing.

History.--s. 13, ch. 93-133.

381.00897  Access to migrant labor camps and residential migrant housing.--

(1)  RIGHT OF ACCESS OF INVITED GUEST.--A resident of a migrant labor camp or residential migrant housing may decide who may visit him or her in the resident's private living quarters. A person may not prohibit or attempt to prohibit an invited guest access to or egress from the private living quarters of the resident who invited the guest by the erection or maintenance of any physical barrier, by physical force or violence, by threat of force or violence, or by any verbal order or notice given in any manner. Any invited guest must leave the private living quarters upon the reasonable request of a resident residing within the same private living quarters.

(2)  RIGHT OF ACCESS OF OTHERS.--Other authorized visitors have a right of access to or egress from the common areas of a migrant labor camp or residential migrant housing as provided in this subsection. A person may not prohibit or attempt to prohibit other visitors access to or egress from the common areas of a migrant labor camp or residential migrant housing by the erection or maintenance of any physical barrier, by physical force or violence, by threat of force or violence, or by any verbal order or notice given in any manner, except as provided in this section. Owners or operators of migrant labor camps or residential migrant housing may adopt reasonable rules regulating hours of access to housing, if such rules permit at least 4 hours of access each day during nonworking hours Monday through Saturday and between the hours of 12 noon and 8 p.m. on Sunday. Any other authorized visitor must leave the private living quarters upon the reasonable request of a person who resides in the same private living quarters.

(3)  CIVIL ACTION.--Any person prevented from exercising rights guaranteed by this section may bring an action in the appropriate court of the county in which the alleged infringement occurred; and, upon favorable adjudication, the court shall enjoin the enforcement of any rule, practice, or conduct that operates to deprive the person of such rights.

(4)  CIVIL LIABILITY.--Other visitors are licensees, not guests or invitees, for purposes of any premises liability.

(5)  OTHER RULES.--The housing owner or operator may require invited guests and other visitors to check in before entry and to present picture identification. Migrant labor camp and residential migrant housing owners or operators may adopt other rules regulating access to a camp only if the rules are reasonably related to the purpose of promoting the safety, welfare, or security of residents, visitors, farmworkers, or the owner's or operator's business.

(6)  POSTING REQUIRED.--Rules relating to access are unenforceable unless they have been conspicuously posted in the migrant labor camp or migrant residential housing and a copy has been furnished to the department.

(7)  LIMITATIONS.--This section does not create a general right of solicitation in migrant labor camps or residential migrant housing. This section does not prohibit the erection or maintenance of a fence around a migrant labor camp or residential migrant housing if one or more unlocked gates or gateways in the fence are provided; nor does this section prohibit posting the land adjacent to a migrant labor camp or residential migrant housing if access to the camp is clearly marked; nor does this section restrict migrant workers residing within the same living quarters from imposing reasonable restrictions on their fellow residents to accommodate reasonable privacy and other concerns of the residents.

History.--s. 10, ch. 93-133; s. 654, ch. 95-148.

381.009  Toilets required by department regulations; charge for use of prohibited.--No place of employment or place serving the public shall make a charge for the use of any toilet which is required to be provided by regulation of the Department of Health. Any place of employment or place serving the public which violates this act is guilty of a misdemeanor of the second degree, punishable as provided in s. 775.083.

History.--s. 1, ch. 74-240; s. 98, ch. 77-147; s. 41, ch. 91-297; s. 42, ch. 97-101.

Note.--Former s. 381.522.

381.0091  Separate restrooms and separate dressing rooms for males and females.--

(1)  Any business may designate separate restrooms and separate dressing rooms for males and for females and may prohibit any female from using a restroom or dressing room designated for males and any male from using a restroom or dressing room designated for females.

(2)  If more than one restroom is provided in any building or facility owned or operated by the state or any political subdivision of the state, the restrooms for males shall be separate from the restrooms for females and each restroom shall be designated by an appropriate sign as a restroom for use by males or for use by females, if said restroom has occupant capacity of more than one person.

History.--ss. 1, 2, ch. 77-242; s. 41, ch. 91-297.

Note.--Former s. 381.523.

381.0098  Biomedical waste.--

(1)  LEGISLATIVE INTENT.--It is the intent of the Legislature to protect the public health by establishing standards for the safe packaging, transport, storage, treatment, and disposal of biomedical waste. Except as otherwise provided herein, the Department of Health shall regulate the packaging, transport, storage, and treatment of biomedical waste. The Department of Environmental Protection shall regulate onsite and offsite incineration and disposal of biomedical waste. Consistent with the foregoing, the Department of Health shall have the exclusive authority to establish treatment efficacy standards for biomedical waste and the Department of Environmental Protection shall have the exclusive authority to establish statewide standards relating to environmental impacts, if any, of treatment and disposal including, but not limited to, water discharges and air emissions. An interagency agreement between the Department of Environmental Protection and the Department of Health shall be developed to ensure maximum efficiency in coordinating, administering, and regulating biomedical wastes.

(2)  DEFINITIONS.--As used in this section, the term:

(a)  "Biomedical waste" means any solid or liquid waste which may present a threat of infection to humans. The term includes, but is not limited to, nonliquid human tissue and body parts; laboratory and veterinary waste which contains human-disease-causing agents; discarded disposable sharps; human blood, blood products, and body fluids; and other materials which in the opinion of the department represent a significant risk of infection to persons outside the generating facility. The term does not include human remains that are disposed of by persons licensed under chapter 470.

(b)  "Biomedical waste generator" means a facility or person that produces or generates biomedical waste. The term includes, but is not limited to, hospitals, skilled nursing or convalescent hospitals, intermediate care facilities, clinics, dialysis clinics, dental offices, health maintenance organizations, surgical clinics, medical buildings, physicians' offices, laboratories, veterinary clinics, and funeral homes where embalming procedures are performed.

(c)  "Department" means the Department of Health.

(d)  "Sharps" mean those biomedical wastes which as a result of their physical characteristics are capable of puncturing, lacerating, or otherwise breaking the skin when handled.

(e)  "Treatment" means any process, including steam treatment, chemical treatment, and microwave shredding, which changes the character or composition of biomedical waste so as to render it noninfectious. For the purposes of this section, treatment does not include the incineration of biomedical waste.

(3)  OPERATING STANDARDS.--The department shall adopt rules necessary to protect the health, safety, and welfare of the public and to carry out the purpose of this section. Such rules shall address, but need not be limited to, definitions of terms, the packaging of biomedical waste, including specific requirements for the segregation of the waste at the point of generation; the safe packaging of sharps; the placement of the waste in containers that will protect waste handlers and the public from exposure; the appropriate labeling of containers of waste; written operating plans for managing biomedical waste; and the transport, storage, and treatment of biomedical wastes.

(4)  PERMITS AND FEES.--

(a)  All persons who generate, store, or treat biomedical waste shall obtain a permit from the department prior to commencing operation, except that a biomedical waste generator generating less than 25 pounds of biomedical waste in each 30-day period shall be exempt from the registration and fee requirements of this subsection. A biomedical waste generator need not obtain a separate permit if such generator works less than 6 hours in a 7-day period at a location different than the location specified on the permit. The department may issue combined permits for generation, storage, and treatment as appropriate to streamline permitting procedures. Application for such permit shall be made on an application form provided by the department and within the timeframes and in the manner prescribed by department rule.

(b)  Once the department determines that the person generating, storing, or treating biomedical waste is capable of constructing a facility or operating in compliance with this section and the rules adopted under this section, the department shall grant the permit.

(c)  If the department determines that the person generating, storing, or treating biomedical waste does not meet the provisions outlined in this section or the rules adopted under this section, the department shall deny the application for the permit pursuant to provisions of chapter 120. Such denial shall be in writing and shall list the circumstances for denial. Upon correction of such circumstances, the permit shall be issued.

(d)  The permit for a biomedical waste facility may not be transferred. When the ownership, control, or name of a biomedical waste facility is changed and continues to operate, the new owner shall apply to the department, upon forms provided by the department, for issuance of a permit in the timeframe and manner prescribed by rule of the department.

(e)  The department shall establish a schedule of fees for such permits. Fees assessed under this section shall be in an amount sufficient to meet the costs of carrying out the provisions of this section and rules adopted under this section. The fee schedule shall not be less than $50 or more than $400 for each year the permit is valid. Fees may be prorated on a quarterly basis when a facility will be in operation for 6 months or less before the annual renewal date. The department shall assess the minimum fees provided in this subsection until a fee schedule is adopted by rule of the department. Facilities owned and operated by the state shall be exempt from the payment of any fees.

(f)  Fees collected by the department in accordance with provisions of this section and the rules adopted under this section shall be deposited into a trust fund administered by the department for the payment of costs incurred in the administration of this section.

(g)  Permits issued by the department shall be valid for no more than 5 years. However, upon expiration, a new permit may be issued by the department in accordance with this section and the rules of the department.

(h)  The department may develop a streamlined process for permitting biomedical waste storage facilities that accept and store only sharps collected from the public, which may include the issuance of a single permit for each applicant that develops or sponsors a sharps collection program.

(5)  TRANSPORTERS.--Any person who transports biomedical waste within the state must register with the department prior to engaging in the transport of biomedical waste in accordance with rules adopted by the department. A registration may not be transferred from one biomedical waste transporter to another. If the ownership or name of a biomedical waste transporter is changed and the owner intends to continue operation of the transporter, the owner must apply to the department on departmental forms within the timeframes and in the manner prescribed by department rule. The department may charge registration fees in the same manner as is provided in paragraphs (4)(e) and (f). The department may exempt from this requirement any person who, or facility that, transports less than 25 pounds of such waste on any single occasion.

(6)  TRACKING SYSTEM.--The department shall adopt rules for a system of tracking biomedical waste.

(a)  Such system shall, at a minimum, provide for tracking of the transportation of the waste from the generator to the treatment or incineration facility, including a means for providing the generator of the waste assurance that the waste is received by the treatment or incineration facility, and shall include the identification of the entity transporting the waste on the container.

(b)  Inspections may be conducted for purposes of compliance with this section. Any such inspection shall be commenced and completed with reasonable promptness. If the officer, employee, or representative of the department obtains any samples, prior to leaving the premises he or she shall give the owner, operator, or agent in charge a receipt describing the sample obtained.

(c)  Any person who fails to comply with the provisions of this subsection commits a misdemeanor of the second degree, punishable as provided in s. 775.082 or s. 775.083.

(7)  ENFORCEMENT AND PENALTIES.--Any person or public body in violation of this section or rules adopted under this section is subject to penalties provided in ss. 381.0012, 381.0025, and 381.0061. However, an administrative fine not to exceed $2,500 may be imposed for each day such person or public body is in violation of this section. The department may deny, suspend, or revoke any biomedical waste permit or registration if the permittee violates this section, any rule adopted under this section, or any lawful order of the department.

(8)  PREEMPTION OF AUTHORITY TO REGULATE.--The regulation and inspection of biomedical waste generators is hereby preempted by the state. Nothing in this chapter shall be construed to affect a local government's zoning and land use authority over biomedical waste generators. Acute care hospitals, licensed under chapter 395, which utilize a certified onsite treatment process involving grinding and treatment, may dispose of such treated biomedical waste in the normal municipal solid waste stream upon notifying the local governments that are responsible for solid waste collection and disposal.

(9)  TRANSITION.--

(a)  Nothing in this act is intended to repeal or modify any existing rules of the Department of Environmental Protection relating to biomedical waste unless such rule or part thereof is in direct conflict with this act. Rules of the Department of Environmental Protection relating to transport, storage, or treatment of biomedical waste existing on the effective date of this act shall remain in effect and be enforceable by the department until comparable rules are adopted by the department, and no judicial or administrative proceeding pending on the effective date of this act shall be abated as a result of the provisions of this act.

(b)  Any person operating or in the process of constructing a biomedical storage or treatment facility, or any person transporting biomedical waste, in accordance with a permit or registration issued by the Department of Environmental Protection on the effective date of this act, may continue to operate under that permit or registration until that permit or registration expires, or until December 31, 1996, whichever is later. The department's rules concerning the permitting or registering of biomedical waste storage facilities, treatment facilities, and transporters shall be designed to accomplish a smooth transition between permitting or registration authorities.

(c)  A permit application which is received after or which is pending on the effective date of this act, which would have been considered a renewal application if submitted to the Department of Environmental Protection, will be considered a renewal application for purposes of s. 120.60 when submitted to the department.

(d)  Prior to implementing the change in the regulation of offsite treatment facilities described in this act, and after full consultation with affected persons, the department and the Department of Environmental Protection shall establish an interagency agreement to streamline the permitting and inspection of these treatment facilities. The agreement also shall be designed to avoid any duplicative or overlapping regulation of these treatment facilities. Such agreement shall at least provide:

1.  That the Department of Environmental Protection will continue to accept and act on permit applications for these facilities;

2.  That the department will review these permit applications with respect to those matters within its jurisdiction;

3.  That these permits will be consolidated with other required Department of Environmental Protection permits, where possible; and

4.  That any inspections will be consolidated to avoid duplicate inspections, where possible.

History.--s. 51, ch. 88-130; s. 2, ch. 89-138; s. 42, ch. 91-297; s. 1, ch. 92-104; s. 6, ch. 93-207; s. 353, ch. 94-356; s. 1, ch. 96-284; s. 184, ch. 97-101; s. 13, ch. 98-151; s. 13, ch. 2000-242.

Note.--Former s. 381.80.

381.0101  Environmental health professionals.--

(1)  LEGISLATIVE INTENT.--Persons responsible for providing technical and scientific evaluations of environmental health and sanitary conditions in business establishments and communities throughout the state may create a danger to the public health if they are not skilled or competent to perform such evaluations. The public relies on the judgment of environmental health professionals employed by both government agencies and industries to assure them that environmental hazards are identified and removed before they endanger the health or safety of the public. The purpose of this section is to assure the public that persons specifically responsible for performing environmental health and sanitary evaluations have been certified by examination as competent to perform such work.

(2)  DEFINITIONS.--As used in this section:

(a)  "Board" means the Environmental Health Professionals Advisory Board.

(b)  "Department" means the Department of Health.

(c)  "Environmental health" means that segment of public health work which deals with the examination of those factors in the human environment which may impact adversely on the health status of an individual or the public.

(d)  "Environmental health professional" means a person who is employed or assigned the responsibility for assessing the environmental health or sanitary conditions, as defined by the department, within a building, on an individual's property, or within the community at large, and who has the knowledge, skills, and abilities to carry out these tasks. Environmental health professionals may be either field, supervisory, or administrative staff members.

(e)  "Certified" means a person who has displayed competency to perform evaluations of environmental or sanitary conditions through examination.

(f)  "Registered sanitarian," "R.S.," "Registered Environmental Health Specialist," or "R.E.H.S." means a person who has been certified by either the National Environmental Health Association or the Florida Environmental Health Association as knowledgeable in the environmental health profession.

(g)  "Primary environmental health program" means those programs determined by the department to be essential for providing basic environmental and sanitary protection to the public. At a minimum, these programs shall include food protection program work and onsite sewage treatment and disposal system evaluations.

(3)  CERTIFICATION REQUIRED.--No person shall perform environmental health or sanitary evaluations in any primary program area of environmental health without being certified by the department as competent to perform such evaluations. The requirements of this section shall not be mandatory for persons performing inspections of public food service establishments licensed under chapter 509.

(4)  ENVIRONMENTAL HEALTH PROFESSIONALS ADVISORY BOARD.--The State Health Officer shall appoint an advisory board to assist the department in the promulgation of rules for certification, testing, establishing standards, and seeking enforcement actions against certified professionals.

(a)  The board shall be comprised of the Division Director for Environmental Health or his or her designee, one individual who will be certified under this section, one individual not employed in a governmental capacity who will or does employ a certified environmental health professional, one individual whose business is or will be evaluated by a certified environmental health professional, a citizen of the state who neither employs nor is routinely evaluated by a person certified under this section.

(b)  The board shall advise the department as to the minimum disciplinary guidelines and standards of competency and proficiency necessary to obtain certification in a primary area of environmental health practice.

1.  The board shall recommend primary areas of environmental health practice in which environmental health professionals should be required to obtain certification.

2.  The board shall recommend minimum standards of practice which the department shall incorporate into rule.

3.  The board shall evaluate and recommend to the department existing registrations and certifications which meet or exceed minimum department standards and should, therefore, exempt holders of such certificates or registrations from compliance with this section.

4.  The board shall hear appeals of certificate denials, revocation, or suspension and shall advise the department as to the disposition of such an appeal.

5.  The board shall meet as often as necessary, but no less than semiannually, handle appeals to the department, and conduct other duties of the board.

6.  Members of the board shall receive no compensation but are entitled to reimbursement for per diem and travel expenses in accordance with s. 112.061.

(5)  STANDARDS FOR CERTIFICATION.--The department shall adopt rules that establish definitions of terms and minimum standards of education, training, or experience for those persons subject to this section. The rules must also address the process for application, examination, issuance, expiration, and renewal of certification and ethical standards of practice for the profession.

(a)  Persons employed as environmental health professionals shall exhibit a knowledge of rules and principles of environmental and public health law in Florida through examination. A person may not conduct environmental health evaluations in a primary program area unless he or she is currently certified in that program area or works under the direct supervision of a certified environmental health professional.

1.  All persons who begin employment in a primary environmental health program on or after September 21, 1994, must be certified in that program within 6 months after employment.

2.  Persons employed in the primary environmental health program of a food protection program or an onsite sewage treatment and disposal system prior to September 21, 1994, shall be considered certified while employed in that position and shall be required to adhere to any professional standards established by the department pursuant to paragraph (b), complete any continuing education requirements imposed under paragraph (d), and pay the certificate renewal fee imposed under subsection (7).

3.  Persons employed in the primary environmental health program of a food protection program or an onsite sewage treatment and disposal system prior to September 21, 1994, who change positions or program areas and transfer into another primary environmental health program area on or after September 21, 1994, must be certified in that program within 6 months after such transfer, except that they will not be required to possess the college degree required under paragraph (e).

4.  Registered sanitarians shall be considered certified and shall be required to adhere to any professional standards established by the department pursuant to paragraph (b).

(b)  At a minimum, the department shall establish standards for professionals in the areas of food hygiene and onsite sewage treatment and disposal.

(c)  Those persons conducting primary environmental health evaluations shall be certified by examination to be knowledgeable in any primary area of environmental health in which they are routinely assigned duties.

(d)  Persons who are certified shall renew their certification biennially by completing not less than 24 contact hours of continuing education for each program area in which they maintain certification, subject to a maximum of 48 hours for multiprogram certification.

(e)  Applicants for certification shall have graduated from an accredited 4-year college or university with a degree or major coursework in public health, environmental health, environmental science, or a physical or biological science.

(f)  A certificateholder shall notify the department within 60 days after any change of name or address from that which appears on the current certificate.

(6)  EXEMPTIONS.--A person who conducts primary environmental evaluation activities and maintains a current registration or certification from another state agency which examined the person's knowledge of the primary program area and requires comparable continuing education to maintain the certificate shall not be required to be certified by this section. Examples of persons not subject to certification are physicians, registered dietitians, certified laboratory personnel, and nurses.

(7)  FEES.--The department shall charge fees in amounts necessary to meet the cost of providing certification. Fees for certification shall be not less than $10 or more than $300 and shall be set by rule. Application, examination, and certification costs shall be included in this fee. Fees for renewal of a certificate shall be no less than $25 nor more than $150 per biennium.

(8)  PENALTIES.--The department may deny, suspend, or revoke a certificate or impose an administrative fine of up to $500 for each violation of this section or a rule adopted under this section or may pursue any other enforcement action authorized by law. Any person who has had a certificate revoked may not conduct environmental health evaluations in a primary program area for a minimum of 5 years from the date of revocation.

History.--ss. 43, 61, 62, ch. 91-297; ss. 4, 5, ch. 91-429; s. 655, ch. 95-148; s. 23, ch. 97-100; s. 43, ch. 97-101; s. 22, ch. 97-237; s. 14, ch. 98-151; s. 14, ch. 2000-242; s. 11, ch. 2000-367.

381.0201  Technical and support services.--The department shall establish certain technical and support programs to enable the county health departments and other public or private agencies to carry out the public health mission. These programs shall include, but not be limited to, laboratory, pharmacy, vital statistics, and emergency medical services.

History.--s. 44, ch. 91-297; s. 44, ch. 97-101.

381.0202  Laboratory services.--

(1)  The department may establish and maintain, in suitable and convenient places in the state, laboratories for microbiological and chemical analyses and any other purposes it determines necessary for the protection of the public health.

(2)  The department may contract or agree with any person or public or private agency to provide laboratory services relating to or having potential impact on the public health or relating to the health of clients directly under the care of the state.

(3)  The department is authorized to establish and collect reasonable fees and charges for laboratory services provided. Such fees and charges shall be deposited in a trust fund administered by the department and shall be used solely for this purpose.

History.--s. 2, ch. 29834, 1955; ss. 19, 35, ch. 69-106; s. 3, ch. 77-113; s. 77, ch. 77-147; s. 31, ch. 83-276; s. 45, ch. 91-297.

Note.--Former s. 381.321.

381.0203  Pharmacy services.--

(1)  The department may contract on a statewide basis for the purchase of drugs, as defined in s. 499.003, to be used by state agencies and political subdivisions, and may adopt rules to administer this section.

(2)  The department may establish and maintain a pharmacy services program, including, but not limited to:

(a)  A central pharmacy to support pharmaceutical services provided by the county health departments, including pharmaceutical repackaging, dispensing, and the purchase and distribution of immunizations and other pharmaceuticals.

(b)  Regulation of drugs, cosmetics, and household products pursuant to chapter 499.

(c)  Consultation to county health departments as required by s. 154.04(1)(c).

(d)  A contraception distribution program which shall be implemented, to the extent resources permit, through the licensed pharmacies of county health departments. A woman who is eligible for participation in the contraceptive distribution program is deemed a patient of the county health department.

1.  To be eligible for participation in the program a woman must:

a.  Be a client of the department or the Department of Children and Family Services.

b.  Be of childbearing age with undesired fertility.

c.  Have an income between 150 and 200 percent of the federal poverty level.

d.  Have no Medicaid benefits or applicable health insurance benefits.

e.  Have had a medical examination by a licensed health care provider within the past 6 months.

f.  Have a valid prescription for contraceptives that are available through the contraceptive distribution program.

g.  Consent to the release of necessary medical information to the county health department.

2.  Fees charged for the contraceptives under the program must cover the cost of purchasing and providing contraceptives to women participating in the program.

3.  The department may adopt rules to administer this program.

History.--s. 46, ch. 91-297; s. 6, ch. 94-309; s. 45, ch. 97-101; s. 23, ch. 97-237; s. 194, ch. 99-13; s. 15, ch. 2000-242; s. 11, ch. 2000-326.

381.0204  Vital statistics.--The department shall provide for a statewide vital statistics program pursuant to chapter 382.

History.--s. 47, ch. 91-297.

381.0205  Emergency medical services.--The department shall provide for a statewide emergency medical services program pursuant to chapters 395 and 401.

History.--s. 48, ch. 91-297.

381.026  Florida Patient's Bill of Rights and Responsibilities.--

(1)  SHORT TITLE.--This section may be cited as the "Florida Patient's Bill of Rights and Responsibilities."

(2)  DEFINITIONS.--As used in this section and s. 381.0261, the term:

(a)  "Department" means the Department of Health.

(b)  "Health care facility" means a facility licensed under chapter 395.

(c)  "Health care provider" means a physician licensed under chapter 458, an osteopathic physician licensed under chapter 459, or a podiatric physician licensed under chapter 461.

(d)  "Responsible provider" means a health care provider who is primarily responsible for patient care in a health care facility or provider's office.

(3)  PURPOSE.--It is the purpose of this section to promote the interests and well-being of the patients of health care providers and health care facilities and to promote better communication between the patient and the health care provider. It is the intent of the Legislature that health care providers understand their responsibility to give their patients a general understanding of the procedures to be performed on them and to provide information pertaining to their health care so that they may make decisions in an informed manner after considering the information relating to their condition, the available treatment alternatives, and substantial risks and hazards inherent in the treatments. It is the intent of the Legislature that patients have a general understanding of their responsibilities toward health care providers and health care facilities. It is the intent of the Legislature that the provision of such information to a patient eliminate potential misunderstandings between patients and health care providers. It is a public policy of the state that the interests of patients be recognized in a patient's bill of rights and responsibilities and that a health care facility or health care provider may not require a patient to waive his or her rights as a condition of treatment. This section shall not be used for any purpose in any civil or administrative action and neither expands nor limits any rights or remedies provided under any other law.

(4)  RIGHTS OF PATIENTS.--Each health care facility or provider shall observe the following standards:

(a)  Individual dignity.--

1.  The individual dignity of a patient must be respected at all times and upon all occasions.

2.  Every patient who is provided health care services retains certain rights to privacy, which must be respected without regard to the patient's economic status or source of payment for his or her care. The patient's rights to privacy must be respected to the extent consistent with providing adequate medical care to the patient and with the efficient administration of the health care facility or provider's office. However, this subparagraph does not preclude necessary and discreet discussion of a patient's case or examination by appropriate medical personnel.

3.  A patient has the right to a prompt and reasonable response to a question or request. A health care facility shall respond in a reasonable manner to the request of a patient's health care provider for medical services to the patient. The health care facility shall also respond in a reasonable manner to the patient's request for other services customarily rendered by the health care facility to the extent such services do not require the approval of the patient's health care provider or are not inconsistent with the patient's treatment.

4.  A patient in a health care facility has the right to retain and use personal clothing or possessions as space permits, unless for him or her to do so would infringe upon the right of another patient or is medically or programmatically contraindicated for documented medical, safety, or programmatic reasons.

(b)  Information.--

1.  A patient has the right to know the name, function, and qualifications of each health care provider who is providing medical services to the patient. A patient may request such information from his or her responsible provider or the health care facility in which he or she is receiving medical services.

2.  A patient in a health care facility has the right to know what patient support services are available in the facility.

3.  A patient has the right to be given by his or her health care provider information concerning diagnosis, planned course of treatment, alternatives, risks, and prognosis, unless it is medically inadvisable or impossible to give this information to the patient, in which case the information must be given to the patient's guardian or a person designated as the patient's representative. A patient has the right to refuse this information.

4.  A patient has the right to refuse any treatment based on information required by this paragraph, except as otherwise provided by law. The responsible provider shall document any such refusal.

5.  A patient in a health care facility has the right to know what facility rules and regulations apply to patient conduct.

6.  A patient has the right to express grievances to a health care provider, a health care facility, or the appropriate state licensing agency regarding alleged violations of patients' rights. A patient has the right to know the health care provider's or health care facility's procedures for expressing a grievance.

7.  A patient in a health care facility who does not speak English has the right to be provided an interpreter when receiving medical services if the facility has a person readily available who can interpret on behalf of the patient.

(c)  Financial information and disclosure.--

1.  A patient has the right to be given, upon request, by the responsible provider, his or her designee, or a representative of the health care facility full information and necessary counseling on the availability of known financial resources for the patient's health care.

2.  A health care provider or a health care facility shall, upon request, disclose to each patient who is eligible for Medicare, in advance of treatment, whether the health care provider or the health care facility in which the patient is receiving medical services accepts assignment under Medicare reimbursement as payment in full for medical services and treatment rendered in the health care provider's office or health care facility.

3.  A health care provider or a health care facility shall, upon request, furnish a patient, prior to provision of medical services, a reasonable estimate of charges for such services. Such reasonable estimate shall not preclude the health care provider or health care facility from exceeding the estimate or making additional charges based on changes in the patient's condition or treatment needs.

4.  A patient has the right to receive a copy of an itemized bill upon request. A patient has a right to be given an explanation of charges upon request.

(d)  Access to health care.--

1.  A patient has the right to impartial access to medical treatment or accommodations, regardless of race, national origin, religion, handicap, or source of payment.

2.  A patient has the right to treatment for any emergency medical condition that will deteriorate from failure to provide such treatment.

3.  A patient has the right to access any mode of treatment that is, in his or her own judgment and the judgment of his or her health care practitioner, in the best interests of the patient, including complementary or alternative health care treatments, in accordance with the provisions of s. 456.41.

(e)  Experimental research.--In addition to the provisions of s. 766.103, a patient has the right to know if medical treatment is for purposes of experimental research and to consent prior to participation in such experimental research. For any patient, regardless of ability to pay or source of payment for his or her care, participation must be a voluntary matter; and a patient has the right to refuse to participate. The patient's consent or refusal must be documented in the patient's care record.

(f)  Patient's knowledge of rights and responsibilities.--In receiving health care, patients have the right to know what their rights and responsibilities are.

(5)  RESPONSIBILITIES OF PATIENTS.--Each patient of a health care provider or health care facility shall respect the health care provider's and health care facility's right to expect behavior on the part of patients which, considering the nature of their illness, is reasonable and responsible. Each patient shall observe the responsibilities described in the following summary.

(6)  SUMMARY OF RIGHTS AND RESPONSIBILITIES.--Any health care provider who treats a patient in an office or any health care facility licensed under chapter 395 that provides emergency services and care or outpatient services and care to a patient, or admits and treats a patient, shall adopt and make available to the patient, in writing, a statement of the rights and responsibilities of patients, including the following:

Florida law requires that your health care provider or health care facility recognize your rights while you are receiving medical care and that you respect the health care provider's or health care facility's right to expect certain behavior on the part of patients. You may request a copy of the full text of this law from your health care provider or health care facility. A summary of your rights and responsibilities follows:

A patient has the right to be treated with courtesy and respect, with appreciation of his or her individual dignity, and with protection of his or her need for privacy.

A patient has the right to a prompt and reasonable response to questions and requests.

A patient has the right to know who is providing medical services and who is responsible for his or her care.

A patient has the right to know what patient support services are available, including whether an interpreter is available if he or she does not speak English.

A patient has the right to know what rules and regulations apply to his or her conduct.

A patient has the right to be given by the health care provider information concerning diagnosis, planned course of treatment, alternatives, risks, and prognosis.

A patient has the right to refuse any treatment, except as otherwise provided by law.

A patient has the right to be given, upon request, full information and necessary counseling on the availability of known financial resources for his or her care.

A patient who is eligible for Medicare has the right to know, upon request and in advance of treatment, whether the health care provider or health care facility accepts the Medicare assignment rate.

A patient has the right to receive, upon request, prior to treatment, a reasonable estimate of charges for medical care.

A patient has the right to receive a copy of a reasonably clear and understandable, itemized bill and, upon request, to have the charges explained.

A patient has the right to impartial access to medical treatment or accommodations, regardless of race, national origin, religion, handicap, or source of payment.

A patient has the right to treatment for any emergency medical condition that will deteriorate from failure to provide treatment.

A patient has the right to know if medical treatment is for purposes of experimental research and to give his or her consent or refusal to participate in such experimental research.

A patient has the right to express grievances regarding any violation of his or her rights, as stated in Florida law, through the grievance procedure of the health care provider or health care facility which served him or her and to the appropriate state licensing agency.

A patient is responsible for providing to the health care provider, to the best of his or her knowledge, accurate and complete information about present complaints, past illnesses, hospitalizations, medications, and other matters relating to his or her health.

A patient is responsible for reporting unexpected changes in his or her condition to the health care provider.

A patient is responsible for reporting to the health care provider whether he or she comprehends a contemplated course of action and what is expected of him or her.

A patient is responsible for following the treatment plan recommended by the health care provider.

A patient is responsible for keeping appointments and, when he or she is unable to do so for any reason, for notifying the health care provider or health care facility.

A patient is responsible for his or her actions if he or she refuses treatment or does not follow the health care provider's instructions.

A patient is responsible for assuring that the financial obligations of his or her health care are fulfilled as promptly as possible.

A patient is responsible for following health care facility rules and regulations affecting patient care and conduct.

History.--s. 1, ch. 91-127; s. 65, ch. 92-289; s. 656, ch. 95-148; s. 21, ch. 98-89; s. 178, ch. 98-166; s. 64, ch. 99-397; s. 7, ch. 2001-53; s. 2, ch. 2001-116.

381.0261  Summary of patient's bill of rights; distribution; penalty.--

(1)  The Agency for Health Care Administration shall have printed and made continuously available to health care facilities licensed under chapter 395, physicians licensed under chapter 458, osteopathic physicians licensed under chapter 459, and podiatric physicians licensed under chapter 461 a summary of the Florida Patient's Bill of Rights and Responsibilities. In adopting and making available to patients the summary of the Florida Patient's Bill of Rights and Responsibilities, health care providers and health care facilities are not limited to the format in which the Agency for Health Care Administration prints and distributes the summary.

(2)  Health care providers and health care facilities, if requested, shall inform patients of the address and telephone number of each state agency responsible for responding to patient complaints about a health care provider or health care facility's alleged noncompliance with state licensing requirements established pursuant to law.

(3)  Health care facilities shall adopt policies and procedures to ensure that inpatients are provided the opportunity during the course of admission to receive information regarding their rights and how to file complaints with the facility and appropriate state agencies.

(4)(a)  An administrative fine may be imposed by the Agency for Health Care Administration when any health care facility fails to make available to patients a summary of their rights, pursuant to s. 381.026 and this section. Initial nonwillful violations shall be subject to corrective action and shall not be subject to an administrative fine. The Agency for Health Care Administration may levy a fine against a health care facility of up to $5,000 for nonwillful violations and up to $25,000 for intentional and willful violations. Each intentional and willful violation constitutes a separate violation and is subject to a separate fine.

(b)  An administrative fine may be imposed by the appropriate regulatory board, or the department if there is no board, when any health care provider fails to make available to patients a summary of their rights, pursuant to s. 381.026 and this section. Initial nonwillful violations shall be subject to corrective action and shall not be subject to an administrative fine. The appropriate regulatory board or department may levy a fine against a health care provider of up to $100 for nonwillful violations and up to $500 for willful violations. Each intentional and willful violation constitutes a separate violation and is subject to a separate fine.

(5)  In determining the amount of fine to be levied for a violation, as provided in subsection (4), the following factors shall be considered:

(a)  The scope and severity of the violation, including the number of patients found to not have received notice of patient rights, and whether the failure to provide notice to patients was willful.

(b)  Actions taken by the health care provider or health care facility to correct the violations or to remedy complaints.

(c)  Any previous violations of this section by the health care provider or health care facility.

History.--s. 2, ch. 91-127; s. 22, ch. 98-89; s. 179, ch. 98-166; s. 65, ch. 99-397.

381.0301  Education and resource development.--

(1)  The department shall foster the recruitment, retention, and continuing education and training of health professionals and managers needed to administer the public health mission. This responsibility shall be conducted in cooperation with federal, state, and local agencies whose purpose is to prepare persons for service in public health, especially the Centers for Disease Control and Prevention, the State University System, Florida medical schools, and the College of Public Health of the University of South Florida. To support the department in this endeavor:

(2)  The Legislature intends that the College of Public Health of the University of South Florida assume a leadership role within the public health system through the development of academic programs intended to meet this state's unique health care, environmental, economic, political, and social service needs. Beyond its roles as educator of public health professionals in this state and as sponsor of relevant academic research, the School of Public Health shall be consulted by the public officials of this state in the management of public health affairs.

History.--s. 49, ch. 91-297; s. 24, ch. 97-100.

381.0302  Florida Health Services Corps.--

(1)  To encourage qualified medical professionals to practice in underserved locations where there are shortages of such personnel, the Legislature establishes the Florida Health Services Corps.

(2)  As used in this section, the term:

(a)  "Department" means the Department of Health.

(b)  "Florida Health Services Corps" means a program authorized by this section which:

1.  Offers scholarships to allopathic, osteopathic, chiropractic, podiatric, dental, physician assistant, and nursing students, and loan repayment assistance and travel and relocation expenses to allopathic and osteopathic residents and physicians, chiropractic physicians, podiatric physicians, nurse practitioners, dentists, and physician assistants, in return for service in a public health care program or in a medically underserved area.

2.  Offers membership on a voluntary basis to physicians and other health care personnel who provide uncompensated care.

(c)  "Medically underserved area" means:

1.  A geographic area, a special population, or a facility that has a shortage of health professionals as defined by federal regulations;

2.  A county health department, community health center, or migrant health center; or

3.  A geographic area or facility designated by rule by the department that has a shortage of health care practitioners who serve Medicaid and other low-income patients.

(d)  "Medically indigent person" means a person who lacks public or private health insurance, is unable to pay for care, and is a member of a family with an income at or below 185 percent of the federal poverty level.

(e)  "Public health program" means a county health department, a children's medical services program, a federally funded community health center, a federally funded migrant health center, or other publicly funded or nonprofit health care program designated by the department.

(f)  "Primary care" means family and general practice, general pediatrics, obstetrics/gynecology, and general internal medicine by primary care physicians licensed under chapters 458, 459, 460, and 461.

(3)  The Florida Health Services Corps shall be developed by the department in cooperation with the programs in the area health education center network as defined in s. 381.0402 and the state's health care education and training institutions. The State Health Officer shall be the director of the Florida Health Services Corps.

(4)  Corps members shall be supervised by the State Health Officer, or his or her physician designee, for the purpose of practice guidelines, continuing education, and other matters pertaining to professional conduct.

(5)  The department may award scholarships to students studying medicine, osteopathic medicine, chiropractic medicine, podiatric, nursing, or dentistry.

(a)  The program shall require a student who receives a scholarship to accept an assignment in a public health care program or work in a specific community located in a medically underserved area upon completion of primary care training. The department shall determine assignments. If a practitioner is assigned to a medically underserved area, the practitioner must treat Medicaid patients and other patients with low incomes.

(b)  An eligible student must be pursuing a full-time course of study in:

1.  Allopathic or osteopathic medicine, including physician assistants;

2.  Dentistry;

3.  Podiatric medicine;

4.  Nursing, including registered nurses, nurse midwives, and other nurse practitioners; or

5.  Chiropractic medicine.

(c)  In selecting students to participate in the scholarship program, priority shall be given to students who indicate a desire to practice a primary care specialty in a medically underserved area after their obligation is completed and who indicate an intent to practice medical specialties for which the department has a need.

(d)  Scholarship assistance shall consist of reimbursement for tuition and other educational costs such as books, supplies, equipment, transportation, and monthly living expense stipends. The department shall pay the same amount for living expense stipends as is paid by the National Health Services Corps. Each monthly living expense stipend shall be for a 12-month period beginning with the first month of each school year in which the student is a participant. The department may reimburse a participant for books, supplies, and equipment based on average costs incurred by participants for these items. The department shall prescribe, by rule, eligible expenses for reimbursement and allowable amounts.

(e)  For an allopathic or osteopathic medical student, enrollment in the corps may begin in the second year of medical school or in any year thereafter. For a nursing student or other student, enrollment may occur in any year.

(f)  For a student who receives scholarship assistance, participation in the corps after completion of training shall be 1 year for each school year of scholarship assistance, up to a maximum of 3 years. The period of obligated service shall begin when the participant is assigned by the department to a public health program or to a medically underserved area.

(6)  The department may provide loan repayment assistance and travel and relocation reimbursement to allopathic and osteopathic medical residents with primary care specialties during their last 2 years of residency training or upon completion of residency training, and to physician assistants and nurse practitioners with primary care specialties, in return for an agreement to serve a minimum of 2 years in the Florida Health Services Corps. During the period of service, the maximum amount of annual financial payments shall not be greater than the annual total of loan repayment assistance and tax subsidies authorized by the National Health Services Corps loan repayment program.

(7)  The financial penalty for noncompliance with participation requirements for persons who have received financial payments under subsection (5) or subsection (6) shall be determined in the same manner as in the National Health Services Corps scholarship program. In addition, noncompliance with participation requirements shall also result in ineligibility for professional licensure or renewal of licensure under chapter 458, chapter 459, chapter 460, part I of chapter 464, chapter 465, or chapter 466. For a participant who is unable to participate for reasons of disability, the penalty is the actual amount of financial assistance provided to the participant. Financial penalties shall be deposited in the Florida Health Services Corps Trust Fund and shall be used to provide additional scholarship and financial assistance.

(8)  Membership in the corps may be extended to any licensed physician or other health care practitioner who provides uncompensated care to medically indigent persons referred by the department. Participation in the corps is voluntary and subject to the supervision of the department for the purpose of practice guidelines, continuing education, and other matters pertaining to professional conduct.

(9)  Persons who receive loan repayment assistance under s. 1009.65 shall be members of the Florida Health Services Corps.

(10)  Corps members shall be enrolled in Medicaid and accept all patients referred by the department pursuant to an agreement with the department.

(11)  A Florida Health Services Corps member is an agent of the state under s. 768.28(9) while providing uncompensated services to medically indigent persons who are referred by the department.

(12)  Funds appropriated under this section shall be deposited in the Florida Health Services Corps Trust Fund, which shall be administered by the department. The department may use funds appropriated for the Florida Health Services Corps as matching funds for federal service-obligation scholarship programs for health care practitioners, such as the Demonstration Grants to States for Community Scholarship Grants program. If funds appropriated under this section are used as matching funds, federal criteria shall be followed whenever there is a conflict between provisions in this section and federal requirements.

(13)  The department shall adopt rules to implement the Florida Health Services Corps. The rules must also quantify penalties for noncompliance.

History.--s. 111, ch. 92-33; s. 10, ch. 92-278; s. 26, ch. 93-129; s. 657, ch. 95-148; s. 46, ch. 97-101; s. 24, ch. 97-237; ss. 180, 253, ch. 98-166; s. 89, ch. 2000-318; s. 977, ch. 2002-387.

381.0303  Health practitioner recruitment for special needs shelters.--

(1)  PURPOSE.--The purpose of this section is to designate the Department of Health, through its county health departments, as the lead agency for coordination of the recruitment of health care practitioners, as defined in s. 456.001(4), to staff special needs shelters in times of emergency or disaster and to provide resources to the department to carry out this responsibility. However, nothing in this section prohibits a county health department from entering into an agreement with a local emergency management agency to assume the lead responsibility for recruiting health care practitioners.

(2)  SPECIAL NEEDS SHELTER PLAN AND STAFFING.--Provided funds have been appropriated to support medical services disaster coordinator positions in county health departments, the department shall assume lead responsibility for the local coordination of local medical and health care providers, the American Red Cross, and other interested parties in developing a plan for the staffing and medical management of special needs shelters. The plan shall be in conformance with the local comprehensive emergency management plan.

(a)  County health departments shall, in conjunction with the local emergency management agencies, have the lead responsibility for coordination of the recruitment of health care practitioners to staff local special needs shelters. County health departments shall assign their employees to work in special needs shelters when needed to protect the health of patients.

(b)  The appropriate county health department and local emergency management agency shall jointly determine who has responsibility for medical supervision in a special needs shelter.

(c)  Local emergency management agencies shall be responsible for the designation and operation of special needs shelters during times of emergency or disaster. County health departments shall assist the local emergency management agency with regard to the management of medical services in special needs shelters.

(3)  REIMBURSEMENT TO HEALTH CARE PRACTITIONERS.--The Department of Health shall reimburse, subject to the availability of funds for this purpose, health care practitioners, as defined in s. 456.001, provided the practitioner is not providing care to a patient under an existing contract, and emergency medical technicians and paramedics licensed pursuant to chapter 401 for medical care provided at the request of the department in special needs shelters or at other locations during times of emergency or major disaster. Reimbursement for health care practitioners, except for physicians licensed pursuant to chapter 458 or chapter 459, shall be based on the average hourly rate that such practitioners were paid according to the most recent survey of Florida hospitals conducted by the Florida Hospital Association. Reimbursement shall be requested on forms prepared by the Department of Health. If a Presidential Disaster Declaration has been made, and the Federal Government makes funds available, the department shall use such funds for reimbursement of eligible expenditures. In other situations, or if federal funds do not fully compensate the department for reimbursement made pursuant to this section, the department shall submit to the Cabinet or Legislature, as appropriate, a budget amendment to obtain reimbursement from the working capital fund. Travel expense and per diem costs shall be reimbursed pursuant to s. 112.061.

(4)  HEALTH CARE PRACTITIONER REGISTRY.--The department may use the registries established in ss. 401.273 and 456.38 when health care practitioners are needed to staff special needs shelters or to staff disaster medical assistance teams.

(5)  SPECIAL NEEDS SHELTER INTERAGENCY COMMITTEE.--The Department of Health may establish a special needs shelter interagency committee, to be chaired and staffed by the department. The committee shall resolve problems related to special needs shelters not addressed in the state comprehensive emergency medical plan and shall serve as an oversight committee to monitor the planning and operation of special needs shelters.

(a)  The committee may:

1.  Develop and negotiate any necessary interagency agreements.

2.  Undertake other such activities as the department deems necessary to facilitate the implementation of this section.

3.  Submit recommendations to the Legislature as necessary.

(b)  The special needs shelter interagency committee shall be composed of representatives of emergency management, health, medical, and social services organizations. Membership shall include, but shall not be limited to, the Departments of Community Affairs, Children and Family Services, Elderly Affairs, Labor and Employment Security, and Education; the Agency for Health Care Administration; the Florida Medical Association; the Florida Osteopathic Medical Association; Associated Home Health Industries of Florida, Inc.; the Florida Nurses Association; the Florida Health Care Association; the Florida Assisted Living Association; the Florida Hospital Association; the Florida Statutory Teaching Hospital Council; the Florida Association of Homes for the Aging; the Florida Emergency Preparedness Association; the American Red Cross; Florida Hospices, Inc.; the Association of Community Hospitals and Health Systems; the Florida Association of Health Maintenance Organizations; the Florida League of Health Systems; Private Care Association; and the Salvation Army.

(c)  Meetings of the committee shall be held in Tallahassee, and members of the committee shall serve at the expense of the agencies or organizations they represent.

(6)  RULES.--The department has the authority to adopt rules necessary to implement this section. Rules may include a definition of a special needs patient, specify physician reimbursement, and designate which county health departments will have responsibility for implementation of subsections (2) and (3).

(7)  REVIEW OF EMERGENCY MANAGEMENT PLANS.--The submission of emergency management plans to county health departments by home health agencies pursuant to s. 400.497(8)(c) and (d) and by nurse registries pursuant to s. 400.506(16)(e) and by hospice programs pursuant to s. 400.610(1)(b) is conditional upon the receipt of an appropriation by the department to establish medical services disaster coordinator positions in county health departments unless the secretary of the department and a local county commission jointly determine to require such plans to be submitted based on a determination that there is a special need to protect public health in the local area during an emergency.

History.--s. 11, ch. 2000-140; s. 20, ch. 2001-62.

381.0402  Area health education center network.--The department, in cooperation with the state-approved medical schools in this state, shall organize an area health education center network based on earlier medically indigent demonstration projects and shall evaluate the impact of each network on improving access to services by persons who are medically underserved. The network shall be a catalyst for the primary care training of health professionals through increased opportunities for training in medically underserved areas.

(1)  The department shall contract to assist in funding an area health education center network which links the provision of primary care services to low-income persons with the education of medical students, interns, and residents. The network shall:

(a)  Be coordinated with and under contract with the state-approved medical schools, which shall be responsible for the clinical training and supervision.

(b)  Divide the state into service areas with each state-approved medical school coordinating the recruiting, training, and retention of medical students within its assigned area.

(c)  Use a multidisciplinary approach with appropriate medical supervision.

(d)  Use current community resources such as county health departments, federally funded primary care centers, or other primary health care providers as community-based sites for training medical students, interns, and residents.

(2)  The department shall establish criteria and procedures for quality assurance, performance evaluations, periodic audits, and other appropriate safeguards for the network.

(3)  The department shall make every effort to assure that participating medical schools do not discriminate among enrollees with respect to age, race, sex, or health status. However, such schools may target high-risk medically needy population groups.

(4)  The department may use no more than 5 percent of the annual appropriation for administering and evaluating the network.

History.--s. 10, ch. 87-92; s. 24, ch. 88-294; s. 18, ch. 90-295; s. 50, ch. 91-297; s. 47, ch. 97-101.

Note.--Former s. 409.2661.

381.0403  The Community Hospital Education Act.--

(1)  SHORT TITLE.--This section shall be known and cited as "The Community Hospital Education Act."

(2)  LEGISLATIVE INTENT.--

(a)  It is the intent of the Legislature that health care services for the citizens of this state be upgraded and that a program for continuing these services be maintained through a plan for community medical education. The program is intended to provide additional outpatient and inpatient services, a continuing supply of highly trained physicians, and graduate medical education.

(b)  The Legislature further acknowledges the critical need for increased numbers of primary care physicians to provide the necessary current and projected health and medical services. In order to meet both present and anticipated needs, the Legislature supports an expansion in the number of family practice residency positions. The Legislature intends that the funding for graduate education in family practice be maintained and that funding for all primary care specialties be provided at a minimum of $10,000 per resident per year. Should funding for this act remain constant or be reduced, it is intended that all programs funded by this act be maintained or reduced proportionately.

(3)  PROGRAM FOR COMMUNITY HOSPITAL EDUCATION; STATE AND LOCAL PLANNING.--

(a)  There is established under the Department of Health a program for statewide graduate medical education. It is intended that continuing graduate medical education programs for interns and residents be established on a statewide basis. The program shall provide financial support for primary care specialty interns and residents based on policies recommended and approved by the Community Hospital Education Council, herein established, and the Department of Health. Only those programs with at least three residents or interns in each year of the training program are qualified to apply for financial support. Programs with fewer than three residents or interns per training year are qualified to apply for financial support, but only if the appropriate accrediting entity for the particular specialty has approved the program for fewer positions. Programs added after fiscal year 1997-1998 shall have 5 years to attain the requisite number of residents or interns. When feasible and to the extent allowed through the General Appropriations Act, state funds shall be used to generate federal matching funds under Medicaid, or other federal programs, and the resulting combined state and federal funds shall be allocated to participating hospitals for the support of graduate medical education. The department may spend up to $75,000 of the state appropriation for administrative costs associated with the production of the annual report as specified in subsection (9), and for administration of the program.

(b)  For the purposes of this section, primary care specialties include emergency medicine, family practice, internal medicine, pediatrics, psychiatry, obstetrics/gynecology, and combined pediatrics and internal medicine, and other primary care specialties as may be included by the council and Department of Health.

(c)  Medical institutions throughout the state may apply to the Community Hospital Education Council for grants-in-aid for financial support of their approved programs. Recommendations for funding of approved programs shall be forwarded to the Department of Health.

(d)  The program shall provide a plan for community clinical teaching and training with the cooperation of the medical profession, hospitals, and clinics. The plan shall also include formal teaching opportunities for intern and resident training. In addition, the plan shall establish an off-campus medical faculty with university faculty review to be located throughout the state in local communities.

(4)  PROGRAM FOR GRADUATE MEDICAL EDUCATION INNOVATIONS.--

(a)  There is established under the Department of Health a program for fostering graduate medical education innovations. Funds appropriated annually by the Legislature for this purpose shall be distributed to participating hospitals or consortia of participating hospitals and Florida medical schools or to a Florida medical school for the direct costs of providing graduate medical education in community-based clinical settings on a competitive grant or formula basis to achieve state health care workforce policy objectives, including, but not limited to:

1.  Increasing the number of residents in primary care and other high demand specialties or fellowships;

2.  Enhancing retention of primary care physicians in Florida practice;

3.  Promoting practice in medically underserved areas of the state;

4.  Encouraging racial and ethnic diversity within the state's physician workforce; and

5.  Encouraging increased production of geriatricians.

(b)  Participating hospitals or consortia of participating hospitals and Florida medical schools or a Florida medical school providing graduate medical education in community-based clinical settings may apply to the Community Hospital Education Council for funding under this innovations program, except when such innovations directly compete with services or programs provided by participating hospitals or consortia of participating hospitals, or by both hospitals and consortia. Innovations program funding shall provide funding based on policies recommended and approved by the Community Hospital Education Council and the Department of Health.

(c)  Participating hospitals or consortia of participating hospitals and Florida medical schools or Florida medical schools awarded an innovations grant shall provide the Community Hospital Education Council and Department of Health with an annual report on their project.

(5)  FAMILY PRACTICE RESIDENCIES.--In addition to the programs established in subsection (3), the Community Hospital Education Council and the Department of Health shall establish an ongoing statewide program of family practice residencies. The administration of this program shall be in the manner described in this section.

(6)  COUNCIL AND DIRECTOR.--

(a)  There is established the Community Hospital Education Council, hereinafter referred to as the council, which shall consist of 11 members, as follows:

1.  Seven members must be program directors of accredited graduate medical education programs or practicing physicians who have faculty appointments in accredited graduate medical education programs. Six of these members must be board certified or board eligible in family practice, internal medicine, pediatrics, emergency medicine, obstetrics-gynecology, and psychiatry, respectively, and licensed pursuant to chapter 458. No more than one of these members may be appointed from any one specialty. One member must be licensed pursuant to chapter 459.

2.  One member must be a representative of the administration of a hospital with an approved community hospital medical education program;

3.  One member must be the dean of a medical school in this state; and

4.  Two members must be consumer representatives.

All of the members shall be appointed by the Governor for terms of 4 years each.

(b)  Council membership shall cease when a member's representative status no longer exists. Members of similar representative status shall be appointed to replace retiring or resigning members of the council.

(c)  The secretary of the Department of Health shall designate an administrator to serve as staff director. The council shall elect a chair from among its membership. Such other personnel as may be necessary to carry out the program shall be employed as authorized by the Department of Health.

(7)  DEPARTMENT OF HEALTH; STANDARDS.--

(a)  The Department of Health, with recommendations from the council, shall establish standards and policies for the use and expenditure of graduate medical education funds appropriated pursuant to subsection (8) for a program of community hospital education. The Department of Health shall establish requirements for hospitals to be qualified for participation in the program which shall include, but not be limited to:

1.  Submission of an educational plan and a training schedule.

2.  A determination by the council to ascertain that each portion of the program of the hospital provides a high degree of academic excellence and is accredited by the Accreditation Council for Graduate Medical Education of the American Medical Association or is accredited by the American Osteopathic Association.

3.  Supervision of the educational program of the hospital by a physician who is not the hospital administrator.

(b)  The Department of Health shall periodically review the educational program provided by a participating hospital to assure that the program includes a reasonable amount of both formal and practical training and that the formal sessions are presented as scheduled in the plan submitted by each hospital.

(c)  In years that funds are transferred to the Agency for Health Care Administration, the Department of Health shall certify to the Agency for Health Care Administration on a quarterly basis the number of primary care specialty residents and interns at each of the participating hospitals for which the Community Hospital Education Council and the department recommends funding.

(8)  MATCHING FUNDS.--State funds shall be used to match funds from any local governmental or hospital source. The state shall provide up to 50 percent of the funds, and the community hospital medical education program shall provide the remainder. However, except for fixed capital outlay, the provisions of this subsection shall not apply to any program authorized under the provisions of subsection (5) for the first 3 years after such program is in operation.

(9)  ANNUAL REPORT ON GRADUATE MEDICAL EDUCATION; COMMITTEE.--The Executive Office of the Governor, the Department of Health, and the Agency for Health Care Administration shall collaborate to establish a committee that shall produce an annual report on graduate medical education. The committee shall be comprised of 11 members: five members shall be deans of the medical schools or their designees; the Governor shall appoint two members, one of whom must be a representative of the Florida Medical Association who has supervised or currently supervises residents or interns and one of whom must be a representative of the Florida Hospital Association; the Secretary of Health Care Administration shall appoint two members, one of whom must be a representative of a statutory teaching hospital and one of whom must be a physician who has supervised or is currently supervising residents or interns; and the Secretary of Health shall appoint two members, one of whom must be a representative of a statutory family practice teaching hospital and one of whom must be a physician who has supervised or is currently supervising residents or interns. With the exception of the deans, members shall serve 4-year terms. In order to stagger the terms, the Governor's appointees shall serve initial terms of 4 years, the Secretary of Health's appointees shall serve initial terms of 3 years, and the Secretary of Health Care Administration's appointees shall serve initial terms of 2 years. A member's term shall be deemed terminated when the member's representative status no longer exists. Once the committee is appointed, it shall elect a chair to serve for a 1-year term. The report shall be provided to the Governor, the President of the Senate, and the Speaker of the House of Representatives by January 15 annually. Committee members shall serve without compensation. The report shall address the following:

(a)  The role of residents and medical faculty in the provision of health care.

(b)  The relationship of graduate medical education to the state's physician workforce.

(c)  The costs of training medical residents for hospitals, medical schools, teaching hospitals, including all hospital-medical affiliations, practice plans at all of the medical schools, and municipalities.

(d)  The availability and adequacy of all sources of revenue to support graduate medical education and recommend alternative sources of funding for graduate medical education.

(e)  The use of state and federal appropriated funds for graduate medical education by hospitals receiving such funds.

(10)  RULEMAKING.--The department has authority to adopt rules pursuant to ss. 120.536(1) and 120.54 to implement the provisions of this section.

History.--s. 1, ch. 71-311; ss. 1-4, ch. 72-137; s. 1, ch. 74-135; s. 1, ch. 74-358; s. 1, ch. 76-63; s. 1, ch. 82-46; s. 45, ch. 82-241; s. 2, ch. 83-265; s. 6, ch. 84-94; s. 2, ch. 88-291; ss. 1, 2, 3, ch. 91-129; s. 50, ch. 91-297; s. 5, ch. 91-429; s. 25, ch. 92-173; s. 658, ch. 95-148; s. 29, ch. 99-5; s. 27, ch. 2000-163; s. 2, ch. 2001-222.

Note.--Former s. 381.503.

381.0404  Center for Health Technologies.--

(1)(a)  There is hereby established the Center for Health Technologies, to be located at and administered by a statutory teaching hospital located in Dade County and hereafter referred to as the administrator.

(b)  The purpose of the center is to encourage the development and growth of the health sciences in the state, with an emphasis on technologies which will help to prevent illness and reduce health care costs; to assist coordination between and with educational institutions, health care providers, and persons engaged in research and development of health care products; to provide services to persons and incipient firms engaged in the incubation of health care products; to assist in technology transfer; and to establish academic laboratories, libraries, and other resource facilities to be shared among the center's constituents.

(2)  The objectives of the center will be to:

(a)  Maintain a database of all resources to encourage linkages and promote the activities of its constituents.

(b)  Provide a network of shared facilities and technical services such as, but not restricted to:

1.  Physical, chemical, and biological testing.

2.  Electronic, mechanical, and process design.

3.  Engineering documentation.

4.  Professional training and continuing education.

(c)  Incubate small companies by offering them access to:

1.  Affordable physical space.

2.  Administrative, managerial, and financial services.

3.  Seed and venture capital.

4.  Business planning and legal services.

(d)  Promote technology transfer, cooperative research and development, and commercialization among local businesses and industrial firms, the universities, hospitals, and local government.

(e)  Initiate or coordinate large grant applications by linking local resources.

(3)(a)  In carrying out the purposes and objectives of the center, the administrator is authorized to engage managers, administrators, analysts, and employees in all disciplines; to engage consultants, advisers, attorneys, accountants, actuaries, engineers, and educators of all disciplines; and to enter into contracts for management of the center with persons, firms, and corporations, both profit and nonprofit, including, but not limited to, a nonprofit corporation which is organized for the purpose of carrying out the objectives and purposes of the center. In all instances, the administrator is authorized to pay reasonable compensation for the performance of such services, subject to compliance with this act and state law governing the expenditure of public funds.

(b)  The administrator is further authorized to apply for and accept gifts, grants, and contributions in cash and in kind given in furtherance of the purposes and objectives of the center from all lawful donors and to establish an account or accounts at financial institutions qualified to do business within the state, which accounts may or need not bear interest as determined appropriate.

(4)  The administrator shall submit a report on an annual basis to the Governor, the Speaker of the House of Representatives, and the President of the Senate providing an accounting of expenditures and progress on research and development programs.

History.--s. 10, ch. 89-354; s. 13, ch. 89-527; s. 50, ch. 91-297.

Note.--Former s. 381.504.

381.0405  Office of Rural Health.--

(1)  ESTABLISHMENT.--The Department of Health shall establish an Office of Rural Health. The Office of Rural Health shall coordinate its activities with the area health education center network established pursuant to s. 381.0402 and with any appropriate research and policy development centers within universities that have state-approved medical schools. The Office of Rural Health may enter into a formal relationship with any center that designates the office as an affiliate of the center.

(2)  PURPOSE.--The Office of Rural Health shall actively foster the provision of health care services in rural areas and serve as a catalyst for improved health services to citizens in rural areas of the state.

(3)  GENERAL FUNCTIONS.--The office shall:

(a)  Integrate policies related to physician workforce, hospitals, public health, and state regulatory functions.

(b)  Propose solutions to problems affecting health care delivery in rural areas.

(c)  Seek grant funds from foundations and the Federal Government.

(4)  COORDINATION.--The office shall:

(a)  Identify federal and state rural health programs and provide technical assistance to rural providers regarding participation in such programs.

(b)  Act as a clearinghouse for collecting and disseminating information on rural health care issues, research findings on rural health care, and innovative approaches to the delivery of health care in rural areas.

(c)  Foster the creation of regional health care systems that promote cooperation, rather than competition.

(d)  Coordinate the department's rural health care activities, programs, and policies.

(e)  Design initiatives to improve access to emergency medical services in rural areas.

(f)  Assume responsibility for state coordination of the Rural Hospital Transition Grant Program, the Essential Access Community Hospital Program, and other federal rural health care programs.

(5)  TECHNICAL ASSISTANCE.--The office shall:

(a)  Help rural health care providers obtain health care practitioners by promoting the location and relocation of health care practitioners in rural areas.

(b)  Provide technical assistance to hospitals, community and migrant health centers, and other health care providers.

(c)  Design strategies to improve health care workforce recruitment and placement programs.

(6)  RESEARCH PUBLICATIONS AND SPECIAL STUDIES.--The office shall:

(a)  Conduct policy and research studies.

(b)  Conduct health status studies of rural residents.

(c)  Collect relevant data on rural health care issues for use in department policy development.

(7)  APPROPRIATION.--The Legislature shall appropriate such sums as are necessary to support the Office of Rural Health.

History.--s. 51, ch. 91-297; s. 659, ch. 95-148; s. 25, ch. 97-237.

381.0406  Rural health networks.--

(1)  LEGISLATIVE FINDINGS AND INTENT.--

(a)  The Legislature finds that, in rural areas, access to health care is limited and the quality of health care is negatively affected by inadequate financing, difficulty in recruiting and retaining skilled health professionals, and because of a migration of patients to urban areas for general acute care and specialty services.

(b)  The Legislature further finds that the efficient and effective delivery of health care services in rural areas requires the integration of public and private resources and the coordination of health care providers.

(c)  The Legislature further finds that the availability of a continuum of quality health care services, including preventive, primary, secondary, tertiary, and long-term care, is essential to the economic and social vitality of rural communities.

(d)  The Legislature further finds that the creation of rural health networks can help to alleviate these problems. Rural health networks shall act in the broad public interest and, to the extent possible, be structured to provide a continuum of quality health care services for rural residents through the cooperative efforts of rural health network members.

(e)  The Legislature further finds that rural health networks shall have the goal of increasing the utilization of statutory rural hospitals for appropriate health care services whenever feasible, which shall help to ensure their survival and thereby support the economy and protect the health and safety of rural residents.

(f)  Finally, the Legislature finds that rural health networks may serve as "laboratories" to determine the best way of organizing rural health services, to move the state closer to ensuring that everyone has access to health care, and to promote cost containment efforts. The ultimate goal of rural health networks shall be to ensure that quality health care is available and efficiently delivered to all persons in rural areas.

(2)  DEFINITIONS.--

(a)  "Rural" means an area with a population density of less than 100 individuals per square mile or an area defined by the most recent United States Census as rural.

(b)  "Health care provider" means any individual, group, or entity, public or private, that provides health care, including: preventive health care, primary health care, secondary and tertiary health care, in-hospital health care, public health care, and health promotion and education.

(c)  "Rural health network" or "network" means a nonprofit legal entity, consisting of rural and urban health care providers and others, that is organized to plan and deliver health care services on a cooperative basis in a rural area, except for some secondary and tertiary care services.

(3)  Because each rural area is unique, with a different health care provider mix, health care provider membership may vary, but all networks shall include members that provide public health, comprehensive primary care, emergency medical care, and acute inpatient care.

(4)  Network membership shall be available to all health care providers, provided that they render care to all patients referred to them from other network members, comply with network quality assurance and risk management requirements, abide by the terms and conditions of network provider agreements in paragraph (11)(c), and provide services at a rate or price equal to the rate or price negotiated by the network.

(5)  Network areas do not need to conform to local political boundaries or state administrative district boundaries. The geographic area of one rural health network, however, may not overlap the territory of any other rural health network.

(6)  Networks shall develop provisions for referral to tertiary inpatient care and to other services that are not available in rural areas.

(7)  Networks shall make available health promotion, disease prevention, and primary care services to improve the health status of rural residents and to contain health care costs.

(8)  Networks may have multiple points of entry, such as through private physicians, community health centers, county health departments, certified rural health clinics, hospitals, or other providers; or they may have a single point of entry.

(9)  Networks shall establish standard protocols, coordinate and share patient records, and develop patient information exchange systems.

(10)  Networks shall develop risk management and quality assurance programs for network providers.

(11)  NETWORK GOVERNANCE AND ORGANIZATION.--

(a)  Networks shall be incorporated under the laws of the state.

(b)  Networks shall have a board of directors that derives membership from local government, health care providers, businesses, consumers, and others.

(c)  Network boards of directors shall have the responsibility of determining the content of health care provider agreements that link network members. The agreements shall specify:

1.  Who provides what services.

2.  The extent to which the health care provider provides care to persons who lack health insurance or are otherwise unable to pay for care.

3.  The procedures for transfer of medical records.

4.  The method used for the transportation of patients between providers.

5.  Referral and patient flow including appointments and scheduling.

6.  Payment arrangements for the transfer or referral of patients.

(d)  There shall be no liability on the part of, and no cause of action of any nature shall arise against, any member of a network board of directors, or its employees or agents, for any lawful action taken by them in the performance of their administrative powers and duties under this subsection.

(12)  NETWORK SERVICES.--

(a)  Networks, to the extent feasible, shall provide for a continuum of care for all patients served by the network. Each network shall include the following core services: disease prevention, health promotion, comprehensive primary care, emergency medical care, and acute inpatient care. Each network shall ensure the availability of comprehensive maternity care, including prenatal, delivery, and postpartum care for uncomplicated pregnancies, either directly, by contract, or through referral agreements. Networks shall, to the extent feasible, also ensure the availability of the following services within the specified timeframes, either directly, by contract, or through referral agreements:

1.  Services available in the home.

a.  Home health care.

b.  Hospice care.

2.  Services accessible within 30 minutes travel time or less.

a.  Emergency medical services, including advanced life support, ambulance, and basic emergency room services.

b.  Primary care.

c.  Prenatal and postpartum care for uncomplicated pregnancies.

d.  Community-based services for elders, such as adult day care and assistance with activities of daily living.

e.  Public health services, including communicable disease control, disease prevention, health education, and health promotion.

f.  Outpatient psychiatric and substance abuse services.

3.  Services accessible within 45 minutes travel time or less.

a.  Hospital acute inpatient care for persons whose illnesses or medical problems are not severe.

b.  Level I obstetrical care, which is labor and delivery for low-risk patients.

c.  Skilled nursing services, long-term care, including nursing home care.

d.  Dialysis.

e.  Osteopathic and chiropractic manipulative therapy.

4.  Services accessible within 2 hours travel time or less.

a.  Specialist physician care.

b.  Hospital acute inpatient care for severe illnesses and medical problems.

c.  Level II and III obstetrical care, which is labor and delivery care for high-risk patients and neonatal intensive care.

d.  Comprehensive medical rehabilitation.

e.  Inpatient psychiatric and substance abuse services.

f.  Magnetic resonance imaging, lithotripter treatment, advanced radiology, and other technologically advanced services.

g.  Subacute care.

(b)  Networks shall actively participate with area health education center programs, whenever feasible, in developing and implementing recruitment, training, and retention programs directed at positively influencing the supply and distribution of health care professionals serving in, or receiving training in, network areas.

(c)  As funds become available, networks shall emphasize community care alternatives for elders who would otherwise be placed in nursing homes.

(d)  To promote the most efficient use of resources, networks shall emphasize disease prevention, early diagnosis and treatment of medical problems, and community care alternatives for persons with mental health and substance abuse disorders who are at risk to be institutionalized.

(13)  TRAUMA SERVICES.--In those network areas which have an established trauma agency approved by the Department of Health, that trauma agency must be a participant in the network. Trauma services provided within the network area must comply with s. 395.405.

(14)  NETWORK FINANCING.--Networks may use all sources of public and private funds to support network activities. Nothing in this section prohibits networks from becoming managed care providers.

(15)  NETWORK IMPLEMENTATION.--As funds become available, networks shall be developed and implemented in two phases.

(a)  Phase I shall consist of a network planning and development grant program. Planning grants shall be used to organize networks, incorporate network boards, and develop formal provider agreements as provided for in this section. The Department of Health shall develop a request-for-proposal process to solicit grant applications.

(b)  Phase II shall consist of network operations. As funds become available, certified networks shall be eligible to receive grant funds to be used to help defray the costs of network infrastructure development, patient care, and network administration. Infrastructure development includes, but is not limited to: recruitment and retention of primary care practitioners; development of preventive health care programs; linkage of urban and rural health care systems; design and implementation of automated patient records, outcome measurement, quality assurance, and risk management systems; establishment of one-stop service delivery sites; upgrading of medical technology available to network providers; enhancement of emergency medical systems; enhancement of medical transportation; and development of telecommunication capabilities. A Phase II award may occur in the same fiscal year as a Phase I award.

(16)  CERTIFICATION.--For the purpose of certifying networks that are eligible for Phase II funding, the Department of Health shall certify networks that meet the criteria delineated in this section and the rules governing rural health networks.

(17)  RULES.--The Department of Health shall establish rules that govern the creation and certification of networks, including establishing outcome measures for networks.

History.--s. 27, ch. 93-129; s. 1, ch. 95-298; s. 48, ch. 97-101; s. 26, ch. 97-237; s. 8, ch. 2000-153; s. 41, ch. 2000-256; s. 8, ch. 2000-296.

381.04065  Rural health network cooperative agreements.--

(1)  INTENT.--It is the Legislature's intent that, to the extent necessary to foster the development of rural health networks as provided for in s. 381.0406, competitive market forces shall be replaced with state regulation, as provided for in this section. It is also the intent of the Legislature that consolidation of network hospital services or technologies undertaken pursuant to this section, and cooperative agreements between members of rural health networks, shall not violate the state's antitrust laws when such arrangements improve the quality of health care, moderate cost increases, and are made between members of rural health networks as defined in s. 381.0406. It is also the intent of the Legislature that such arrangements be protected from federal antitrust laws, subject to the approval and supervision of the Department of Health. Such intent is within the public policy of the state to facilitate the provision of quality, cost-efficient medical care to rural patients.

(2)  DEPARTMENT APPROVAL.--Providers who are members of certified rural health networks who seek to consolidate services or technologies or enter into cooperative agreements shall seek approval from the Department of Health, which may consult with the Department of Legal Affairs. The department shall determine that the likely benefits resulting from the agreement outweigh any disadvantages attributable to any potential reduction in competition resulting from the agreement and issue a letter of approval if, in its determination, the agreement reduces or moderates costs and meets any of the following criteria:

(a)  Consolidates services or facilities in a market area used by rural health network patients to avoid duplication;

(b)  Promotes cooperation between rural health network members in the market area;

(c)  Encourages cost sharing among rural health network facilities;

(d)  Enhances the quality of rural health care; or

(e)  Improves utilization of rural health resources and equipment.

(3)  STATE OVERSIGHT.--The Department of Health shall review each agreement approved under this section at least every 2 years. If the department determines that the likely benefits resulting from its state action approval no longer outweigh any disadvantages attributable to any potential reduction in competition resulting from the agreement, the department shall initiate proceedings to terminate its state action approval governing the agreement. Such termination proceeding shall be governed by chapter 120.

(4)  JUDICIAL REVIEW.--Any applicant aggrieved by a decision of the Department of Health shall be entitled to both administrative and judicial review thereof in accordance with chapter 120. In such review, the decision of the department shall be affirmed unless it is arbitrary, capricious, or it is not in compliance with this section.

(5)  RULEMAKING.--The Department of Health, in consultation with the Office of the Attorney General, shall establish rules necessary to implement this section.

History.--s. 29, ch. 93-129; s. 2, ch. 95-298; s. 27, ch. 97-237.

Note.--Former s. 395.606.

381.0407  Managed care and publicly funded primary care program coordination.--

(1)  SHORT TITLE.--This section may be cited as the "Managed Care and Publicly Funded Primary Care Program Coordination Act."

(2)  LEGISLATIVE FINDINGS AND INTENT.--The Legislature finds that it is in the public interest for publicly funded health providers to be reimbursed by managed care plans when certain health care services are provided that are needed to protect and improve public health. The Legislature also finds that the use of publicly funded perinatal programs should be encouraged, but not required, to make advantageous use of the system of public health services.

(3)  DEFINITIONS.--As used in this section the term:

(a)  "Managed care plan" or "plan" means an entity that contracts with the Agency for Health Care Administration on a prepaid or fixed-sum basis for the provision of Medicaid services pursuant to s. 409.912.

(b)  "Publicly funded primary care provider" or "public provider" means a county health department or a migrant health center funded under s. 329 of the Public Health Services Act or a community health center funded under s. 330 of the Public Health Services Act.

(4)  REIMBURSEMENT REQUIRED.--Without prior authorization, managed care plans, and the MediPass program as administered by the Agency for Health Care Administration, shall pay claims initiated by any public provider, to the extent the managed care plan or MediPass program provides coverage, for:

(a)  The diagnosis and treatment of sexually transmitted diseases and other communicable diseases such as tuberculosis and human immunodeficiency virus infection.

(b)  The provision of immunizations.

(c)  Family planning services and related pharmaceuticals.

(d)  School health services listed in paragraphs (a), (b), and (c) and services rendered on an urgent basis. Services rendered on an urgent basis are health care services needed to immediately relieve pain or distress for medical problems such as injuries, nausea, and fever, and to treat infectious diseases and other similar conditions.

Public providers shall attempt to contact managed care plans before providing health care services to their subscribers. Public providers shall provide managed care plans with the results of the office visit, including test results, and shall be reimbursed by managed care plans at the rate negotiated between the managed care plan and the public provider or, if a rate has not been negotiated, at the lesser of either the rate charged by the public provider or the Medicaid fee-for-service reimbursement rate.

(5)  EMERGENCY SHELTER MEDICAL SCREENING REIMBURSEMENT.--County health departments shall be reimbursed by managed care plans, and the MediPass program as administered by the Agency for Health Care Administration, for clients of the Department of Children and Family Services who receive emergency shelter medical screenings.

(6)  MATERNAL AND CHILD HEALTH SERVICES.--The Agency for Health Care Administration, in consultation with the Department of Health, shall encourage agreements between Medicaid-financed managed care plans and public providers for the authorization of and payment for the following services:

(a)  Maternity case management.

(b)  Well-child care.

(c)  Prenatal care.

(7)  VACCINE-PREVENTABLE DISEASE EMERGENCIES.--In the event that a vaccine-preventable disease emergency is declared by the State Health Officer or a county health department director or administrator, managed care plans, the MediPass program as administered by the Agency for Health Care Administration, and health maintenance organizations and prepaid health clinics licensed under chapter 641 shall reimburse county health departments for the cost of the administration of vaccines to persons covered by these entities, provided such action is necessary to end the emergency. Reimbursement shall be at the rate negotiated between the entity and the county health department or, if a rate has not been negotiated, at the lesser of either the rate charged by the county health department or the Medicaid fee-for-service reimbursement rate. No charge shall be made by the county health department for the actual cost of the vaccine or for services not covered under the policy or contract of the entity.

History.--s. 1, ch. 96-199; s. 185, ch. 97-101; s. 28, ch. 97-237.

381.045  Hepatitis B or HIV carriers.--The Department of Health shall have the authority to establish procedures to handle, counsel, and provide other services to health care professionals licensed or certified under chapter 401, chapter 467, part IV of chapter 468, and chapter 483 who are infected with hepatitis B or the human immunodeficiency virus.

History.--s. 70, ch. 91-297; s. 49, ch. 97-101.

381.0601  Self-derived and directed-donor blood programs.--

(1)  Any person residing in this state shall be entitled and allowed to participate in a program to donate his or her own blood, in order to have such blood available for autologous, or self-derived, transfusion at the time of a planned medical need.

(2)  Any person residing in this state shall be entitled and allowed to participate in a directed-donor blood program to donate the blood of specific donors for use by a designated recipient, in order to have such blood available for blood transfusions at the time of a planned medical need.

(3)  Such blood shall not be administered to any other individual until such time as the designated recipient no longer has a need for the blood, after which time the blood shall revert to the blood bank's general account, except that in the event of a medical emergency, such blood from a designated donor may be used to meet the emergency need.

History.--s. 1, ch. 87-366; s. 52, ch. 91-297; s. 660, ch. 95-148.

Note.--Former s. 381.6015.

381.06015  Public Cord Blood Tissue Bank.--

(1)  There is established a statewide consortium to be known as the Public Cord Blood Tissue Bank. The Public Cord Blood Tissue Bank is established as a nonprofit legal entity to collect, screen for infectious and genetic diseases, perform tissue typing, cryopreserve, and store umbilical cord blood as a resource to the public. The University of Florida, the University of South Florida, the University of Miami, and the Mayo Clinic, Jacksonville shall jointly form the collaborative consortium, each working with community resources such as regional blood banks, hospitals, and other health care providers to develop local and regional coalitions for the purposes set forth in this act. The consortium participants shall align their outreach programs and activities to all geographic areas of the state, covering the entire state. The consortium is encouraged to conduct outreach and research for Hispanics, African Americans, Native Americans, and other ethnic and racial minorities.

(2)  The Agency for Health Care Administration and the Department of Health shall encourage health care providers, including, but not limited to, hospitals, birthing facilities, county health departments, physicians, midwives, and nurses, to disseminate information about the Public Cord Blood Tissue Bank.

(3)  Nothing in this section creates a requirement of any health care or services program that is directly affiliated with a bona fide religious denomination that includes as an integral part of its beliefs and practices the tenet that blood transfer is contrary to the moral principles the denomination considers to be an essential part of its beliefs.

(4)  Any health care facility or health care provider receiving financial remuneration for the collection of umbilical cord blood shall provide written disclosure of this information to any woman postpartum or parent of a newborn from whom the umbilical cord blood is collected prior to the harvesting of the umbilical cord blood.

(5)  A woman admitted to a hospital or birthing facility for obstetrical services may be offered the opportunity to donate umbilical cord blood to the Public Cord Blood Tissue Bank. A woman may not be required to make such a donation.

(6)  The consortium may charge reasonable rates and fees to recipients of cord blood tissue bank products.

(7)  In order to fund the provisions of this section the consortium participants, the Agency for Health Care Administration, and the Department of Health shall seek private or federal funds to initiate program actions for fiscal year 2000-2001.

History.--s. 1, ch. 2000-305.

381.0602  Organ Transplant Advisory Council; membership; responsibilities.--

(1)  There is hereby created within the Agency for Health Care Administration a statewide technical Organ Transplant Advisory Council consisting of twelve members to represent the interests of the public and the clients of the Department of Health or the agency. The members shall be physicians licensed according to chapter 458 or chapter 459. A person employed by the agency may not be appointed as a member of the council.

(2)  The Secretary of Health Care Administration shall appoint all members of the council to serve a term of 2 years.

(3)  The Secretary of Health Care Administration shall fill each vacancy on the council for the balance of the unexpired term. Priority consideration must be given to the appointment of an individual whose primary interest, experience, or expertise lies with clients of the Department of Health and the agency. If an appointment is not made within 120 days after a vacancy occurs on the council, the vacancy must be filled by the majority vote of the council.

(4)  The members of the council shall elect a chairperson. The term of the chairperson shall be for 2 years, and an individual may not serve as chairperson for more than two consecutive terms.

(5)  Members of the council shall receive no compensation, but shall be reimbursed for per diem and travel expenses by the Agency for Health Care Administration in accordance with the provisions of s. 112.061 while engaged in the performance of their duties.

(6)  The responsibilities of the council shall be to recommend to the Agency for Health Care Administration indications for adult and pediatric organ transplants. The council shall also formulate guidelines and standards for organ transplants and for the development of End Stage Organ Disease and Tissue/Organ Transplant programs. The recommendations, guidelines, and standards developed by the council are applicable only to those health programs funded through the Agency for Health Care Administration.

(7)  The council shall meet at least annually or upon the call of the chairperson or the Secretary of Health Care Administration.

History.--ss. 1, 2, ch. 86-208; ss. 88, 89, ch. 86-220; s. 3, ch. 87-50; s. 8, ch. 91-49; s. 52, ch. 91-297; s. 5, ch. 91-429; s. 3, ch. 94-305; s. 50, ch. 97-101; s. 1, ch. 99-299; s. 6, ch. 2000-305.

Note.--Former s. 381.602.

381.0605  Survey of state hospital facilities; Agency for Health Care Administration.--

(1)  The Agency for Health Care Administration is designated as the sole agency of the state to carry out the purposes of and administer the Federal Hospital and Medical Facilities Amendments of 1964 (Pub. L. No. 88-443).

(2)  The Governor is authorized to provide for carrying out such purposes in accordance with the standards prescribed by the Surgeon General.

History.--s. 1, ch. 22851, 1945; s. 1, ch. 59-401; ss. 1, 10, ch. 65-46; ss. 19, 35, ch. 69-106; s. 2, ch. 71-213; s. 91, ch. 77-147; s. 52, ch. 91-297; s. 4, ch. 94-305.

Note.--Former s. 380.01; s. 965.01; s. 381.492.

381.1001  Short title; Florida Community Health Protection Act.--Sections 381.1001-381.103 may be cited as the "Florida Community Health Protection Act."

History.--s. 10, ch. 99-356.

381.1015  Community Environmental Health Program; creation; purposes.--

(1)  There is created the Community Environmental Health Program. The primary purpose of the program is to ensure the availability of public health services to members of low-income communities that may be adversely affected by contaminated sites located in or near the community. These services extend beyond health services that are currently provided pursuant to chapter 154 and include measures to address the health effects that are associated with exposure to environmental contamination.

(2)  The Department of Health shall establish a Community Environmental Health Advisory Board. The majority of board members shall be low-income residents. The board must also include representatives from the respective county health departments, health care professionals and providers, and elected officials. The board shall identify the community environmental health needs and types of services which should be provided.

(3)  As used in this section:

(a)  "Low-income community" means a contiguous grouping of residences with a significant portion of occupants who have a family income equal to or below 100 percent of the most recent federal poverty level and who are exposed to multiple sources of environmental contamination.

(b)  "Contaminated site" means any contiguous land, surface water, or groundwater areas that contain contaminants that may be harmful to human health or the environment and includes federal Superfund sites and state or federally designated Brownfield areas.

History.--s. 3, ch. 98-304.

381.102  Community Health pilot projects.--

(1)  The Legislature has determined that:

(a)  The state is committed to the economic, environmental, and public health revitalization of its communities;

(b)  Measures to address the public health needs of low-income communities in urban and rural areas must be implemented in order to ensure the sustainability of these communities;

(c)  The implementation of these measures will enhance cooperative efforts among the private sector, government, and nonprofit organizations in this state to ensure the sustainability of Florida; and

(d)  It would be beneficial to provide resources in this state to undertake a series of pilot projects that demonstrate techniques and approaches to ensure health care for disease prevention and health promotion for low-income persons who are living in urban and rural communities.

(2)  Community Health pilot projects are hereby established to promote disease prevention and health promotion among low-income persons living in urban and rural communities.

(3)  The pilot projects may form partnerships with existing health care providers and units, contribute to a health care needs assessment, provide research capacity to improve health status, and serve as the basis for health care capacity in urban and rural communities.

(4)  The following pilot projects are created:

(a)  In Pinellas County, for the Greenwood Community Health Center in Clearwater.

(b)  In Escambia County, for the low-income communities within the Palafox Redevelopment Area.

(c)  In Hillsborough, Pasco, Pinellas, and Manatee counties for the Urban League of Pinellas County, to operate its mobile health screening unit to provide public health care to persons living in low-income urban and rural communities.

(d)  In Palm Beach County, for the low-income communities within the City of Riviera Beach.

(e)  In the City of St. Petersburg, for the low-income communities within the Challenge 2001 Area.

(f)  In Broward County, the communities immediately surrounding the Miles Health Center in Ft. Lauderdale.

History.--s. 11, ch. 99-356.

381.103  Community Health Pilot Projects; duties of department.--To the extent feasible, the department may:

(1)  Assist the pilot projects in development and implementation of their community programs by acting as the granting agency and contracting with the pilot projects.

(2)  Facilitate the integration of the pilot projects with ongoing departmental programs, so that duplication of services is avoided and synergy between the programs enhanced.

(3)  Develop educational and outreach programs for health care providers and communities that increase awareness of health care needs for low-income persons living in urban and rural communities.

(4)  Assist the pilot projects in obtaining low-cost health care services designed to prevent disease and promote health in low-income communities.

(5)  Prepare a report to be submitted to the President of the Senate, the Speaker of the House of Representatives, and the Governor on the findings, accomplishments, and recommendations of the Community Health pilot projects by or on January 1, 2001.

(6)  Facilitate cooperation between affected communities, appropriate agencies, and ongoing initiatives, such as Front Porch Florida.

History.--s. 12, ch. 99-356.

381.6021  Certification of organizations engaged in the practice of cadaveric organ and tissue procurement.--The Agency for Health Care Administration shall:

(1)  Establish a program for the certification of organizations, agencies, or other entities engaged in the procurement of organs, tissues, and eyes for transplantation;

(2)  Adopt rules that set forth appropriate standards and guidelines for the program. These standards and guidelines must be substantially based on the existing laws of the Federal Government and this state and the existing standards and guidelines of the United Network for Organ Sharing (UNOS), the American Association of Tissue Banks (AATB), the South-Eastern Organ Procurement Foundation (SEOPF), the North American Transplant Coordinators Organization (NATCO), and the Eye Bank Association of America (EBAA). In addition, the Agency for Health Care Administration shall, before adopting these standards and guidelines, seek input from all organ procurement organizations, tissue banks, and eye banks based in this state;

(3)  Collect, keep, and make available to the Governor and the Legislature information regarding the numbers and disposition of organs and tissues procured by each certified entity;

(4)  Monitor participating facilities and agencies for program compliance; and

(5)  Provide for the administration of the Organ and Tissue Procurement and Transplantation Advisory Board.

History.--ss. 2, 9, ch. 91-271; s. 5, ch. 91-429; s. 5, ch. 94-305.

381.6022  Certification of organ procurement organizations, tissue banks, and eye banks.--

(1)  An organization, agency, or other entity may not engage in the practice of organ procurement in this state without being designated as an organ procurement organization by the secretary of the United States Department of Health and Human Services and being appropriately certified by the Agency for Health Care Administration. As used in this subsection, the term "procurement" includes the retrieval, processing, or distribution of human organs. A physician or organ procurement organization based outside this state is exempt from these certification requirements if:

(a)  The organs are procured for an out-of-state patient who is listed on, or referred through, the United Network for Organ Sharing System; and

(b)  The organs are procured through an agreement of an organ procurement organization certified by the state.

(2)  An organization, agency, or other entity may not engage in tissue procurement in this state unless it is appropriately certified by the Agency for Health Care Administration. As used in this subsection, the term "procurement" includes any retrieval, processing, storage, or distribution of human tissue for transplantation.

(3)  An organization, agency, or other entity may not engage in the practice of eye procurement in this state without being appropriately certified by the Agency for Health Care Administration. As used in this subsection, the term "procurement" includes the retrieval, processing, or distribution of human eye tissue. Funeral directors or direct disposers that retrieve eye tissue for an eye bank certified under this subsection are exempt from the certification requirements under this subsection.

(4)  A limited certificate may be issued to a tissue bank or eye bank, certifying only those components of procurement which the bank has chosen to perform. The Agency for Health Care Administration may issue a limited certificate if it determines that the tissue bank or eye bank is adequately staffed and equipped to operate in conformity with the rules adopted under this section.

History.--s. 3, ch. 91-271; s. 6, ch. 94-305.

381.60225  Background screening.--

(1)  Each applicant for certification must comply with the following requirements:

(a)  Upon receipt of a completed, signed, and dated application, the Agency for Health Care Administration shall require background screening, in accordance with the level 2 standards for screening set forth in chapter 435, of the managing employee, or other similarly titled individual responsible for the daily operation of the organization, agency, or entity, and financial officer, or other similarly titled individual who is responsible for the financial operation of the organization, agency, or entity, including billings for services. The applicant must comply with the procedures for level 2 background screening as set forth in chapter 435, as well as the requirements of s. 435.03(3).

(b)  The Agency for Health Care Administration may require background screening of any other individual who is an applicant if the Agency for Health Care Administration has probable cause to believe that he or she has been convicted of a crime or has committed any other offense prohibited under the level 2 standards for screening set forth in chapter 435.

(c)  Proof of compliance with the level 2 background screening requirements of chapter 435 which has been submitted within the previous 5 years in compliance with any other health care licensure requirements of this state is acceptable in fulfillment of the requirements of paragraph (a).

(d)  A provisional certification may be granted to the organization, agency, or entity when each individual required by this section to undergo background screening has met the standards for the Department of Law Enforcement background check, but the agency has not yet received background screening results from the Federal Bureau of Investigation, or a request for a disqualification exemption has been submitted to the agency as set forth in chapter 435, but a response has not yet been issued. A standard certification may be granted to the organization, agency, or entity upon the agency's receipt of a report of the results of the Federal Bureau of Investigation background screening for each individual required by this section to undergo background screening which confirms that all standards have been met, or upon the granting of a disqualification exemption by the agency as set forth in chapter 435. Any other person who is required to undergo level 2 background screening may serve in his or her capacity pending the agency's receipt of the report from the Federal Bureau of Investigation. However, the person may not continue to serve if the report indicates any violation of background screening standards and a disqualification exemption has not been requested of and granted by the agency as set forth in chapter 435.

(e)  Each applicant must submit to the agency, with its application, a description and explanation of any exclusions, permanent suspensions, or terminations of the applicant from the Medicare or Medicaid programs. Proof of compliance with the requirements for disclosure of ownership and control interests under the Medicaid or Medicare programs shall be accepted in lieu of this submission.

(f)  Each applicant must submit to the agency a description and explanation of any conviction of an offense prohibited under the level 2 standards of chapter 435 by a member of the board of directors of the applicant, its officers, or any individual owning 5 percent or more of the applicant. This requirement does not apply to a director of a not-for-profit corporation or organization if the director serves solely in a voluntary capacity for the corporation or organization, does not regularly take part in the day-to-day operational decisions of the corporation or organization, receives no remuneration for his or her services on the corporation or organization's board of directors, and has no financial interest and has no family members with a financial interest in the corporation or organization, provided that the director and the not-for-profit corporation or organization include in the application a statement affirming that the director's relationship to the corporation satisfies the requirements of this paragraph.

(g)  The agency may not certify any organization, agency, or entity if any applicant or managing employee has been found guilty of, regardless of adjudication, or has entered a plea of nolo contendere or guilty to, any offense prohibited under the level 2 standards for screening set forth in chapter 435, unless an exemption from disqualification has been granted by the agency as set forth in chapter 435.

(h)  The agency may deny or revoke certification of any organization, agency, or entity if the applicant:

1.  Has falsely represented a material fact in the application required by paragraph (e) or paragraph (f), or has omitted any material fact from the application required by paragraph (e) or paragraph (f); or

2.  Has had prior action taken against the applicant under the Medicaid or Medicare program as set forth in paragraph (e).

(i)  An application for renewal of certification must contain the information required under paragraphs (e) and (f).

(2)  An organ procurement organization, tissue bank, or eye bank certified by the Agency for Health Care Administration in accordance with ss. 381.6021 and 381.6022 is not subject to the requirements of this section if the entity has no direct patient care responsibilities and does not bill patients or insurers directly for services under the Medicare or Medicaid programs, or for privately insured services.

History.--ss. 6, 71, ch. 98-171; s. 59, ch. 2000-349; s. 25, ch. 2001-53; s. 2, ch. 2001-67; s. 148, ch. 2001-277.

381.6023  Organ and Tissue Procurement and Transplantation Advisory Board; creation; duties.--

(1)  There is hereby created the Organ and Tissue Procurement and Transplantation Advisory Board, which shall consist of 14 members who are appointed by and report directly to the Secretary of Health Care Administration. The membership must be regionally distributed and must include:

(a)  Two representatives who have expertise in vascular organ transplant surgery;

(b)  Two representatives who have expertise in vascular organ procurement, preservation, and distribution;

(c)  Two representatives who have expertise in musculoskeletal tissue transplant surgery;

(d)  Two representatives who have expertise in musculoskeletal tissue procurement, processing, and distribution;

(e)  A representative who has expertise in eye and cornea transplant surgery;

(f)  A representative who has expertise in eye and cornea procurement, processing, and distribution;

(g)  A representative who has expertise in bone marrow procurement, processing, and transplantation;

(h)  A representative from the Florida Pediatric Society;

(i)  A representative from the Florida Society of Pathologists; and

(j)  A representative from the Florida Medical Examiners Commission.

(2)  The advisory board members may not be compensated for their services except that they may be reimbursed for their travel expenses as provided by law. Members of the board shall be appointed for 3-year terms of office.

(3)  The board shall:

(a)  Assist the Agency for Health Care Administration in the development of necessary professional qualifications, including, but not limited to, the education, training, and performance of persons engaged in the various facets of organ and tissue procurement, processing, preservation, and distribution for transplantation;

(b)  Assist the Agency for Health Care Administration in monitoring the appropriate and legitimate expenses associated with organ and tissue procurement, processing, and distribution for transplantation and developing methodologies to assure the uniform statewide reporting of data to facilitate the accurate and timely evaluation of the organ and tissue procurement and transplantation system;

(c)  Provide assistance to the Florida Medical Examiners Commission in the development of appropriate procedures and protocols to assure continued improvement in the approval and release of potential organ and tissue donors by the district medical examiners and associate medical examiners;

(d)  Develop with and recommend to the Agency for Health Care Administration the necessary procedures and protocols required to assure that all residents of this state have reasonable access to available organ and tissue transplantation therapy and that residents of this state can be reasonably assured that the statewide procurement transplantation system will be able to fulfill their organ and tissue requirements within the limits of the available supply and according to the severity of their medical condition and need; and

(e)  Develop with and recommend to the Agency for Health Care Administration any changes to the laws of this state or administrative rules or procedures required to assure that the statewide organ and tissue procurement and transplantation system will be able to function smoothly, effectively, and efficiently, in accordance with the Federal Anatomical Gift Act and in a manner that assures the residents of this state that no person or entity profits from the altruistic voluntary donation of organs or tissues.

History.--ss. 4, 9, ch. 91-271; s. 5, ch. 91-429; s. 7, ch. 94-305; s. 7, ch. 2000-305.

381.6024  Fees; Florida Organ and Tissue Donor Education and Procurement Trust Fund.--

(1)  The Agency for Health Care Administration shall collect an initial application fee of $1,000 from organ procurement organizations and tissue banks and $500 from eye banks. The fee must be submitted with each application for initial certification and is nonrefundable.

(2)  The Agency for Health Care Administration shall assess annual fees to be used, in the following order of priority, for the certification program, the advisory board, maintenance of the organ and tissue donor registry, and the organ and tissue donor education program in the following amounts, which may not exceed $35,000 per organization:

(a)  Each general organ procurement organization shall pay the greater of $1,000 or 0.25 percent of its total revenues produced from procurement activity in this state by the certificateholder during its most recently completed fiscal year or operational year.

(b)  Each bone and tissue procurement agency or bone and tissue bank shall pay the greater of $1,000 or 0.25 percent of its total revenues from procurement and processing activity in this state by the certificateholder during its most recently completed fiscal year or operational year.

(c)  Each eye bank shall pay the greater of $500 or 0.25 percent of its total revenues produced from procurement activity in this state by the certificateholder during its most recently completed fiscal year or operational year.

(3)  The Agency for Health Care Administration shall provide by rule for administrative penalties for the purpose of ensuring adherence to the standards of quality and practice required by this chapter and rules of the agency for continued certification.

(4)(a)  Proceeds from fees, administrative penalties, and surcharges collected pursuant to subsections (2) and (3) must be deposited into the Florida Organ and Tissue Donor Education and Procurement Trust Fund created by s. 765.52155.

(b)  Moneys deposited in the trust fund pursuant to this section must be used exclusively for the implementation, administration, and operation of the certification program and the advisory board, for maintaining the organ and tissue donor registry, and for organ and tissue donor education.

(5)  As used in this section, the term "procurement activity in this state" includes the bringing into this state for processing, storage, distribution, or transplantation of organs or tissues that are initially procured in another state or country.

History.--s. 5, ch. 91-271; s. 8, ch. 94-305; s. 32, ch. 96-418; ss. 3, 4, ch. 98-68; s. 54, ch. 2002-1.

381.6025  Physician supervision of cadaveric organ and tissue procurement coordinators.--Organ procurement organizations, tissue banks, and eye banks may employ coordinators, who are registered nurses, physician's assistants, or other medically trained personnel who meet the relevant standards for organ procurement organizations, tissue banks, or eye banks as adopted by the Agency for Health Care Administration under s. 381.6021, to assist in the medical management of organ donors or in the surgical procurement of cadaveric organs, tissues, or eyes for transplantation or research. A coordinator who assists in the medical management of organ donors or in the surgical procurement of cadaveric organs, tissues, or eyes for transplantation or research must do so under the direction and supervision of a licensed physician medical director pursuant to rules and guidelines to be adopted by the Agency for Health Care Administration. With the exception of organ procurement surgery, this supervision may be indirect supervision. For purposes of this section, the term "indirect supervision" means that the medical director is responsible for the medical actions of the coordinator, that the coordinator is operating under protocols expressly approved by the medical director, and that the medical director or his or her physician designee is always available, in person or by telephone, to provide medical direction, consultation, and advice in cases of organ, tissue, and eye donation and procurement. Although indirect supervision is authorized under this section, direct physician supervision is to be encouraged when appropriate.

History.--s. 6, ch. 91-271; s. 9, ch. 94-305; s. 1035, ch. 95-148.

381.6026  Procurement of cadaveric organs for transplant by out-of-state physicians.--Any physician currently licensed to practice medicine and surgery in the United States may surgically procure in this state cadaveric organs for transplant if:

(1)  The organs are being procured for an out-of-state patient who is listed on, or referred through, the United Network for Organ Sharing System; and

(2)  The organs are being procured through the auspices of an organ procurement organization certified in this state.

History.--s. 7, ch. 91-271.

381.731  Strategic planning.--The Department of Health shall include population-based health-promotion strategies in the department's strategic plan developed under ¹s. 186.021. The strategic plan must include data on the health status of the state's population, health status objectives and outcome measures, and public health strategies, including health promotion strategies. The strategic plan must also provide an overall conceptual framework for the state's health promotion programs that considers available information on mortality, morbidity, disability, and behavioral risk factors associated with chronic diseases and conditions.

History.--s. 106, ch. 92-33; s. 107, ch. 97-101; s. 2, ch. 98-224; s. 30, ch. 99-5; s. 73, ch. 99-8; s. 47, ch. 99-397; s. 12, ch. 2000-367.

¹Note.--"Strategic plans" in s. 186.021 were redesignated "long-range program plans" by s. 42, ch. 2000-371.

Note.--Former s. 408.601.

381.732  Short title; Healthy Communities, Healthy People Act.--Sections 381.731-381.734 may be cited as the "Healthy Communities, Healthy People Act."

History.--s. 107, ch. 92-33; s. 2, ch. 98-224; s. 195, ch. 99-13.

Note.--Former s. 408.602.

381.733  Definitions relating to Healthy Communities, Healthy People Act.--As used in ss. 381.731-381.734, the term:

(1)  "Department" means the Department of Health.

(2)  "Primary prevention" means interventions directed toward healthy populations with a focus on avoiding disease prior to its occurrence.

(3)  "Secondary prevention" means interventions designed to promote the early detection and treatment of diseases and to reduce the risks experienced by at-risk populations.

(4)  "Tertiary prevention" means interventions directed at rehabilitating and minimizing the effects of disease in a chronically ill population.

History.--s. 108, ch. 92-33; s. 2, ch. 98-224; s. 74, ch. 99-8; s. 196, ch. 99-13.

Note.--Former s. 408.603.

381.734  Healthy Communities, Healthy People Program.--

(1)  The department shall develop and implement the Healthy Communities, Healthy People Program, a comprehensive and community-based health promotion and wellness program. The program shall be designed to reduce major behavioral risk factors associated with chronic diseases, including those chronic diseases identified in chapter 385, by enhancing the knowledge, skills, motivation, and opportunities for individuals, organizations, and communities to develop and maintain healthy lifestyles.

(2)  The department shall consolidate and use existing resources, programs, and program data to develop this program, to avoid duplication of efforts or services. Such resources, programs, and program data shall include the community intervention programs operated under s. 385.103.

(3)  The program shall include:

(a)  Statewide assessments of specific, causal, and behavioral risk factors that affect the health of residents of the state.

(b)  The development of community-based health promotion programs, incorporating health promotion and preventive care practices supported in scientific and medical literature.

(c)  The development and implementation of statewide age-specific, disease-specific, and community-specific health promotion and preventive care strategies using primary, secondary, and tertiary prevention interventions.

(d)  The promotion of community-based health-promotion model programs that meet specific criteria and address major risk factors in the state and motivate individuals to permanently adopt healthy behaviors, enhance self-esteem, and increase social and personal responsibilities.

(e)  The enhancement of the department's special initiatives to develop the mental, emotional, and social competencies of children and adolescents, using innovative school-based and neighborhood-based approaches to build self-esteem and prevent later problems such as drug abuse, poor school performance, criminal behavior, and other behavioral problems.

(f)  The development and implementation of a statewide health education program to educate the public and communities about health risks and assist them in modifying unhealthy behaviors.

(g)  The establishment of a comprehensive program to inform the public, health care professionals, and communities about the prevalence of chronic diseases in the state; known and potential risks, including social and behavioral risks; and behavior changes that would reduce risks.

(h)  The development and implementation of a program for enhancing self-help organizations and volunteer programs that enlist the support of volunteers in health promotion activities, particularly persons who serve as role models because of their public visibility or because of their recovery from or skill in coping with disease.

(i)  The development of policies that encourage the use of alternative community delivery sites for health promotion and preventive care programs and promote the use of neighborhood delivery sites that are close to work, home, and school.

(j)  An emphasis on the importance of a physically active lifestyle to build self-esteem, reduce morbidity and mortality associated with chronic disease, and reduce obesity.

History.--s. 109, ch. 92-33; s. 2, ch. 98-224; s. 9, ch. 2000-153; s. 13, ch. 2000-367.

Note.--Former s. 408.604.

381.7351  Short title; Closing the Gap Act.--Sections 381.7351-381.7356 may be cited as the "Reducing Racial and Ethnic Health Disparities: Closing the Gap Act."

History.--s. 27, ch. 2000-256.

381.7352  Legislative findings and intent.--

(1)  The Legislature finds that despite state investments in health care programs, certain racial and ethnic populations in Florida continue to have significantly poorer health outcomes when compared to non-Hispanic whites. The Legislature finds that local solutions to health care problems can have a dramatic and positive effect on the health status of these populations. Local governments and communities are best equipped to identify the health education, health promotion, and disease prevention needs of the racial and ethnic populations in their communities, mobilize the community to address health outcome disparities, enlist and organize local public and private resources, and faith-based organizations to address these disparities, and evaluate the effectiveness of interventions.

(2)  It is therefore the intent of the Legislature to provide funds within Florida counties and Front Porch Florida Communities, in the form of Reducing Racial and Ethnic Health Disparities: Closing the Gap grants, to stimulate the development of community-based and neighborhood-based projects which will improve the health outcomes of racial and ethnic populations. Further, it is the intent of the Legislature that these programs foster the development of coordinated, collaborative, and broad-based participation by public and private entities, and faith-based organizations. Finally, it is the intent of the Legislature that the grant program function as a partnership between state and local governments, faith-based organizations, and private-sector health care providers, including managed care, voluntary health care resources, social service providers, and nontraditional partners.

History.--s. 28, ch. 2000-256.

381.7353  Reducing Racial and Ethnic Health Disparities: Closing the Gap grant program; administration; department duties.--

(1)  The Reducing Racial and Ethnic Health Disparities: Closing the Gap grant program shall be administered by the Department of Health.

(2)  The department shall:

(a)  Publicize the availability of funds and establish an application process for submitting a grant proposal.

(b)  Provide technical assistance and training, including a statewide meeting promoting best practice programs, as requested, to grant recipients.

(c)  Develop uniform data reporting requirements for the purpose of evaluating the performance of the grant recipients and demonstrating improved health outcomes.

(d)  Develop a monitoring process to evaluate progress toward meeting grant objectives.

(e)  Coordinate with existing community-based programs, such as chronic disease community intervention programs, cancer prevention and control programs, diabetes control programs, the Healthy Start program, the Florida KidCare Program, the HIV/AIDS program, immunization programs, and other related programs at the state and local levels, to avoid duplication of effort and promote consistency.

(3)  Pursuant to s. 20.43(6), the secretary may appoint an ad hoc advisory committee to: examine areas where public awareness, public education, research, and coordination regarding racial and ethnic health outcome disparities are lacking; consider access and transportation issues which contribute to health status disparities; and make recommendations for closing gaps in health outcomes and increasing the public's awareness and understanding of health disparities that exist between racial and ethnic populations.

History.--s. 29, ch. 2000-256.

381.7354  Eligibility.--

(1)  Any person, entity, or organization within a county may apply for a Closing the Gap grant and may serve as the lead agency to administer and coordinate project activities within the county and develop community partnerships necessary to implement the grant.

(2)  Persons, entities, or organizations within adjoining counties with populations of less than 100,000, based on the annual estimates produced by the Population Program of the University of Florida Bureau of Economic and Business Research, may jointly submit a multicounty Closing the Gap grant proposal. However, the proposal must clearly identify a single lead agency with respect to program accountability and administration.

(3)  In addition to the grants awarded under subsections (1) and (2), up to 20 percent of the funding for the Reducing Racial and Ethnic Health Disparities: Closing the Gap grant program shall be dedicated to projects that address improving racial and ethnic health status within specific Front Porch Florida Communities, as designated pursuant to s. 14.2015(9)(b).

(4)  Nothing in ss. 381.7351-381.7356 shall prevent a person, entity, or organization within a county or group of counties from separately contracting for the provision of racial and ethnic health promotion, health awareness, and disease prevention services.

History.--s. 30, ch. 2000-256.

381.7355  Project requirements; review criteria.--

(1)  Closing the Gap grant proposals shall be submitted to the Department of Health for review.

(2)  A proposal must include each of the following elements:

(a)  The purpose and objectives of the proposal, including identification of the particular racial or ethnic disparity the project will address. The proposal must address one or more of the following priority areas:

1.  Decreasing racial and ethnic disparities in maternal and infant mortality rates.

2.  Decreasing racial and ethnic disparities in morbidity and mortality rates relating to cancer.

3.  Decreasing racial and ethnic disparities in morbidity and mortality rates relating to HIV/AIDS.

4.  Decreasing racial and ethnic disparities in morbidity and mortality rates relating to cardiovascular disease.

5.  Decreasing racial and ethnic disparities in morbidity and mortality rates relating to diabetes.

6.  Increasing adult and child immunization rates in certain racial and ethnic populations.

(b)  Identification and relevance of the target population.

(c)  Methods for obtaining baseline health status data and assessment of community health needs.

(d)  Mechanisms for mobilizing community resources and gaining local commitment.

(e)  Development and implementation of health promotion and disease prevention interventions.

(f)  Mechanisms and strategies for evaluating the project's objectives, procedures, and outcomes.

(g)  A proposed work plan, including a timeline for implementing the project.

(h)  Likelihood that project activities will occur and continue in the absence of funding.

(3)  Priority shall be given to proposals that:

(a)  Represent areas with the greatest documented racial and ethnic health status disparities.

(b)  Exceed the minimum local contribution requirements specified in s. 381.7356.

(c)  Demonstrate broad-based local support and commitment from entities representing racial and ethnic populations, including non-Hispanic whites. Indicators of support and commitment may include agreements to participate in the program, letters of endorsement, letters of commitment, interagency agreements, or other forms of support.

(d)  Demonstrate a high degree of participation by the health care community in clinical preventive service activities and community-based health promotion and disease prevention interventions.

(e)  Have been submitted from counties with a high proportion of residents living in poverty and with poor health status indicators.

(f)  Demonstrate a coordinated community approach to addressing racial and ethnic health issues within existing publicly financed health care programs.

(g)  Incorporate intervention mechanisms which have a high probability of improving the targeted population's health status.

(h)  Demonstrate a commitment to quality management in all aspects of project administration and implementation.

History.--s. 31, ch. 2000-256.

381.7356  Local matching funds; grant awards.--

(1)  One or more Closing the Gap grants may be awarded in a county, or in a group of adjoining counties from which a multicounty application is submitted. Front Porch Florida Communities grants may also be awarded in a county or group of adjoining counties that are also receiving a grant award.

(2)  Closing the Gap grants shall be awarded on a matching basis. One dollar in local matching funds must be provided for each $3 grant payment made by the state, except that:

(a)  In counties with populations greater than 50,000, up to 50 percent of the local match may be in kind in the form of free services or human resources. Fifty percent of the local match must be in the form of cash.

(b)  In counties with populations of 50,000 or less, the required local matching funds may be provided entirely through in-kind contributions.

(c)  Grant awards to Front Porch Florida Communities shall not be required to have a matching requirement.

(3)  The amount of the grant award shall be based on the county or neighborhood's population, or on the combined population in a group of adjoining counties from which a multicounty application is submitted, and on other factors, as determined by the department.

(4)  Dissemination of grant awards shall begin no later than January 1, 2001.

(5)  A Closing the Gap grant shall be funded for 1 year and may be renewed annually upon application to and approval by the department, subject to the achievement of quality standards, objectives, and outcomes and to the availability of funds.

(6)  Implementation of the Reducing Racial and Ethnic Health Disparities: Closing the Gap grant program shall be subject to a specific appropriation provided in the General Appropriations Act.

History.--s. 32, ch. 2000-256.

381.739  Short title; Charlie Mack Overstreet Brain or Spinal Cord Injuries Act.--Sections 381.739-381.79 may be cited as the "Charlie Mack Overstreet Brain or Spinal Cord Injuries Act."

History.--s. 32, ch. 94-324; s. 17, ch. 99-240.

Note.--Former s. 413.465.

381.7395  Legislative intent.--It is the intent of the Legislature to ensure the referral of individuals who have moderate-to-severe brain or spinal cord injuries to the brain and spinal cord injury program, a coordinated rehabilitation program administered by the department. The program shall provide eligible persons, as defined in s. 381.76, the opportunity to obtain the necessary rehabilitative services enabling them to be referred to a vocational rehabilitation program or to return to an appropriate level of functioning in their community. Further, it is intended that permanent disability be avoided, whenever possible, through prevention, early identification, emergency medical services and transport, and proper medical and rehabilitative treatment.

History.--s. 1, ch. 74-254; s. 148, ch. 77-104; s. 2, ch. 87-320; s. 31, ch. 94-324; s. 64, ch. 2000-153; s. 14, ch. 2000-367.

Note.--Former s. 413.46.

381.74  Establishment and maintenance of a central registry.--The department shall establish and maintain a central registry of persons who have moderate-to-severe brain or spinal cord injuries.

(1)  Every public health agency, private health agency, public social agency, private social agency, and attending physician shall report to the division within 5 days after identification or diagnosis of any person who has a moderate-to-severe brain or spinal cord injury. The consent of such person shall not be required.

(2)  The report shall contain the name, age, residence, and type of disability of the individual and such additional information as may be deemed necessary by the department.

History.--s. 3, ch. 74-254; s. 1, ch. 75-168; s. 4, ch. 87-320; s. 33, ch. 94-324; s. 18, ch. 99-240.

Note.--Former s. 413.48.

381.745  Definitions; ss. 381.739-381.79.--As used in ss. 381.739-381.79, the term:

(1)  "Activity of daily living" means an activity required on a frequent basis which permits an individual to secure or maintain independence. Such activities include, but are not limited to, personal home care, transportation, personal assistance services, housekeeping, shopping, attending school, communication, and employment.

(2)  "Brain or spinal cord injury" means:

(a)  A lesion to the spinal cord or cauda equina, resulting from external trauma, with evidence of significant involvement of two of the following deficits or dysfunctions:

1.  Motor deficit.

2.  Sensory deficit.

3.  Bowel and bladder dysfunction.

(b)  An insult to the skull, brain, or its covering, resulting from external trauma that produces an altered state of consciousness or anatomic motor, sensory, cognitive, or behavioral deficits.

(3)  "Emergency medical evacuation system" means a department-approved transportation system that provides timely and skilled emergency care and movement of individuals believed to have sustained a brain or spinal cord injury.

(4)  "Personal assistance services" means a range of services, provided by one or more individuals, which are designed to assist an individual who has a disability to perform activities of daily living.

(5)  "Funded services" means services paid for through the brain and spinal cord injury program.

(6)  "Designated facility" means a facility approved by the brain and spinal cord injury program which meets the criteria and standards of care of the brain and spinal cord injury program for individuals who have sustained a brain or spinal cord injury.

(7)  "Third-party coverage" means any claim for, right to receive payment for, or any coverage for the payment of any services under the brain and spinal cord injury program.

(8)  "Third-party payment" means any and all payments received or due as a result of any third-party obligation created by gift, coverage or other contract, settlement or judicial decision, or action of law.

(9)  "Transitional living facility" means a state-approved facility, as defined and licensed under chapter 400, or a facility approved by the brain and spinal cord injury program in accordance with this chapter.

(10)  "Trauma center" means a department-approved acute care facility that provides diagnosis and treatment of individuals who have sustained a brain or spinal cord injury.

History.--s. 15, ch. 2000-367.

381.75  Duties and responsibilities of the department, of transitional living facilities, and of residents.--Consistent with the mandate of s. 381.7395, the department shall develop and administer a multilevel treatment program for individuals who sustain brain or spinal cord injuries and who are referred to the brain and spinal cord injury program.

(1)  Within 15 days after any report of an individual who has sustained a brain or spinal cord injury, the department shall notify the individual or the most immediate available family members of their right to assistance from the state, the services available, and the eligibility requirements.

(2)  The department shall refer individuals who have brain or spinal cord injuries to other state agencies to assure that rehabilitative services, if desired, are obtained by that individual.

(3)  The department, in consultation with emergency medical service, shall develop standards for an emergency medical evacuation system that will ensure that all individuals who sustain traumatic brain or spinal cord injuries are transported to a department-approved trauma center that meets the standards and criteria established by the emergency medical service and the acute-care standards of the brain and spinal cord injury program.

(4)  The department shall develop standards for designation of rehabilitation centers to provide rehabilitation services for individuals who have brain or spinal cord injuries.

(5)  The department shall determine the appropriate number of designated acute-care facilities, inpatient rehabilitation centers, and outpatient rehabilitation centers, needed based on incidence, volume of admissions, and other appropriate criteria.

(6)  The department shall develop standards for designation of transitional living facilities to provide individuals the opportunity to adjust to their disabilities and to develop physical and functional skills in a supported living environment.

(a)  The Agency for Health Care Administration, in consultation with the department, shall develop rules for the licensure of transitional living facilities for individuals who have brain or spinal cord injuries.

(b)  The goal of a transitional living program for individuals who have brain or spinal cord injuries is to assist each individual who has such a disability to achieve a higher level of independent functioning and to enable that person to reenter the community. The program shall be focused on preparing participants to return to community living.

(c)  A transitional living facility for an individual who has a brain or spinal cord injury shall provide to such individual, in a residential setting, a goal-oriented treatment program designed to improve the individual's physical, cognitive, communicative, behavioral, psychological, and social functioning, as well as to provide necessary support and supervision. A transitional living facility shall offer at least the following therapies: physical, occupational, speech, neuropsychology, independent living skills training, behavior analysis for programs serving brain-injured individuals, health education, and recreation.

(d)  All residents shall use the transitional living facility as a temporary measure and not as a permanent home or domicile. The transitional living facility shall develop an initial treatment plan for each resident within 3 days after the resident's admission. The transitional living facility shall develop a comprehensive plan of treatment and a discharge plan for each resident as soon as practical, but no later than 30 days after the resident's admission. Each comprehensive treatment plan and discharge plan must be reviewed and updated as necessary, but no less often than quarterly. This subsection does not require the discharge of an individual who continues to require any of the specialized services described in paragraph (c) or who is making measurable progress in accordance with that individual's comprehensive treatment plan. The transitional living facility shall discharge any individual who has an appropriate discharge site and who has achieved the goals of his or her discharge plan or who is no longer making progress toward the goals established in the comprehensive treatment plan and the discharge plan. The discharge location must be the least restrictive environment in which an individual's health, well-being, and safety is preserved.

(7)  Recipients of services, under this section, from any of the facilities referred to in this section shall pay a fee based on ability to pay.

History.--s. 4, ch. 74-254; s. 5, ch. 87-320; s. 34, ch. 94-324; s. 2, ch. 98-12; s. 19, ch. 99-240; s. 16, ch. 2000-367.

Note.--Former s. 413.49.

381.755  Benefits not assignable.--The right of an eligible individual to any services provided by the brain and spinal cord injury program is not transferable or assignable, and any benefits, including money, goods, or chattels, received as services under the brain and spinal cord injury program are exempt from all state, county, and municipal taxes and from sale under the process of any court, except for obligations contracted for the purchase of such property.

History.--s. 17, ch. 2000-367.

381.76  Eligibility for the brain and spinal cord injury program.--

(1)  An individual shall be accepted as eligible for the brain and spinal cord injury program following certification by the department that the individual:

(a)  Has been referred to the central registry pursuant to s. 381.74;

(b)  Is a legal resident of this state at the time of application for services;

(c)  Has sustained a brain or spinal cord injury;

(d)  Is medically stable; and

(e)  Is reasonably expected to achieve reintegration into the community through services provided by the brain and spinal cord injury program.

(2)  If the department is unable to provide services to all eligible individuals, the department may establish an order of selection.

History.--s. 35, ch. 94-324; s. 20, ch. 99-240; s. 10, ch. 2000-153; s. 18, ch. 2000-367.

Note.--Former s. 413.507.

381.765  Retention of title to and disposal of equipment.--

(1)  The department may retain title to any property, tools, instruments, training supplies, equipment, or other items of value acquired for services provided under the brain and spinal cord injury program or for personnel employed in operating the brain and spinal cord injury program, and may repossess or transfer such property, tools, instruments, supplies, equipment, or other items of value.

(2)  The department may offer for sale any surplus items acquired in operating the brain and spinal cord injury program when they are no longer necessary or exchange them for necessary items that may be used to greater advantage. When any such surplus equipment is sold or exchanged, a receipt for the equipment shall be taken from the purchaser showing the consideration given for such equipment and forwarded to the Treasurer, and any funds received by the brain and spinal cord injury program pursuant to any such transaction shall be deposited in the Brain and Spinal Cord Injury Rehabilitation Trust Fund and shall be available for expenditure for any purpose consistent with this ¹part.

(3)  The department may adopt rules relating to records and recordkeeping for department-owned property referenced in subsections (1) and (2).

History.--s. 19, ch. 2000-367.

¹Note.--Chapter 381 is not divided into parts.

381.77  Nursing home residents, age 55 and under; annual survey.--The department shall conduct an annual survey of nursing homes in the state to determine the number of persons 55 years of age and under who reside in such homes due to brain or spinal cord injuries. All persons identified in such a survey shall be evaluated as to their rehabilitation potential, and any person who may benefit from rehabilitation shall be given an opportunity to participate in an appropriate rehabilitation program for which she or he may be eligible.

History.--s. 18, ch. 76-201; s. 8, ch. 87-320; s. 36, ch. 94-324; s. 62, ch. 97-103; s. 21, ch. 99-240.

Note.--Former s. 413.604.

381.775  Applicant and recipient records; confidential and privileged.--

(1)  All oral and written records, information, letters, and reports received, made, or maintained by the department relative to any applicant for or recipient of services under the brain and spinal cord injury program are privileged, confidential, and exempt from s. 119.07(1). Any person who discloses or releases such records, information, or communications in violation of this section commits a misdemeanor of the second degree, punishable as provided in s. 775.082 or s. 775.083. Such records may not be released, except that:

(a)  Records may be released to the applicant or recipient, or his or her representative, upon receipt of a written waiver from the applicant or recipient. Medical, psychological, or other information that the department believes may be harmful to an applicant or recipient may not be released directly to him or her, but must be provided through a licensed health care professional designated by the applicant or recipient.

(b)  Records that do not identify applicants or recipients may be released for the purpose of research, when the research is approved by the department.

(c)  Records used in administering the brain and spinal cord injury program may be released as required to administer the program or as required by an agency or political subdivision of the state in the performance of its duties. Any agency or political subdivision to which records are released under this paragraph may not disclose the records to third parties.

(d)  Records may be released upon the order of an administrative law judge, a hearing officer, a judge of compensation claims, an agency head exercising quasi-judicial authority, or a judge of a court of competent jurisdiction following a finding in an in camera proceeding that the records are relevant to the inquiry before the court and should be released. The in camera proceeding and all records relating thereto are confidential and exempt from s. 119.07(1).

(e)  Whenever an applicant for or recipient of services under the brain and spinal cord injury program has declared any intention to harm other persons or property, such declaration may be disclosed.

(f)  The department may release personal information about an applicant for or recipient of services under the brain and spinal cord injury program in order to protect him or her or others when the applicant or recipient poses a threat to his or her own safety or to the safety of others and shall, upon official request, release such information to law enforcement agencies investigating the commission of a crime.

(2)  Records that come into the possession of the department relative to any applicant for or receipt of services under the brain and spinal cord injury program and that are confidential by other provisions of law are confidential and exempt from s. 119.07(1), and may not be released by the department, except as provided in this section.

History.--s. 20, ch. 2000-367.

381.78  Advisory council on brain and spinal cord injuries.--

(1)  There is created within the department a 16-member advisory council on brain and spinal cord injuries. The council shall be composed of a minimum of four individuals who have brain injuries or are family members of individuals who have brain injuries, a minimum of four individuals who have spinal cord injuries or are family members of individuals who have spinal cord injuries, and a minimum of two individuals who represent the special needs of children who have brain or spinal cord injuries. The balance of the council members shall be physicians, other allied health professionals, administrators of brain and spinal cord injury programs, and representatives from support groups that have expertise in areas related to the rehabilitation of individuals who have brain or spinal cord injuries.

(2)  Members of the council shall be appointed to serve by the Secretary of Health. All members' terms shall be for 4 years. An individual may not serve more than two terms. Any council member who is unwilling or unable to properly fulfill the duties of the office shall be succeeded by an individual chosen by the secretary to serve out the unexpired balance of the replaced council member's term. If the unexpired balance of the replaced council member's term is less than 18 months, then, notwithstanding the provisions of this subsection, the succeeding council member may be reappointed by the secretary twice.

(3)  The council shall meet at least two times annually.

(4)  The council shall:

(a)  Provide advice and expertise to the department in the preparation, implementation, and periodic review of the brain and spinal cord injury program.

(b)  Annually appoint a five-member committee composed of one individual who has a brain injury or has a family member with a brain injury, one individual who has a spinal cord injury or has a family member with a spinal cord injury, and three members who shall be chosen from among these representative groups: physicians, other allied health professionals, administrators of brain and spinal cord injury programs, and representatives from support groups with expertise in areas related to the rehabilitation of individuals who have brain or spinal cord injuries, except that one and only one member of the committee shall be an administrator of a transitional living facility. Membership on the council is not a prerequisite for membership on this committee.

1.  The committee shall perform onsite visits to those transitional living facilities identified by the Agency for Health Care Administration as being in possible violation of the statutes and rules regulating such facilities. The committee members have the same rights of entry and inspection granted under s. 400.805(8) to designated representatives of the agency.

2.  Factual findings of the committee resulting from an onsite investigation of a facility pursuant to subparagraph 1. shall be adopted by the agency in developing its administrative response regarding enforcement of statutes and rules regulating the operation of the facility.

3.  Onsite investigations by the committee shall be funded by the Health Care Trust Fund.

4.  Travel expenses for committee members shall be reimbursed in accordance with s. 112.061.

5.  Members of the committee shall recuse themselves from participating in any investigation that would create a conflict of interest under state law, and the council shall replace the member, either temporarily or permanently.

(5)  Members of the advisory council are entitled to reimbursement for per diem and travel expenses for required attendance at council meetings in accordance with s. 112.061. Reasonable expenses for personal assistance services and interpreters needed by members during required attendance at council meetings shall be reimbursed. A member may not receive any compensation for performing duties specified in, or arising out of, her or his duties as a council member under this ¹part, except as otherwise specified in this ¹part.

(6)  A member of the advisory council may not cast a vote on any matter that would provide direct financial benefit to the member or create a conflict of interest under state law.

(7)  A member of the advisory council may be removed from office by the Secretary of Health for malfeasance, misfeasance, neglect of duty, incompetence, or permanent inability to perform official duties or for pleading nolo contendere to, or being found guilty of, a crime. Malfeasance includes, but is not limited to, a violation of any specific prohibition within this ¹part.

History.--s. 19, ch. 76-201; s. 9, ch. 87-320; s. 2, ch. 88-303; s. 5, ch. 91-429; s. 37, ch. 94-324; s. 3, ch. 98-12; s. 50, ch. 99-5; s. 22, ch. 99-240; s. 11, ch. 2000-153; s. 21, ch. 2000-367.

¹Note.--Chapter 381 is not divided into parts.

Note.--Former s. 413.605.

381.785  Recovery of third-party payments for funded services.--

(1)  Third-party coverage for funded services constitutes primary coverage.

(2)  An applicant for or recipient of services funded under the brain and spinal cord injury program must inform the brain and spinal cord injury program of any rights she or he has to third-party payments for such services, and the brain and spinal cord injury program shall be subrogated to her or his rights to such third-party payments. The brain and spinal cord injury program may recover directly from:

(a)  Any third party that is liable to make a benefit payment to the provider of the recipient's funded services or to the recipient under the terms of any contract, settlement, or award;

(b)  The recipient, if she or he has received a third-party payment for funded services provided to her or him; or

(c)  The provider of the recipient's funded services, if third-party payment for such services has been recovered by the provider.

(3)  An applicant for or a recipient of funded services is deemed to have assigned to the brain and spinal cord injury program her or his rights to any payments for such services from a third party and to have authorized the brain and spinal cord injury program to release information with respect to such services for the sole purpose of obtaining reimbursement.

(4)  The brain and spinal cord injury program may, in order to enforce its rights under this section, institute, intervene in, or join any legal proceeding against a third party against whom recovery rights arise. Action taken by the brain and spinal cord injury program does not preclude the recipient's recovery for that portion of her or his damages not subrogated to the brain and spinal cord injury program, and action taken by the recipient does not prejudice the rights of the brain and spinal cord injury program.

(5)  When the brain and spinal cord injury program provides, pays for, or becomes liable for funded services, it has a lien for the amount of such services upon all causes of action that accrue to the recipient or to her or his legal representatives as a result of sickness, injury, disease, disability, or death due to the liability of a third party which necessitated funded services. To perfect such lien, a notice of lien must be filed with the clerk of the circuit court in the recipient's county of residence. The notice of lien must contain the name and address of the person to whom services were furnished and the name, address, and telephone number of a person at the brain and spinal cord injury program from whom information regarding the lien can be obtained. Failure of the brain and spinal cord injury program to file a notice of lien does not affect the program's other rights provided in this section. Any notice of lien filed as provided under this subsection is valid for 5 years after filing, and may be extended for an additional 5-year period by filing a new notice of lien at any time prior to the expiration of the original notice of lien.

(6)  In recovering any payments in accordance with this section, the brain and spinal cord injury program may make appropriate settlements.

(7)  Notwithstanding any other law to the contrary, payments made for funded services are neither collateral payments nor collateral sources within the meaning of chapter 86-160, Laws of Florida, or chapter 88-1, Laws of Florida.

(8)  Notwithstanding any other law to the contrary, the brain and spinal cord injury program retains all rights and remedies granted under this section as against moneys paid under chapter 440.

(9)  The department shall adopt rules to administer this section.

History.--s. 22, ch. 2000-367.

381.79  Brain and Spinal Cord Injury Program Trust Fund.--

(1)  There is created in the State Treasury the Brain and Spinal Cord Injury Program Trust Fund. Moneys in the fund shall be appropriated to the department for the purpose of providing the cost of care for brain or spinal cord injuries as a payor of last resort to residents of this state, for multilevel programs of care established pursuant to s. 381.75.

(a)  Authorization of expenditures for brain or spinal cord injury care shall be made only by the department.

(b)  Authorized expenditures include acute care, rehabilitation, transitional living, equipment and supplies necessary for activities of daily living, public information, prevention, education, and research. In addition, the department may provide matching funds for public or private assistance provided under the brain and spinal cord injury program and may provide funds for any approved expansion of services for treating individuals who have sustained a brain or spinal cord injury.

(2)  The department shall issue a report to the President of the Senate and the Speaker of the House of Representatives by March 1 of each year, summarizing the activities supported by the trust fund.

(3)  Annually, 5 percent of the revenues deposited monthly in the fund pursuant to s. 318.21(2)(d) shall be appropriated to the University of Florida and 5 percent to the University of Miami for spinal cord injury and brain injury research. The amount to be distributed to the universities shall be calculated based on the deposits into the fund for each quarter in the fiscal year, but may not exceed $500,000 per university per year. Funds distributed under this subsection shall be made in quarterly payments at the end of each quarter during the fiscal year.

(4)  The ¹Board of Regents shall establish a program administration process which shall include: an annual prospective program plan with goals, research design, proposed outcomes, a proposed budget, an annual report of research activities and findings, and an annual end-of-year financial statement. Prospective program plans shall be submitted to the ¹Board of Regents, and funds shall be released upon acceptance of the proposed program plans. The annual report of research activities and findings shall be submitted to the ¹Board of Regents, with the executive summaries submitted to the President of the Senate, the Speaker of the House of Representatives, and the Secretary of Health.

(5)  Moneys received under s. 381.785 shall be deposited into the trust fund and used for the purposes specified in subsection (1).

(6)  The department may accept, deposit into the trust fund, and use for carrying out the purposes of this ²part gifts made unconditionally by will or otherwise. Any gift made under conditions that, in the judgment of the department, are proper and consistent with this section, the laws of the United States, and the laws of this state may be accepted and shall be held, invested, reinvested, and used in accordance with the conditions of the gift.

History.--s. 63, ch. 88-381; s. 2, ch. 92-65; s. 38, ch. 94-324; s. 23, ch. 99-240; s. 10, ch. 99-252; s. 12, ch. 2000-153; s. 23, ch. 2000-367.

¹Note.--Abolished by s. 3, ch. 2001-170.

²Note.--Chapter 381 is not divided into parts.

Note.--Former s. 413.613.

381.795  Long-term community-based supports.--The department shall, contingent upon specific appropriations for these purposes:

(1)  Study the long-term needs for community-based supports and services for individuals who have sustained traumatic brain or spinal cord injuries. The purpose of this study is to prevent inappropriate residential and institutional placement of these individuals, and promote placement in the most cost effective and least restrictive environment. Any placement recommendations for these individuals shall ensure full utilization of and collaboration with other state agencies, programs, and community partners. This study shall be submitted to the Governor, the President of the Senate, and the Speaker of the House of Representatives not later than December 31, 2000.

(2)  Based upon the results of this study, establish a plan for the implementation of a program of long-term community-based supports and services for individuals who have sustained traumatic brain or spinal cord injuries who may be subject to inappropriate residential and institutional placement as a direct result of such injuries.

(a)  The program shall be payor of last resort for program services, and expenditures for such services shall be considered funded services for purposes of s. 381.785; however, notwithstanding s. 381.79(5), proceeds resulting from this subsection shall be used solely for this program.

(b)  The department shall create, by rule, procedures to ensure, that in the event the program is unable to directly or indirectly provide such services to all eligible individuals due to lack of funds, those individuals most at risk to suffer the greatest harm from an imminent inappropriate residential or institutional placement are served first.

(c)  Every applicant or recipient of the long-term community-based supports and services program shall have been a resident of the state for 1 year immediately preceding application and be a resident of the state at the time of application.

(d)  The department shall adopt rules pursuant to ss. 120.536(1) and 120.54 to implement the provision of this subsection.

History.--s. 29, ch. 2000-367.

381.815  Sickle-cell program.--The Department of Health shall, to the extent that resources are available:

(1)  Provide education to the citizens of Florida about sickle-cell disease.

(2)  Work cooperatively with not-for-profit centers to provide community-based education, patient teaching, and counseling and to encourage diagnostic screening.

(3)  Make grants or enter into contracts with not-for-profit centers.

History.--s. 1, ch. 96-292; s. 186, ch. 97-101.

381.83  Trade secrets; confidentiality.--Records, reports, or information obtained from any person under this chapter, unless otherwise provided by law, shall be available to the public, except upon a showing satisfactory to the department by the person from whom the records, reports, or information is obtained that such records, reports, or information, or a particular part thereof, contains trade secrets as defined in s. 812.081(1)(c). Such trade secrets shall be confidential and are exempt from the provisions of s. 119.07(1) and s. 24(a), Art. I of the State Constitution. The person submitting such trade secret information to the department must request that it be kept confidential and must inform the department of the basis for the claim of trade secret. The department shall, subject to notice and opportunity for hearing, determine whether the information, or portions thereof, claimed to be a trade secret is or is not a trade secret. Such trade secrets may be disclosed, however, to authorized representatives of the department or, pursuant to request, to other governmental entities in order for them to properly perform their duties, or when relevant in any proceeding under this chapter. Authorized representatives and other governmental entities receiving such trade secret information shall retain its confidentiality. Those involved in any proceeding under this chapter, including a hearing officer or judge or justice, shall retain the confidentiality of any trade secret information revealed at such proceeding.

History.--s. 4, ch. 95-366; s. 188, ch. 96-406.

381.85  Biomedical and social research.--

(1)  SHORT TITLE; PURPOSE AND INTENT.--

(a)  This section may be cited as the "Florida Biomedical and Social Research Act."

(b)  The purpose of this section is to provide a procedure by which proposed research on children or adults will be supported with funds appropriated to the department, and can be efficiently and expeditiously assessed for compliance with the substantive and procedural requirements established by the Review Council for Biomedical and Social Research in rules adopted by the department.

(c)  It is the intent of the Legislature that:

1.  Research involving human beings be conducted by the department, or with funds appropriated to the department, only when necessary and appropriate, and only after review and approval pursuant to the provisions of this section and related rules.

2.  The department and the Review Council for Biomedical and Social Research jointly develop rules under which proposed research on human beings shall be promptly and appropriately submitted for review and approval pursuant to this section.

3.  The rules to be adopted by the department and the procedures and criteria to be adopted by the Review Council for Biomedical and Social Research be guided by the ethical standards for human research set forth in the report of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research.

(2)  DEFINITIONS.--When used in this section:

(a)  "Department" means the Department of Health.

(b)  "Research" means a systematic investigation designed to develop or contribute to knowledge that can be generalized.

(c)  "Intervention" means physical procedures by which data are gathered and manipulations of the subject or the subject's environment that are performed for research purposes.

(d)  "Interaction" means communication or interpersonal contact between investigator and subject.

(e)  "Private information" means information about behavior that occurs in a context in which an individual can reasonably expect that no observation or recording is taking place, and information which has been provided for specific purposes by an individual and which the individual can reasonably expect will not be made public.

(3)  REVIEW COUNCIL FOR BIOMEDICAL AND SOCIAL RESEARCH.--

(a)  There is created the Review Council for Biomedical and Social Research to consist of nine members. The Governor, the President of the Senate, and the Speaker of the House of Representatives shall each appoint, no later than January 1, 1991, three members, as follows: one individual knowledgeable in biomedical research, one individual knowledgeable in behavioral research, and one individual from the client advocacy community. The chairperson shall be elected by majority vote of the members.

(b)  Members of the Review Council for Biomedical and Social Research shall be appointed to serve terms of 3 years. A member may not serve more than two consecutive terms.

(c)  The council shall adopt internal organizational procedures or bylaws necessary for efficient operation of the council.

(d)  The council shall have a budget and shall be financed through an annual appropriation made for this purpose in the General Appropriations Act. Each member shall be entitled to receive per diem and expenses for travel, as provided in s. 112.061, while carrying out official business of the council. For administrative purposes only, the council shall be assigned to the Department of Legal Affairs.

(e)  The council shall be staffed by an executive director and a secretary who shall be appointed by the council and who shall be exempt from the provisions of part II of chapter 110 relating to the Career Service System.

(f)  The council shall meet and conduct business at least quarterly, or more often at the call of the chairperson.

(g)  The council shall consult outside experts, target populations, and others to assist in decisionmaking during the review process.

(h)  Meetings of the council shall be subject to the provisions of chapter 119 and s. 286.011.

(4)  RESEARCH SUBJECT TO REVIEW.--Any research on human beings conducted under the authority of the department shall be subject to review and approval by the Review Council for Biomedical and Social Research. In order to effectuate the review and approval process, the council shall adopt criteria to be used in its review of proposed research, procedures by which proposals for research on human beings by the department are to be submitted to the council, and other procedures necessary to assist in providing an efficient and effective decisionmaking process.

(5)  RULES.--The department, in consultation with the Review Council for Biomedical and Social Research, shall adopt rules necessary to carry out the provisions of this section. Such rules shall include, but not be limited to, defining the type of research to which such rules shall apply and prescribing internal departmental procedures for review and approval of research on human beings prior to submission to the council.

History.--ss. 75, 76, ch. 90-306; s. 5, ch. 91-429; s. 77, ch. 95-143; s. 805, ch. 95-148; s. 47, ch. 97-237.

Note.--Former s. 402.105.

381.87  Osteoporosis prevention and education program.--

(1)  The Department of Health, using available federal funds, state funds appropriated for that purpose, or other available funding as provided for in this section, shall establish, promote, and maintain an osteoporosis prevention and education program to promote public awareness of the causes of osteoporosis, options for prevention, the value of early detection, and possible treatments, including the benefits and risks of those treatments. The department shall consult with medical professionals, including physicians licensed under chapter 458 or chapter 459, in carrying out these duties. The department may accept, for that purpose, any special grant of money, services, or property from the Federal Government or any of its agencies or from any foundation, organization, or medical school.

(2)  The program must include:

(a)  Development of a public education and outreach campaign to promote osteoporosis prevention and education, including, but not limited to, the following subjects:

1.  The cause and nature of the disease.

2.  Risk factors.

3.  The role of oophorectomy and hysterectomy.

4.  Prevention of osteoporosis, including nutrition, diet, and physical exercise.

5.  Diagnostic procedures and appropriate indications for their use.

6.  Hormone replacement, including benefits and risks.

7.  Environmental safety and injury prevention.

8.  Availability of osteoporosis treatment services in the community.

(b)  Distribution of educational materials to be made available for consumers, particularly targeted to high-risk groups, through local health departments, local physicians, and other providers, including, but not limited to, health maintenance organizations, hospitals, and clinics, and through women's organizations and the Department of Elderly Affairs.

(c)  Development of professional education programs for health care providers to assist them in understanding research findings and the subjects set forth in paragraph (a).

(3)  The Department of Health shall implement this section. The department shall consult with the Agency for Health Care Administration and the Department of Elderly Affairs with respect to the prevention and education activities relating to osteoporosis which are described in this section.

History.--s. 1, ch. 96-282; s. 51, ch. 97-237.

Note.--Former s. 402.475.

381.88  Insect sting emergency treatment.--

(1)  This section may be cited as the "Insect Sting Emergency Treatment Act."

(2)  The purpose of this section is to provide for the certification of persons who administer lifesaving treatment to persons who have severe adverse reactions to insect stings when a physician is not immediately available.

(3)  The Department of Health may:

(a)  Adopt rules necessary to administer this section.

(b)  Conduct educational training programs as described in subsection (4), and approve programs conducted by other persons or governmental agencies.

(c)  Issue and renew certificates of training to persons who have complied with this section and the rules adopted by the department.

(d)  Collect fees necessary to administer this section.

(4)  Educational training programs required by this section must be conducted by a physician licensed to practice medicine in this state. The curriculum must include at a minimum:

(a)  Recognition of the symptoms of systemic reactions to insect stings; and

(b)  The proper administration of a subcutaneous injection of epinephrine.

(5)  A certificate of training may be given to a person who:

(a)  Is 18 years of age or older;

(b)  Has, or reasonably expects to have, responsibility for at least one other person who has severe adverse reactions to insect stings as a result of his or her occupational or volunteer status, including a camp counselor, scout leader, school teacher, forest ranger, tour guide, or chaperone;

(c)  Has successfully completed an educational training program as described in subsection (4).

(6)  A person who successfully completes an educational training program may obtain a certificate upon payment of an application fee of $25.

(7)  A certificate issued pursuant to this section authorizes the holder thereof to receive, upon presentment of the certificate, from any physician licensed in this state or from the department, a prescription for premeasured doses of epinephrine and the necessary paraphernalia for administration. The certificate also authorizes the holder thereof to possess and administer, in an emergency situation when a physician is not immediately available, the prescribed epinephrine to a person suffering a severe adverse reaction to an insect sting.

History.--s. 1, ch. 91-297; s. 816, ch. 95-148; s. 52, ch. 97-237.

Note.--Former s. 402.60.

381.89  Regulation of tanning facilities.--

(1)  As used in this section:

(a)  "Tanning facility" means a place of business which provides access to a tanning device by customers.

(b)  "Department" means the Department of Health.

(c)  "Tanning device" means equipment that emits electromagnetic radiation of wavelengths between 200 and 400 nanometers and that is used for tanning the skin, including a sunlamp, tanning booth, or tanning bed or any accompanying equipment.

(2)  This section does not apply to a tanning facility that uses only phototherapy devices that emit ultraviolet radiation which are used only by or under the direct supervision of a physician licensed under chapter 458 or an osteopathic physician licensed under chapter 459.

(3)(a)  A person may not operate a tanning facility unless it is licensed under this section.

(b)  The department shall establish procedures for the issuance and annual renewal of licenses and shall establish annual license and renewal fees in an amount necessary to cover the expenses of administering this section. Annual license and renewal fees shall be not less than $125 nor more than $250 per tanning device. Effective October 1, 1991, the fee amount shall be the minimum fee proscribed in this paragraph and such fee amount shall remain in effect until the effective date of a fee schedule adopted by the department.

(c)  The department may adopt a system under which licenses expire on staggered dates and the annual renewal fees are prorated monthly to reflect the actual number of months the license is valid.

(d)  The department may cancel, revoke, or suspend a license to operate a tanning facility if the licensee:

1.  Fails to pay any fee required by this section;

2.  Obtains or attempts to obtain a license by fraud; or

3.  Violates a provision of this section.

(4)(a)  A tanning facility must give each customer a written warning that states that:

1.  Not wearing the provided eye protection can cause damage to the eyes.

2.  Overexposure causes burns.

3.  Repeated exposure can cause premature aging of the skin or skin cancer.

4.  Abnormal skin sensitivity or burning may be caused by certain foods, cosmetics, or medications, including, without limitation, tranquilizers, diuretics, antibiotics, high blood pressure medicines, or birth control pills.

5.  Any person who takes a prescription or over-the-counter medication should consult a physician before using a tanning device.

6.  It does not carry liability insurance for injuries caused by tanning devices or states the limits of any liability insurance it carries.

(b)  A tanning facility must have a copy of the facility's most recent inspection report available to the public and must post a warning sign in any area where a tanning device is used. Posting this sign does not absolve the facility of any liability. The sign must state:

1.  Avoid frequent or lengthy exposure. As with natural sunlight, exposure can cause eye and skin injury or allergic reactions. Repeated exposure can cause chronic sun damage characterized by wrinkling, dryness, fragility and bruising of the skin or skin cancer.

2.  Wear protective eyewear. FAILURE TO USE PROTECTIVE EYEWEAR CAN RESULT IN SEVERE BURNS OR LONG-TERM INJURY TO THE EYES.

3.  Ultraviolet radiation from sunlamps will aggravate the effects of the sun. Therefore, do not sunbathe before or after exposure to ultraviolet radiation.

4.  Using medications or cosmetics can increase your sensitivity to ultraviolet radiation. Consult a physician before using a sunlamp if you are using medications, have a history of skin problems, or believe you are especially sensitive to sunlight. Women who are pregnant or on birth control who use this product can develop discolored skin. IF YOU DO NOT TAN IN THE SUN YOU WILL NOT TAN BY USING THIS DEVICE.

(5)  A tanning facility may not claim or distribute promotional materials that claim a tanning device is safe or free from risk.

(6)  A tanning facility must:

(a)  During operating hours, have an operator present who is sufficiently knowledgeable and trained in accordance with rules of the department in the correct operation of the tanning devices to inform and assist each customer in the proper use of the devices.

(b)  Before each use of a tanning device:

1.  Properly sanitize that tanning device equipment, including, without limitation, handrails, headrests, and bed surfaces; and

2.  Provide a customer with properly sanitized protective eyewear that protects the eye from ultraviolet radiation and allows adequate vision to maintain balance.

(c)  Show each customer how to use suitable physical aids, such as handrails and floor markings, to maintain proper exposure distances recommended by the manufacturer.

(d)  Use a timer on each tanning device which is accurate for any selected time interval to plus or minus 10 percent.

(e)  Limit each customer to the maximum exposure time recommended by the manufacturer of the tanning device.

(f)  Maintain the interior temperature of the tanning facility below 100 °F.

(g)  Each time a person uses a tanning facility or executes or renews a contract to use a tanning facility, have the person sign a written statement acknowledging that he or she has read and understands the warnings before using the device and that he or she agrees to use the protective eyewear.

(h)  Display its license in a public area of the tanning facility.

(i)  Report any injury or any complaint of injury to the department on forms prescribed by the department and provide a copy of the report to the complainant. The department shall send to the federal Food and Drug Administration a copy of any report of an injury occurring in a tanning facility.

(j)  Keep a record, for a period of not less than 4 years, of each customer's use of a tanning device.

(7)  A tanning facility may not allow a minor between the ages of 14 and 18 to use a tanning device unless it has on file a statement signed by the minor's parent or legal guardian stating that the parent or legal guardian has read and understands the warnings given by the tanning facility, consents to the minor's use of a tanning device, and agrees that the minor will use the provided protective eyewear.

(8)  A minor under the age of 14 must be accompanied by a parent or legal guardian when using a tanning device.

(9)  The department shall inspect or investigate a tanning facility as necessary but at least annually.

(10)  PENALTIES.--

(a)  Each of the following acts constitutes a felony of the third degree, punishable as provided in s. 775.082 or s. 775.083:

1.  Owning or operating, or soliciting business as, a tanning facility in this state without first procuring a license from the department, unless specifically exempted by this section.

2.  Obtaining or attempting to obtain a license by means of fraud, misrepresentation, or concealment.

(b)  Each of the following acts constitutes a misdemeanor of the second degree, punishable as provided in s. 775.082 or s. 775.083:

1.  Failing to maintain the records required by this section or knowingly making false entries in such records.

2.  Failing to comply with subsection (7) or subsection (8).

(c)  The court may, in addition to other punishment provided for, suspend or revoke the license of any licensee under this section who has been found guilty of any violation listed in paragraph (a) or paragraph (b).

(d)  In the event the department or any state attorney shall have probable cause to believe that a tanning facility or other person has violated any provision of paragraph (a), an action may be brought by the department or any state attorney to enjoin such tanning facility or any person from continuing such violation, or engaging therein or doing any acts in furtherance thereof, and for such other relief as to the court seems appropriate.

(11)(a)  The department may impose an administrative fine not to exceed $1,000 per violation per day, for the violation of any provision of this section, rule adopted under this section, or term or condition of any license issued by the department.

(b)  In determining the amount of fine to be levied for a violation, as provided in paragraph (a), the following factors shall be considered:

1.  The severity of the violation and the extent to which the provisions of this act, the rules adopted under this act, or any terms or conditions of any license were violated.

2.  Actions taken by the licensee to correct the violation.

3.  Any previous violations by the licensee.

(12)  The department may institute legal action for injunctive or other relief to enforce this section. If a tanning facility or other person violates this section or any rule adopted under this section, the department may issue a stop-use order, as prescribed by rule, to remove a tanning device from service.

(13)  The department shall adopt rules to administer this section. The rules may include, but need not be limited to, requirements for training tanning facility operators and employees; definitions of terms; the approval of training courses; safety; plan review; and the design, construction, operation, maintenance, and cleanliness of tanning facilities and tanning devices.

History.--ss. 1, 2, ch. 91-212; s. 4, ch. 91-429; s. 20, ch. 97-96; s. 53, ch. 97-237; s. 15, ch. 98-151; s. 16, ch. 2000-242.

Note.--Former s. 402.61.

381.895  Standards for compressed air used for recreational diving.--

(1)  The Department of Health shall establish maximum allowable levels for contaminants in compressed air used for recreational sport diving in this state. In developing the standards, the department must take into consideration the levels of contaminants allowed by the Grade "E" Recreational Diving Standards of the Compressed Gas Association.

(2)  The standards prescribed under this section do not apply to:

(a)  Any person providing compressed air for his or her own use.

(b)  Any governmental entity using a governmentally owned compressed air source for work related to the governmental entity.

(c)  Foreign registered vessels upon which a compressor is used to provide compressed air for work related to the operation of the vessel.

(3)  A person or entity that, for compensation, provides compressed air for recreational sport diving in this state, including compressed air provided as part of a dive package of equipment rental, dive boat rental, or dive boat charter, must ensure that the compressed air is tested quarterly by a laboratory that is accredited by either the American Industrial Hygiene Association or the American Association for Laboratory Accreditation and that the results of such tests are provided quarterly to the Department of Health. In addition, the person or entity must post the certificate issued by the laboratory accredited by the American Industrial Hygiene Association or the American Association for Laboratory Accreditation in a conspicuous location where it can readily be seen by any person purchasing compressed air.

(4)  The Department of Health shall maintain a record of all quarterly test results provided under this section.

(5)  It is a misdemeanor of the second degree for any person or entity to provide, for compensation, compressed air for recreational sport diving in this state, including compressed air provided as part of a dive package of equipment rental, dive boat rental, or dive boat charter, without:

(a)  Having received a valid certificate issued by a laboratory accredited by the American Industrial Hygiene Association or the American Association for Laboratory Accreditation which certifies that the compressed air meets the standards for contaminant levels established by the Department of Health.

(b)  Posting the certificate issued by a laboratory accredited by the American Industrial Hygiene Association or the American Association for Laboratory Accreditation in a conspicuous location where it can readily be seen by persons purchasing compressed air.

(6)  The department shall adopt rules necessary to carry out the provisions of this section, which must include:

(a)  Maximum allowable levels of contaminants in compressed air used for sport diving.

(b)  Procedures for the submission of test results to the department.

History.--s. 199, ch. 99-397; s. 55, ch. 2002-1.

381.90  Health Information Systems Council; legislative intent; creation, appointment, duties.--

(1)  The Legislature finds that it is in the state's interest to create a council consisting of executive-level managers for the state's health-related entities, to facilitate the sharing and coordination of health-related data.

(2)  There is created a Health Information Systems Council in the Department of Health to facilitate the identification, collection, standardization, sharing, and coordination of health-related data, including fraud and abuse data, and professional and facility licensing data among federal, state, local, and private entities. The Department of Health shall provide administrative support to the council.

(3)  The council shall be composed of the following members or their senior executive-level designees:

(a)  The secretary of the Department of Health;

(b)  The secretary of the Department of Business and Professional Regulation;

(c)  The secretary of the Department of Children and Family Services;

(d)  The Secretary of Health Care Administration;

(e)  The secretary of the Department of Corrections;

(f)  The Attorney General;

(g)  The executive director of the Correctional Medical Authority;

(h)  Two members representing county health departments, one from a small county and one from a large county, appointed by the Governor;

(i)  A representative from the Florida Association of Counties;

(j)  The State Treasurer and Insurance Commissioner;

(k)  A representative from the Florida Healthy Kids Corporation;

(l)  A representative from a school of public health chosen by the ¹Board of Regents;

(m)  The Commissioner of Education;

(n)  The secretary of the Department of Elderly Affairs; and

(o)  The secretary of the Department of Juvenile Justice.

Representatives of the Federal Government may serve without voting rights.

(4)  Members of the council who are appointed by the Governor shall serve 2-year terms beginning January 1 through December 31. A member may be removed by the Governor for cause or if such member is absent from three consecutive meetings. Any member appointed to fill a vacancy shall serve for the unexpired term of his or her predecessor.

(5)  The council shall annually elect its chair and other officers. The council shall meet at least quarterly or at the call of its chair, at the request of a majority of its membership, or at the request of a department. All actions taken by the council shall be based upon approval by a simple majority.

(6)  Members of the council shall be reimbursed for per diem and travel expenses as provided in s. 112.061.

(7)  The council's duties and responsibilities include, but are not limited to, the following:

(a)  By March 1 of each year, to develop and approve a strategic plan pursuant to the requirements set forth in ²s. 186.022(9). Copies of the plan shall be transmitted electronically or in writing to the Executive Office of the Governor, the Speaker of the House of Representatives, and the President of the Senate.

(b)  To develop a mission statement, goals, and plan of action, based on the guiding principles specified in s. 282.3032, for the identification, collection, standardization, sharing, and coordination of health-related data across federal, state, and local government and private-sector entities.

(c)  To develop a review process to ensure cooperative planning among agencies that collect or maintain health-related data.

(d)  To create ad hoc issue-oriented technical workgroups, on an as-needed basis, to make recommendations to the council.

History.--s. 27, ch. 97-286; s. 13, ch. 99-397; s. 8, ch. 2000-305; s. 21, ch. 2001-62.

¹Note.--Abolished by s. 3, ch. 2001-170.

²Note.--All subunits were deleted from s. 186.022 by s. 43, ch. 2000-371; the remaining language is similar to former subsection (9).

381.91  Jessie Trice Cancer Prevention Program.--

(1)  It is the intent of the Legislature to:

(a)  Reduce the rates of illness and death from lung cancer and other cancers and improve the quality of life among low-income African-American and Hispanic populations through increased access to early, effective screening and diagnosis, education, and treatment programs.

(b)  Create a community faith-based disease-prevention program in conjunction with the Health Choice Network and other community health centers to build upon the natural referral and education networks in place within minority communities and to increase access to health service delivery in South Florida.

(c)  Establish a funding source to build upon local private participation to sustain the operation of the program.

(2)(a)  There is created the Jessie Trice Cancer Prevention Program, to be located, for administrative purposes, within the Department of Health, and operated from the community health centers within the Health Choice Network in South Florida.

(b)  Funding will be provided to develop contracts with community health centers and local community faith-based education programs to provide cancer screening, diagnosis, education, and treatment services to low-income populations throughout the state. Pilot programs will be initially created in the communities of Goulds, Naranja, Coconut Grove, Liberty City, and East Little Havana in Dade County and Dunbar in Lee County.

History.--s. 31, ch. 2000-367.

381.93  Breast and cervical cancer early detection program.--This section may be cited as the "Mary Brogan Breast and Cervical Cancer Early Detection Program Act."

(1)  It is the intent of the Legislature to reduce the rates of death due to breast and cervical cancer through early diagnosis and increased access to early screening, diagnosis, and treatment programs.

(2)  The Department of Health, using available federal funds and state funds appropriated for that purpose, is authorized to establish the Mary Brogan Breast and Cervical Cancer Screening and Early Detection Program to provide screening, diagnosis, evaluation, treatment, case management, and followup and referral to the Agency for Health Care Administration for coverage of treatment services.

(3)  The Mary Brogan Breast and Cervical Cancer Early Detection Program shall be funded through grants for such screening and early detection purposes from the federal Centers for Disease Control and Prevention under Title XV of the Public Health Service Act, 42 U.S.C. ss. 300k et seq.

(4)  The department shall limit enrollment in the program to persons with incomes up to and including 200 percent of the federal poverty level. The department shall establish an eligibility process that includes an income-verification process to ensure that persons served under the program meet income guidelines.

(5)  The department may provide other breast and cervical cancer screening and diagnostic services; however, such services shall be funded separately through other sources than this act.

History.--s. 1, ch. 2001-52.

381.931  Annual report on Medicaid expenditures.--The Department of Health and the Agency for Health Care Administration shall monitor the total Medicaid expenditures for services made under this act. If Medicaid expenditures are projected to exceed the amount appropriated by the Legislature, the Department of Health shall limit the number of screenings to ensure Medicaid expenditures do not exceed the amount appropriated. The Department of Health, in cooperation with the Agency for Health Care Administration, shall prepare an annual report that must include the number of women screened; the percentage of positive and negative outcomes; the number of referrals to Medicaid and other providers for treatment services; the estimated number of women who are not screened or not served by Medicaid due to funding limitations, if any; the cost of Medicaid treatment services; and the estimated cost of treatment services for women who were not screened or referred for treatment due to funding limitations. The report shall be submitted to the President of the Senate, the Speaker of the House of Representatives, and the Executive Office of the Governor by March 1 of each year.

History.--s. 3, ch. 2001-52.

381.95  Medical facility information maintained for terrorism response purposes; confidentiality.--Any information identifying or describing the name, location, pharmaceutical cache, contents, capacity, equipment, physical features, or capabilities of individual medical facilities, storage facilities, or laboratories established, maintained, or regulated by the Department of Health as part of the state's plan to defend against an act of terrorism as defined in s. 775.30 is exempt from the requirements of s. 119.07(1) and s. 24(a), Art. I of the State Constitution. The certification by the Governor of the sufficiency of any location, pharmaceutical cache, contents, capacity, equipment, physical features, or capabilities of individual medical facilities, storage facilities, or laboratories established, maintained, or regulated by the Department of Health as part of the state's plan to defend against an act of terrorism is a public record. This exemption is remedial in nature, and it is the intent of the Legislature that this exemption be applied to information received by the Department of Health before, on, or after the effective date of this section. Information made exempt by this section may be disclosed by the custodial agency to another state or federal agency in order to prevent, detect, guard against, respond to, investigate, or manage the consequences of any attempted or actual act of terrorism, or to prosecute those responsible for such attempts or acts, and the exempt status of such information shall be retained while in the possession of the receiving agency. This section is subject to the Open Government Sunset Review Act of 1995 in accordance with s. 119.15 and shall stand repealed October 2, 2006, unless reviewed and saved from repeal through reenactment by the Legislature.

History.--s. 1, ch. 2001-363.