House Bill 2125

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    Florida House of Representatives - 1999                HB 2125

        By the Committee on Health Care Services and
    Representative Peaden





  1                      A bill to be entitled

  2         An act relating to the Department of Health;

  3         amending s. 20.43, F.S.; providing the

  4         department with authority for certain

  5         divisions; revising certain division names;

  6         revising language with respect to the use of

  7         certain funds; amending s. 39.303, F.S.;

  8         conforming titles relating to Children's

  9         Medical Services; amending s. 63.162, F.S.;

10         clarifying terms; amending s. 110.205, F.S.;

11         conforming language relating to exempt

12         positions with respect to the career service;

13         amending s. 120.80, F.S.; providing the

14         department with contract authority for certain

15         administrative hearings; amending s. 154.504,

16         F.S.; providing requirements for provider

17         contracts; amending s. 287.155, F.S.; providing

18         certain authority to purchase automotive

19         equipment; amending s. 372.6672, F.S.; removing

20         responsibility regarding alligator management

21         and trapping from the Department of Health and

22         Rehabilitative Services; amending s. 381.004,

23         F.S.; revising requirements relating to HIV

24         tests on deceased persons; amending s.

25         381.0051, F.S.; providing the department with

26         certain rulemaking authority; amending s.

27         381.006, F.S.; providing the department with

28         rulemaking authority relating to inspection of

29         certain group care facilities under the

30         environmental health program; amending s.

31         381.0061, F.S.; providing the department with

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  1         authority to impose certain fines; amending s.

  2         381.0062, F.S.; revising definitions to clarify

  3         differences in regulatory requirements for

  4         drinking water systems; amending s. 381.90,

  5         F.S.; revising membership and duties of the

  6         Health Information Systems Council; requiring a

  7         report; amending s. 382.003, F.S.; removing

  8         unnecessary language; providing for certain

  9         rules; amending s. 382.004, F.S.; revising

10         language with respect to reproduction and

11         destruction of certain records; amending s.

12         382.008, F.S.; removing language conflicting

13         with federal law; amending s. 382.013, F.S.;

14         providing certain requirements relating to

15         birth registration; amending s. 382.015, F.S.;

16         providing for technical changes with respect to

17         certificates of live birth; amending s.

18         382.016, F.S.; providing for administrative

19         procedures for acknowledging paternity;

20         amending s. 382.019, F.S.; establishing certain

21         requirements and rulemaking authority for

22         registration; amending s. 382.025, F.S.;

23         setting requirements for certain data; amending

24         s. 382.0255, F.S.; revising requirements for

25         fee transfer; amending s. 383.14, F.S.;

26         correcting the name of the WIC program to

27         conform to federal law; amending s. 385.202,

28         F.S.; removing certain department reimbursement

29         requirements; amending s. 385.203, F.S.;

30         revising requirements and membership for the

31         Diabetes Advisory Council; amending s. 391.021,

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  1         F.S.; conforming references to Children's

  2         Medical Services; amending s. 391.028, F.S.;

  3         providing the Director of Children's Medical

  4         Services with certain appointment authority;

  5         amending s. 391.0315, F.S.; providing

  6         requirements for benefits to children with

  7         special health care needs; amending ss.

  8         391.221, 391.222, and 391.223, F.S.; conforming

  9         references to Children's Medical Services;

10         amending s. 392.69, F.S.; authorizing the

11         department to use certain excess money for

12         improvements to facilities and establishing an

13         advisory board for the A.G. Holley State

14         Hospital; amending s. 409.9126, F.S.; revising

15         date requirements for certain capitation

16         payments to Children's Medical Services;

17         amending s. 465.019, F.S.; authorizing certain

18         nursing homes to purchase medical oxygen;

19         amending s. 499.005, F.S.; requiring and

20         clarifying certain prohibitions relating to

21         sales of prescription drugs and legend devices;

22         amending s. 499.007, F.S.; conforming

23         prescription statement requirements to federal

24         language; amending s. 499.028, F.S.;

25         authorizing certain federal, state, or local

26         government employees to possess drug samples;

27         amending s. 499.066, F.S.; authorizing

28         immediate effect of certain cease and desist

29         orders; amending ss. 499.069 and 742.10, F.S.;

30         conforming cross references; naming the Wilson

31         T. Sowder, M.D., Building, the William G. "Doc"

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  1         Myers, M.D., Building, and the E. Charlton

  2         Prather, M.D., Building; repealing s.

  3         381.731(3), F.S., relating to submission of the

  4         Healthy Communities, Healthy People Plan;

  5         repealing s. 383.307(5), F.S., relating to

  6         consultations between birth centers and the

  7         Department of Health; repealing s. 404.20(7),

  8         F.S., relating to obsolete radioactive

  9         monitoring systems; repealing s. 409.9125,

10         F.S., relating to Medicaid alternative service

11         networks; providing an effective date.

12

13  Be It Enacted by the Legislature of the State of Florida:

14

15         Section 1.  Subsection (3) and paragraphs (a) and (b)

16  of subsection (7) of section 20.43, Florida Statutes, 1998

17  Supplement, are amended to read:

18         20.43  Department of Health.--There is created a

19  Department of Health.

20         (3)  The following divisions of the Department of

21  Health are established:

22         (a)  Division of Administration.

23         (b)  Division of Environmental Health.

24         (c)  Division of Disease Control.

25         (d)  Division of Family Health Services.

26         (e)  Division of Children's Medical Services Network.

27         (f)  Division of Emergency Medical Services and

28  Community Health Resources Local Health Planning, Education,

29  and Workforce Development.

30

31

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  1         (g)  Division of Medical Quality Assurance, which is

  2  responsible for the following boards and professions

  3  established within the division:

  4         1.  Nursing assistants, as provided under s. 400.211.

  5         2.  Health care services pools, as provided under s.

  6  402.48.

  7         3.  The Board of Acupuncture, created under chapter

  8  457.

  9         4.  The Board of Medicine, created under chapter 458.

10         5.  The Board of Osteopathic Medicine, created under

11  chapter 459.

12         6.  The Board of Chiropractic Medicine, created under

13  chapter 460.

14         7.  The Board of Podiatric Medicine, created under

15  chapter 461.

16         8.  Naturopathy, as provided under chapter 462.

17         9.  The Board of Optometry, created under chapter 463.

18         10.  The Board of Nursing, created under chapter 464.

19         11.  The Board of Pharmacy, created under chapter 465.

20         12.  The Board of Dentistry, created under chapter 466.

21         13.  Midwifery, as provided under chapter 467.

22         14.  The Board of Speech-Language Pathology and

23  Audiology, created under part I of chapter 468.

24         15.  The Board of Nursing Home Administrators, created

25  under part II of chapter 468.

26         16.  The Board of Occupational Therapy, created under

27  part III of chapter 468.

28         17.  Respiratory therapy, as provided under part V of

29  chapter 468.

30         18.  Dietetics and nutrition practice, as provided

31  under part X of chapter 468.

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  1         19.  Athletic trainers, as provided under part XIII of

  2  chapter 468.

  3         20.  The Board of Orthotists and Prosthetists, created

  4  under part XIV of chapter 468.

  5         21.  Electrolysis, as provided under chapter 478.

  6         22.  The Board of Massage Therapy, created under

  7  chapter 480.

  8         23.  The Board of Clinical Laboratory Personnel,

  9  created under part III of chapter 483.

10         24.  Medical physicists, as provided under part IV of

11  chapter 483.

12         25.  The Board of Opticianry, created under part I of

13  chapter 484.

14         26.  The Board of Hearing Aid Specialists, created

15  under part II of chapter 484.

16         27.  The Board of Physical Therapy Practice, created

17  under chapter 486.

18         28.  The Board of Psychology, created under chapter

19  490.

20         29.  School psychologists, as provided under chapter

21  490.

22         30.  The Board of Clinical Social Work, Marriage and

23  Family Therapy, and Mental Health Counseling, created under

24  chapter 491.

25         (h)  Division of Children's Medical Services Prevention

26  and Intervention.

27         (i)  Division of Information Resource Management.

28         (j)  Division of Health Awareness and Tobacco.

29

30  The department may contract with the Agency for Health Care

31  Administration who shall provide consumer complaint,

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  1  investigative, and prosecutorial services required by the

  2  Division of Medical Quality Assurance, councils, or boards, as

  3  appropriate.

  4         (7)  To protect and improve the public health, the

  5  department may use state or federal funds to:

  6         (a)  Provide incentives, including, but not limited to,

  7  the promotional items listed in paragraph (b) of this

  8  subsection, food and food coupons, and or payment for travel

  9  expenses, for encouraging healthy lifestyle and disease

10  prevention behaviors and patient compliance with medical

11  treatment, such as tuberculosis therapy and smoking cessation

12  programs.  Such incentives shall be intended to cause an

13  individual to take action to improve his or her health.  Any

14  incentive for food, food coupons, or travel expenses shall not

15  exceed the limitations in s. 112.061.

16         (b)  Plan and conduct health education campaigns for

17  the purpose of protecting or improving public health. The

18  department may purchase promotional items, such as, but not

19  limited to, T-shirts, hats, sports items such as water bottles

20  and sweat bands, calendars, nutritional charts, baby bibs,

21  growth charts, and other items printed with health promotion

22  messages, and advertising, such as space on billboards or in

23  publications or radio or television time, for health

24  information and promotional messages that recognize that the

25  following behaviors, among others, are detrimental to public

26  health: unprotected sexual intercourse, other than with one's

27  spouse; cigarette and cigar smoking, use of smokeless tobacco

28  products, and exposure to environmental tobacco smoke; alcohol

29  consumption or other substance abuse during pregnancy; alcohol

30  abuse or other substance abuse; lack of exercise and poor diet

31  and nutrition habits; and failure to recognize and address a

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  1  genetic tendency to suffer from sickle-cell anemia, diabetes,

  2  high blood pressure, cardiovascular disease, or cancer. For

  3  purposes of activities under this paragraph, the Department of

  4  Health may establish requirements for local matching funds or

  5  in-kind contributions to create and distribute advertisements,

  6  in either print or electronic format, which are concerned with

  7  each of the targeted behaviors, establish an independent

  8  evaluation and feedback system for the public health

  9  communication campaign, and monitor and evaluate the efforts

10  to determine which of the techniques and methodologies are

11  most effective.

12         Section 2.  Section 39.303, Florida Statutes, 1998

13  Supplement, is amended to read:

14         39.303  Child protection teams; services; eligible

15  cases.--The Division of Children's Medical Services of the

16  Department of Health shall develop, maintain, and coordinate

17  the services of one or more multidisciplinary child protection

18  teams in each of the service districts of the Department of

19  Children and Family Services.  Such teams may be composed of

20  representatives of appropriate health, mental health, social

21  service, legal service, and law enforcement agencies. The

22  Legislature finds that optimal coordination of child

23  protection teams and sexual abuse treatment programs requires

24  collaboration between the Department of Health and the

25  Department of Children and Family Services. The two

26  departments shall maintain an interagency agreement that

27  establishes protocols for oversight and operations of child

28  protection teams and sexual abuse treatment programs. The

29  Secretary of Health and the Director of Deputy Secretary for

30  Children's Medical Services, in consultation with the

31  Secretary of Children and Family Services, shall maintain the

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  1  responsibility for the screening, employment, and, if

  2  necessary, the termination of child protection team medical

  3  directors, at headquarters and in the 15 districts. Child

  4  protection team medical directors shall be responsible for

  5  oversight of the teams in the districts.

  6         (1)  The Department of Health shall utilize and convene

  7  the teams to supplement the assessment and protective

  8  supervision activities of the family safety and preservation

  9  program of the Department of Children and Family Services.

10  Nothing in this section shall be construed to remove or reduce

11  the duty and responsibility of any person to report pursuant

12  to this chapter all suspected or actual cases of child abuse,

13  abandonment, or neglect or sexual abuse of a child.  The role

14  of the teams shall be to support activities of the program and

15  to provide services deemed by the teams to be necessary and

16  appropriate to abused, abandoned, and neglected children upon

17  referral.  The specialized diagnostic assessment, evaluation,

18  coordination, consultation, and other supportive services that

19  a child protection team shall be capable of providing include,

20  but are not limited to, the following:

21         (a)  Medical diagnosis and evaluation services,

22  including provision or interpretation of X rays and laboratory

23  tests, and related services, as needed, and documentation of

24  findings relative thereto.

25         (b)  Telephone consultation services in emergencies and

26  in other situations.

27         (c)  Medical evaluation related to abuse, abandonment,

28  or neglect, as defined by policy or rule of the Department of

29  Health.

30         (d)  Such psychological and psychiatric diagnosis and

31  evaluation services for the child or the child's parent or

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  1  parents, legal custodian or custodians, or other caregivers,

  2  or any other individual involved in a child abuse,

  3  abandonment, or neglect case, as the team may determine to be

  4  needed.

  5         (e)  Expert medical, psychological, and related

  6  professional testimony in court cases.

  7         (f)  Case staffings to develop treatment plans for

  8  children whose cases have been referred to the team.  A child

  9  protection team may provide consultation with respect to a

10  child who is alleged or is shown to be abused, abandoned, or

11  neglected, which consultation shall be provided at the request

12  of a representative of the family safety and preservation

13  program or at the request of any other professional involved

14  with a child or the child's parent or parents, legal custodian

15  or custodians, or other caregivers.  In every such child

16  protection team case staffing, consultation, or staff activity

17  involving a child, a family safety and preservation program

18  representative shall attend and participate.

19         (g)  Case service coordination and assistance,

20  including the location of services available from other public

21  and private agencies in the community.

22         (h)  Such training services for program and other

23  employees of the Department of Children and Family Services,

24  employees of the Department of Health, and other medical

25  professionals as is deemed appropriate to enable them to

26  develop and maintain their professional skills and abilities

27  in handling child abuse, abandonment, and neglect cases.

28         (i)  Educational and community awareness campaigns on

29  child abuse, abandonment, and neglect in an effort to enable

30  citizens more successfully to prevent, identify, and treat

31  child abuse, abandonment, and neglect in the community.

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  1         (2)  The child abuse, abandonment, and neglect cases

  2  that are appropriate for referral by the family safety and

  3  preservation program to child protection teams of the

  4  Department of Health for support services as set forth in

  5  subsection (1) include, but are not limited to, cases

  6  involving:

  7         (a)  Bruises, burns, or fractures in a child under the

  8  age of 3 years or in a nonambulatory child of any age.

  9         (b)  Unexplained or implausibly explained bruises,

10  burns, fractures, or other injuries in a child of any age.

11         (c)  Sexual abuse of a child in which vaginal or anal

12  penetration is alleged or in which other unlawful sexual

13  conduct has been determined to have occurred.

14         (d)  Venereal disease, or any other sexually

15  transmitted disease, in a prepubescent child.

16         (e)  Reported malnutrition of a child and failure of a

17  child to thrive.

18         (f)  Reported medical, physical, or emotional neglect

19  of a child.

20         (g)  Any family in which one or more children have been

21  pronounced dead on arrival at a hospital or other health care

22  facility, or have been injured and later died, as a result of

23  suspected abuse, abandonment, or neglect, when any sibling or

24  other child remains in the home.

25         (h)  Symptoms of serious emotional problems in a child

26  when emotional or other abuse, abandonment, or neglect is

27  suspected.

28         (3)  In all instances in which a child protection team

29  is providing certain services to abused, abandoned, or

30  neglected children, other offices and units of the Department

31  of Health, and offices and units of the Department of Children

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  1  and Family Services, shall avoid duplicating the provision of

  2  those services.

  3         Section 3.  Paragraph (d) of subsection (4) of section

  4  63.162, Florida Statutes, is amended to read:

  5         63.162  Hearings and records in adoption proceedings;

  6  confidential nature.--

  7         (4)  A person may not disclose from the records the

  8  name and identity of a birth parent, an adoptive parent, or an

  9  adoptee unless:

10         (d)  Upon order of the court for good cause shown and

11  pursuant to a petition filed in accordance with subsection

12  (7).  In determining whether good cause exists, the court

13  shall give primary consideration to the best interests of the

14  adoptee, but must also give due consideration to the interests

15  of the adoptive and birth parents.  Factors to be considered

16  in determining whether good cause exists include, but are not

17  limited to:

18         1.  The reason the information is sought;

19         2.  The existence of means available to obtain the

20  desired information without disclosing the identity of the

21  birth parents, such as by having the court, an intermediary a

22  person appointed by the court, the department, or the licensed

23  child-placing agency contact the birth parents and request

24  specific information;

25         3.  The desires, to the extent known, of the adoptee,

26  the adoptive parents, and the birth parents;

27         4.  The age, maturity, judgment, and expressed needs of

28  the adoptee; and

29         5.  The recommendation of the department, licensed

30  child-placing agency, or professional which prepared the

31  preliminary study and home investigation, or the department if

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  1  no such study was prepared, concerning the advisability of

  2  disclosure.

  3         Section 4.  Paragraphs (l), (p), and (s) of subsection

  4  (2) of section 110.205, Florida Statutes, are amended to read:

  5         110.205  Career service; exemptions.--

  6         (2)  EXEMPT POSITIONS.--The exempt positions which are

  7  not covered by this part include the following, provided that

  8  no position, except for positions established for a limited

  9  period of time pursuant to paragraph (h), shall be exempted if

10  the position reports to a position in the career service:

11         (l)  All assistant division director, deputy division

12  director, and bureau chief positions in any department, and

13  those positions determined by the department to have

14  managerial responsibilities comparable to such positions,

15  which positions include, but are not limited to, positions in

16  the Department of Health, the Department of Children and

17  Family Services, and Rehabilitative Services and the

18  Department of Corrections that are assigned primary duties of

19  serving as the superintendent of an institution: positions in

20  the Department of Transportation that are assigned primary

21  duties of serving as regional toll managers and managers of

22  offices as defined in s. 20.23(3)(d)3. and (4)(d); positions

23  in the Department of Environmental Protection that are

24  assigned the duty of an Environmental Administrator or program

25  administrator; and positions in the Department of Health and

26  Rehabilitative Services that are assigned the duties duty of

27  an Environmental Administrator, Assistant County Health

28  Department Director, and County Health Department Financial

29  Administrator. Unless otherwise fixed by law, the department

30  shall set the salary and benefits of these positions in

31

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  1  accordance with the rules established for the Selected Exempt

  2  Service.

  3         (p)  The staff directors, assistant staff directors,

  4  district program managers, district program coordinators,

  5  district subdistrict administrators, district administrative

  6  services directors, district attorneys, county health

  7  department directors, county health department administrators,

  8  and the Deputy Director of Central Operations Services of the

  9  Department of Children and Family Services and the county

10  health department directors and county health department

11  administrators of the Department of Health and Rehabilitative

12  Services.  Unless otherwise fixed by law, the departments

13  department shall establish the salary range and benefits for

14  these positions in accordance with the rules of the Selected

15  Exempt Service.

16         (s)  The executive director of each board or commission

17  established within the Department of Business and Professional

18  Regulation and the Department of Health. Unless otherwise

19  fixed by law, the department shall establish the salary and

20  benefits for these positions in accordance with the rules

21  established for the Selected Exempt Service.

22         Section 5.  Subsection (15) of section 120.80, Florida

23  Statutes, 1998 Supplement, is amended to read:

24         120.80  Exceptions and special requirements;

25  agencies.--

26         (15)  DEPARTMENT OF HEALTH.--Notwithstanding s.

27  120.57(1)(a), formal hearings may not be conducted by the

28  Secretary of Health, the director of the Agency for Health

29  Care Administration, or a board or member of a board within

30  the Department of Health or the Agency for Health Care

31  Administration for matters relating to the regulation of

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  1  professions, as defined by part II of chapter 455.

  2  Notwithstanding s. 120.57(1)(a), hearings conducted within the

  3  Department of Health in the execution of the Special

  4  Supplemental Nutrition Program for Women, Infants, and

  5  Children; Child Care Food Program; Children's Medical Services

  6  program; and the exemption from disqualification reviews for

  7  the certified nursing assistants program need not be conducted

  8  by an administrative law judge assigned by the division. The

  9  Department of Health may contract with the Department of

10  Children and Family Services for a hearing officer in these

11  matters.

12         Section 6.  Subsection (1) of section 154.504, Florida

13  Statutes, 1998 Supplement, is amended to read:

14         154.504  Eligibility and benefits.--

15         (1)  Any county or counties may apply for a primary

16  care for children and families challenge grant to provide

17  primary health care services to children and families with

18  incomes of up to 150 percent of the federal poverty level.

19  Participants shall pay no monthly premium for participation,

20  but shall be required to pay a copayment at the time a service

21  is provided. Copayments may be paid from sources other than

22  the participant, including, but not limited to, the child's or

23  parent's employer, or other private sources. Providers may

24  enter into contracts pursuant to As used in s. 766.1115,

25  provided that copayments the term "copayment" may not be

26  considered and may not be used as compensation for services to

27  health care providers, and all funds generated from copayments

28  shall be used by the governmental contractor, and all other

29  provisions in s. 766.1115 are met.

30         Section 7.  Subsection (3) is added to section 287.155,

31  Florida Statutes, to read:

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  1         287.155  Motor vehicles; purchase by Division of

  2  Universities, Department of Health and Rehabilitative

  3  Services, Department of Juvenile Justice, and Department of

  4  Corrections.--

  5         (3)  The Department of Health is authorized, subject to

  6  the approval of the Department of Management Services, to

  7  purchase automobiles, trucks, and other automotive equipment

  8  for use by county health departments.

  9         Section 8.  Subsection (3) of section 372.6672, Florida

10  Statutes, 1998 Supplement, is amended to read:

11         372.6672  Alligator management and trapping program

12  implementation; commission authority.--

13         (3)  The powers and duties of the commission hereunder

14  shall not be construed so as to supersede the regulatory

15  authority or lawful responsibility of the Department of Health

16  and Rehabilitative Services, the Department of Agriculture and

17  Consumer Services, or any local governmental entity regarding

18  the processing or handling of food products, but shall be

19  deemed supplemental thereto.

20         Section 9.  Paragraphs (d) and (h) of subsection (3) of

21  section 381.004, Florida Statutes, 1998 Supplement, are

22  amended to read:

23         381.004  Testing for human immunodeficiency virus.--

24         (3)  HUMAN IMMUNODEFICIENCY VIRUS TESTING; INFORMED

25  CONSENT; RESULTS; COUNSELING; CONFIDENTIALITY.--

26         (d)  No test result shall be determined as positive,

27  and no positive test result shall be revealed to any person,

28  without corroborating or confirmatory tests being conducted

29  except in the following situations:

30         1.  Preliminary test results may be released to

31  licensed physicians or the medical or nonmedical personnel

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  1  subject to the significant exposure for purposes of

  2  subparagraphs (h)10., 11., and 12.

  3         2.  Preliminary test results may be released to health

  4  care providers and to the person tested when decisions about

  5  medical care or treatment of the person tested cannot await

  6  the results of confirmatory testing.  Positive preliminary HIV

  7  test results shall not be characterized to the patient as a

  8  diagnosis of HIV infection.  Justification for the use of

  9  preliminary test results must be documented in the medical

10  record by the health care provider who ordered the test.  This

11  subparagraph does not authorize the release of preliminary

12  test results for the purpose of routine identification of

13  HIV-infected individuals or when HIV testing is incidental to

14  the preliminary diagnosis or care of a patient.  Corroborating

15  or confirmatory testing must be conducted as followup to a

16  positive preliminary test.  Results shall be communicated to

17  the patient according to statute regardless of the outcome.

18  Except as provided in this section, test results are

19  confidential and exempt from the provisions of s. 119.07(1).

20         (h)  Notwithstanding the provisions of paragraph (a),

21  informed consent is not required:

22         1.  When testing for sexually transmissible diseases is

23  required by state or federal law, or by rule including the

24  following situations:

25         a.  HIV testing pursuant to s. 796.08 of persons

26  convicted of prostitution or of procuring another to commit

27  prostitution.

28         b.  Testing for HIV by a medical examiner in accordance

29  with s. 406.11.

30

31

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  1         2.  Those exceptions provided for blood, plasma,

  2  organs, skin, semen, or other human tissue pursuant to s.

  3  381.0041.

  4         3.  For the performance of an HIV-related test by

  5  licensed medical personnel in bona fide medical emergencies

  6  when the test results are necessary for medical diagnostic

  7  purposes to provide appropriate emergency care or treatment to

  8  the person being tested and the patient is unable to consent,

  9  as supported by documentation in the medical record.

10  Notification of test results in accordance with paragraph (c)

11  is required.

12         4.  For the performance of an HIV-related test by

13  licensed medical personnel for medical diagnosis of acute

14  illness where, in the opinion of the attending physician,

15  obtaining informed consent would be detrimental to the

16  patient, as supported by documentation in the medical record,

17  and the test results are necessary for medical diagnostic

18  purposes to provide appropriate care or treatment to the

19  person being tested. Notification of test results in

20  accordance with paragraph (c) is required if it would not be

21  detrimental to the patient.  This subparagraph does not

22  authorize the routine testing of patients for HIV infection

23  without informed consent.

24         5.  When HIV testing is performed as part of an autopsy

25  for which consent was obtained pursuant to s. 872.04.

26         6.  For the performance of an HIV test upon a defendant

27  pursuant to the victim's request in a prosecution for any type

28  of sexual battery where a blood sample is taken from the

29  defendant voluntarily, pursuant to court order for any

30  purpose, or pursuant to the provisions of s. 775.0877, s.

31  951.27, or s. 960.003; however, the results of any HIV test

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  1  performed shall be disclosed solely to the victim and the

  2  defendant, except as provided in ss. 775.0877, 951.27, and

  3  960.003.

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

  5         8.  For epidemiological research pursuant to s.

  6  381.0032, for research consistent with institutional review

  7  boards created by 45 C.F.R. part 46, or for the performance of

  8  an HIV-related test for the purpose of research, if the

  9  testing is performed in a manner by which the identity of the

10  test subject is not known and may not be retrieved by the

11  researcher.

12         9.  When human tissue is collected lawfully without the

13  consent of the donor for corneal removal as authorized by s.

14  732.9185 or enucleation of the eyes as authorized by s.

15  732.919.

16         10.  For the performance of an HIV test upon an

17  individual who comes into contact with medical personnel in

18  such a way that a significant exposure has occurred during the

19  course of employment or within the scope of practice and where

20  a blood sample is available that was taken from that

21  individual voluntarily by medical personnel for other

22  purposes.  "Medical personnel" includes a licensed or

23  certified health care professional; an employee of a health

24  care professional, health care facility, or blood bank; and a

25  paramedic or emergency medical technician as defined in s.

26  401.23.

27         a.  Prior to performance of an HIV test on a

28  voluntarily obtained blood sample, the individual from whom

29  the blood was obtained shall be requested to consent to the

30  performance of the test and to the release of the results.

31  The individual's refusal to consent and all information

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  1  concerning the performance of an HIV test and any HIV test

  2  result shall be documented only in the medical personnel's

  3  record unless the individual gives written consent to entering

  4  this information on the individual's medical record.

  5         b.  Reasonable attempts to locate the individual and to

  6  obtain consent shall be made and all attempts must be

  7  documented. If the individual cannot be found, an HIV test may

  8  be conducted on the available blood sample. If the individual

  9  does not voluntarily consent to the performance of an HIV

10  test, the individual shall be informed that an HIV test will

11  be performed, and counseling shall be furnished as provided in

12  this section.  However, HIV testing shall be conducted only

13  after a licensed physician documents, in the medical record of

14  the medical personnel, that there has been a significant

15  exposure and that, in the physician's medical judgment, the

16  information is medically necessary to determine the course of

17  treatment for the medical personnel.

18         c.  Costs of any HIV test of a blood sample performed

19  with or without the consent of the individual, as provided in

20  this subparagraph, shall be borne by the medical personnel or

21  the employer of the medical personnel. However, costs of

22  testing or treatment not directly related to the initial HIV

23  tests or costs of subsequent testing or treatment shall not be

24  borne by the medical personnel or the employer of the medical

25  personnel.

26         d.  In order to utilize the provisions of this

27  subparagraph, the medical personnel must either be tested for

28  HIV pursuant to this section or provide the results of an HIV

29  test taken within 6 months prior to the significant exposure

30  if such test results are negative.

31

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  1         e.  A person who receives the results of an HIV test

  2  pursuant to this subparagraph shall maintain the

  3  confidentiality of the information received and of the persons

  4  tested.  Such confidential information is exempt from s.

  5  119.07(1).

  6         f.  If the source of the exposure will not voluntarily

  7  submit to HIV testing and a blood sample is not available, the

  8  medical personnel or the employer of such person acting on

  9  behalf of the employee may seek a court order directing the

10  source of the exposure to submit to HIV testing.  A sworn

11  statement by a physician licensed under chapter 458 or chapter

12  459 that a significant exposure has occurred and that, in the

13  physician's medical judgment, testing is medically necessary

14  to determine the course of treatment constitutes probable

15  cause for the issuance of an order by the court.  The results

16  of the test shall be released to the source of the exposure

17  and to the person who experienced the exposure.

18         11.  For the performance of an HIV test upon an

19  individual who comes into contact with medical personnel in

20  such a way that a significant exposure has occurred during the

21  course of employment or within the scope of practice of the

22  medical personnel while the medical personnel provides

23  emergency medical treatment to the individual; or who comes

24  into contact with nonmedical personnel in such a way that a

25  significant exposure has occurred while the nonmedical

26  personnel provides emergency medical assistance during a

27  medical emergency.  For the purposes of this subparagraph, a

28  medical emergency means an emergency medical condition outside

29  of a hospital or health care facility that provides physician

30  care. The test may be performed only during the course of

31  treatment for the medical emergency.

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  1         a.  An individual who is capable of providing consent

  2  shall be requested to consent to an HIV test prior to the

  3  testing. The individual's refusal to consent, and all

  4  information concerning the performance of an HIV test and its

  5  result, shall be documented only in the medical personnel's

  6  record unless the individual gives written consent to entering

  7  this information on the individual's medical record.

  8         b.  HIV testing shall be conducted only after a

  9  licensed physician documents, in the medical record of the

10  medical personnel or nonmedical personnel, that there has been

11  a significant exposure and that, in the physician's medical

12  judgment, the information is medically necessary to determine

13  the course of treatment for the medical personnel or

14  nonmedical personnel.

15         c.  Costs of any HIV test performed with or without the

16  consent of the individual, as provided in this subparagraph,

17  shall be borne by the medical personnel or the employer of the

18  medical personnel or nonmedical personnel. However, costs of

19  testing or treatment not directly related to the initial HIV

20  tests or costs of subsequent testing or treatment shall not be

21  borne by the medical personnel or the employer of the medical

22  personnel or nonmedical personnel.

23         d.  In order to utilize the provisions of this

24  subparagraph, the medical personnel or nonmedical personnel

25  shall be tested for HIV pursuant to this section or shall

26  provide the results of an HIV test taken within 6 months prior

27  to the significant exposure if such test results are negative.

28         e.  A person who receives the results of an HIV test

29  pursuant to this subparagraph shall maintain the

30  confidentiality of the information received and of the persons

31

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  1  tested.  Such confidential information is exempt from s.

  2  119.07(1).

  3         f.  If the source of the exposure will not voluntarily

  4  submit to HIV testing and a blood sample was not obtained

  5  during treatment for the medical emergency, the medical

  6  personnel, the employer of the medical personnel acting on

  7  behalf of the employee, or the nonmedical personnel may seek a

  8  court order directing the source of the exposure to submit to

  9  HIV testing.  A sworn statement by a physician licensed under

10  chapter 458 or chapter 459 that a significant exposure has

11  occurred and that, in the physician's medical judgment,

12  testing is medically necessary to determine the course of

13  treatment constitutes probable cause for the issuance of an

14  order by the court.  The results of the test shall be released

15  to the source of the exposure and to the person who

16  experienced the exposure.

17         12.  For the performance of an HIV test by the medical

18  examiner or attending physician upon an a deceased individual

19  who is the source of a significant exposure to medical

20  personnel or nonmedical personnel who provided emergency

21  medical assistance and who expired or could not be

22  resuscitated while receiving during treatment for the medical

23  emergency medical assistance or care and who was the source of

24  a significant exposure to medical or nonmedical personnel

25  providing such assistance or care.

26         a.  HIV testing shall be conducted only after a

27  licensed physician documents in the medical record of the

28  medical personnel or nonmedical personnel that there has been

29  a significant exposure and that, in the physician's medical

30  judgment, the information is medically necessary to determine

31

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  1  the course of treatment for the medical or nonmedical

  2  personnel.

  3         b.  Costs of any HIV test performed pursuant to this

  4  subparagraph shall not be charged to the deceased or to the

  5  deceased person's family.

  6         c.  For the provisions of this subparagraph to be

  7  applicable, the medical personnel or nonmedical personnel

  8  shall be tested for HIV pursuant to this section or shall

  9  provide the results of an HIV test taken within 6 months prior

10  to the significant exposure if such test results are negative.

11         d.  A person who receives the results of an HIV test

12  pursuant to this subparagraph shall comply with paragraph (e).

13         13.  For the performance of an HIV-related test

14  medically indicated by licensed medical personnel for medical

15  diagnosis of a hospitalized infant as necessary to provide

16  appropriate care and treatment of the infant when, after a

17  reasonable attempt, a parent cannot be contacted to provide

18  consent. The medical records of the infant shall reflect the

19  reason consent of the parent was not initially obtained.  Test

20  results shall be provided to the parent when the parent is

21  located.

22         14.  For the performance of HIV testing conducted to

23  monitor the clinical progress of a patient previously

24  diagnosed to be HIV positive.

25         15.  For the performance of repeated HIV testing

26  conducted to monitor possible conversion from a significant

27  exposure.

28         Section 10.  Subsection (7) is added to section

29  381.0051, Florida Statutes, to read:

30         381.0051  Family planning.--

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  1         (7)  The department may adopt rules pursuant to ss.

  2  120.54 and 120.536(1) to implement this section.

  3         Section 11.  Subsection (16) is added to section

  4  381.006, Florida Statutes, 1998 Supplement, to read:

  5         381.006  Environmental health.--The department shall

  6  conduct an environmental health program as part of fulfilling

  7  the state's public health mission. The purpose of this program

  8  is to detect and prevent disease caused by natural and manmade

  9  factors in the environment.  The environmental health program

10  shall include, but not be limited to:

11         (16)  A group care facilities function, where "group

12  care facility" is defined as any public or private school,

13  housing, building or buildings, section of a building, or

14  distinct part of a building, or other place, whether operated

15  for profit or not, which undertakes, through its ownership or

16  management, to provide one or more personal services, care,

17  protection, and supervision to persons who require such

18  services and who are not related to the owner or

19  administrator. The department may adopt rules necessary to

20  protect the health and safety of residents, staff, and patrons

21  of group care facilities, such as child care facilities,

22  family day care homes, nursing homes, assisted living

23  facilities, adult day care centers, adult family-care homes,

24  hospice, residential treatment facilities, crisis

25  stabilization units, pediatric extended care centers,

26  intermediate care facilities for the developmentally disabled,

27  group care homes, and, jointly with the Department of

28  Education, private and public schools. These rules may include

29  provisions relating to operation and maintenance of

30  facilities, buildings, grounds, equipment, and furnishings;

31  occupant space requirements; lighting; heating, cooling, and

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  1  ventilation; water supply; plumbing; sewage; sanitary

  2  facilities; insect and rodent control; garbage; safety;

  3  personnel health, hygiene, and work practices; and such other

  4  matters as the department finds to be appropriate or necessary

  5  to protect the safety and health of the residents, staff, or

  6  patrons. The department may not adopt rules which conflict

  7  with rules adopted by the licensing or certifying agency. The

  8  department may enter and inspect at reasonable hours to

  9  determine compliance with applicable statutes or rules. In

10  addition to any sanctions which the department may impose for

11  violations of rules adopted under this section, the department

12  shall also report such violations to any agency responsible

13  for licensing or certifying the group care facility. The

14  licensing or certifying agency is also authorized to impose

15  any sanction based solely on the findings of the department.

16

17  The department may adopt rules to carry out the provisions of

18  this section.

19         Section 12.  Subsection (1) of section 381.0061,

20  Florida Statutes, is amended to read:

21         381.0061  Administrative fines.--

22         (1)  In addition to any administrative action

23  authorized by chapter 120 or by other law, the department may

24  impose a fine, which shall not exceed $500 for each violation,

25  for a violation of s. 381.006(16), s. 381.0065, s. 381.0066,

26  s. 381.0072, or part III of chapter 489, for a violation of

27  any rule adopted under this chapter, or for a violation of any

28  of the provisions of chapter 386.  Notice of intent to impose

29  such fine shall be given by the department to the alleged

30  violator.  Each day that a violation continues may constitute

31  a separate violation.

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  1         Section 13.  Subsections (2), (3), (4), and (5) of

  2  section 381.0062, Florida Statutes, 1998 Supplement, are

  3  amended to read:

  4         381.0062  Supervision; private and certain public water

  5  systems.--

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

  7         (a)  "Contaminant" means any physical, biological,

  8  chemical, or radiological substance or matter in water.

  9         (b)  "Department" means the Department of Health,

10  including the county health departments.

11         (c)  "Florida Safe Drinking Water Act" means part VI of

12  chapter 403.

13         (d)  "Health hazard" means any condition, contaminant,

14  device, or practice in a water system or its operation which

15  will create or has the potential to create an acute or chronic

16  threat to the health and well-being of the water consumer.

17         (e)  "Limited use commercial public water system" means

18  a public water system not covered or included in the Florida

19  Safe Drinking Water Act, which serves one or more

20  nonresidential establishments and provides piped water.

21         (f)  "Limited use community public water system" means

22  a public water system not covered or included in the Florida

23  Safe Drinking Water Act, which serves five or more private

24  residences or two or more rental residences, and provides

25  piped water.

26         (g)  "Maximum contaminant level" means the maximum

27  permissible level of a contaminant in potable water delivered

28  to consumers.

29         (h)  "Multifamily water system" means a water system

30  that provides piped water for three to four residences, one of

31  which may be a rental residence.

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  1         (i)(h)  "Person" means an individual, public or private

  2  corporation, company, association, partnership, municipality,

  3  agency of the state, district, federal, or any other legal

  4  entity, or its legal representative, agent, or assignee.

  5         (j)(i)  "Potable water" means water that is

  6  satisfactory for human consumption, dermal contact, culinary

  7  purposes, or dishwashing as approved by the department.

  8         (k)(j)  "Private water system" means a water system

  9  that provides piped water for one or two residences, one of

10  which may be a rental residence, or for a church located more

11  than 200 feet from a water system covered under the Florida

12  Safe Drinking Water Act no more than four nonrental

13  residences.

14         (l)(k)  "Public consumption" means oral ingestion or

15  physical contact with water by a person for any purpose other

16  than cleaning work areas or simple handwashing.  Examples of

17  public consumption include, when making food or beverages

18  available to the general public, water used for washing food,

19  cooking utensils, or food service areas and water used for

20  preparing food or beverages; washing surfaces accessed by

21  children as in a child care center or similar setting; washing

22  medical instruments or surfaces accessed by a patient; any

23  water usage in health care facilities; emergency washing

24  devices such as eye washing sinks; washing in food processing

25  plants or establishments like slaughterhouses and

26  packinghouses; and water used in schools.

27         (m)(l)  "Public water system" means a water system that

28  is not included or covered under the Florida Safe Drinking

29  Water Act, provides piped water to the public, and is not a

30  private or multifamily water system. For purposes of this

31

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  1  section, public water systems are classified as limited use

  2  community or limited use commercial.

  3         (n)(m)  "Supplier of water" means the person, company,

  4  or corporation that owns or operates a limited use community

  5  or limited use commercial public water system, a multifamily

  6  water system, or a private water system.

  7         (o)(n)  "Variance" means a sanction from the department

  8  affording a supplier of water an extended time to correct a

  9  maximum contaminant level violation caused by the raw water or

10  to deviate from construction standards established by rule of

11  the department.

12         (3)  SUPERVISION.--The department and its agents shall

13  have general supervision and control over all private water

14  systems, multifamily water systems, and public water systems

15  not covered or included in the Florida Safe Drinking Water Act

16  (part VI of chapter 403), and over those aspects of the public

17  water supply program for which it has the duties and

18  responsibilities provided for in part VI of chapter 403.  The

19  department shall:

20         (a)  Administer and enforce the provisions of this

21  section and all rules and orders adopted or issued under this

22  section, including water quality and monitoring standards.

23         (b)  Require any person wishing to construct, modify,

24  or operate a limited use community or limited use commercial

25  public water system or a multifamily private water system to

26  first make application to and obtain approval from the

27  department on forms adopted by rule of the department.

28         (c)  Review and act upon any application for the

29  construction, modification, operation, or change of ownership

30  of, and conduct surveillance, enforcement, and compliance

31  investigations of, limited use community and limited use

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  1  commercial public water systems, and multifamily private water

  2  systems.

  3         (d)  Require a fee from the supplier of water in an

  4  amount sufficient to cover the costs of reviewing and acting

  5  upon any application for the construction, modification, or

  6  operation of a limited use community and limited use

  7  commercial public water system, of not less than $10 or more

  8  than $90 annually.

  9         (e)  Require a fee from the supplier of water in an

10  amount sufficient to cover the costs of reviewing and acting

11  upon any application for the construction or change of

12  ownership of a multifamily private water system serving more

13  than one residence, of not less than $10 or more than $90.

14         (f)  Require a fee from the supplier of water in an

15  amount sufficient to cover the costs of sample collection,

16  review of analytical results, health-risk interpretations, and

17  coordination with other agencies when such work is not

18  included in paragraphs (b) and (c) and is requested by the

19  supplier of water, of not less than $10 or more than $90.

20         (g)  Require suppliers of water to collect samples of

21  water, to submit such samples to a department-certified

22  drinking water laboratory for contaminant analysis, and to

23  keep sampling records as required by rule of the department.

24         (h)  Require all fees collected by the department in

25  accordance with the provisions of this section to be deposited

26  in an appropriate trust fund of the department, and used

27  exclusively for the payment of costs incurred in the

28  administration of this section.

29         (i)  Prohibit any supplier of water from, intentionally

30  or otherwise, introducing any contaminant which poses a health

31  hazard into a drinking water system.

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  1         (j)  Require suppliers of water to give public notice

  2  of water problems and corrective measures under the conditions

  3  specified by rule of the department.

  4         (k)  Require a fee to cover the cost of reinspection of

  5  any system regulated under this section, which may not be less

  6  than $25 or more than $40.

  7         (4)  RIGHT OF ENTRY.--For purposes of this section,

  8  department personnel may enter, at any reasonable time and if

  9  they have reasonable cause to believe a violation of this

10  section is occurring or about to occur, upon any and all parts

11  of the premises of such limited use public and multifamily

12  private drinking water systems serving more than one

13  residence, to make an examination and investigation to

14  determine the sanitary and safety conditions of such systems.

15  Any person who interferes with, hinders, or opposes any

16  employee of the department in the discharge of his or her

17  duties pursuant to the provisions of this section is subject

18  to the penalties provided in s. 381.0025.

19         (5)  ENFORCEMENT AND PENALTIES.--

20         (a)  Any person who constructs, modifies, or operates a

21  limited use community or limited use commercial public water

22  system, a multifamily, or a private water system, without

23  first complying with the requirements of this section, who

24  operates a water system in violation of department order, or

25  who maintains or operates a water system after revocation of

26  the permit is guilty of a misdemeanor of the second degree,

27  punishable as provided in s. 775.082 or s. 775.083.

28         (b)  This section and rules adopted pursuant to this

29  section may be enforced by injunction or restraining order

30  granted by a circuit court as provided in s. 381.0012(2).

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  1         (c)  Additional remedies available to county health

  2  department staff through any county or municipal ordinance may

  3  be applied, over and above the penalties set forth in this

  4  section, to any violation of this section or the rules adopted

  5  pursuant to this section.

  6         Section 14.  Subsection (3) of section 381.90, Florida

  7  Statutes, is amended, paragraph (c) of subsection (7) is

  8  redesignated as paragraph (d), and a new paragraph (c) is

  9  added to said subsection, to read:

10         381.90  Health Information Systems Council; legislative

11  intent; creation, appointment, duties.--

12         (3)  The council shall be composed of the following

13  members or their senior executive-level designees:

14         (a)  The secretary of the Department of Health;

15         (b)  The secretary of the Department of Business and

16  Professional Regulation;

17         (c)  The secretary of the Department of Children and

18  Family Services;

19         (d)  The director of the Agency for Health Care

20  Administration;

21         (e)  The secretary of the Department of Corrections;

22         (f)  The Attorney General;

23         (g)  The executive director of the Correctional Medical

24  Authority;

25         (h)  Two members representing county health

26  departments, one from a small county and one from a large

27  county, appointed by the Governor; and

28         (i)  A representative from the Florida Association of

29  Counties;.

30         (j)  The State Treasurer/Insurance Commissioner;

31

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  1         (k)  A representative from the Florida Healthy Kids

  2  Corporation;

  3         (l)  A representative from a school of public health

  4  chosen by the Board of Regents;

  5         (m)  The Commissioner of Education;

  6         (n)  The secretary of the Department of Elderly

  7  Affairs; and

  8         (o)  The secretary of the Department of Juvenile

  9  Justice.

10

11  Representatives of the Federal Government may serve without

12  voting rights.

13         (7)  The council's duties and responsibilities include,

14  but are not limited to, the following:

15         (c)  To develop a review process to ensure cooperative

16  planning among agencies that collect or maintain

17  health-related data. The council shall submit a report on the

18  implementation of this requirement to the Executive Office of

19  the Governor, the Speaker of the House of Representatives, and

20  the President of the Senate by January 1, 2000.

21         Section 15.  Subsection (10) of section 382.003,

22  Florida Statutes, is amended, and subsection (11) is added to

23  said section, to read:

24         382.003  Powers and duties of the department.--The

25  department may:

26         (10)  Adopt, promulgate, and enforce rules necessary

27  for the creation, issuance, recording, rescinding,

28  maintenance, and processing of vital records and for carrying

29  out the provisions of ss. 382.004-382.014 and ss.

30  382.016-382.019.

31

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  1         (11)  By rule, require that forms, documents, and

  2  information submitted to the department in anticipation of the

  3  creation or amendment of a vital record be under oath.

  4         Section 16.  Subsection (3) of section 382.004, Florida

  5  Statutes, is amended to read:

  6         382.004  Reproduction and destruction of records.--

  7         (3)  Photographs, microphotographs, or reproductions of

  8  any record in the form of film, prints, or electronically

  9  produced certifications made in compliance with the provisions

10  of this chapter and certified by the department shall have the

11  same force and effect as the originals thereof, shall be

12  treated as originals for the purpose of their admissibility in

13  any court or case, and shall be prima facie evidence in all

14  courts and cases of the facts stated therein.

15         Section 17.  Subsection (1) of section 382.008, Florida

16  Statutes, 1998 Supplement, is amended to read:

17         382.008  Death and fetal death registration.--

18         (1)  A certificate for each death and fetal death which

19  occurs in this state shall be filed on a form prescribed by

20  the department with the local registrar of the district in

21  which the death occurred within 5 days after such death and

22  prior to final disposition, and shall be registered by such

23  registrar if it has been completed and filed in accordance

24  with this chapter or adopted rules. The certificate shall

25  include the decedent's social security number, if available.

26  Disclosure of social security numbers obtained through this

27  requirement shall be limited to the purpose of administration

28  of the Title IV-D program for child support enforcement and as

29  otherwise provided by law. In addition, each certificate of

30  death or fetal death:

31

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  1         (a)  If requested by the informant, shall include

  2  aliases or "also known as" (AKA) names of a decedent in

  3  addition to the decedent's name of record.  Aliases shall be

  4  entered on the face of the death certificate in the space

  5  provided for name if there is sufficient space.  If there is

  6  not sufficient space, aliases may be recorded on the back of

  7  the certificate and shall be considered part of the official

  8  record of death;

  9         (b)  If the place of death is unknown, shall be

10  registered in the registration district in which the dead body

11  or fetus is found within 5 days after such occurrence; and

12         (c)  If death occurs in a moving conveyance, shall be

13  registered in the registration district in which the dead body

14  was first removed from such conveyance.

15         Section 18.  Section 382.013, Florida Statutes, 1998

16  Supplement, is amended to read:

17         382.013  Birth registration.--A certificate for each

18  live birth that occurs in this state shall be filed within 5

19  days after such birth with the local registrar of the district

20  in which the birth occurred and with the mother's health

21  insurer or HMO. The birth shall be registered by the local

22  registrar if the certificate has been completed and filed in

23  accordance with this chapter and adopted rules. The

24  information regarding registered births shall be used for

25  comparison with information in the state case registry, as

26  defined in chapter 61.

27         (1)  FILING.--

28         (a)  If a birth occurs in a hospital, birth center, or

29  other health care facility, or en route thereto, the person in

30  charge of the facility shall be responsible for preparing the

31  certificate, certifying the facts of the birth, and filing the

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  1  certificate with the local registrar.  Within 48 hours after

  2  the birth, the physician, midwife, or person in attendance

  3  during or immediately after the delivery shall provide the

  4  facility with the medical information required by the birth

  5  certificate.

  6         (b)  If a birth occurs outside a facility and a Florida

  7  licensed physician, certified nurse midwife, Florida licensed

  8  midwife, or a public health nurse employed by the department

  9  was in attendance during or immediately after the delivery,

10  then such individual shall prepare and file the certificate.

11  and the child is not taken to the facility within 3 days after

12  delivery, the certificate shall be prepared and filed by one

13  of the following persons in the indicated order of priority:

14         1.  The physician or midwife in attendance during or

15  immediately after the birth.

16         2.  In the absence of persons described in subparagraph

17  1., any other person in attendance during or immediately after

18  the birth.

19         3.  In the absence of persons described in subparagraph

20  2., the father or mother.

21         4.  In the absence of the father and the inability of

22  the mother, the person in charge of the premises where the

23  birth occurred.

24         (c)  If a birth occurs outside a facility and the

25  delivery is not attended by one of the individuals described

26  in paragraph (b), then the person in attendance or the mother

27  or the father shall report the birth to the registrar and

28  provide proof of the facts of birth. The department may

29  require that such documents be presented and such proof be

30  filed as it deems necessary and sufficient to establish the

31

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  1  truth of the facts to be recorded by the certificate and may

  2  withhold registering the birth until its requirements are met.

  3         (d)(c)  If a birth occurs in a moving conveyance and

  4  the child is first removed from the conveyance in this state,

  5  the birth shall be filed and registered in this state and the

  6  place to which the child is first removed shall be considered

  7  the place of birth.

  8         (e)(d)  The mother or the father At least one of the

  9  parents of the child shall attest to the accuracy of the

10  personal data entered on the certificate in time to permit the

11  timely registration of the certificate.

12         (f)(e)  If a certificate of live birth is incomplete,

13  the local registrar shall immediately notify the health care

14  facility or person filing the certificate and shall require

15  the completion of the missing items of information if they can

16  be obtained prior to issuing certified copies of the birth

17  certificate.

18         (g)(f)  Regardless of any plan to place a child for

19  adoption after birth, the information on the birth certificate

20  as required by this section must be as to the child's birth

21  parents unless and until an application for a new birth record

22  is made under s. 63.152.

23         (2)  PATERNITY.--

24         (a)  If the mother is married at the time of birth, the

25  name of the husband shall be entered on the birth certificate

26  as the father of the child, unless paternity has been

27  determined otherwise by a court of competent jurisdiction.

28         (b)  Notwithstanding paragraph (a), if the husband of

29  the mother dies while the mother is pregnant but before the

30  birth of the child, the name of the deceased husband shall be

31  entered on the birth certificate as the father of the child,

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  1  unless paternity has been determined otherwise by a court of

  2  competent jurisdiction.

  3         (c)  If the mother is not married at the time of birth,

  4  the name of the father may not be entered on the birth

  5  certificate without the execution of a consenting affidavit

  6  signed by both the mother and the person to be named as the

  7  father.  After giving notice orally or through the use of

  8  video or audio equipment, and in writing, of the alternatives

  9  to, the legal consequences of, and the rights, including, if

10  one parent is a minor, any rights afforded due to minority

11  status, and responsibilities that arise from signing an

12  acknowledgment of paternity, the facility shall provide the

13  mother and the person to be named as the father with the

14  affidavit, as well as information provided by the Title IV-D

15  agency established pursuant to s. 409.2557, regarding the

16  benefits of voluntary establishment of paternity. Upon request

17  of the mother and the person to be named as the father, the

18  facility shall assist in the execution of the affidavit.

19         (d)  If the paternity of the child is determined by a

20  court of competent jurisdiction as provided under s. 382.015,

21  the name of the father and the surname of the child shall be

22  entered on the certificate in accordance with the finding and

23  order of the court.  If the court fails to specify a surname

24  for the child, the surname shall be entered in accordance with

25  subsection (3).

26         (e)  If the father is not named on the certificate, no

27  other information about the father shall be entered on the

28  certificate.

29         (3)  NAME OF CHILD.--

30         (a)  If the mother is married at the time of birth, the

31  mother and father whose names are entered on the birth

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  1  certificate shall select the given names and surname of the

  2  child if both parents have custody of the child, otherwise the

  3  parent who has custody shall select the child's name.

  4         (b)  If the mother and father whose names are entered

  5  on the birth certificate disagree on the surname of the child

  6  and both parents have custody of the child, the surname

  7  selected by the father and the surname selected by the mother

  8  shall both be entered on the birth certificate, separated by a

  9  hyphen, with the selected names entered in alphabetical order.

10  If the parents disagree on the selection of a given name, the

11  given name may not be entered on the certificate until a joint

12  agreement that lists the agreed upon given name and is

13  notarized by both parents is submitted to the department, or

14  until a given name is selected by a court.

15         (c)  If the mother is not married at the time of birth,

16  the parent who will have custody of the child shall select the

17  child's given name and surname.

18         (d)  If multiple names of the child exceed the space

19  provided on the face of the birth certificate they shall be

20  listed on the back of the certificate.  Names listed on the

21  back of the certificate shall be part of the official record.

22         (4)  UNDETERMINED PARENTAGE.--The person having custody

23  of a child of undetermined parentage shall register a birth

24  certificate shall be registered for every child of

25  undetermined parentage showing all known or approximate facts

26  relating to the birth.  To assist in later determination,

27  information concerning the place and circumstances under which

28  the child was found shall be included on the portion of the

29  birth certificate relating to marital status and medical

30  details.  In the event the child is later identified to the

31  satisfaction of the department, a new birth certificate shall

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  1  be prepared which shall bear the same number as the original

  2  birth certificate, and the original certificate shall be

  3  sealed and filed, shall be confidential and exempt from the

  4  provisions of s. 119.07(1), and shall not be opened to

  5  inspection by, nor shall certified copies of the same be

  6  issued except by court order to, any person other than the

  7  registrant if of legal age.

  8         (5)  DISCLOSURE.--The original certificate of live

  9  birth shall contain all the information required by the

10  department for legal, social, and health research purposes.

11  However, all information concerning parentage, marital status,

12  and medical details shall be confidential and exempt from the

13  provisions of s. 119.07(1), except for health research

14  purposes as approved by the department, nor shall copies of

15  the same be issued except as provided in s. 382.025.

16         Section 19.  Section 382.015, Florida Statutes, is

17  amended to read:

18         382.015  New certificates of live birth; duty of clerks

19  of court and department.--The clerk of the court in which any

20  proceeding for adoption, annulment of an adoption, affirmation

21  of parental status, or determination of paternity is to be

22  registered, shall within 30 days after the final disposition,

23  forward to the department a certified court-certified copy of

24  the court order decree, or a report of the proceedings upon a

25  form to be furnished by the department, together with

26  sufficient information to identify the original birth

27  certificate and to enable the preparation of a new birth

28  certificate.

29         (1)  ADOPTION AND ANNULMENT OF ADOPTION.--

30         (a)  Upon receipt of the report or certified copy of an

31  adoption decree, together with the information necessary to

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  1  identify the original certificate of live birth, and establish

  2  a new certificate, the department shall prepare and file a new

  3  birth certificate, absent objection by the court decreeing the

  4  adoption, the adoptive parents, or the adoptee if of legal

  5  age. The certificate shall bear the same file number as the

  6  original birth certificate.  All names and identifying

  7  information relating to the adoptive parents entered on the

  8  new certificate shall refer to the adoptive parents, but

  9  nothing in the certificate shall refer to or designate the

10  parents as being adoptive.  All other items not affected by

11  adoption shall be copied as on the original certificate,

12  including the date of registration and filing.

13         (b)  Upon receipt of the report or certified copy of an

14  annulment-of-adoption decree, together with the sufficient

15  information to identify the original certificate of live

16  birth, the department shall, if a new certificate of birth was

17  filed following an adoption report or decree, remove the new

18  certificate and restore the original certificate to its

19  original place in the files, and the certificate so removed

20  shall be sealed by the department.

21         (c)  Upon receipt of a report or certified copy of an

22  adoption decree or annulment-of-adoption decree for a person

23  born in another state, the department shall forward the report

24  or decree to the state of the registrant's birth.  If the

25  adoptee was born in Canada, the department shall send a copy

26  of the report or decree to the appropriate birth registration

27  authority in Canada.

28         (2)  DETERMINATION OF PATERNITY.--

29         (a)  Upon receipt of the report or a certified copy of

30  a final decree of determination of paternity, or upon written

31  request and receipt of a consenting affidavit signed by both

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  1  parents acknowledging the paternity of the registrant,

  2  together with sufficient information to identify the original

  3  certificate of live birth, the department shall prepare and

  4  file a new birth certificate which shall bear the same file

  5  number as the original birth certificate.  If paternity has

  6  been established pursuant to court order, The registrant's

  7  name shall be entered as decreed by the court.  Otherwise, the

  8  surname of the registrant may be changed from that shown on

  9  the original birth certificate at the request of the parents

10  or the registrant if of legal age. The names and identifying

11  information of the parents shall be entered as of the date of

12  the registrant's birth.

13         (b)  If the parents marry each other at any time after

14  the registrant's birth, the department shall, upon request of

15  the parents or registrant if of legal age and proof of the

16  marriage, amend the certificate with regard to the parent's

17  marital status as though the parents were married at the time

18  of birth.

19         (c)  If a father's name is already listed on the birth

20  certificate, the birth certificate may only be amended to add

21  a different father's name upon court order.  If a change in

22  the registrant's surname is also desired, such change must be

23  included in the court order determining paternity or the name

24  must be changed pursuant to s. 68.07.

25         (3)  AFFIRMATION OF PARENTAL STATUS.--Upon receipt of

26  an order of affirmation of parental status issued pursuant to

27  s. 742.16, together with sufficient information to identify

28  the original certificate of live birth, the department shall

29  prepare and file a new birth certificate which shall bear the

30  same file number as the original birth certificate.  The names

31  and identifying information of the registrant's parents

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  1  entered on the new certificate shall be the commissioning

  2  couple, but the new certificate may not make reference to or

  3  designate the parents as the commissioning couple.

  4         (4)  SUBSTITUTION OF NEW CERTIFICATE OF BIRTH FOR

  5  ORIGINAL.--When a new certificate of birth is prepared, the

  6  department shall substitute the new certificate of birth for

  7  the original certificate on file.  All copies of the original

  8  certificate of live birth in the custody of a local registrar

  9  or other state custodian of vital records shall be forwarded

10  to the State Registrar.  Thereafter, when a certified copy of

11  the certificate of birth of such person or portion thereof is

12  issued, it shall be a copy of the new certificate of birth or

13  portion thereof, except when a court order requires issuance

14  of a certified copy of the original certificate of birth. In

15  an adoption, change in paternity, affirmation of parental

16  status, undetermined parentage, or court-ordered substitution,

17  the department shall place the original certificate of birth

18  and all papers pertaining thereto under seal, not to be broken

19  except by order of a court of competent jurisdiction or as

20  otherwise provided by law.

21         (5)  FORM.--Except for certificates of foreign birth

22  which are registered as provided in s. 382.017, and delayed

23  certificates of birth which are registered as provided in ss.

24  382.019 and 382.0195, all original, new, or amended

25  certificates of live birth shall be identical in form,

26  regardless of the marital status of the parents or the fact

27  that the registrant is adopted or of undetermined parentage.

28         (6)  RULES.--The department shall adopt and enforce all

29  rules necessary for carrying out the provisions of this

30  section.

31

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  1         Section 20.  Subsections (3), (4), and (5) are added to

  2  section 382.016, Florida Statutes, to read:

  3         382.016  Amendment of records.--

  4         (3)  Upon written request and receipt of an affidavit

  5  signed by the mother and father acknowledging the paternity of

  6  a registrant born out of wedlock, together with sufficient

  7  information to identify the original certificate of live

  8  birth, the department shall prepare a new birth certificate

  9  which shall bear the same file number as the original birth

10  certificate. The names and identifying information of the

11  parents shall be entered as of the date of the registrant's

12  birth. The surname of the registrant may be changed from that

13  shown on the original birth certificate at the request of the

14  mother and father of the registrant or the registrant if of

15  legal age. If the mother and father marry each other at any

16  time after the registrant's birth, the department shall, upon

17  request of the mother and father or registrant if of legal age

18  and proof of the marriage, amend the certificate with regard

19  to the parents' marital status as though the parents were

20  married at the time of birth.

21         (4)  When a new certificate of birth is prepared

22  pursuant to subsection (3), the department shall substitute

23  the new certificate of birth for the original certificate on

24  file. All copies of the original certificate of live birth in

25  the custody of a local registrar or other state custodian of

26  vital records shall be forwarded to the State Registrar.

27  Thereafter, when a certified copy of the certificate of birth

28  or portion thereof is issued, it shall be a copy of the new

29  certificate of birth or portion thereof, except when a court

30  order requires issuance of a certified copy of the original

31  certificate of birth. The department shall place the original

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  1  certificate of birth and all papers pertaining thereto under

  2  seal, not to be broken except by order of a court of competent

  3  jurisdiction or as otherwise provided by law.

  4         (5)  If a father's name is listed on the birth

  5  certificate, the birth certificate may only be amended to

  6  remove the father's name or to add a different father's name

  7  upon court order. If a change in the registrant's surname is

  8  also desired, such change must be included in the court order

  9  or the name must be changed pursuant to s. 68.07.

10         Section 21.  Subsection (1) of section 382.019, Florida

11  Statutes, is amended, and subsection (8) is added to said

12  section, to read:

13         382.019  Delayed registration; administrative

14  procedures.--

15         (1)  Registration after 1 year is a delayed

16  registration, and the department may, upon receipt of an

17  application and the fee required under s. 382.0255, and proof

18  of the birth, death, or fetal death as prescribed by this

19  section or rule, register a delayed certificate if the

20  department does not already have a certificate of the birth,

21  death, or fetal death on file.

22         (8)  In addition to the rulemaking authority found in

23  s. 382.003(10), the department may, by rule, provide for the

24  dismissal of an application which is not pursued within 1

25  year.

26         Section 22.  Subsections (1) and (2) of section

27  382.025, Florida Statutes, are amended to read:

28         382.025  Certified copies of vital records;

29  confidentiality; research.--

30         (1)  BIRTH RECORDS.--Except for birth records over 100

31  years old and not under seal pursuant to court order, all

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  1  birth records of this state shall be confidential and are

  2  exempt from the provisions of s. 119.07(1).

  3         (a)  Certified copies of the original birth certificate

  4  or a new or amended certificate, or affidavits thereof, are

  5  confidential and exempt from the provisions of s. 119.07(1)

  6  and, upon receipt of a request and payment of the fee

  7  prescribed in s. 382.0255, shall be issued only as authorized

  8  by the department and in the form prescribed by the

  9  department, and only:

10         1.  To the registrant, if of legal age;

11         2.  To the registrant's parent or guardian or other

12  legal representative;

13         3.  Upon receipt of the registrant's death certificate,

14  to the registrant's spouse or to the registrant's child,

15  grandchild, or sibling, if of legal age, or to the legal

16  representative of any of such persons;

17         4.  To any person if the birth record is over 100 years

18  old and not under seal pursuant to court order;

19         5.  To a law enforcement agency for official purposes;

20         6.  To any agency of the state or the United States for

21  official purposes upon approval of the department; or

22         7.  Upon order of any court of competent jurisdiction.

23         (b)  To protect the integrity of vital records and

24  prevent the fraudulent use of the birth certificates of

25  deceased persons, the department shall match birth and death

26  certificates and post the fact of death to the appropriate

27  birth certificate. Except for a commemorative birth

28  certificate, any A certification of a birth certificate of a

29  deceased registrant shall be marked "deceased." In the case of

30  a commemorative birth certificate, such indication of death

31  shall be made on the back of the certificate.

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  1         (c)  The department shall issue, upon request and upon

  2  payment of an additional fee as prescribed under s. 382.0255,

  3  a commemorative birth certificate representing that the birth

  4  of the person named thereon is recorded in the office of the

  5  registrar. The certificate issued under this paragraph shall

  6  be in a form consistent with the need to protect the integrity

  7  of vital records but shall be suitable for display.  It may

  8  bear the seal of the state printed thereon and may be signed

  9  by the Governor.

10         (2)  OTHER RECORDS.--

11         (a)  The department shall authorize the issuance of a

12  certified copy of all or part of any marriage, dissolution of

13  marriage, or death or fetal death certificate, excluding that

14  portion which is confidential and exempt from the provisions

15  of s. 119.07(1) as provided under s. 382.008, to any person

16  requesting it upon receipt of a request and payment of the fee

17  prescribed by this section.  A certification of the death or

18  fetal death certificate which includes the confidential

19  portions shall be issued only:

20         1.  To the registrant's spouse or parent, or to the

21  registrant's child, grandchild, or sibling, if of legal age,

22  or to any person family member who provides a will which has

23  been executed pursuant to s. 732.502, insurance policy, or

24  other document that demonstrates his or her the family

25  member's interest in the estate of the registrant, or to any

26  person who provides documentation that he or she is acting on

27  behalf of any of them;

28         2.  To any agency of the state or local government or

29  the United States for official purposes upon approval of the

30  department; or

31         3.  Upon order of any court of competent jurisdiction.

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  1         (b)  All portions of a certificate of death shall cease

  2  to be exempt from the provisions of s. 119.07(1) 50 years

  3  after the date of death.

  4         (c)  The department shall issue, upon request and upon

  5  payment of an additional fee prescribed by this section, a

  6  commemorative marriage license representing that the marriage

  7  of the persons named thereon is recorded in the office of the

  8  registrar.  The certificate issued under this paragraph shall

  9  be in a form consistent with the need to protect the integrity

10  of vital records but shall be suitable for display.  It may

11  bear the seal of the state printed thereon and may be signed

12  by the Governor.

13         Section 23.  Subsection (2) of section 382.0255,

14  Florida Statutes, is amended to read:

15         382.0255  Fees.--

16         (2)  The fee charged for each request for a

17  certification of a birth record issued by the department or by

18  the local registrar shall be subject to an additional fee of

19  $4 which shall be deposited in the appropriate departmental

20  trust fund. On a quarterly basis, the department shall

21  transfer $2 of this additional fee to the General Revenue Fund

22  and $1.50 to the Child Welfare Training Trust Fund created in

23  s. 402.40. Fifty cents of the fee shall be available for

24  appropriation to the department for administration of this

25  chapter.

26         Section 24.  Paragraph (e) of subsection (3) of section

27  383.14, Florida Statutes, is amended to read:

28         383.14  Screening for metabolic disorders, other

29  hereditary and congenital disorders, and environmental risk

30  factors.--

31

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  1         (3)  DEPARTMENT OF HEALTH; POWERS AND DUTIES.--The

  2  department shall administer and provide certain services to

  3  implement the provisions of this section and shall:

  4         (e)  Supply the necessary dietary treatment products

  5  where practicable for diagnosed cases of phenylketonuria and

  6  other metabolic diseases for as long as medically indicated

  7  when the products are not otherwise available. Provide

  8  nutrition education and supplemental foods to those families

  9  eligible for the Special Supplemental Nutrition Food Program

10  for Women, Infants, and Children as provided in s. 383.011.

11

12  All provisions of this subsection must be coordinated with the

13  provisions and plans established under this chapter, chapter

14  411, and Pub. L. No. 99-457.

15         Section 25.  Subsection (4) of section 385.202, Florida

16  Statutes, is amended to read:

17         385.202  Statewide cancer registry.--

18         (4)  Funds appropriated for this section shall be used

19  for establishing, administering, compiling, processing, and

20  providing biometric and statistical analyses to the reporting

21  facilities.  Funds may also be used to ensure the quality and

22  accuracy of the information reported and to provide management

23  information to the reporting facilities.  Such reporting

24  hospitals shall be reimbursed for reasonable costs.

25         Section 26.  Section 385.203, Florida Statutes, is

26  amended to read:

27         385.203  Diabetes Advisory Council; creation; function;

28  membership.--

29         (1)  To guide a statewide comprehensive approach to

30  diabetes prevention, diagnosis, education, care, treatment,

31  impact, and costs thereof, there is created a Diabetes

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  1  Advisory Council that serves as the advisory unit to the

  2  diabetes centers, the Board of Regents, and the Department of

  3  Health, other governmental agencies, professional and other

  4  organizations, and the general public.  The council shall:

  5         (a)  Provide statewide leadership to continuously

  6  improve the lives of all Floridians with diabetes and reduce

  7  the burden of diabetes.

  8         (b)  Serve as a forum for the discussion and study of

  9  issues related to the public health approach for the delivery

10  of health care services to persons with diabetes.

11         (b)  Provide advice and consultation to the deans of

12  the medical schools in which are located diabetes centers, and

13  by June 30 of each year, the council shall submit written

14  recommendations to the deans regarding the need for diabetes

15  education, treatment, and research activities to promote the

16  prevention and control of diabetes.

17         (c)  By June 30 of each year, meet with the secretary

18  of the Department of Health or a his or her designee to make

19  specific recommendations regarding the public health aspects

20  of the prevention and control of diabetes.

21         (2)  The members of the council shall be appointed by

22  the Governor with advice from nominations by the Board of

23  Regents, the Board of Trustees of the University of Miami, and

24  the secretary of the Department of Health. Members shall serve

25  4-year terms or until their successors are appointed or

26  qualified.

27         (3)  The council shall be composed of 25 18 citizens of

28  the state who have knowledge of or work in the area of

29  diabetes mellitus as follows:  four practicing physicians; one

30  representative from each medical school; seven interested

31  citizens, at least three of whom shall be persons who have or

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  1  have had diabetes mellitus or who have a child with diabetes

  2  mellitus; the Secretary of Health or his or her designee; one

  3  representative from the Division of Children's Medical

  4  Services of the Department of Health; and one professor of

  5  nutrition.

  6         (a)  Five interested citizens, three of whom are

  7  affected by diabetes.

  8         (b)  Twenty members representing nursing with diabetes

  9  educator certification; dietetics with diabetes educator

10  certification; podiatry; ophthalmology/optometry; psychology;

11  pharmacy; adult endocrinology; pediatric endocrinology; the

12  American Diabetes Association; the Juvenile Diabetes

13  Foundation; community health centers; county health

14  departments; American Diabetes Association-recognized

15  community education programs; each Florida medical school; the

16  insurance industry; Children's Medical Services diabetes

17  regional programs; and employers.

18         (c)  One or more representatives from the Department of

19  Health shall serve on the council as ex officio members.

20         (4)(a)  The council shall annually elect from its

21  members a chair and vice chair a secretary.  The council shall

22  meet at the chair's discretion; however, at least three

23  meetings shall be held each year.

24         (b)  In conducting its meetings, the council shall use

25  accepted rules of procedure.  A majority of the members of the

26  council constitutes a quorum, and action by a majority of a

27  quorum is necessary for the council to take any official

28  action.  The Department of Health secretary shall keep a

29  complete record of the proceedings of each meeting.  The

30  record shall show the names of the members present and the

31  actions taken.  The records shall be kept on file with the

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  1  department, and these and other documents about matters within

  2  the jurisdiction of the council may be inspected by members of

  3  the council.

  4         (5)  Members of the council shall serve without

  5  remuneration but may be reimbursed for per diem and travel

  6  expenses as provided in s. 112.061, to the extent resources

  7  are available.

  8         (6)  The department shall serve as an intermediary for

  9  the council if the council coordinates, applies for, or

10  accepts any grants, funds, gifts, or services made available

11  to it by any agency or department of the Federal Government,

12  or any private agency or individual, for assistance in the

13  operation of the council or the diabetes centers established

14  in the various medical schools.

15         Section 27.  Subsection (8) of section 391.021, Florida

16  Statutes, 1998 Supplement, is amended to read:

17         391.021  Definitions.--When used in this act, unless

18  the context clearly indicates otherwise:

19         (8)  "Program" means the Children's Medical Services

20  program established in the Division of Children's Medical

21  Services of the department.

22         Section 28.  Section 391.028, Florida Statutes, 1998

23  Supplement, is amended to read:

24         391.028  Administration.--The Children's Medical

25  Services program shall have a central office and area offices.

26         (1)  The Director of the Division of Children's Medical

27  Services must be a physician licensed under chapter 458 or

28  chapter 459 who has specialized training and experience in the

29  provision of health care to children and who has recognized

30  skills in leadership and the promotion of children's health

31  programs. The division director shall be the deputy secretary

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  1  and the Deputy State Health Officer for Children's Medical

  2  Services and is appointed by and reports to the secretary. The

  3  director may appoint division directors subject to the

  4  approval of the secretary.

  5         (2)  The division director shall designate Children's

  6  Medical Services area offices to perform operational

  7  activities, including, but not limited to:

  8         (a)  Providing case management services for the

  9  network.

10         (b)  Providing local oversight of the program.

11         (c)  Determining an individual's medical and financial

12  eligibility for the program.

13         (d)  Participating in the determination of a level of

14  care and medical complexity for long-term care services.

15         (e)  Authorizing services in the program and developing

16  spending plans.

17         (f)  Participating in the development of treatment

18  plans.

19         (g)  Taking part in the resolution of complaints and

20  grievances from participants and health care providers.

21         (3)  Each Children's Medical Services area office shall

22  be directed by a physician licensed under chapter 458 or

23  chapter 459 who has specialized training and experience in the

24  provision of health care to children.  The director of a

25  Children's Medical Services area office shall be appointed by

26  the division director from the active panel of Children's

27  Medical Services physician consultants.

28         Section 29.  Section 391.0315, Florida Statutes, 1998

29  Supplement, is amended to read:

30         391.0315  Benefits.--Benefits provided under the

31  program for children with special health care needs shall be

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  1  the same benefits provided to children as specified in ss.

  2  409.905 and 409.906. The department may offer additional

  3  benefits for early intervention services, respite services,

  4  genetic testing, genetic and nutritional counseling, and

  5  parent support services, if such services are determined to be

  6  medically necessary. No child or person determined eligible

  7  for the program who is eligible under Title XIX or Title XXI

  8  of the Social Security Act shall receive any service other

  9  than an initial health care screening or treatment of an

10  emergency medical condition as defined in s. 395.002, until

11  such child or person is enrolled in Medicaid or a Title XXI

12  program.

13         Section 30.  Paragraph (b) of subsection (1) of section

14  391.221, Florida Statutes, 1998 Supplement, is amended to

15  read:

16         391.221  Statewide Children's Medical Services Network

17  Advisory Council.--

18         (1)  The secretary of the department may appoint a

19  Statewide Children's Medical Services Network Advisory Council

20  for the purpose of acting as an advisory body to the

21  department.  Specifically, the duties of the council shall

22  include, but not be limited to:

23         (b)  Making recommendations to the director of the

24  Division of Children's Medical Services concerning the

25  selection of health care providers for the Children's Medical

26  Services network.

27         Section 31.  Subsection (1) of section 391.222, Florida

28  Statutes, 1998 Supplement, is amended to read:

29         391.222  Cardiac Advisory Council.--

30         (1)  The secretary of the department may appoint a

31  Cardiac Advisory Council for the purpose of acting as the

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  1  advisory body to the Department of Health Division of

  2  Children's Medical Services in the delivery of cardiac

  3  services to children. Specifically, the duties of the council

  4  shall include, but not be limited to:

  5         (a)  Recommending standards for personnel and

  6  facilities rendering cardiac services for the Division of

  7  Children's Medical Services;

  8         (b)  Receiving reports of the periodic review of

  9  cardiac personnel and facilities to determine if established

10  standards for the Division of Children's Medical Services

11  cardiac services are met;

12         (c)  Making recommendations to the division director as

13  to the approval or disapproval of reviewed personnel and

14  facilities;

15         (d)  Making recommendations as to the intervals for

16  reinspection of approved personnel and facilities; and

17         (e)  Providing input to the Division of Children's

18  Medical Services on all aspects of Children's Medical Services

19  cardiac programs, including the rulemaking process.

20         Section 32.  Section 391.223, Florida Statutes, 1998

21  Supplement, is amended to read:

22         391.223  Technical advisory panels.--The secretary of

23  the department may establish technical advisory panels to

24  assist the Division of Children's Medical Services in

25  developing specific policies and procedures for the Children's

26  Medical Services program.

27         Section 33.  Subsection (3) of section 392.69, Florida

28  Statutes, is amended, and subsection (4) is added to said

29  section, to read:

30         392.69  Appropriation, sinking, and maintenance trust

31  funds; additional powers of the department.--

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  1         (3)  In the execution of its public health program

  2  functions, notwithstanding chapter 216, the department is

  3  hereby authorized to use any sums of money which it may

  4  heretofore have saved or which it may hereafter save from its

  5  regular operating appropriation, or use any sums of money

  6  acquired by gift or grant, or any sums of money it may acquire

  7  by the issuance of revenue certificates of the hospital to

  8  match or supplement any state or federal funds, or any moneys

  9  received by said department by gift or otherwise, for the

10  construction or maintenance of additional facilities or

11  improvement to existing facilities, as the department deems

12  necessary.

13         (4)  The department shall appoint an advisory board,

14  which shall meet quarterly to review and make recommendations

15  relating to patient care at A.G. Holley State Hospital.

16  Members shall be appointed for a term of 3 years, with such

17  appointments being staggered so that the terms of no more than

18  two members expire in any one year. Members shall serve

19  without remuneration, but may be reimbursed for per diem and

20  travel expenses as provided in s. 112.061.

21         Section 34.  Subsection (3) of section 409.9126,

22  Florida Statutes, 1998 Supplement, is amended to read:

23         409.9126  Children with special health care needs.--

24         (3)  Services provided through the Children's Medical

25  Services network shall be reimbursed on a fee-for-service

26  basis and shall utilize a primary care case management

27  process. Starting July 1, 1999, the Florida Medicaid program

28  shall phase in by geographical area capitation payments to

29  Children's Medical Services for services provided to

30  Medicaid-eligible children with special health care needs. By

31  January 1, 2001, the Agency for Health Care Administration

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  1  shall make capitation payments for Children's Medical Services

  2  enrollees statewide, to the extent permitted by federal law.

  3  However, effective July 1, 1999, reimbursement to the

  4  Children's Medical Services program for services provided to

  5  Medicaid-eligible children with special health care needs

  6  through the Children's Medical Services network shall be on a

  7  capitated basis.

  8         Section 35.  Paragraph (a) of subsection (2) of section

  9  465.019, Florida Statutes, 1998 Supplement, is amended to

10  read:

11         465.019  Institutional pharmacies; permits.--

12         (2)  The following classes of institutional pharmacies

13  are established:

14         (a)  "Class I institutional pharmacies" are those

15  institutional pharmacies in which all medicinal drugs are

16  administered from individual prescription containers to the

17  individual patient and in which medicinal drugs are not

18  dispensed on the premises, except that nursing homes licensed

19  under part II of chapter 400 may purchase medical oxygen for

20  administration to residents.  No medicinal drugs may be

21  dispensed in a Class I institutional pharmacy.

22         Section 36.  Subsections (14), (15), (16), (19), and

23  (22) of section 499.005, Florida Statutes, 1998 Supplement,

24  are amended, and subsection (24) is added to said section, to

25  read:

26         499.005  Prohibited acts.--It is unlawful to perform or

27  cause the performance of any of the following acts in this

28  state:

29         (14)  The purchase or receipt of a legend drug from a

30  person that is not authorized under this chapter the law of

31

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  1  the state in which the person resides to distribute legend

  2  drugs.

  3         (15)  The sale or transfer of a legend drug to a person

  4  that is not authorized under the law of the jurisdiction in

  5  which the person receives the drug resides to purchase or

  6  possess legend drugs.

  7         (16)  The purchase or receipt of a compressed medical

  8  gas from a person that is not authorized under this chapter

  9  the law of the state in which the person resides to distribute

10  compressed medical gases.

11         (19)  Providing the department with false or fraudulent

12  records, or making false or fraudulent statements, regarding

13  any matter within the provisions of this chapter a drug,

14  device, or cosmetic.

15         (22)  Failure to obtain a permit or registration, or

16  operating without a valid permit, when a permit or

17  registration is as required by ss. 499.001-499.081 for that

18  activity.

19         (24)  The distribution of a legend device to the

20  patient or ultimate consumer without a prescription or order

21  from a practitioner licensed by law to use or prescribe the

22  device.

23         Section 37.  Subsections (13) of section 499.007,

24  Florida Statutes, is amended to read:

25         499.007  Misbranded drug or device.--A drug or device

26  is misbranded:

27         (13)  If it is a drug that is subject to paragraph

28  (12)(a), and if, at any time before it is dispensed, its label

29  fails to bear the statement:

30

31

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  1         (a)  "Caution:  Federal Law Prohibits Dispensing

  2  Without Prescription"; "Rx Only" or the prescription symbol

  3  followed by the word "Only"; or

  4         (b)  "Caution:  State Law Prohibits Dispensing Without

  5  Prescription."

  6

  7  A drug dispensed by filling or refilling a written or oral

  8  prescription of a practitioner licensed by law to prescribe

  9  such drug is exempt from the requirements of this section,

10  except subsections (1), (8), (10), and (11) and the packaging

11  requirements of subsections (6) and (7), if the drug bears a

12  label that contains the name and address of the dispenser or

13  seller, the prescription number and the date the prescription

14  was written or filled, the name of the prescriber and the name

15  of the patient, and the directions for use and cautionary

16  statements.  This exemption does not apply to any drug

17  dispensed in the course of the conduct of a business of

18  dispensing drugs pursuant to diagnosis by mail or to any drug

19  dispensed in violation of subsection (12).  The department

20  may, by rule, exempt drugs subject to ss. 499.062-499.064 from

21  subsection (12) if compliance with that subsection is not

22  necessary to protect the public health, safety, and welfare.

23         Section 38.  Subsection (15) of section 499.028,

24  Florida Statutes, is amended to read:

25         499.028  Drug samples or complimentary drugs; starter

26  packs; permits to distribute.--

27         (15)  A person may not possess a prescription drug

28  sample unless:

29         (a)  The drug sample was prescribed to her or him as

30  evidenced by the label required in s. 465.0276(5).

31

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  1         (b)  She or he is the employee of a complimentary drug

  2  distributor that holds a permit issued under ss.

  3  499.001-499.081.

  4         (c)  She or he is a person to whom prescription drug

  5  samples may be distributed pursuant to this section.

  6         (d)  She or he is an officer or employee of a federal,

  7  state, or local government acting within the scope of

  8  employment.

  9         Section 39.  Subsection (1) of section 499.066, Florida

10  Statutes, is amended to read:

11         499.066  Penalties; remedies.--In addition to other

12  penalties and other enforcement provisions:

13         (1)  When the department believes that any person has

14  violated ss. 499.001-499.081 or any rules adopted pursuant to

15  those sections, it may issue and deliver an order to cease and

16  desist from such violation. A cease and desist order issued

17  pursuant to this subsection shall take effect immediately upon

18  issuance and shall remain in effect until the department takes

19  final agency action. A cease and desist order shall be

20  reviewable at the request of the person to whom it is directed

21  as follows:

22         (a)  If formal proceedings have been requested and the

23  matter has been referred to the Division of Administrative

24  Hearings, a motion to abate or modify the cease and desist

25  order may be filed with the division. Any interlocutory order

26  of the presiding administrative law judge shall be binding on

27  the parties until final agency action is taken by the

28  department.

29         (b)  If informal proceedings have been requested, the

30  department may consider and determine a request from the

31  affected person to abate or modify the cease and desist order.

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  1         (c)  If a person is aggrieved by a cease and desist

  2  order after seeking to have the order abated or modified

  3  pursuant to paragraph (a) or paragraph (b), the person may

  4  seek interlocutory judicial review by the appropriate district

  5  court of appeal pursuant to the applicable rules of appellate

  6  procedure.

  7         Section 40.  Subsection (1) of section 499.069, Florida

  8  Statutes, is amended to read:

  9         499.069  Punishment for violations of s. 499.005;

10  dissemination of false advertisement.--

11         (1)  Any person who violates any of the provisions of

12  s. 499.005 is guilty of a misdemeanor of the second degree,

13  punishable as provided in s. 775.082 or s. 775.083; but, if

14  the violation is committed after a conviction of such person

15  under this section has become final, such person is guilty of

16  a misdemeanor of the first degree, punishable as provided in

17  s. 775.082 or s. 775.083 or as otherwise provided in ss.

18  499.001-499.081, except that any person who violates

19  subsection (8), subsection (10), subsection (14), subsection

20  (15), subsection (16), or subsection (17) of s. 499.005 is

21  guilty of a felony of the third degree, punishable as provided

22  in s. 775.082, s. 775.083, or s. 775.084, or as otherwise

23  provided in ss. 499.001-499.081.

24         Section 41.  Subsection (1) of section 742.10, Florida

25  Statutes, is amended to read:

26         742.10  Establishment of paternity for children born

27  out of wedlock.--

28         (1)  This chapter provides the primary jurisdiction and

29  procedures for the determination of paternity for children

30  born out of wedlock. When the establishment of paternity has

31  been raised and determined within an adjudicatory hearing

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  1  brought under the statutes governing inheritance, or

  2  dependency under workers' compensation or similar compensation

  3  programs, or when an affidavit acknowledging paternity or a

  4  stipulation of paternity is executed by both parties and filed

  5  with the clerk of the court, or when a consenting affidavit as

  6  provided for in s. 382.013 or s. 382.016 s. 382.015 is

  7  executed by both parties, it shall constitute the

  8  establishment of paternity for purposes of this chapter. If no

  9  adjudicatory proceeding was held, a voluntary acknowledgment

10  of paternity shall create a rebuttable presumption, as defined

11  by s. 90.304, of paternity and is subject to the right of any

12  signatory to rescind the acknowledgment within 60 days of the

13  date the acknowledgment was signed or the date of an

14  administrative or judicial proceeding relating to the child,

15  including a proceeding to establish a support order, in which

16  the signatory is a party, whichever is earlier.  Both parents

17  are required to provide their social security numbers on any

18  acknowledgment of paternity, consent affidavit, or stipulation

19  of paternity. Except for consenting affidavits under seal

20  pursuant to ss. s. 382.015 and 382.016, the Office of Vital

21  Statistics shall provide certified copies of affidavits to the

22  Title IV-D agency upon request.

23         Section 42.  The building that is known as the 1911

24  State Board of Health Building, which is part of a

25  multibuilding complex with the address of 1217 Pearl Street,

26  Jacksonville, Florida, shall be known as the Wilson T. Sowder,

27  M.D., Building.

28         Section 43.  The building authorized by chapter 98-307,

29  Laws of Florida, that will be located on Seagrape Drive on the

30  Tampa Campus of the University of South Florida, which will

31

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  1  house laboratory facilities for the Department of Health,

  2  shall be known as the William G. "Doc" Myers, M.D., Building.

  3         Section 44.  The Department of Health headquarters

  4  building that will comprise approximately 100,000 square feet

  5  that is authorized by item 1986 in the 1998-1999

  6  Appropriations Act shall be known as the E. Charlton Prather,

  7  M.D., Building.

  8         Section 45.  Subsection (3) of section 381.731, Florida

  9  Statutes, 1998 Supplement, as transferred from section

10  408.601, Florida Statutes, by chapter 98-224, Laws of Florida,

11  is repealed.

12         Section 46.  Subsection (5) of section 383.307, Florida

13  Statutes, is repealed.

14         Section 47.  Subsection (7) of section 404.20, Florida

15  Statutes, is repealed.

16         Section 48.  Section 409.9125, Florida Statutes, is

17  repealed.

18         Section 49.  This act shall take effect July 1, 1999.

19

20

21

22

23

24

25

26

27

28

29

30

31

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  1            *****************************************

  2                          HOUSE SUMMARY

  3
      Revises provisions of law relating to the Department of
  4    Health to:
           1.  Provide for additional divisions within the
  5    department and to provide that the department may use
      state or federal funds for described purposes to protect
  6    and improve the public health.
           2.  Revise provisions throughout the affected
  7    provisions of the Florida Statutes to conform to federal
      law and to conform titles relating to the Children's
  8    Medical Services.
           3.  Clarify terms, delete obsolete language, and
  9    conform the statutes to terminology and titles in current
      usage.
10         4.  Provide the department with contract authority
      for described administrative hearings.
11         5.  Provide requirements for provider contracts and
      to provide authority to purchase described automotive
12    equipment.
           6.  Revise language with respect to alligator
13    management and trapping.
           7.  Revise requirements relating to HIV test on
14    deceased persons.
           8.  Revise the rulemaking authority of the
15    department and to provide for the inspection of certain
      group care facilities under the environmental health
16    program.
           9.  Provide the department with authority to impose
17    described fines.
           10.  Clarify differences in regulatory requirements
18    for drinking water systems.
           11.  Revise membership and duties of the Health
19    Information Systems Council.
           12.  Provide requirements relating to birth
20    registrations.
           13.  Provide described administrative procedures for
21    acknowledging paternity.
           14.  Provide requirements and membership for the
22    Diabetes Advisory Council.
           15.  Provide the Director of Children's Medical
23    Services with described appointment authority.
           16.  Provide requirements for benefits to children
24    with special health care needs.
           17.  Authorize the department to use described
25    excess money for improvements to facilities and to
      establish an advisory board for the A.G. Holley State
26    Hospital.
           18.  Revise date requirements for described
27    capitation payments to Children's Medical Services.
           19.  Authorize described nursing homes to purchase
28    medical oxygen.
           20.  Clarify language with respect to prohibitions
29    relating to sales of prescription drugs and legend
      devices.
30         21.  Authorize described federal, state, or local
      government employees to possess drug samples.
31         22.  Provide for the immediate effect of described
      cease and desist orders.
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CODING: Words stricken are deletions; words underlined are additions.






    Florida House of Representatives - 1999                HB 2125

    169-434-99






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