House Bill 2125e1

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                                          HB 2125, First Engrossed



  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. 110.205, F.S.;

10         conforming language relating to exempt

11         positions with respect to the career service;

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

13         department with contract authority for certain

14         administrative hearings; amending s. 154.504,

15         F.S.; providing requirements for provider

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

17         certain authority to purchase automotive

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

19         responsibility regarding alligator management

20         and trapping from the Department of Health and

21         Rehabilitative Services; amending s. 381.0022,

22         F.S.; allowing the department to share certain

23         confidential information relating to Medicaid

24         recipients for certain payment purposes;

25         amending s. 381.004, F.S.; revising

26         requirements relating to HIV tests on deceased

27         persons; amending s. 381.0051, F.S.; providing

28         the department with certain rulemaking

29         authority; amending s. 381.006, F.S.; providing

30         the department with rulemaking authority

31         relating to inspection of certain group care


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                                          HB 2125, First Engrossed



  1         facilities under the environmental health

  2         program; amending s. 381.0061, F.S.; providing

  3         the department with authority to impose certain

  4         fines; amending s. 381.0062, F.S.; revising

  5         definitions to clarify differences in

  6         regulatory requirements for drinking water

  7         systems; amending s. 381.90, F.S.; revising

  8         membership and duties of the Health Information

  9         Systems Council; requiring a report; amending

10         s. 382.003, F.S.; removing unnecessary

11         language; providing for certain rules; amending

12         s. 382.004, F.S.; revising language with

13         respect to reproduction and destruction of

14         certain records; amending s. 382.008, F.S.;

15         removing language conflicting with federal law;

16         amending s. 382.013, F.S.; providing certain

17         requirements relating to birth registration;

18         amending s. 382.015, F.S.; providing for

19         technical changes with respect to certificates

20         of live birth; amending s. 382.016, F.S.;

21         providing for administrative procedures for

22         acknowledging paternity; amending s. 382.019,

23         F.S.; establishing certain requirements and

24         rulemaking authority for registration; amending

25         s. 382.025, F.S.; setting requirements for

26         certain data; amending s. 382.0255, F.S.;

27         revising requirements for fee transfer;

28         amending s. 383.011, F.S.; clarifying

29         Department of Health rulemaking authority

30         relating to the Child Care Food Program;

31         amending s. 383.14, F.S.; correcting the name


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                                          HB 2125, First Engrossed



  1         of the WIC program to conform to federal law;

  2         amending s. 385.202, F.S.; removing certain

  3         department reimbursement requirements; amending

  4         s. 385.203, F.S.; revising requirements and

  5         membership for the Diabetes Advisory Council;

  6         amending s. 391.021, F.S.; conforming

  7         references to Children's Medical Services;

  8         amending s. 391.028, F.S.; providing the

  9         Director of Children's Medical Services with

10         certain appointment authority; amending s.

11         391.0315, F.S.; providing requirements for

12         benefits to children with special health care

13         needs; amending ss. 391.221, 391.222, and

14         391.223, F.S.; conforming references to

15         Children's Medical Services; amending s.

16         392.69, F.S.; authorizing the department to use

17         certain excess money for improvements to

18         facilities and establishing an advisory board

19         for the A.G. Holley State Hospital; amending s.

20         409.912, F.S.; requiring the Agency for Health

21         Care Administration to enter into certain

22         agreements; amending s. 409.9126, F.S.;

23         revising date requirements for certain

24         capitation payments to Children's Medical

25         Services; amending s. 455.564, F.S.;

26         authorizing certain boards to require

27         continuing education hours in certain areas;

28         providing construction; authorizing certain

29         boards within the Division of Medical Quality

30         Assurance to adopt rules granting continuing

31         education hours for certain activities;


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                                          HB 2125, First Engrossed



  1         amending s. 455.5651, F.S.; prohibiting certain

  2         information from being included in practitioner

  3         profiles; amending s. 465.019, F.S.;

  4         authorizing certain nursing homes to purchase

  5         medical oxygen; amending ss. 468.304 and

  6         468.306, F.S.; permitting the department to

  7         increase certain examination costs; amending s.

  8         468.309, F.S.; providing the department with

  9         rulemaking authority for establishing

10         expirations for radiologic technologist's

11         certificates; amending s. 499.005, F.S.;

12         requiring and clarifying certain prohibitions

13         relating to sales of prescription drugs and

14         legend devices; amending s. 499.007, F.S.;

15         conforming prescription statement requirements

16         to federal language; amending s. 499.028, F.S.;

17         authorizing certain federal, state, or local

18         government employees to possess drug samples;

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

20         immediate effect of certain cease and desist

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

22         conforming cross references; naming the Wilson

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

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

25         Prather, M.D., Building; directing the

26         Department of Children and Family Services and

27         the Agency for Health Care Administration to

28         develop a system for newborn Medicaid

29         identification; repealing s. 381.731(3), F.S.,

30         relating to submission of the Healthy

31         Communities, Healthy People Plan; repealing s.


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                                          HB 2125, First Engrossed



  1         383.307(5), F.S., relating to consultations

  2         between birth centers and the Department of

  3         Health; repealing s. 404.20(7), F.S., relating

  4         to obsolete radioactive monitoring systems;

  5         repealing s. 409.9125, F.S., relating to

  6         Medicaid alternative service networks;

  7         authorizing the Department of Health to become

  8         an accrediting authority for environmental

  9         laboratory standards; providing intent and

10         rulemaking authority for the department to

11         implement standards of the National

12         Environmental Laboratory Accreditation Program;

13         providing an effective date.

14

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

16

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

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

19  Supplement, are amended to read:

20         20.43  Department of Health.--There is created a

21  Department of Health.

22         (3)  The following divisions of the Department of

23  Health are established:

24         (a)  Division of Administration.

25         (b)  Division of Environmental Health.

26         (c)  Division of Disease Control.

27         (d)  Division of Family Health Services.

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

29         (f)  Division of Emergency Medical Services and

30  Community Health Resources Local Health Planning, Education,

31  and Workforce Development.


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                                          HB 2125, First Engrossed



  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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                                          HB 2125, First Engrossed



  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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                                          HB 2125, First Engrossed



  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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                                          HB 2125, First Engrossed



  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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                                          HB 2125, First Engrossed



  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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                                          HB 2125, First Engrossed



  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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                                          HB 2125, First Engrossed



  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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                                          HB 2125, First Engrossed



  1  and Family Services, shall avoid duplicating the provision of

  2  those services.

  3         Section 3.  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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                                          HB 2125, First Engrossed



  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 department shall

13  establish the salary range and benefits for these positions in

14  accordance with the rules of the Selected Exempt Service.

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

16  established within the Department of Business and Professional

17  Regulation and the Department of Health. Unless otherwise

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

19  benefits for these positions in accordance with the rules

20  established for the Selected Exempt Service.

21         Section 4.  Subsection (15) of section 120.80, Florida

22  Statutes, 1998 Supplement, is amended to read:

23         120.80  Exceptions and special requirements;

24  agencies.--

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

26  120.57(1)(a), formal hearings may not be conducted by the

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

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

29  the Department of Health or the Agency for Health Care

30  Administration for matters relating to the regulation of

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


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                                          HB 2125, First Engrossed



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

  2  Department of Health in the execution of the Special

  3  Supplemental Nutrition Program for Women, Infants, and

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

  5  program; and the exemption from disqualification reviews for

  6  the certified nursing assistants program need not be conducted

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

  8  Department of Health may contract with the Department of

  9  Children and Family Services for a hearing officer in these

10  matters.

11         Section 5.  Subsection (1) of section 154.504, Florida

12  Statutes, 1998 Supplement, is amended to read:

13         154.504  Eligibility and benefits.--

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

15  care for children and families challenge grant to provide

16  primary health care services to children and families with

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

18  Participants shall pay no monthly premium for participation,

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

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

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

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

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

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

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

26  health care providers, and all funds generated from copayments

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

28  provisions in s. 766.1115 are met.

29         Section 6.  Subsection (3) is added to section 287.155,

30  Florida Statutes, to read:

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                                          HB 2125, First Engrossed



  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 7.  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 8.  Section 381.0022, Florida Statutes, 1998

21  Supplement, is amended to read:

22         381.0022  Sharing confidential or exempt information.--

23         (1)  Notwithstanding any other provision of law to the

24  contrary, the Department of Health and the Department of

25  Children and Family Services may share confidential

26  information or information exempt from disclosure under

27  chapter 119 on any individual who is or has been the subject

28  of a program within the jurisdiction of each agency.

29  Information so exchanged remains confidential or exempt as

30  provided by law.

31


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                                          HB 2125, First Engrossed



  1         (2)  Notwithstanding any other provision of law to the

  2  contrary, the Department of Health may share confidential

  3  information or information exempt from disclosure under

  4  chapter 119 on any individual who is or has been a Medicaid

  5  recipient and is or was the subject of a program within the

  6  jurisdiction of the Department of Health for the purpose of

  7  requesting, receiving, or auditing payment for services.

  8  Information so exchanged remains confidential or exempt as

  9  provided by law.

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

11  section 381.004, Florida Statutes, 1998 Supplement, are

12  amended to read:

13         381.004  Testing for human immunodeficiency virus.--

14         (3)  HUMAN IMMUNODEFICIENCY VIRUS TESTING; INFORMED

15  CONSENT; RESULTS; COUNSELING; CONFIDENTIALITY.--

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

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

18  without corroborating or confirmatory tests being conducted

19  except in the following situations:

20         1.  Preliminary test results may be released to

21  licensed physicians or the medical or nonmedical personnel

22  subject to the significant exposure for purposes of

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

24         2.  Preliminary test results may be released to health

25  care providers and to the person tested when decisions about

26  medical care or treatment of the person tested cannot await

27  the results of confirmatory testing.  Positive preliminary HIV

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

29  diagnosis of HIV infection.  Justification for the use of

30  preliminary test results must be documented in the medical

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


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                                          HB 2125, First Engrossed



  1  subparagraph does not authorize the release of preliminary

  2  test results for the purpose of routine identification of

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

  4  the preliminary diagnosis or care of a patient.  Corroborating

  5  or confirmatory testing must be conducted as followup to a

  6  positive preliminary test.  Results shall be communicated to

  7  the patient according to statute regardless of the outcome.

  8  Except as provided in this section, test results are

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

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

11  informed consent is not required:

12         1.  When testing for sexually transmissible diseases is

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

14  following situations:

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

16  convicted of prostitution or of procuring another to commit

17  prostitution.

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

19  with s. 406.11.

20         2.  Those exceptions provided for blood, plasma,

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

22  381.0041.

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

24  licensed medical personnel in bona fide medical emergencies

25  when the test results are necessary for medical diagnostic

26  purposes to provide appropriate emergency care or treatment to

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

28  as supported by documentation in the medical record.

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

30  is required.

31


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                                          HB 2125, First Engrossed



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

  2  licensed medical personnel for medical diagnosis of acute

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

  4  obtaining informed consent would be detrimental to the

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

  6  and the test results are necessary for medical diagnostic

  7  purposes to provide appropriate care or treatment to the

  8  person being tested. Notification of test results in

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

10  detrimental to the patient.  This subparagraph does not

11  authorize the routine testing of patients for HIV infection

12  without informed consent.

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

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

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

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

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

18  defendant voluntarily, pursuant to court order for any

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

20  951.27, or s. 960.003; however, the results of any HIV test

21  performed shall be disclosed solely to the victim and the

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

23  960.003.

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

25         8.  For epidemiological research pursuant to s.

26  381.0032, for research consistent with institutional review

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

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

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

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

31  researcher.


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                                          HB 2125, First Engrossed



  1         9.  When human tissue is collected lawfully without the

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

  3  732.9185 or enucleation of the eyes as authorized by s.

  4  732.919.

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

  6  individual who comes into contact with medical personnel in

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

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

  9  a blood sample is available that was taken from that

10  individual voluntarily by medical personnel for other

11  purposes.  "Medical personnel" includes a licensed or

12  certified health care professional; an employee of a health

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

14  paramedic or emergency medical technician as defined in s.

15  401.23.

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

17  voluntarily obtained blood sample, the individual from whom

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

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

20  The individual's refusal to consent and all information

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

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

23  record unless the individual gives written consent to entering

24  this information on the individual's medical record.

25         b.  Reasonable attempts to locate the individual and to

26  obtain consent shall be made and all attempts must be

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

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

29  does not voluntarily consent to the performance of an HIV

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

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


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                                          HB 2125, First Engrossed



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

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

  3  the medical personnel, that there has been a significant

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

  5  information is medically necessary to determine the course of

  6  treatment for the medical personnel.

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

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

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

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

11  testing or treatment not directly related to the initial HIV

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

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

14  personnel.

15         d.  In order to utilize the provisions of this

16  subparagraph, the medical personnel must either be tested for

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

18  test taken within 6 months prior to the significant exposure

19  if such test results are negative.

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

21  pursuant to this subparagraph shall maintain the

22  confidentiality of the information received and of the persons

23  tested.  Such confidential information is exempt from s.

24  119.07(1).

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

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

27  medical personnel or the employer of such person acting on

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

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

30  statement by a physician licensed under chapter 458 or chapter

31  459 that a significant exposure has occurred and that, in the


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                                          HB 2125, First Engrossed



  1  physician's medical judgment, testing is medically necessary

  2  to determine the course of treatment constitutes probable

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

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

  5  and to the person who experienced the exposure.

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

  7  individual who comes into contact with medical personnel in

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

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

10  medical personnel while the medical personnel provides

11  emergency medical treatment to the individual; or who comes

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

13  significant exposure has occurred while the nonmedical

14  personnel provides emergency medical assistance during a

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

16  medical emergency means an emergency medical condition outside

17  of a hospital or health care facility that provides physician

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

19  treatment for the medical emergency.

20         a.  An individual who is capable of providing consent

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

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

23  information concerning the performance of an HIV test and its

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

25  record unless the individual gives written consent to entering

26  this information on the individual's medical record.

27         b.  HIV testing shall be conducted only after a

28  licensed physician documents, in the medical record of the

29  medical personnel or nonmedical personnel, that there has been

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

31  judgment, the information is medically necessary to determine


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                                          HB 2125, First Engrossed



  1  the course of treatment for the medical personnel or

  2  nonmedical personnel.

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

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

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

  6  medical personnel or nonmedical personnel. However, costs of

  7  testing or treatment not directly related to the initial HIV

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

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

10  personnel or nonmedical personnel.

11         d.  In order to utilize the provisions of this

12  subparagraph, the medical personnel or nonmedical personnel

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

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

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

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

17  pursuant to this subparagraph shall maintain the

18  confidentiality of the information received and of the persons

19  tested.  Such confidential information is exempt from s.

20  119.07(1).

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

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

23  during treatment for the medical emergency, the medical

24  personnel, the employer of the medical personnel acting on

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

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

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

28  chapter 458 or chapter 459 that a significant exposure has

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

30  testing is medically necessary to determine the course of

31  treatment constitutes probable cause for the issuance of an


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                                          HB 2125, First Engrossed



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

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

  3  experienced the exposure.

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

  5  examiner or attending physician upon an a deceased individual

  6  who is the source of a significant exposure to medical

  7  personnel or nonmedical personnel who provided emergency

  8  medical assistance and who expired or could not be

  9  resuscitated while receiving during treatment for the medical

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

11  a significant exposure to medical or nonmedical personnel

12  providing such assistance or care.

13         a.  HIV testing shall be conducted only after a

14  licensed physician documents in the medical record of the

15  medical personnel or nonmedical personnel that there has been

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

17  judgment, the information is medically necessary to determine

18  the course of treatment for the medical or nonmedical

19  personnel.

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

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

22  deceased person's family.

23         c.  For the provisions of this subparagraph to be

24  applicable, 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         d.  A person who receives the results of an HIV test

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

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

31  medically indicated by licensed medical personnel for medical


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                                          HB 2125, First Engrossed



  1  diagnosis of a hospitalized infant as necessary to provide

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

  3  reasonable attempt, a parent cannot be contacted to provide

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

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

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

  7  located.

  8         14.  For the performance of HIV testing conducted to

  9  monitor the clinical progress of a patient previously

10  diagnosed to be HIV positive.

11         15.  For the performance of repeated HIV testing

12  conducted to monitor possible conversion from a significant

13  exposure.

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

15  381.0051, Florida Statutes, to read:

16         381.0051  Family planning.--

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

18  120.54 and 120.536(1) to implement this section.

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

20  381.006, Florida Statutes, 1998 Supplement, to read:

21         381.006  Environmental health.--The department shall

22  conduct an environmental health program as part of fulfilling

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

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

25  factors in the environment.  The environmental health program

26  shall include, but not be limited to:

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

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

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

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

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


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                                          HB 2125, First Engrossed



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

  2  protection, and supervision to persons who require such

  3  services and who are not related to the owner or

  4  administrator. The department may adopt rules necessary to

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

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

  7  family day care homes, assisted living facilities, adult day

  8  care centers, adult family-care homes, hospice, residential

  9  treatment facilities, crisis stabilization units, pediatric

10  extended care centers, intermediate care facilities for the

11  developmentally disabled, group care homes, and, jointly with

12  the Department of Education, private and public schools. These

13  rules may include provisions relating to operation and

14  maintenance of facilities, buildings, grounds, equipment, and

15  furnishings; occupant space requirements; lighting; heating,

16  cooling, and ventilation; water supply; plumbing; sewage;

17  sanitary facilities; insect and rodent control; garbage;

18  safety; personnel health, hygiene, and work practices; and

19  such other matters as the department finds to be appropriate

20  or necessary to protect the safety and health of the

21  residents, staff, or patrons. The department may not adopt

22  rules which conflict with rules adopted by the licensing or

23  certifying agency. The department may enter and inspect at

24  reasonable hours to determine compliance with applicable

25  statutes or rules. In addition to any sanctions which the

26  department may impose for violations of rules adopted under

27  this section, the department shall also report such violations

28  to any agency responsible for licensing or certifying the

29  group care facility. The licensing or certifying agency is

30  also authorized to impose any sanction based solely on the

31  findings of the department.


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                                          HB 2125, First Engrossed



  1

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

  3  this section.

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

  5  Florida Statutes, is amended to read:

  6         381.0061  Administrative fines.--

  7         (1)  In addition to any administrative action

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

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

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

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

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

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

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

15  violator.  Each day that a violation continues may constitute

16  a separate violation.

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

18  section 381.0062, Florida Statutes, 1998 Supplement, are

19  amended to read:

20         381.0062  Supervision; private and certain public water

21  systems.--

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

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

24  chemical, or radiological substance or matter in water.

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

26  including the county health departments.

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

28  chapter 403.

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

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

31


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                                          HB 2125, First Engrossed



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

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

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

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

  5  Safe Drinking Water Act, which serves one or more

  6  nonresidential establishments and provides piped water.

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

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

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

10  residences or two or more rental residences, and provides

11  piped water.

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

13  permissible level of a contaminant in potable water delivered

14  to consumers.

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

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

17  which may be a rental residence.

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

19  corporation, company, association, partnership, municipality,

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

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

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

23  satisfactory for human consumption, dermal contact, culinary

24  purposes, or dishwashing as approved by the department.

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

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

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

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

29  Safe Drinking Water Act no more than four nonrental

30  residences.

31


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                                          HB 2125, First Engrossed



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

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

  3  than cleaning work areas or simple handwashing.  Examples of

  4  public consumption include, when making food or beverages

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

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

  7  preparing food or beverages; washing surfaces accessed by

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

  9  medical instruments or surfaces accessed by a patient; any

10  water usage in health care facilities; emergency washing

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

12  plants or establishments like slaughterhouses and

13  packinghouses; and water used in schools.

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

15  is not included or covered under the Florida Safe Drinking

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

17  private or multifamily water system. For purposes of this

18  section, public water systems are classified as limited use

19  community or limited use commercial.

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

21  or corporation that owns or operates a limited use community

22  or limited use commercial public water system, a multifamily

23  water system, or a private water system.

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

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

26  maximum contaminant level violation caused by the raw water or

27  to deviate from construction standards established by rule of

28  the department.

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

30  have general supervision and control over all private water

31  systems, multifamily water systems, and public water systems


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                                          HB 2125, First Engrossed



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

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

  3  water supply program for which it has the duties and

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

  5  department shall:

  6         (a)  Administer and enforce the provisions of this

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

  8  section, including water quality and monitoring standards.

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

10  or operate a limited use community or limited use commercial

11  public water system or a multifamily private water system to

12  first make application to and obtain approval from the

13  department on forms adopted by rule of the department.

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

15  construction, modification, operation, or change of ownership

16  of, and conduct surveillance, enforcement, and compliance

17  investigations of, limited use community and limited use

18  commercial public water systems, and multifamily private water

19  systems.

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

21  amount sufficient to cover the costs of reviewing and acting

22  upon any application for the construction, modification, or

23  operation of a limited use community and limited use

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

25  than $90 annually.

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

27  amount sufficient to cover the costs of reviewing and acting

28  upon any application for the construction or change of

29  ownership of a multifamily private water system serving more

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

31


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                                          HB 2125, First Engrossed



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

  2  amount sufficient to cover the costs of sample collection,

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

  4  coordination with other agencies when such work is not

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

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

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

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

  9  drinking water laboratory for contaminant analysis, and to

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

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

12  accordance with the provisions of this section to be deposited

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

14  exclusively for the payment of costs incurred in the

15  administration of this section.

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

17  or otherwise, introducing any contaminant which poses a health

18  hazard into a drinking water system.

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

20  of water problems and corrective measures under the conditions

21  specified by rule of the department.

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

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

24  than $25 or more than $40.

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

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

27  they have reasonable cause to believe a violation of this

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

29  of the premises of such limited use public and multifamily

30  private drinking water systems serving more than one

31  residence, to make an examination and investigation to


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                                          HB 2125, First Engrossed



  1  determine the sanitary and safety conditions of such systems.

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

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

  4  duties pursuant to the provisions of this section is subject

  5  to the penalties provided in s. 381.0025.

  6         (5)  ENFORCEMENT AND PENALTIES.--

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

  8  limited use community or limited use commercial public water

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

10  first complying with the requirements of this section, who

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

12  who maintains or operates a water system after revocation of

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

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

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

16  section may be enforced by injunction or restraining order

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

18         (c)  Additional remedies available to county health

19  department staff through any county or municipal ordinance may

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

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

22  pursuant to this section.

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

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

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

26  added to said subsection, to read:

27         381.90  Health Information Systems Council; legislative

28  intent; creation, appointment, duties.--

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

30  members or their senior executive-level designees:

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


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                                          HB 2125, First Engrossed



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

  2  Professional Regulation;

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

  4  Family Services;

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

  6  Administration;

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

  8         (f)  The Attorney General;

  9         (g)  The executive director of the Correctional Medical

10  Authority;

11         (h)  Two members representing county health

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

13  county, appointed by the Governor; and

14         (i)  A representative from the Florida Association of

15  Counties;.

16         (j)  The State Treasurer/Insurance Commissioner;

17         (k)  A representative from the Florida Healthy Kids

18  Corporation;

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

20  chosen by the Board of Regents;

21         (m)  The Commissioner of Education;

22         (n)  The secretary of the Department of Elderly

23  Affairs; and

24         (o)  The secretary of the Department of Juvenile

25  Justice.

26

27  Representatives of the Federal Government may serve without

28  voting rights.

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

30  but are not limited to, the following:

31


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                                          HB 2125, First Engrossed



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

  2  planning among agencies that collect or maintain

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

  4  implementation of this requirement to the Executive Office of

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

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

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

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

  9  said section, to read:

10         382.003  Powers and duties of the department.--The

11  department may:

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

13  for the creation, issuance, recording, rescinding,

14  maintenance, and processing of vital records and for carrying

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

16  382.016-382.019.

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

18  information submitted to the department in anticipation of the

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

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

21  Statutes, is amended to read:

22         382.004  Reproduction and destruction of records.--

23         (3)  Photographs, microphotographs, or reproductions of

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

25  produced certifications made in compliance with the provisions

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

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

28  treated as originals for the purpose of their admissibility in

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

30  courts and cases of the facts stated therein.

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                                          HB 2125, First Engrossed



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

  2  Statutes, 1998 Supplement, is amended to read:

  3         382.008  Death and fetal death registration.--

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

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

  6  the department with the local registrar of the district in

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

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

  9  registrar if it has been completed and filed in accordance

10  with this chapter or adopted rules. The certificate shall

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

12  Disclosure of social security numbers obtained through this

13  requirement shall be limited to the purpose of administration

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

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

16  death or fetal death:

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

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

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

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

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

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

23  the certificate and shall be considered part of the official

24  record of death;

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

26  registered in the registration district in which the dead body

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

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

29  registered in the registration district in which the dead body

30  was first removed from such conveyance.

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                                          HB 2125, First Engrossed



  1         Section 18.  Section 382.013, Florida Statutes, 1998

  2  Supplement, is amended to read:

  3         382.013  Birth registration.--A certificate for each

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

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

  6  in which the birth occurred and shall be registered by the

  7  local registrar if the certificate has been completed and

  8  filed in accordance with this chapter and adopted rules. The

  9  information regarding registered births shall be used for

10  comparison with information in the state case registry, as

11  defined in chapter 61.

12         (1)  FILING.--

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

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

15  charge of the facility shall be responsible for preparing the

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

17  certificate with the local registrar.  Within 48 hours after

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

19  during or immediately after the delivery shall provide the

20  facility with the medical information required by the birth

21  certificate.

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

23  licensed physician, certified nurse midwife, Florida licensed

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

25  was in attendance during or immediately after the delivery,

26  then such individual shall prepare and file the certificate.

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

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

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

30         1.  The physician or midwife in attendance during or

31  immediately after the birth.


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                                          HB 2125, First Engrossed



  1         2.  In the absence of persons described in subparagraph

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

  3  the birth.

  4         3.  In the absence of persons described in subparagraph

  5  2., the father or mother.

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

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

  8  birth occurred.

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

10  delivery is not attended by one of the individuals described

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

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

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

14  require that such documents be presented and such proof be

15  filed as it deems necessary and sufficient to establish the

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

17  withhold registering the birth until its requirements are met.

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

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

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

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

22  the place of birth.

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

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

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

26  timely registration of the certificate.

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

28  the local registrar shall immediately notify the health care

29  facility or person filing the certificate and shall require

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

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                                          HB 2125, First Engrossed



  1  be obtained prior to issuing certified copies of the birth

  2  certificate.

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

  4  adoption after birth, the information on the birth certificate

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

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

  7  is made under s. 63.152.

  8         (2)  PATERNITY.--

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

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

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

12  determined otherwise by a court of competent jurisdiction.

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

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

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

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

17  unless paternity has been determined otherwise by a court of

18  competent jurisdiction.

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

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

21  certificate without the execution of a consenting affidavit

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

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

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

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

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

27  status, and responsibilities that arise from signing an

28  acknowledgment of paternity, the facility shall provide the

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

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

31  agency established pursuant to s. 409.2557, regarding the


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                                          HB 2125, First Engrossed



  1  benefits of voluntary establishment of paternity. Upon request

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

  3  facility shall assist in the execution of the affidavit.

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

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

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

  7  entered on the certificate in accordance with the finding and

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

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

10  subsection (3).

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

12  other information about the father shall be entered on the

13  certificate.

14         (3)  NAME OF CHILD.--

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

16  mother and father whose names are entered on the birth

17  certificate shall select the given names and surname of the

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

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

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

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

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

23  selected by the father and the surname selected by the mother

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

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

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

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

28  agreement that lists the agreed upon given name and is

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

30  until a given name is selected by a court.

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                                          HB 2125, First Engrossed



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

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

  3  child's given name and surname.

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

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

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

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

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

  9  of a child of undetermined parentage shall register a birth

10  certificate shall be registered for every child of

11  undetermined parentage showing all known or approximate facts

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

13  information concerning the place and circumstances under which

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

15  birth certificate relating to marital status and medical

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

17  satisfaction of the department, a new birth certificate shall

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

19  birth certificate, and the original certificate shall be

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

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

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

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

24  registrant if of legal age.

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

26  birth shall contain all the information required by the

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

28  However, all information concerning parentage, marital status,

29  and medical details shall be confidential and exempt from the

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

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                                          HB 2125, First Engrossed



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

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

  3         Section 19.  Section 382.015, Florida Statutes, is

  4  amended to read:

  5         382.015  New certificates of live birth; duty of clerks

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

  7  proceeding for adoption, annulment of an adoption, affirmation

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

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

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

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

12  form to be furnished by the department, together with

13  sufficient information to identify the original birth

14  certificate and to enable the preparation of a new birth

15  certificate.

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

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

18  adoption decree, together with the information necessary to

19  identify the original certificate of live birth, and establish

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

21  birth certificate, absent objection by the court decreeing the

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

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

24  original birth certificate.  All names and identifying

25  information relating to the adoptive parents entered on the

26  new certificate shall refer to the adoptive parents, but

27  nothing in the certificate shall refer to or designate the

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

29  adoption shall be copied as on the original certificate,

30  including the date of registration and filing.

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                                          HB 2125, First Engrossed



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

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

  3  information to identify the original certificate of live

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

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

  6  certificate and restore the original certificate to its

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

  8  shall be sealed by the department.

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

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

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

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

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

14  of the report or decree to the appropriate birth registration

15  authority in Canada.

16         (2)  DETERMINATION OF PATERNITY.--

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

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

19  request and receipt of a consenting affidavit signed by both

20  parents acknowledging the paternity of the registrant,

21  together with sufficient information to identify the original

22  certificate of live birth, the department shall prepare and

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

24  number as the original birth certificate.  If paternity has

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

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

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

28  the original birth certificate at the request of the parents

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

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

31  the registrant's birth.


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                                          HB 2125, First Engrossed



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

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

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

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

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

  6  of birth.

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

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

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

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

11  included in the court order determining paternity or the name

12  must be changed pursuant to s. 68.07.

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

14  an order of affirmation of parental status issued pursuant to

15  s. 742.16, together with sufficient information to identify

16  the original certificate of live birth, the department shall

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

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

19  and identifying information of the registrant's parents

20  entered on the new certificate shall be the commissioning

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

22  designate the parents as the commissioning couple.

23         (4)  SUBSTITUTION OF NEW CERTIFICATE OF BIRTH FOR

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

25  department shall substitute the new certificate of birth for

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

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

28  or other state custodian of vital records shall be forwarded

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

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

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


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                                          HB 2125, First Engrossed



  1  portion thereof, except when a court order requires issuance

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

  3  an adoption, change in paternity, affirmation of parental

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

  5  the department shall place the original certificate of birth

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

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

  8  otherwise provided by law.

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

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

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

12  382.019 and 382.0195, all original, new, or amended

13  certificates of live birth shall be identical in form,

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

15  that the registrant is adopted or of undetermined parentage.

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

17  rules necessary for carrying out the provisions of this

18  section.

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

20  section 382.016, Florida Statutes, to read:

21         382.016  Amendment of records.--

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

23  signed by the mother and father acknowledging the paternity of

24  a registrant born out of wedlock, together with sufficient

25  information to identify the original certificate of live

26  birth, the department shall prepare a new birth certificate

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

28  certificate. The names and identifying information of the

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

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

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


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                                          HB 2125, First Engrossed



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

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

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

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

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

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

  7  married at the time of birth.

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

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

10  the new certificate of birth for the original certificate on

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

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

13  vital records shall be forwarded to the State Registrar.

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

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

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

17  order requires issuance of a certified copy of the original

18  certificate of birth. The department shall place the original

19  certificate of birth and all papers pertaining thereto under

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

21  jurisdiction or as otherwise provided by law.

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

23  certificate, the birth certificate may only be amended to

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

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

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

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

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

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

30  section, to read:

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                                          HB 2125, First Engrossed



  1         382.019  Delayed registration; administrative

  2  procedures.--

  3         (1)  Registration after 1 year is a delayed

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

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

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

  7  section or rule, register a delayed certificate if the

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

  9  death, or fetal death on file.

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

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

12  dismissal of an application which is not pursued within 1

13  year.

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

15  382.025, Florida Statutes, are amended to read:

16         382.025  Certified copies of vital records;

17  confidentiality; research.--

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

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

20  birth records of this state shall be confidential and are

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

22         (a)  Certified copies of the original birth certificate

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

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

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

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

27  by the department and in the form prescribed by the

28  department, and only:

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

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

31  legal representative;


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                                          HB 2125, First Engrossed



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

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

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

  4  representative of any of such persons;

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

  6  old and not under seal pursuant to court order;

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

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

  9  official purposes upon approval of the department; or

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

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

12  prevent the fraudulent use of the birth certificates of

13  deceased persons, the department shall match birth and death

14  certificates and post the fact of death to the appropriate

15  birth certificate. Except for a commemorative birth

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

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

18  a commemorative birth certificate, such indication of death

19  shall be made on the back of the certificate.

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

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

22  a commemorative birth certificate representing that the birth

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

24  registrar. The certificate issued under this paragraph shall

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

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

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

28  by the Governor.

29         (2)  OTHER RECORDS.--

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

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


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                                          HB 2125, First Engrossed



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

  2  portion which is confidential and exempt from the provisions

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

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

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

  6  fetal death certificate which includes the confidential

  7  portions shall be issued only:

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

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

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

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

12  other document that demonstrates his or her the family

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

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

15  behalf of any of them;

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

17  the United States for official purposes upon approval of the

18  department; or

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

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

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

22  after the date of death.

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

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

25  commemorative marriage license representing that the marriage

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

27  registrar.  The certificate issued under this paragraph shall

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

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

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

31  by the Governor.


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                                          HB 2125, First Engrossed



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

  2  Florida Statutes, is amended to read:

  3         382.0255  Fees.--

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

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

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

  7  $4 which shall be deposited in the appropriate departmental

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

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

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

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

12  appropriation to the department for administration of this

13  chapter.

14         Section 24.  Paragraph (c) of subsection (2) of section

15  383.011, Florida Statutes, 1998 Supplement, is amended to

16  read:

17         383.011  Administration of maternal and child health

18  programs.--

19         (2)  The Department of Health shall follow federal

20  requirements and may adopt any rules necessary for the

21  implementation of the maternal and child health care program,

22  the WIC program, and the Child Care Food Program.

23         (c)  With respect to the Child Care Food Program, the

24  department shall adopt rules that interpret and implement

25  relevant federal regulations, including 7 C.F.R. part 226. The

26  rules may must address at least those program requirements and

27  procedures identified in paragraph (1)(i).

28         Section 25.  Paragraph (e) of subsection (3) of section

29  383.14, Florida Statutes, is amended to read:

30

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                                          HB 2125, First Engrossed



  1         383.14  Screening for metabolic disorders, other

  2  hereditary and congenital disorders, and environmental risk

  3  factors.--

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

  5  department shall administer and provide certain services to

  6  implement the provisions of this section and shall:

  7         (e)  Supply the necessary dietary treatment products

  8  where practicable for diagnosed cases of phenylketonuria and

  9  other metabolic diseases for as long as medically indicated

10  when the products are not otherwise available. Provide

11  nutrition education and supplemental foods to those families

12  eligible for the Special Supplemental Nutrition Food Program

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

14

15  All provisions of this subsection must be coordinated with the

16  provisions and plans established under this chapter, chapter

17  411, and Pub. L. No. 99-457.

18         Section 26.  Subsection (4) of section 385.202, Florida

19  Statutes, is amended to read:

20         385.202  Statewide cancer registry.--

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

22  for establishing, administering, compiling, processing, and

23  providing biometric and statistical analyses to the reporting

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

25  accuracy of the information reported and to provide management

26  information to the reporting facilities.  Such reporting

27  hospitals shall be reimbursed for reasonable costs.

28         Section 27.  Section 385.203, Florida Statutes, is

29  amended to read:

30         385.203  Diabetes Advisory Council; creation; function;

31  membership.--


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                                          HB 2125, First Engrossed



  1         (1)  To guide a statewide comprehensive approach to

  2  diabetes prevention, diagnosis, education, care, treatment,

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

  4  Advisory Council that serves as the advisory unit to the

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

  6  Health, other governmental agencies, professional and other

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

  8         (a)  Provide statewide leadership to continuously

  9  improve the lives of all Floridians with diabetes and reduce

10  the burden of diabetes.

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

12  issues related to the public health approach for the delivery

13  of health care services to persons with diabetes.

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

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

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

17  recommendations to the deans regarding the need for diabetes

18  education, treatment, and research activities to promote the

19  prevention and control of diabetes.

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

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

22  specific recommendations regarding the public health aspects

23  of the prevention and control of diabetes.

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

25  the Governor with advice from nominations by the Board of

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

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

28  4-year terms or until their successors are appointed or

29  qualified.

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

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


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                                          HB 2125, First Engrossed



  1  diabetes mellitus as follows:  four practicing physicians; one

  2  representative from each medical school; seven interested

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

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

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

  6  representative from the Division of Children's Medical

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

  8  nutrition.

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

10  affected by diabetes.

11         (b)  Twenty members representing nursing with diabetes

12  educator certification; dietetics with diabetes educator

13  certification; podiatry; ophthalmology/optometry; psychology;

14  pharmacy; adult endocrinology; pediatric endocrinology; the

15  American Diabetes Association; the Juvenile Diabetes

16  Foundation; community health centers; county health

17  departments; American Diabetes Association-recognized

18  community education programs; each Florida medical school; the

19  insurance industry; Children's Medical Services diabetes

20  regional programs; and employers.

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

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

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

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

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

26  meetings shall be held each year.

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

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

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

30  quorum is necessary for the council to take any official

31  action.  The Department of Health secretary shall keep a


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                                          HB 2125, First Engrossed



  1  complete record of the proceedings of each meeting.  The

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

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

  4  department, and these and other documents about matters within

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

  6  the council.

  7         (5)  Members of the council shall serve without

  8  remuneration but may be reimbursed for per diem and travel

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

10  are available.

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

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

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

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

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

16  operation of the council or the diabetes centers established

17  in the various medical schools.

18         Section 28.  Subsection (8) of section 391.021, Florida

19  Statutes, 1998 Supplement, is amended to read:

20         391.021  Definitions.--When used in this act, unless

21  the context clearly indicates otherwise:

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

23  program established in the Division of Children's Medical

24  Services of the department.

25         Section 29.  Section 391.028, Florida Statutes, 1998

26  Supplement, is amended to read:

27         391.028  Administration.--The Children's Medical

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

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

30  Services must be a physician licensed under chapter 458 or

31  chapter 459 who has specialized training and experience in the


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                                          HB 2125, First Engrossed



  1  provision of health care to children and who has recognized

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

  3  programs. The division director shall be the deputy secretary

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

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

  6  director may appoint division directors subject to the

  7  approval of the secretary.

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

  9  Medical Services area offices to perform operational

10  activities, including, but not limited to:

11         (a)  Providing case management services for the

12  network.

13         (b)  Providing local oversight of the program.

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

15  eligibility for the program.

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

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

18         (e)  Authorizing services in the program and developing

19  spending plans.

20         (f)  Participating in the development of treatment

21  plans.

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

23  grievances from participants and health care providers.

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

25  be directed by a physician licensed under chapter 458 or

26  chapter 459 who has specialized training and experience in the

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

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

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

30  Medical Services physician consultants.

31


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                                          HB 2125, First Engrossed



  1         Section 30.  Section 391.0315, Florida Statutes, 1998

  2  Supplement, is amended to read:

  3         391.0315  Benefits.--Benefits provided under the

  4  program for children with special health care needs shall be

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

  6  409.905 and 409.906. The department may offer additional

  7  benefits for early intervention services, respite services,

  8  genetic testing, genetic and nutritional counseling, and

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

10  medically necessary. No child or person determined eligible

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

12  of the Social Security Act shall receive any service other

13  than an initial health care screening or treatment of an

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

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

16  program.

17         Section 31.  Paragraph (b) of subsection (1) of section

18  391.221, Florida Statutes, 1998 Supplement, is amended to

19  read:

20         391.221  Statewide Children's Medical Services Network

21  Advisory Council.--

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

23  Statewide Children's Medical Services Network Advisory Council

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

25  department.  Specifically, the duties of the council shall

26  include, but not be limited to:

27         (b)  Making recommendations to the director of the

28  Division of Children's Medical Services concerning the

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

30  Services network.

31


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                                          HB 2125, First Engrossed



  1         Section 32.  Subsection (1) of section 391.222, Florida

  2  Statutes, 1998 Supplement, is amended to read:

  3         391.222  Cardiac Advisory Council.--

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

  5  Cardiac Advisory Council for the purpose of acting as the

  6  advisory body to the Department of Health Division of

  7  Children's Medical Services in the delivery of cardiac

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

  9  shall include, but not be limited to:

10         (a)  Recommending standards for personnel and

11  facilities rendering cardiac services for the Division of

12  Children's Medical Services;

13         (b)  Receiving reports of the periodic review of

14  cardiac personnel and facilities to determine if established

15  standards for the Division of Children's Medical Services

16  cardiac services are met;

17         (c)  Making recommendations to the division director as

18  to the approval or disapproval of reviewed personnel and

19  facilities;

20         (d)  Making recommendations as to the intervals for

21  reinspection of approved personnel and facilities; and

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

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

24  cardiac programs, including the rulemaking process.

25         Section 33.  Section 391.223, Florida Statutes, 1998

26  Supplement, is amended to read:

27         391.223  Technical advisory panels.--The secretary of

28  the department may establish technical advisory panels to

29  assist the Division of Children's Medical Services in

30  developing specific policies and procedures for the Children's

31  Medical Services program.


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                                          HB 2125, First Engrossed



  1         Section 34.  Subsection (3) of section 392.69, Florida

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

  3  section, to read:

  4         392.69  Appropriation, sinking, and maintenance trust

  5  funds; additional powers of the department.--

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

  7  functions, notwithstanding s. 216.292(5) (b), the department

  8  is hereby authorized to use any sums of money which it may

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

10  regular operating appropriation, or use any sums of money

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

12  by the issuance of revenue certificates of the hospital to

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

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

15  construction or maintenance of additional facilities or

16  improvement to existing facilities, as the department deems

17  necessary.

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

19  which shall meet quarterly to review and make recommendations

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

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

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

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

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

25  travel expenses as provided in s. 112.061.

26         Section 35.  Subsection (36) is added to section

27  409.912, Florida Statutes, 1998 Supplement, to read:

28         409.912  Cost-effective purchasing of health care.--The

29  agency shall purchase goods and services for Medicaid

30  recipients in the most cost-effective manner consistent with

31  the delivery of quality medical care.  The agency shall


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                                          HB 2125, First Engrossed



  1  maximize the use of prepaid per capita and prepaid aggregate

  2  fixed-sum basis services when appropriate and other

  3  alternative service delivery and reimbursement methodologies,

  4  including competitive bidding pursuant to s. 287.057, designed

  5  to facilitate the cost-effective purchase of a case-managed

  6  continuum of care. The agency shall also require providers to

  7  minimize the exposure of recipients to the need for acute

  8  inpatient, custodial, and other institutional care and the

  9  inappropriate or unnecessary use of high-cost services.

10         (36)  The agency shall enter into agreements with

11  not-for-profit organizations based in the state for the

12  purpose of vision screening.

13         Section 36.  Subsection (3) of section 409.9126,

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

15         409.9126  Children with special health care needs.--

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

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

18  basis and shall utilize a primary care case management

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

20  shall phase in by geographical area capitation payments to

21  Children's Medical Services for services provided to

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

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

24  shall make capitation payments for Children's Medical Services

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

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

27  Children's Medical Services program for services provided to

28  Medicaid-eligible children with special health care needs

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

30  capitated basis.

31


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                                          HB 2125, First Engrossed



  1         Section 37.  Subsection (6) of section 455.564, Florida

  2  Statutes, 1998 Supplement, is amended to read:

  3         455.564  Department; general licensing provisions.--

  4         (6)  As a condition of renewal of a license, the Board

  5  of Medicine, the Board of Osteopathic Medicine, the Board of

  6  Chiropractic Medicine, and the Board of Podiatric Medicine

  7  shall each require licensees which they respectively regulate

  8  to periodically demonstrate their professional competency by

  9  completing at least 40 hours of continuing education every 2

10  years, which may include up to 1 hour of risk management or

11  cost containment and up to 2 hours of other topics related to

12  the applicable medical specialty, if required by board rule.

13  The boards may require by rule that up to 1 hour of the

14  required 40 or more hours be in the area of risk management or

15  cost containment. This provision shall not be construed to

16  limit the number of hours that a licensee may obtain in risk

17  management or cost containment to be credited towards

18  satisfying the 40 or more required hours. This provision shall

19  not be construed to require the boards to impose any

20  requirement on licensees other than the completion of at least

21  40 hours of continuing education every 2 years. Each of such

22  boards shall determine whether any specific continuing

23  education course requirements not otherwise mandated by law

24  shall be mandated and shall approve criteria for, and the

25  content of, any continuing education course mandated by such

26  board. Notwithstanding any other provision of law, the board,

27  or the department when there is no board, may approve by rule

28  alternative methods of obtaining continuing education credits

29  in risk management. The alternative methods may include

30  attending a board meeting at which another a licensee is

31  disciplined, serving as a volunteer expert witness for the


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                                          HB 2125, First Engrossed



  1  department in a disciplinary case, or serving as a member of a

  2  probable cause panel following the expiration of a board

  3  member's term. Other boards within the Division of Medical

  4  Quality Assurance, or the department if there is no board, may

  5  adopt rules granting continuing education hours in risk

  6  management for attending a board meeting at which another

  7  licensee is disciplined, serving as a volnteer expert witness

  8  for the department in a disciplinary case, or serving as a

  9  member of a probable cause panel following the expiration of a

10  board member's term.

11         Section 38.  Subsection (8) is added to section

12  455.5651, Florida Statutes, 1998 Supplement, to read:

13         455.5651  Practitioner profile; creation.--

14         (8)  The Department of Health shall not include

15  disciplinary action taken by a licensed hospital or an

16  ambulatory surgical center in the practitioner profile.

17         Section 39.  Paragraph (a) of subsection (2) of section

18  465.019, Florida Statutes, 1998 Supplement, is amended to

19  read:

20         465.019  Institutional pharmacies; permits.--

21         (2)  The following classes of institutional pharmacies

22  are established:

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

24  institutional pharmacies in which all medicinal drugs are

25  administered from individual prescription containers to the

26  individual patient and in which medicinal drugs are not

27  dispensed on the premises, except that nursing homes licensed

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

29  administration to residents.  No medicinal drugs may be

30  dispensed in a Class I institutional pharmacy.

31


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                                          HB 2125, First Engrossed



  1         Section 40.  Section 468.304, Florida Statutes, 1998

  2  Supplement, is amended to read:

  3         468.304  Certification examination; admission.--The

  4  department shall admit to examination for certification any

  5  applicant who pays to the department a nonrefundable fee not

  6  to exceed $100 plus the actual per-applicant cost to the

  7  department for the purchase of the examination from a national

  8  organization and submits satisfactory evidence, verified by

  9  oath or affirmation, that she or he:

10         (1)  Is at least 18 years of age at the time of

11  application;

12         (2)  Is a high school graduate or has successfully

13  completed the requirements for a graduate equivalency diploma

14  (GED) or its equivalent;

15         (3)  Is of good moral character; and

16         (4)(a)  Has successfully completed an educational

17  program, which program may be established in a hospital

18  licensed pursuant to chapter 395 or in an accredited

19  postsecondary academic institution which is subject to

20  approval by the department as maintaining a satisfactory

21  standard; or

22         (b)1.  With respect to an applicant for a basic X-ray

23  machine operator's certificate, has completed a course of

24  study approved by the department with appropriate study

25  material provided the applicant by the department;

26         2.  With respect to an applicant for a basic X-ray

27  machine operator-podiatric medicine certificate, has completed

28  a course of study approved by the department, provided that

29  such course of study shall be limited to that information

30  necessary to perform radiographic procedures within the scope

31


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                                          HB 2125, First Engrossed



  1  of practice of a podiatric physician licensed pursuant to

  2  chapter 461;

  3         3.  With respect only to an applicant for a general

  4  radiographer's certificate who is a basic X-ray machine

  5  operator certificateholder, has completed an educational

  6  program or a 2-year training program that takes into account

  7  the types of procedures and level of supervision usually and

  8  customarily practiced in a hospital, which educational or

  9  training program complies with the rules of the department; or

10         4.  With respect only to an applicant for a nuclear

11  medicine technologist's certificate who is a general

12  radiographer certificateholder, has completed an educational

13  program or a 2-year training program that takes into account

14  the types of procedures and level of supervision usually and

15  customarily practiced in a hospital, which educational or

16  training program complies with the rules of the department.

17

18  No application for a limited computed tomography certificate

19  shall be accepted.  All persons holding valid computed

20  tomography certificates as of October 1, 1984, are subject to

21  the provisions of s. 468.309.

22         Section 41.  Subsection (4) of section 468.306, Florida

23  Statutes, 1998 Supplement, is amended to read:

24         468.306  Examinations.--All applicants, except those

25  certified pursuant to s. 468.3065, shall be required to pass

26  an examination.  The department is authorized to develop or

27  use examinations for each type of certificate.

28         (4)  A nonrefundable fee not to exceed $75 plus the

29  actual per-applicant cost to the department for the purchase

30  of the examination from a national organization shall be

31  charged for any subsequent examination.


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                                          HB 2125, First Engrossed



  1         Section 42.  Paragraph (a) of subsection (1) of section

  2  468.309, Florida Statutes, is amended to read:

  3         468.309  Certificate; duration; renewal; reversion to

  4  inactive status.--

  5         (1)(a)  A radiologic technologist's certificate issued

  6  in accordance with this part automatically expires as

  7  specified in rules adopted by the department establishing a

  8  procedure for biennial renewal of certificates on December 31

  9  of the year following the year of issuance.  A certificate

10  shall be renewed by the department for a period of 2 years

11  upon payment of a renewal fee in an amount not to exceed $75

12  and upon submission of a renewal application containing such

13  information as the department deems necessary to show that the

14  applicant for renewal is a radiologic technologist in good

15  standing and has completed any continuing education

16  requirements which may be established by the department.

17         Section 43.  Subsections (14), (15), (16), (19), and

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

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

20  read:

21         499.005  Prohibited acts.--It is unlawful to perform or

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

23  state:

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

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

26  the state in which the person resides to distribute legend

27  drugs.

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

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

30  which the person receives the drug resides to purchase or

31  possess legend drugs.


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                                          HB 2125, First Engrossed



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

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

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

  4  compressed medical gases.

  5         (19)  Providing the department with false or fraudulent

  6  records, or making false or fraudulent statements, regarding

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

  8  device, or cosmetic.

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

10  operating without a valid permit, when a permit or

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

12  activity.

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

14  patient or ultimate consumer without a prescription or order

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

16  device.

17         Section 44.  Subsections (13) of section 499.007,

18  Florida Statutes, is amended to read:

19         499.007  Misbranded drug or device.--A drug or device

20  is misbranded:

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

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

23  fails to bear the statement:

24         (a)  "Caution:  Federal Law Prohibits Dispensing

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

26  followed by the word "Only"; or

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

28  Prescription."

29

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

31  prescription of a practitioner licensed by law to prescribe


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                                          HB 2125, First Engrossed



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

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

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

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

  5  seller, the prescription number and the date the prescription

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

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

  8  statements.  This exemption does not apply to any drug

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

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

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

12  may, by rule, exempt drugs subject to ss. 499.062-499.064 from

13  subsection (12) if compliance with that subsection is not

14  necessary to protect the public health, safety, and welfare.

15         Section 45.  Subsection (15) of section 499.028,

16  Florida Statutes, is amended to read:

17         499.028  Drug samples or complimentary drugs; starter

18  packs; permits to distribute.--

19         (15)  A person may not possess a prescription drug

20  sample unless:

21         (a)  The drug sample was prescribed to her or him as

22  evidenced by the label required in s. 465.0276(5).

23         (b)  She or he is the employee of a complimentary drug

24  distributor that holds a permit issued under ss.

25  499.001-499.081.

26         (c)  She or he is a person to whom prescription drug

27  samples may be distributed pursuant to this section.

28         (d)  She or he is an officer or employee of a federal,

29  state, or local government acting within the scope of

30  employment.

31


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                                          HB 2125, First Engrossed



  1         Section 46.  Subsection (1) of section 499.069, Florida

  2  Statutes, is amended to read:

  3         499.069  Punishment for violations of s. 499.005;

  4  dissemination of false advertisement.--

  5         (1)  Any person who violates any of the provisions of

  6  s. 499.005 is guilty of a misdemeanor of the second degree,

  7  punishable as provided in s. 775.082 or s. 775.083; but, if

  8  the violation is committed after a conviction of such person

  9  under this section has become final, such person is guilty of

10  a misdemeanor of the first degree, punishable as provided in

11  s. 775.082 or s. 775.083 or as otherwise provided in ss.

12  499.001-499.081, except that any person who violates

13  subsection (8), subsection (10), subsection (14), subsection

14  (15), subsection (16), or subsection (17) of s. 499.005 is

15  guilty of a felony of the third degree, punishable as provided

16  in s. 775.082, s. 775.083, or s. 775.084, or as otherwise

17  provided in ss. 499.001-499.081.

18         Section 47.  Subsection (1) of section 742.10, Florida

19  Statutes, is amended to read:

20         742.10  Establishment of paternity for children born

21  out of wedlock.--

22         (1)  This chapter provides the primary jurisdiction and

23  procedures for the determination of paternity for children

24  born out of wedlock. When the establishment of paternity has

25  been raised and determined within an adjudicatory hearing

26  brought under the statutes governing inheritance, or

27  dependency under workers' compensation or similar compensation

28  programs, or when an affidavit acknowledging paternity or a

29  stipulation of paternity is executed by both parties and filed

30  with the clerk of the court, or when a consenting affidavit as

31  provided for in s. 382.013 or s. 382.016 s. 382.015 is


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                                          HB 2125, First Engrossed



  1  executed by both parties, it shall constitute the

  2  establishment of paternity for purposes of this chapter. If no

  3  adjudicatory proceeding was held, a voluntary acknowledgment

  4  of paternity shall create a rebuttable presumption, as defined

  5  by s. 90.304, of paternity and is subject to the right of any

  6  signatory to rescind the acknowledgment within 60 days of the

  7  date the acknowledgment was signed or the date of an

  8  administrative or judicial proceeding relating to the child,

  9  including a proceeding to establish a support order, in which

10  the signatory is a party, whichever is earlier.  Both parents

11  are required to provide their social security numbers on any

12  acknowledgment of paternity, consent affidavit, or stipulation

13  of paternity. Except for consenting affidavits under seal

14  pursuant to ss. s. 382.015 and 382.016, the Office of Vital

15  Statistics shall provide certified copies of affidavits to the

16  Title IV-D agency upon request.

17         Section 48.  The building that is known as the 1911

18  State Board of Health Building, which is part of a

19  multibuilding complex with the address of 1217 Pearl Street,

20  Jacksonville, Florida, shall be known as the Wilson T. Sowder,

21  M.D., Building.

22         Section 49.  The building authorized by chapter 98-307,

23  Laws of Florida, that will be located at the University of

24  South Florida, which will house laboratory facilities for the

25  Department of Health, shall be known as the William G. "Doc"

26  Myers, M.D., Building.

27         Section 50.  The Department of Health headquarters

28  building that will comprise approximately 100,000 square feet

29  that is authorized by item 1986 in the 1998-1999

30  Appropriations Act shall be known as the E. Charlton Prather,

31  M.D., Building.


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                                          HB 2125, First Engrossed



  1         Section 51.  The Department of Children and Family

  2  Services, and the Agency for Health Care Administration shall,

  3  by October 1, 1999, develop a system to allow unborn children

  4  of Medicaid-eligible mothers to be issued a Medicaid number

  5  which shall be used for billing purposes and for monitoring of

  6  care for the child beginning with the child's date of birth.

  7         Section 52.  Subsection (3) of section 381.731, Florida

  8  Statutes, 1998 Supplement, as transferred from section

  9  408.601, Florida Statutes, by chapter 98-224, Laws of Florida,

10  is repealed.

11         Section 53.  Subsection (5) of section 383.307, Florida

12  Statutes, is repealed.

13         Section 54.  Subsection (7) of section 404.20, Florida

14  Statutes, is repealed.

15         Section 55.  Section 409.9125, Florida Statutes, is

16  repealed.

17         Section 56.  The Department of Health may apply for and

18  become a National Environmental Laboratory Accreditation

19  program accrediting authority. The Department of Health, as an

20  accrediting entity, may adopt rules pursuant to ss. 120.536(1)

21  and 120.54, Florida Statutes, to implement standards of the

22  National Environmental Laboratory Accreditation Program,

23  including standards for proficiency testing providers, and

24  other rules not inconsistent with this section, including

25  fees, application procedures, standards applicable to

26  environmental or public water supply laboratories, and

27  compliance.

28         Section 57.  This act shall take effect July 1, 1999.

29

30

31


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