Senate Bill 2220c1

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    Florida Senate - 1999                           CS for SB 2220

    By the Committee on Health, Aging and Long-Term Care; and
    Senator Clary




    317-1847A-99

  1                      A bill to be entitled

  2         An act relating to the Department of Health;

  3         amending s. 20.43, F.S.; revising powers and

  4         the internal structure of the department;

  5         amending s. 110.205, F.S.; exempting certain

  6         positions from career service; amending s.

  7         120.80, F.S.; exempting certain hearings within

  8         the department from the requirement of being

  9         conducted by an administrative law judge from

10         the Division of Administrative Hearings;

11         amending s. 154.504, F.S.; revising standards

12         for eligibility to participate in a primary

13         care for children and families challenge grant;

14         amending s. 287.155, F.S.; authorizing the

15         department to purchase vehicles and automotive

16         equipment for county health departments;

17         amending s. 372.6672, F.S.; deleting an

18         obsolete reference to the Department of Health

19         and Rehabilitative Services; amending s.

20         381.004, F.S.; prescribing conditions under

21         which an HIV test may be performed without

22         obtaining consent; amending s. 381.0051, F.S.;

23         authorizing the Department of Health to adopt

24         rules to implement the Comprehensive Family

25         Planning Act; amending s. 381.006, F.S.;

26         providing the department with rule authority

27         relating to inspection of certain group care

28         facilities; amending s. 381.0061, F.S.;

29         providing the department with authority to

30         impose certain fines; amending s. 381.0062,

31         F.S.; redefining the term "private water

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  1         system" and defining the term "multi-family

  2         water system"; providing that either type of

  3         system may include a rental residence in its

  4         service; regulating multi-family systems;

  5         amending s. 381.90, F.S.; revising membership

  6         of the Health Information Systems Council;

  7         prescribing its duties with respect to

  8         developing a review process; requiring a

  9         report; amending s. 382.003, F.S.; revising

10         powers and duties of the department with

11         respect to vital records; providing for forms

12         and documents to be submitted under oath;

13         amending s. 382.004, F.S.; restating the

14         admissibility of copies of records; amending s.

15         382.008, F.S.; deleting provisions relating to

16         restriction on disclosure of a decedent's

17         social security number; amending s. 382.013,

18         F.S.; revising provisions relating to who must

19         file a birth registration; amending s. 382.015,

20         F.S.; revising provisions relating to issuance

21         of new birth certificates upon determination of

22         paternity; amending s. 382.016, F.S.;

23         prescribing procedures for amending records;

24         amending s. 382.019, F.S.; providing for

25         dismissal of an application for delayed

26         registration which is not actively pursued;

27         amending s. 382.025, F.S.; exempting certain

28         birth records from confidentiality

29         requirements; amending s. 382.0255, F.S.;

30         revising provisions relating to disposition of

31         the additional fee imposed on certification of

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  1         birth records; amending s. 383.14, F.S.;

  2         conforming a reference to the name of a

  3         program; amending s. 385.202, F.S.; deleting

  4         provisions relating to reimbursing hospitals

  5         reporting information for the statewide cancer

  6         registry; amending s. 385.203, F.S.;

  7         establishing requirements and membership for

  8         the Diabetes Advisory Council; amending s.

  9         391.028, F.S.; revising provisions relating to

10         administration of the Children's Medical

11         Services program; amending s. 391.0315, F.S.;

12         revising standards for benefits provided under

13         the program for certain children; amending s.

14         392.69, F.S.; providing for an advisory board

15         for the A. G. Holley State Hospital; amending

16         s. 401.25, F.S.; revising qualifications for

17         licensure as basic or advanced life support

18         service; amending s. 401.27, F.S.; requiring

19         applications to be made under oath by emergency

20         medical technicians or paramedics; amending s.

21         401.30, F.S.; providing the department with

22         rule authority for patient care records of

23         licensed ambulance services; amending s.

24         401.35, F.S.; authorizing the department to

25         prescribe by rule requirements for storage, and

26         security of medications maintained by licensed

27         support services; creating s. 401.49, F.S.;

28         authorizing the department's approval of

29         emergency medical technician and paramedic

30         programs; amending s. 409.9126, F.S.; revising

31         requirements for capitation payments to

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  1         Children's Medical Services programs; amending

  2         s. 465.019, F.S.; revising definitions;

  3         amending s. 499.005, F.S.; revising the

  4         elements of certain offenses relating to

  5         purchase or receipt of legend drugs,

  6         recordkeeping with respect to drugs, cosmetics,

  7         and household products, and permit and

  8         registration requirements; amending s. 499.007,

  9         F.S.; revising conditions under which a drug is

10         considered misbranded; amending s. 499.028,

11         F.S.; providing an exemption from the

12         prohibition against possession of a drug

13         sample; amending s. 499.066, F.S.; providing

14         conditions on issuance of cease and desist

15         orders; amending s. 499.069, F.S.; providing

16         penalties for certain violations of s. 499.005,

17         F.S.; amending s. 742.10, F.S.; revising

18         procedures relating to establishing paternity

19         for children born out of wedlock; amending ss.

20         39.303, 385.203, 391.021, 391.221, 391.222,

21         391.223, F.S., to conform to the renaming of

22         the Division of Children's Medical Services;

23         amending s. 63.162, F.S.; revising requirements

24         for release of the name and identity of an

25         adoptee, birth parent, or adoptive parent;

26         repealing s. 381.731(3), F.S., relating to the

27         date for submission of a report; repealing s.

28         383.307(5), F.S., relating to licensure of

29         birth center staff and consultants; repealing

30         s. 404.20(7), F.S., relating to transportation

31         of radioactive materials; repealing s.

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  1         409.9125, F.S., relating to the study of

  2         Medicaid alternative networks; naming a certain

  3         building in Jacksonville the "Wilson T. Sowder,

  4         M.D., Building"; naming a certain building in

  5         Tampa the "William G. 'Doc' Myers, M.D.,

  6         Building"; naming the department headquarters

  7         building the "Charlton E. Prather, M.D.,

  8         Building"; authorizing the Department of Health

  9         to become an accrediting authority for

10         environmental laboratory standards; providing

11         intent and rulemaking authority for the

12         Department of Health to implement standards of

13         the National Environmental Laboratory

14         Accreditation Program; providing an effective

15         date.

16

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

18

19         Section 1.  Paragraphs (e) and (f) of subsection (3)

20  and paragraphs (a) and (b) of subsection (7) of section 20.43,

21  Florida Statutes, 1998 Supplement, are amended, and paragraphs

22  (h), (i), and (j) are added to subsection (3) of that section,

23  to read:

24         20.43  Department of Health.--There is created a

25  Department of Health.

26         (3)  The following divisions of the Department of

27  Health are established:

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

  2  and Intervention.

  3         (i)  Division of Information Resource Management.

  4         (j)  Division of Health Awareness and Tobacco.

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

  6  department may use state or federal funds to:

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

  8  the promotional items listed in paragraph (b), food and

  9  including food coupons, and or payment for travel expenses,

10  for encouraging healthy lifestyle and disease prevention

11  behaviors and patient compliance with medical treatment, such

12  as tuberculosis therapy and smoking cessation programs. Such

13  incentives shall be intended to cause individuals to take

14  action to improve their health. Any incentive for food, food

15  coupons, or travel expenses may not exceed the limitations in

16  s. 112.061.

17         (b)  Plan and conduct health education campaigns for

18  the purpose of protecting or improving public health. The

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

20  limited to, t-shirts, hats, sports items such as water bottles

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

22  growth charts, and other items printed with health-promotion

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

24  publications or radio or television time, for health

25  information and promotional messages that recognize that the

26  following behaviors, among others, are detrimental to public

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

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

29  products, and exposure to environmental tobacco smoke; alcohol

30  consumption or other substance abuse during pregnancy; alcohol

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

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

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

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

  4  purposes of activities under this paragraph, the Department of

  5  Health may establish requirements for local matching funds or

  6  in-kind contributions to create and distribute advertisements,

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

  8  each of the targeted behaviors, establish an independent

  9  evaluation and feedback system for the public health

10  communication campaign, and monitor and evaluate the efforts

11  to determine which of the techniques and methodologies are

12  most effective.

13         Section 2.  Paragraphs (l), (p), and (s) of subsection

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

15         110.205  Career service; exemptions.--

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

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

18  no position, except for positions established for a limited

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

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

21         (l)  All assistant division director, deputy division

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

23  those positions determined by the department to have

24  managerial responsibilities comparable to such positions,

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

26  the Department of Health, the Department of Children and

27  Family Services, and Rehabilitative Services and the

28  Department of Corrections that are assigned primary duties of

29  serving as the superintendent of an institution: positions in

30  the Department of Transportation that are assigned primary

31  duties of serving as regional toll managers and managers of

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

  2  in the Department of Environmental Protection that are

  3  assigned the duty of an Environmental Administrator or program

  4  administrator; and positions in the Department of Health and

  5  Rehabilitative Services that are assigned the duties duty of

  6  an Environmental Administrator, Assistant County Health

  7  Department Director, and County Health Department Financial

  8  Administrator. Unless otherwise fixed by law, the department

  9  shall set the salary and benefits of these positions in

10  accordance with the rules established for the Selected Exempt

11  Service.

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

13  district program managers, district program coordinators,

14  district subdistrict administrators, district administrative

15  services directors, district attorneys, county health

16  department directors, county health department administrators,

17  and the Deputy Director of Central Operations Services of the

18  Department of Children and Family Health and Rehabilitative

19  Services and the county health department directors and county

20  health department administrators of the Department of Health.

21  Unless otherwise fixed by law, the departments department

22  shall establish the salary range and benefits for these

23  positions in accordance with the rules of the Selected Exempt

24  Service.

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

26  established within the Department of Business and Professional

27  Regulation or the Department of Health. Unless otherwise fixed

28  by law, the department shall establish the salary and benefits

29  for these positions in accordance with the rules established

30  for the Selected Exempt Service.

31

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  1         Section 3.  Subsection (15) of section 120.80, Florida

  2  Statutes, 1998 Supplement, is amended to read:

  3         120.80  Exceptions and special requirements;

  4  agencies.--

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

  6  120.57(1)(a), formal hearings may not be conducted by the

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

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

  9  the Department of Health or the Agency for Health Care

10  Administration for matters relating to the regulation of

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

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

13  Department of Health in execution of the Special Supplemental

14  Nutrition Program for Women, Infants, and Children; Child Care

15  Food Program; Children's Medical Services Program; and the

16  exemption from disqualification reviews for certified nurse

17  assistants program need not be conducted by an administrative

18  law judge assigned by the division. The Department of Health

19  may contract with the Department of Children and Family

20  Services for a hearing officer in these matters.

21         Section 4.  Subsection (1) of section 154.504, Florida

22  Statutes, 1998 Supplement, is amended to read:

23         154.504  Eligibility and benefits.--

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

25  care for children and families challenge grant to provide

26  primary health care services to children and families with

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

28  Participants shall pay no monthly premium for participation,

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

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

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

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

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

  3  provided copayments, the term "copayment" may not be

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

  5  health care providers, and all funds generated from copayments

  6  shall be used by the governmental contractor and all other

  7  provisions in s. 766.1115 are met.

  8         Section 5.  Subsection (3) is added to section 287.155,

  9  Florida Statutes, to read:

10         287.155  Motor vehicles; purchase by Division of

11  Universities, Department of Health and Rehabilitative

12  Services, Department of Juvenile Justice, and Department of

13  Corrections.--

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

15  the approval of the Department of Management Services, to

16  purchase automobiles, trucks, and other automotive equipment

17  for use by county health departments.

18         Section 6.  Subsection (3) of section 372.6672, Florida

19  Statutes, 1998 Supplement, is amended to read:

20         372.6672  Alligator management and trapping program

21  implementation; commission authority.--

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

23  shall not be construed so as to supersede the regulatory

24  authority or lawful responsibility of the Department of Health

25  and Rehabilitative Services, the Department of Agriculture and

26  Consumer Services, or any local governmental entity regarding

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

28  deemed supplemental thereto.

29         Section 7.  Paragraph (h) of subsection (3) of section

30  381.004, Florida Statutes, 1998 Supplement, is amended to

31  read:

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  1         381.004  Testing for human immunodeficiency virus.--

  2         (3)  HUMAN IMMUNODEFICIENCY VIRUS TESTING; INFORMED

  3  CONSENT; RESULTS; COUNSELING; CONFIDENTIALITY.--

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

  5  informed consent is not required:

  6         1.  When testing for sexually transmissible diseases is

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

  8  following situations:

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

10  convicted of prostitution or of procuring another to commit

11  prostitution.

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

13  with s. 406.11.

14         2.  Those exceptions provided for blood, plasma,

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

16  381.0041.

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

18  licensed medical personnel in bona fide medical emergencies

19  when the test results are necessary for medical diagnostic

20  purposes to provide appropriate emergency care or treatment to

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

22  as supported by documentation in the medical record.

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

24  is required.

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

26  licensed medical personnel for medical diagnosis of acute

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

28  obtaining informed consent would be detrimental to the

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

30  and the test results are necessary for medical diagnostic

31  purposes to provide appropriate care or treatment to the

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  1  person being tested. Notification of test results in

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

  3  detrimental to the patient.  This subparagraph does not

  4  authorize the routine testing of patients for HIV infection

  5  without informed consent.

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

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

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

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

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

11  defendant voluntarily, pursuant to court order for any

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

13  951.27, or s. 960.003; however, the results of any HIV test

14  performed shall be disclosed solely to the victim and the

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

16  960.003.

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

18         8.  For epidemiological research pursuant to s.

19  381.0032, for research consistent with institutional review

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

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

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

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

24  researcher.

25         9.  When human tissue is collected lawfully without the

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

27  732.9185 or enucleation of the eyes as authorized by s.

28  732.919.

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

30  individual who comes into contact with medical personnel in

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

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

  2  a blood sample is available that was taken from that

  3  individual voluntarily by medical personnel for other

  4  purposes.  "Medical personnel" includes a licensed or

  5  certified health care professional; an employee of a health

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

  7  paramedic or emergency medical technician as defined in s.

  8  401.23.

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

10  voluntarily obtained blood sample, the individual from whom

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

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

13  The individual's refusal to consent and all information

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

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

16  record unless the individual gives written consent to entering

17  this information on the individual's medical record.

18         b.  Reasonable attempts to locate the individual and to

19  obtain consent shall be made and all attempts must be

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

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

22  does not voluntarily consent to the performance of an HIV

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

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

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

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

27  the medical personnel, that there has been a significant

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

29  information is medically necessary to determine the course of

30  treatment for the medical personnel.

31

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

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

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

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

  5  testing or treatment not directly related to the initial HIV

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

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

  8  personnel.

  9         d.  In order to utilize the provisions of this

10  subparagraph, the medical personnel must either be tested for

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

12  test taken within 6 months prior to the significant exposure

13  if such test results are negative.

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

15  pursuant to this subparagraph shall maintain the

16  confidentiality of the information received and of the persons

17  tested.  Such confidential information is exempt from s.

18  119.07(1).

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

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

21  medical personnel or the employer of such person acting on

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

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

24  statement by a physician licensed under chapter 458 or chapter

25  459 that a significant exposure has occurred and that, in the

26  physician's medical judgment, testing is medically necessary

27  to determine the course of treatment constitutes probable

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

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

30  and to the person who experienced the exposure.

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

  2  individual who comes into contact with medical personnel in

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

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

  5  medical personnel while the medical personnel provides

  6  emergency medical treatment to the individual; or who comes

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

  8  significant exposure has occurred while the nonmedical

  9  personnel provides emergency medical assistance during a

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

11  medical emergency means an emergency medical condition outside

12  of a hospital or health care facility that provides physician

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

14  treatment for the medical emergency.

15         a.  An individual who is capable of providing consent

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

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

18  information concerning the performance of an HIV test and its

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

20  record unless the individual gives written consent to entering

21  this information on the individual's medical record.

22         b.  HIV testing shall be conducted only after a

23  licensed physician documents, in the medical record of the

24  medical personnel or nonmedical personnel, that there has been

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

26  judgment, the information is medically necessary to determine

27  the course of treatment for the medical personnel or

28  nonmedical personnel.

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

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

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

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  1  medical personnel or nonmedical personnel. However, costs of

  2  testing or treatment not directly related to the initial HIV

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

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

  5  personnel or nonmedical personnel.

  6         d.  In order to utilize the provisions of this

  7  subparagraph, the medical personnel or nonmedical personnel

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

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

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

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

12  pursuant to this subparagraph shall maintain the

13  confidentiality of the information received and of the persons

14  tested.  Such confidential information is exempt from s.

15  119.07(1).

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

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

18  during treatment for the medical emergency, the medical

19  personnel, the employer of the medical personnel acting on

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

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

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

23  chapter 458 or chapter 459 that a significant exposure has

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

25  testing is medically necessary to determine the course of

26  treatment constitutes probable cause for the issuance of an

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

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

29  experienced the exposure.

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

31  examiner or attending physician upon an a deceased individual

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  1  who is the source of a significant exposure to medical

  2  personnel or nonmedical personnel who provided emergency

  3  medical assistance and who expired or could not be

  4  resuscitated while receiving during treatment for the medical

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

  6  a significant exposure to medical or nonmedical personnel

  7  providing such assistance or care.

  8         a.  HIV testing may be conducted only after a licensed

  9  physician documents in the medical record of the medical

10  personnel or nonmedical personnel that there has been a

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

12  judgment, the information is medically necessary to determine

13  the course of treatment for the medical personnel or

14  nonmedical personnel.

15         b.  Costs of any HIV test performed under this

16  subparagraph may not be charged to the deceased or to the

17  family of the deceased person.

18         c.  For the provisions of this subparagraph to be

19  applicable, the medical personnel or nonmedical personnel must

20  be tested for HIV under this section or must provide the

21  results of an HIV test taken within 6 months before the

22  significant exposure if such test results are negative.

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

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

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

26  medically indicated by licensed medical personnel for medical

27  diagnosis of a hospitalized infant as necessary to provide

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

29  reasonable attempt, a parent cannot be contacted to provide

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

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

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

  2  located.

  3         14.  For the performance of HIV testing conducted to

  4  monitor the clinical progress of a patient previously

  5  diagnosed to be HIV positive.

  6         15.  For the performance of repeated HIV testing

  7  conducted to monitor possible conversion from a significant

  8  exposure.

  9         Section 8.  Subsection (7) is added to section

10  381.0051, Florida Statutes, to read:

11         381.0051  Family planning.--

12         (7)  RULES.--The Department of Health may adopt rules

13  to implement this section.

14         Section 9.  Subsection (16) is added to section

15  381.006, Florida Statutes, 1998 Supplement, to read:

16         381.006  Environmental health.--The department shall

17  conduct an environmental health program as part of fulfilling

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

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

20  factors in the environment.  The environmental health program

21  shall include, but not be limited to:

22         (16)  A group-care-facilities function, where a

23  group-care facility means any public or private school,

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

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

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

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

28  protection, and supervision to persons who require such

29  services and who are not related to the owner or

30  administrator. The department may adopt rules necessary to

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

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  1  of group-care facilities, such as child care facilities,

  2  family day-care homes, nursing homes, assisted-living

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

  4  hospices, residential treatment facilities,

  5  crisis-stabilization units, pediatric extended-care centers,

  6  intermediate-care facilities for the developmentally disabled,

  7  group-care homes, and, jointly with the Department of

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

  9  provisions relating to operation and maintenance of

10  facilities, buildings, grounds, equipment, furnishings, and

11  occupant-space requirements; lighting; heating, cooling, and

12  ventilation; water supply, plumbing; sewage; sanitary

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

14  personnel health, hygiene, and work practices; and other

15  matters the department finds are appropriate or necessary to

16  protect the safety and health of the residents, staff, or

17  patrons. The department may not adopt rules that conflict with

18  rules adopted by the licensing or certifying agency. The

19  department may enter and inspect at reasonable hours to

20  determine compliance with applicable statutes or rules. In

21  addition to any sanctions that the department may impose for

22  violations of rules adopted under this section, the department

23  shall also report such violations to any agency responsible

24  for licensing or certifying the group-care facility. The

25  licensing or certifying agency may also impose any sanction

26  based solely on the findings of the department.

27

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

29  this section.

30         Section 10.  Subsection (1) of section 381.0061,

31  Florida Statutes, is amended to read:

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  1         381.0061  Administrative fines.--

  2         (1)  In addition to any administrative action

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

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

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

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

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

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

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

10  violator.  Each day that a violation continues may constitute

11  a separate violation.

12         Section 11.  Subsections (2), (3), (4), and (5) of

13  section 381.0062, Florida Statutes, 1998 Supplement, are

14  amended to read:

15         381.0062  Supervision; private and certain public water

16  systems.--

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

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

19  chemical, or radiological substance or matter in water.

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

21  including the county health departments.

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

23  chapter 403.

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

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

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

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

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

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

30  Safe Drinking Water Act, which serves one or more

31  nonresidential establishments and provides piped water.

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

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

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

  4  residences or two or more rental residences, and provides

  5  piped water.

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

  7  permissible level of a contaminant in potable water delivered

  8  to consumers.

  9         (h)  "Multi-family water system" means a water system

10  that provides piped water to three or four residences, one of

11  which may be a rental residence.

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

13  corporation, company, association, partnership, municipality,

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

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

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

17  satisfactory for human consumption, dermal contact, culinary

18  purposes, or dishwashing as approved by the department.

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

20  that provides piped water for one or two no more than four

21  nonrental residences, one of which may be a rental residence.

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

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

24  than cleaning work areas or simple handwashing.  Examples of

25  public consumption include, when making food or beverages

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

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

28  preparing food or beverages; washing surfaces accessed by

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

30  medical instruments or surfaces accessed by a patient; any

31  water usage in health care facilities; emergency washing

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

  2  plants or establishments like slaughterhouses and

  3  packinghouses; and water used in schools.

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

  5  is not included or covered under the Florida Safe Drinking

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

  7  private or multi-family water system. For purposes of this

  8  section, public water systems are classified as limited use

  9  community or limited use commercial.

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

11  or corporation that owns or operates a limited use community

12  or limited use commercial public water system, a multi-family

13  water system, or a private water system.

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

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

16  maximum contaminant level violation caused by the raw water or

17  to deviate from construction standards established by rule of

18  the department.

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

20  have general supervision and control over all private water

21  systems, multi-family water systems, and public water systems

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

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

24  water supply program for which it has the duties and

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

26  department shall:

27         (a)  Administer and enforce the provisions of this

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

29  section, including water quality and monitoring standards.

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

31  or operate a limited use community or limited use commercial

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  1  public water system or a multi-family private water system to

  2  first make application to and obtain approval from the

  3  department on forms adopted by rule of the department.

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

  5  construction, modification, operation, or change of ownership

  6  of, and conduct surveillance, enforcement, and compliance

  7  investigations of, limited use community and limited use

  8  commercial public water systems, and multi-family private

  9  water systems.

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

11  amount sufficient to cover the costs of reviewing and acting

12  upon any application for the construction, modification, or

13  operation of a limited use community and limited use

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

15  than $90 annually.

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

17  amount sufficient to cover the costs of reviewing and acting

18  upon any application for the construction or change of

19  ownership of a multi-family private water system serving more

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

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

22  amount sufficient to cover the costs of sample collection,

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

24  coordination with other agencies when such work is not

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

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

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

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

29  drinking water laboratory for contaminant analysis, and to

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

31

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

  2  accordance with the provisions of this section to be deposited

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

  4  exclusively for the payment of costs incurred in the

  5  administration of this section.

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

  7  or otherwise, introducing any contaminant which poses a health

  8  hazard into a drinking water system.

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

10  of water problems and corrective measures under the conditions

11  specified by rule of the department.

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

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

14  than $25 or more than $40.

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

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

17  they have reasonable cause to believe a violation of this

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

19  of the premises of such limited use public and multi-family

20  private drinking water systems serving more than one

21  residence, to make an examination and investigation to

22  determine the sanitary and safety conditions of such systems.

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

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

25  duties pursuant to the provisions of this section is subject

26  to the penalties provided in s. 381.0025.

27         (5)  ENFORCEMENT AND PENALTIES.--

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

29  limited use community or limited use commercial public water

30  system, a multi-family water system, or a private water

31  system, without first complying with the requirements of this

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  1  section, who operates a water system in violation of

  2  department order, or who maintains or operates a water system

  3  after revocation of the permit is guilty of a misdemeanor of

  4  the second degree, punishable as provided in s. 775.082 or s.

  5  775.083.

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

  7  section may be enforced by injunction or restraining order

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

  9         (c)  Additional remedies available to county health

10  department staff through any county or municipal ordinance may

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

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

13  pursuant to this section.

14         Section 12.  Subsections (3) and (7) of section 381.90,

15  Florida Statutes, are amended to read:

16         381.90  Health Information Systems Council; legislative

17  intent; creation, appointment, duties.--

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

19  members or their senior executive-level designees:

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

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

22  Professional Regulation;

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

24  Family Services;

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

26  Administration;

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

28         (f)  The Attorney General;

29         (g)  The executive director of the Correctional Medical

30  Authority;

31

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  1         (h)  Two members representing county health

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

  3  county, appointed by the Governor; and

  4         (i)  A representative from the Florida Association of

  5  Counties;.

  6         (j)  The State Treasurer and Insurance Commissioner;

  7         (k)  A representative from the Florida Healthy Kids

  8  Corporation;

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

10  chosen by the Board of Regents;

11         (m)  The Commissioner of Education;

12         (n)  The Secretary of the Department of Elderly

13  Affairs; and

14         (o)  The Secretary of the Department of Juvenile

15  Justice.

16

17  Representatives of the Federal Government may serve without

18  voting rights.

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

20  but are not limited to, the following:

21         (a)  By March 1 of each year, to develop and approve a

22  strategic plan pursuant to the requirements set forth in s.

23  186.022(9). Copies of the plan shall be transmitted

24  electronically or in writing to the Executive Office of the

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

26  President of the Senate.

27         (b)  To develop a mission statement, goals, and plan of

28  action, based on the guiding principles specified in s.

29  282.3032, for the identification, collection, standardization,

30  sharing, and coordination of health-related data across

31

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  1  federal, state, and local government and private-sector

  2  entities.

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

  4  planning among agencies that collect or maintain

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

  6  implementation of this requirement to the Executive Office of

  7  the Governor, the President of the Senate, and the Speaker of

  8  the House of Representatives by January 1, 2000.

  9         (d)(c)  To create ad hoc issue-oriented technical

10  workgroups, on an as-needed basis, to make recommendations to

11  the council.

12         Section 13.  Subsection (10) of section 382.003,

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

14  that section, to read:

15         382.003  Powers and duties of the department.--The

16  department may:

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

18  for the creation, issuance, recording, rescinding,

19  maintenance, and processing of vital records and for carrying

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

21  382.016-382.019.

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

23  information submitted to the department in the creation or

24  amendment of a vital record be under oath.

25         Section 14.  Subsection (3) of section 382.004, Florida

26  Statutes, is amended to read:

27         382.004  Reproduction and destruction of records.--

28         (3)  Photographs, microphotographs, or reproductions of

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

30  produced certifications made in compliance with the provisions

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

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

  2  treated as originals for the purpose of their admissibility in

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

  4  courts and cases of the facts stated therein.

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

  6  Statutes, 1998 Supplement, is amended to read:

  7         382.008  Death and fetal death registration.--

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

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

10  the department with the local registrar of the district in

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

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

13  registrar if it has been completed and filed in accordance

14  with this chapter or adopted rules. The certificate shall

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

16  Disclosure of social security numbers obtained through this

17  requirement shall be limited to the purpose of administration

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

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

20  death or fetal death:

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

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

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

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

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

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

27  the certificate and shall be considered part of the official

28  record of death;

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

30  registered in the registration district in which the dead body

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

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

  2  registered in the registration district in which the dead body

  3  was first removed from such conveyance.

  4         Section 16.  Subsections (1), (2), and (4) of section

  5  382.013, Florida Statutes, 1998 Supplement, are amended to

  6  read:

  7         382.013  Birth registration.--A certificate for each

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

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

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

11  local registrar if the certificate has been completed and

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

13  information regarding registered births shall be used for

14  comparison with information in the state case registry, as

15  defined in chapter 61.

16         (1)  FILING.--

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

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

19  charge of the facility shall be responsible for preparing the

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

21  certificate with the local registrar.  Within 48 hours after

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

23  during or immediately after the delivery shall provide the

24  facility with the medical information required by the birth

25  certificate.

26         (b)  If a birth occurs outside a facility and a

27  physician licensed in this state, a certified nurse midwife, a

28  midwife licensed in this state, or a public health nurse

29  employed by the department was in attendance during or

30  immediately after the delivery, that person shall prepare and

31  file the certificate.

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

  2  delivery is not attended by one of the persons described in

  3  paragraph (b), the person in attendance, the mother, or the

  4  father shall report the birth to the registrar and provide

  5  proof of the facts of birth. The department may require such

  6  documents to be presented and such proof to be filed as it

  7  deems necessary and sufficient to establish the truth of the

  8  facts to be recorded by the certificate and may withhold

  9  registering the birth until its requirements are met. the

10  child is not taken to the facility within 3 days after

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

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

13         1.  The physician or midwife in attendance during or

14  immediately after the birth.

15         2.  In the absence of persons described in subparagraph

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

17  the birth.

18         3.  In the absence of persons described in subparagraph

19  2., the father or mother.

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

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

22  birth occurred.

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

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

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

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

27  the place of birth.

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

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

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

31  timely registration of the certificate.

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

  2  the local registrar shall immediately notify the health care

  3  facility or person filing the certificate and shall require

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

  5  be obtained prior to issuing certified copies of the birth

  6  certificate.

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

  8  adoption after birth, the information on the birth certificate

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

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

11  is made under s. 63.152.

12         (2)  PATERNITY.--

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

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

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

16  determined otherwise by a court of competent jurisdiction.

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

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

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

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

21  unless paternity has been determined otherwise by a court of

22  competent jurisdiction.

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

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

25  certificate without the execution of a consenting affidavit

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

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

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

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

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

31  status, and responsibilities that arise from signing an

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  1  acknowledgment of paternity, the facility shall provide the

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

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

  4  agency established pursuant to s. 409.2557, regarding the

  5  benefits of voluntary establishment of paternity. Upon request

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

  7  facility shall assist in the execution of the affidavit.

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

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

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

11  entered on the certificate in accordance with the finding and

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

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

14  subsection (3).

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

16  other information about the father shall be entered on the

17  certificate.

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

19  of a child of undetermined parentage shall register a birth

20  certificate shall be registered for every child of

21  undetermined parentage showing all known or approximate facts

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

23  information concerning the place and circumstances under which

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

25  birth certificate relating to marital status and medical

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

27  satisfaction of the department, a new birth certificate shall

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

29  birth certificate, and the original certificate shall be

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

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

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

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

  3  registrant if of legal age.

  4         Section 17.  Section 382.015, Florida Statutes, is

  5  amended to read:

  6         382.015  New certificates of live birth; duty of clerks

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

  8  proceeding for adoption, annulment of an adoption, affirmation

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

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

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

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

13  form to be furnished by the department, together with

14  sufficient information to identify the original birth

15  certificate and to enable the preparation of a new birth

16  certificate.

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

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

19  adoption decree, together with the information necessary to

20  identify the original certificate of live birth, and establish

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

22  birth certificate, absent objection by the court decreeing the

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

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

25  original birth certificate.  All names and identifying

26  information relating to the adoptive parents entered on the

27  new certificate shall refer to the adoptive parents, but

28  nothing in the certificate shall refer to or designate the

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

30  adoption shall be copied as on the original certificate,

31  including the date of registration and filing.

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  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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  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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  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 18.  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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  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  the request of the mother and father or registrant if of legal

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

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

  7  were 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 19.  Section 382.019, Florida Statutes, is

29  amended to read:

30         382.019  Delayed registration; administrative

31  procedures.--

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  1         (1)  Registration after 1 year is a delayed

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

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

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

  5  section or rule, register a delayed certificate if the

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

  7  death, or fetal death on file.

  8         (2)  The department may require such supporting

  9  documents to be presented and such proof to be filed as it

10  deems necessary and sufficient to establish the truth of the

11  facts to be recorded by the certificate, and may withhold

12  registering the birth, death, or fetal death certificate until

13  its requirements are met.

14         (3)  Certificates registered under this section are

15  admissible as prima facie evidence of the facts recited

16  therein with like force and effect as other vital records

17  received or admitted in evidence.

18         (4)  A delayed certificate of birth filed under this

19  section shall include a summary statement of the evidence

20  submitted in support of the delayed registration.

21         (5)  A delayed certificate of birth submitted for

22  registration under this section shall be signed before a

23  notarizing official by the registrant if of legal age, or by

24  the parent or guardian of a minor registrant.

25         (6)  A person may not establish more than one birth

26  certificate, and a delayed certificate of birth may not be

27  registered for a deceased person.

28         (7)  A delayed death or fetal death record shall be

29  registered on a certificate of death or fetal death and marked

30  "delayed."

31

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  1         (8)  In addition to the rulemaking authority found at

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

  3  dismissal of an application that is not pursued within 1 year.

  4         Section 20.  Subsections (1) and (2) of section

  5  382.025, Florida Statutes, are amended to read:

  6         382.025  Certified copies of vital records;

  7  confidentiality; research.--

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

  9  years old which are not under seal pursuant to court order,

10  all birth records of this state shall be confidential and are

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

12         (a)  Certified copies of the original birth certificate

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

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

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

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

17  by the department and in the form prescribed by the

18  department, and only:

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

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

21  legal representative;

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

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

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

25  representative of any of such persons;

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

27  old and not under seal pursuant to court order;

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

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

30  official purposes upon approval of the department; or

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

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

  2  prevent the fraudulent use of the birth certificates of

  3  deceased persons, the department shall match birth and death

  4  certificates and post the fact of death to the appropriate

  5  birth certificate.  Except for a commemorative birth

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

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

  8  a commemorative birth certificate, such indication of death

  9  shall be made on the back of the certificate.

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

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

12  a commemorative birth certificate representing that the birth

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

14  registrar. The certificate issued under this paragraph shall

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

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

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

18  by the Governor.

19         (2)  OTHER RECORDS.--

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

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

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

23  portion which is confidential and exempt from the provisions

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

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

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

27  fetal death certificate which includes the confidential

28  portions shall be issued only:

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

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

31  or to any person family member who provides a will that has

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

  2  other document that demonstrates his or her the family

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

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

  5  behalf of any of them;

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

  7  the United States for official purposes upon approval of the

  8  department; or

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

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

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

12  after the date of death.

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

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

15  commemorative marriage license representing that the marriage

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

17  registrar.  The certificate issued under this paragraph shall

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

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

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

21  by the Governor.

22         Section 21.  Subsection (2) of section 382.0255,

23  Florida Statutes, is amended to read:

24         382.0255  Fees.--

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

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

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

28  $4 which shall be deposited in the appropriate departmental

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

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

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

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

  2  appropriation to the department for administration of this

  3  chapter.

  4         Section 22.  Paragraph (e) of subsection (3) and

  5  subsection (5) of section 383.14, Florida Statutes, are

  6  amended to read:

  7         383.14  Screening for metabolic disorders, other

  8  hereditary and congenital disorders, and environmental risk

  9  factors.--

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

11  department shall administer and provide certain services to

12  implement the provisions of this section and shall:

13         (e)  Supply the necessary dietary treatment products

14  where practicable for diagnosed cases of phenylketonuria and

15  other metabolic diseases for as long as medically indicated

16  when the products are not otherwise available. Provide

17  nutrition education and supplemental foods to those families

18  eligible for the Special Supplemental Nutrition Food Program

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

20

21  All provisions of this subsection must be coordinated with the

22  provisions and plans established under this chapter, chapter

23  411, and Pub. L. No. 99-457.

24         (5)  ADVISORY COUNCIL.--There is established a Genetics

25  and Infant Screening Advisory Council made up of 12 members

26  appointed by the Secretary of Health.  The council shall be

27  composed of two consumer members, three practicing

28  pediatricians, at least one of whom must be a pediatric

29  hematologist, one representative from each of the four medical

30  schools in the state, the Secretary of Health or his or her

31  designee, one representative from the Department of Health

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  1  representing Division of Children's Medical Services, and one

  2  representative from the Developmental Services Program Office

  3  of the Department of Children and Family Services. All

  4  appointments shall be for a term of 4 years.  The chairperson

  5  of the council shall be elected from the membership of the

  6  council and shall serve for a period of 2 years.  The council

  7  shall meet at least semiannually or upon the call of the

  8  chairperson.  The council may establish ad hoc or temporary

  9  technical advisory groups to assist the council with specific

10  topics which come before the council.  Council members shall

11  serve without pay. Pursuant to the provisions of s. 112.061,

12  the council members are entitled to be reimbursed for per diem

13  and travel expenses.  It is the purpose of the council to

14  advise the department about:

15         (a)  Conditions for which testing should be included

16  under the screening program and the genetics program;

17         (b)  Procedures for collection and transmission of

18  specimens and recording of results; and

19         (c)  Methods whereby screening programs and genetics

20  services for children now provided or proposed to be offered

21  in the state may be more effectively evaluated, coordinated,

22  and consolidated.

23         Section 23.  Subsection (4) of section 385.202, Florida

24  Statutes, is amended to read:

25         385.202  Statewide cancer registry.--

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

27  for establishing, administering, compiling, processing, and

28  providing biometric and statistical analyses to the reporting

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

30  accuracy of the information reported and to provide management

31

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  1  information to the reporting facilities.  Such reporting

  2  hospitals shall be reimbursed for reasonable costs.

  3         Section 24.  Section 385.203, Florida Statutes, is

  4  amended to read:

  5         385.203  Diabetes Advisory Council; creation; function;

  6  membership.--

  7         (1)  To guide a statewide comprehensive approach to

  8  diabetes prevention, diagnosis, education, care, treatment,

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

10  Advisory Council that serves as the advisory unit to the

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

12  Health, other governmental agencies, professional and other

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

14         (a)  Provide statewide leadership to continuously

15  improve the lives of Floridians with diabetes and reduce the

16  burden of diabetes.

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

18  issues related to the public health approach for the delivery

19  of health care services to persons with diabetes.

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

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

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

23  recommendations to the deans regarding the need for diabetes

24  education, treatment, and research activities to promote the

25  prevention and control of diabetes.

26         (c)  By June 30 of each year, meet with the Secretary

27  of Health or his or her designee to make specific

28  recommendations regarding the public health aspects of the

29  prevention and control of diabetes.

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

31  the Governor with advice from nominations by the Board of

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

  2  the Secretary of Health. Members shall serve 4-year terms or

  3  until their successors are appointed or qualified.

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

  5  the state who have knowledge of, or work in the area of

  6  diabetes mellitus as follows:

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

  8  affected by diabetes.

  9         (b)  Twenty members, who must include one

10  representative from each of the following areas: nursing with

11  diabetes-educator certification; dietary with diabetes

12  educator certification; podiatry; opthalmology or optometry;

13  psychology; pharmacy; adult endocrinology; pediatric

14  endocrinology; the American Diabetes Association (ADA); the

15  Juvenile Diabetes Foundation (JDF); a community health center;

16  a county health department; an American Diabetes

17  Association-recognized community education program; each

18  medical school in the state; an osteopathic medical school;

19  the insurance industry; a Children's Medical Services diabetes

20  regional program; and an employer.

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

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

23  four practicing physicians; one representative from each

24  medical school; seven interested citizens, at least three of

25  whom shall be persons who have or have had diabetes mellitus

26  or who have a child with diabetes mellitus; the Secretary of

27  Health or his or her designee; one representative from the

28  Division of Children's Medical Services of the Department of

29  Health; and one professor of nutrition.

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

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

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

  2  meetings shall be held each year.

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

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

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

  6  quorum is necessary for the council to take any official

  7  action.  The Department of Health secretary shall keep a

  8  complete record of the proceedings of each meeting.  The

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

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

11  department, and these and other documents about matters within

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

13  the council.

14         (5)  Members of the council shall serve without

15  remuneration but may be reimbursed for per diem and travel

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

17  are available.

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

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

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

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

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

23  operation of the council or the diabetes centers established

24  in the various medical schools.

25         Section 25.  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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  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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  1         Section 26.  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 27.  Subsection (3) of section 392.69, Florida

18  Statutes, is amended, and subsection (4) is added to that

19  section, to read:

20         392.69  Appropriation, sinking, and maintenance trust

21  funds; additional powers of the department.--

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

23  functions, notwithstanding chapter 216, the department is

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

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

26  regular operating appropriation, or use any sums of money

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

28  by the issuance of revenue certificates of the hospital to

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

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

31  construction or maintenance of additional facilities or

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  1  improvement to existing facilities, as the department deems

  2  necessary.

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

  4  which shall meet quarterly to review and make recommendations

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

  6  Members shall be appointed for terms of 3 years, with such

  7  appointments being staggered so that terms of no more than two

  8  members expire in any one year. Members shall serve without

  9  compensation, but they are entitled to be reimbursed for per

10  diem and travel expenses under s. 112.061.

11         Section 28.  Subsection (7) is added to section 401.25,

12  Florida Statutes, to read:

13         401.25  Licensure as a basic life support or an

14  advanced life support service.--

15         (7)(a)  Each basic-life-support-permitted ambulance of

16  a licensee not specifically exempted from this part, when

17  transporting a person who is sick, injured, wounded,

18  incapacitated, or helpless, must be occupied by at least two

19  persons: one patient attendant who is a certified emergency

20  medical technician, certified paramedic, or licensed physician

21  and one ambulance driver who meets the requirements of s.

22  401.281. This subsection does not apply to interfacility

23  transfers governed by s. 401.252(1).

24         (b)  Each advanced-life-support-permitted ambulance of

25  a licensee not specifically exempted from this part, when

26  transporting a person who is sick, injured, wounded,

27  incapacitated, or helpless must be occupied by at least two

28  persons: one who is a certified paramedic or licensed

29  physician and one who is a certified emergency medical

30  technician, certified paramedic, or licensed physician who

31  also meets the requirements of s. 401.281 for drivers. The

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  1  person with the highest medical certifications shall be in

  2  charge of patient care. This subsection does not apply to

  3  interfacility transfers governed by s. 401.252(1).

  4         Section 29.  Subsection (3) of section 401.27, Florida

  5  Statutes, is amended to read:

  6         401.27  Personnel; standards and certification.--

  7         (3)  Any person who desires to be certified or

  8  recertified as an emergency medical technician or paramedic

  9  must apply under oath to the department on forms provided by

10  the department. The department shall determine whether the

11  applicant meets the requirements specified in this section and

12  in rules of the department and shall issue a certificate to

13  any person who meets such requirements.

14         Section 30.  Present subsection (2) of section 401.30,

15  Florida Statutes, 1998 Supplement, is redesignated as

16  subsection (3), and a new subsection (2) is added to that

17  section, to read:

18         401.30  Records.--

19         (2)  Each licensee must provide the receiving hospital

20  with a copy of an individual patient care record for each

21  patient who is transported to the hospital. The information

22  contained on the record and the method and timeframe for

23  providing the record shall be prescribed by rule of the

24  department.

25         Section 31.  Paragraph (l) is added to subsection (1)

26  and paragraph (h) of subsection (2) of section 401.35, Florida

27  Statutes, is amended to read:

28         401.35  Rules.--The department shall adopt rules

29  necessary to carry out the purposes of this part.

30         (1)  The rules must provide at least minimum standards

31  governing:

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  1         (l)  Licensees' security and storage of controlled

  2  substances, medications, and fluids that are not inconsistent

  3  with the requirements of chapter 499 or chapter 893.

  4         (2)  The rules must establish application requirements

  5  for licensure and certification.  Pursuant thereto, the

  6  department must develop application forms for basic life

  7  support services and advanced life support services.  An

  8  application for each respective service license must include,

  9  but is not limited to:

10         (h)  Such other information as the department

11  determines reasonable and necessary. An oath by the authorized

12  representative of the licensed service that all information,

13  documents, and statements are true and correct.

14         Section 32.  Section 401.49, Florida Statutes, is

15  created to read:

16         401.49  Approval of emergency medical technicians and

17  paramedic programs.--

18         (1)  Any private or public institution in this state

19  which desires to conduct an approved program for educating

20  emergency medical technicians and paramedics must submit to

21  the department a completed application on a form provided by

22  the department which includes:

23         (a)  Evidence that the institution is in compliance

24  with all applicable requirements of the Department of

25  Education.

26         (b)  Evidence that the institution has an agreement of

27  affiliation with a hospital that has an emergency department

28  staffed by at least one physician and one registered nurse.

29         (c)  Evidence that the institution has an agreement of

30  affiliation with an emergency medical service provider that

31  holds a current license in this state. Such agreement must

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  1  include, at a minimum, a commitment by the provider to conduct

  2  the field-experience portion of the education program.

  3         (d)  Documentation verifying that the institution's

  4  faculty includes:

  5         1.  A medical director who is a licensed physician who

  6  meets the applicable requirements for an EMS medical director,

  7  as outlined in this chapter and rules of the department. The

  8  medical director shall certify graduates who have successfully

  9  completed all phases of the education program and are

10  proficient in basic or advanced life-support techniques, as

11  applicable.

12         2.  A program director who is responsible for the

13  operation, organization, periodic review, administration,

14  development, and approval of the program.

15         (e)  Documentation verifying that the curriculum:

16         1.  Meets the requirements for course guides and

17  instructor's lesson plans in the most recent Emergency Medical

18  Technician Basic National Standard Curricula for emergency

19  medical technician programs and the Emergency Medical

20  Technician Paramedic National Standard Curricula for paramedic

21  programs.

22         2.  Includes 2 hours of instruction on the trauma

23  scorecard methodologies for assessment of adult trauma

24  patients and pediatric trauma patients, as specified by the

25  department by rule.

26         3.  Includes 4 hours of instruction on HIV and AIDS,

27  which is consistent with the requirements of chapter 381.

28         (f)  Evidence that the institution has sufficient

29  medical and educational equipment to meet the program needs

30  for training in emergency medical services.

31

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  1         (2)  The department must schedule a site visit to the

  2  applicant's institution within 30 days after notifying the

  3  institution that the application is accepted. During the site

  4  visit, the department must determine the applicant's

  5  compliance with the following criteria:

  6         (a)  The program for emergency medical technicians must

  7  require a minimum of 110 hours, with at least 20 hours of

  8  supervised clinical supervision that includes 10 hours in a

  9  hospital emergency department.

10         (b)  The program for paramedics must be available only

11  to an emergency medical technician who is certified in this

12  state or to an applicant for certification as an emergency

13  medical technician who obtains such certification prior to

14  completing phase one of the paramedic program. The paramedic

15  program must require a minimum of 700 hours of didactic and

16  skills-practice components, with a student-to-instructor ratio

17  for the skills laboratory which does not exceed six to one. A

18  paramedic program must provide field-internship experience

19  aboard an ALS permitted ambulance.

20         (3)  After completing the site visit, the department

21  shall provide a report to the institution. Upon completion of

22  the report, the application is complete and s. 120.60 applies.

23         (4)  If the program is approved, the department shall

24  issue the institution a 2-year certificate of approval as an

25  emergency medical technician training program or a paramedic

26  training program. If the application is denied, the department

27  must notify the applicant of areas of strength, areas that

28  need improvement, and suggested means of improving the

29  program. A notice of denial must be provided to the applicant

30  so that the applicant has at least 5 days in which to advise

31  the department in writing under s. 120.60 of its intent to

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  1  submit a plan of correction. Notice of such intent tolls the

  2  time for processing the application under s. 120.60. The plan

  3  of correction must be submitted to the department within 30

  4  days after the notice. The department shall advise the

  5  applicants of its approval or denial of the plan of correction

  6  within 30 days after receipt of the plan of correction. The

  7  denial of a plan of correction or an application is subject to

  8  review under chapter 120.

  9         (5)  Each approved emergency medical services training

10  program shall maintain records and reports that must be made

11  available to the department upon written request. Such records

12  include student applications, records of attendance, records

13  of participation in hospital clinic and field training,

14  medical records, course objectives and outlines, class

15  schedules, learning objectives, lesson plans, the number of

16  applicants, the number of students accepted, admission

17  requirements, descriptions of qualifications, duties and

18  responsibilities of the institution's faculty, and

19  correspondence.

20         (6)  Each approved program must notify the department

21  within 30 days following any change in the status of a faculty

22  member. Each approved program must require its students to

23  pass a comprehensive final written and practical examination

24  that evaluates the skills described in the most current

25  Emergency Medical Technician Basic or Emergency Medical

26  Technician Paramedic National Standard Curriculum of the

27  United States Department of Transportation. Each approved

28  program must issue a certification of completion to a graduate

29  within 14 days after successful completion of the program.

30         Section 33.  Subsection (3) of section 409.9126,

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

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  1         409.9126  Children with special health care needs.--

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

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

  4  basis and shall utilize a primary care case management

  5  process. Beginning July 1, 1999, the Florida Medicaid program

  6  shall phase in by geographical area, capitation payments to

  7  Children's Medical Services for services provided to Medicaid

  8  children with special healthcare needs. By January 1, 2001,

  9  the Agency for Health Care Administration shall make

10  capitation payments for Children's Medical Services enrollees

11  statewide, to the extent provided by federal law. However,

12  effective July 1, 1999, reimbursement to the Children's

13  Medical Services program for services provided to

14  Medicaid-eligible children with special health care needs

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

16  capitated basis.

17         Section 34.  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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  1         Section 35.  Subsections (14), (15), (16), (19), and

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

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

  4  read:

  5         499.005  Prohibited acts.--It is unlawful to perform or

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

  7  state:

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

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

10  the state in which the person resides to distribute legend

11  drugs.

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

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

14  which the person receives the drug resides to purchase or

15  possess legend drugs.

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

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

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

19  compressed medical gases.

20         (19)  Providing the department with false or fraudulent

21  records, or making false or fraudulent statements, regarding

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

23  device, or cosmetic.

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

25  operating without a valid permit when a permit or registration

26  is, as required by ss. 499.001-499.081 for that activity.

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

28  patient or ultimate consumer without a prescription or order

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

30  device.

31

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  1         Section 36.  Subsection (13) of section 499.007,

  2  Florida Statutes, is amended to read:

  3         499.007  Misbranded drug or device.--A drug or device

  4  is misbranded:

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

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

  7  fails to bear the statement:

  8         (a)  "Caution:  Federal Law Prohibits Dispensing

  9  Without Prescription"; or

10         (b)  "Rx Only";

11         (c)  The prescription symbol followed by the word

12  "Only"; or

13         (d)(b)  "Caution:  State Law Prohibits Dispensing

14  Without Prescription."

15

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

17  prescription of a practitioner licensed by law to prescribe

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

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

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

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

22  seller, the prescription number and the date the prescription

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

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

25  statements.  This exemption does not apply to any drug

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

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

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

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

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

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

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  1         Section 37.  Subsection (15) of section 499.028,

  2  Florida Statutes, is amended to read:

  3         499.028  Drug samples or complimentary drugs; starter

  4  packs; permits to distribute.--

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

  6  sample unless:

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

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

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

10  distributor that holds a permit issued under ss.

11  499.001-499.081.

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

13  samples may be distributed pursuant to this section.

14         (d)  He or she is an officer or employee of a federal,

15  state, or local government acting within the scope of his or

16  her employment.

17         Section 38.  Subsection (1) of section 499.066, Florida

18  Statutes, is amended to read:

19         499.066  Penalties; remedies.--In addition to other

20  penalties and other enforcement provisions:

21         (1)  When the department believes that any person has

22  violated ss. 499.001-499.081 or any rules adopted pursuant to

23  those sections, it may issue and deliver an order to cease and

24  desist from such violation. A cease and desist order issued

25  under this subsection shall take effect immediately upon

26  issuance and shall remain in effect until the department takes

27  final agency action. A cease and desist order is reviewable at

28  the request of the person to whom it is directed as follows:

29         (a)  If formal proceedings have been requested and the

30  matter has been referred to the Division of Administrative

31  Hearings, a motion to abate or modify the cease and desist

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  1  order may be filed with the division. Any interlocutory order

  2  of the presiding administrative law judge shall be binding on

  3  the parties until final agency action is taken by the

  4  department.

  5         (b)  If informal proceedings have been requested, the

  6  department may consider and determine a request from the

  7  affected person to abate or modify the cease and desist order.

  8         (c)  If a person is aggrieved by a cease and desist

  9  order after seeking to have the order abated or modified

10  pursuant to paragraph (a) or paragraph (b), the person may

11  seek interlocutory judicial review by the appropriate district

12  court of appeal pursuant to the applicable rules of appellate

13  procedure.

14         Section 39.  Subsection (1) of section 499.069, Florida

15  Statutes, is amended to read:

16         499.069  Punishment for violations of s. 499.005;

17  dissemination of false advertisement.--

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

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

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

21  the violation is committed after a conviction of such person

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

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

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

25  499.001-499.081, except that any person who violates

26  subsection (8), subsection (10), subsection (14), subsection

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

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

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

30  provided in ss. 499.001-499.081.

31

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  1         Section 40.  Subsection (1) of section 742.10, Florida

  2  Statutes, is amended to read:

  3         742.10  Establishment of paternity for children born

  4  out of wedlock.--

  5         (1)  This chapter provides the primary jurisdiction and

  6  procedures for the determination of paternity for children

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

  8  been raised and determined within an adjudicatory hearing

  9  brought under the statutes governing inheritance, or

10  dependency under workers' compensation or similar compensation

11  programs, or when an affidavit acknowledging paternity or a

12  stipulation of paternity is executed by both parties and filed

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

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

15  executed by both parties, it shall constitute the

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

17  adjudicatory proceeding was held, a voluntary acknowledgment

18  of paternity shall create a rebuttable presumption, as defined

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

20  signatory to rescind the acknowledgment within 60 days of the

21  date the acknowledgment was signed or the date of an

22  administrative or judicial proceeding relating to the child,

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

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

25  are required to provide their social security numbers on any

26  acknowledgment of paternity, consent affidavit, or stipulation

27  of paternity. Except for consenting affidavits under seal

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

29  Statistics shall provide certified copies of affidavits to the

30  Title IV-D agency upon request.

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  1         Section 41.  Section 39.303, Florida Statutes, 1998

  2  Supplement, is amended to read:

  3         39.303  Child protection teams; services; eligible

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

  5  Department of Health shall develop, maintain, and coordinate

  6  the services of one or more multidisciplinary child protection

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

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

  9  representatives of appropriate health, mental health, social

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

11  Legislature finds that optimal coordination of child

12  protection teams and sexual abuse treatment programs requires

13  collaboration between the Department of Health and the

14  Department of Children and Family Services. The two

15  departments shall maintain an interagency agreement that

16  establishes protocols for oversight and operations of child

17  protection teams and sexual abuse treatment programs. The

18  Secretary of Health and the director of Deputy Secretary for

19  Children's Medical Services, in consultation with the

20  Secretary of Children and Family Services, shall maintain the

21  responsibility for the screening, employment, and, if

22  necessary, the termination of child protection team medical

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

24  protection team medical directors shall be responsible for

25  oversight of the teams in the districts.

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

27  the teams to supplement the assessment and protective

28  supervision activities of the family safety and preservation

29  program of the Department of Children and Family Services.

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

31  the duty and responsibility of any person to report pursuant

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

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

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

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

  5  appropriate to abused, abandoned, and neglected children upon

  6  referral.  The specialized diagnostic assessment, evaluation,

  7  coordination, consultation, and other supportive services that

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

  9  but are not limited to, the following:

10         (a)  Medical diagnosis and evaluation services,

11  including provision or interpretation of X rays and laboratory

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

13  findings relative thereto.

14         (b)  Telephone consultation services in emergencies and

15  in other situations.

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

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

18  Health.

19         (d)  Such psychological and psychiatric diagnosis and

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

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

22  or any other individual involved in a child abuse,

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

24  needed.

25         (e)  Expert medical, psychological, and related

26  professional testimony in court cases.

27         (f)  Case staffings to develop treatment plans for

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

29  protection team may provide consultation with respect to a

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

31  neglected, which consultation shall be provided at the request

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  1  of a representative of the family safety and preservation

  2  program or at the request of any other professional involved

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

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

  5  protection team case staffing, consultation, or staff activity

  6  involving a child, a family safety and preservation program

  7  representative shall attend and participate.

  8         (g)  Case service coordination and assistance,

  9  including the location of services available from other public

10  and private agencies in the community.

11         (h)  Such training services for program and other

12  employees of the Department of Children and Family Services,

13  employees of the Department of Health, and other medical

14  professionals as is deemed appropriate to enable them to

15  develop and maintain their professional skills and abilities

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

17         (i)  Educational and community awareness campaigns on

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

19  citizens more successfully to prevent, identify, and treat

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

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

22  that are appropriate for referral by the family safety and

23  preservation program to child protection teams of the

24  Department of Health for support services as set forth in

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

26  involving:

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

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

29         (b)  Unexplained or implausibly explained bruises,

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

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

  2  penetration is alleged or in which other unlawful sexual

  3  conduct has been determined to have occurred.

  4         (d)  Venereal disease, or any other sexually

  5  transmitted disease, in a prepubescent child.

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

  7  child to thrive.

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

  9  of a child.

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

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

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

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

14  other child remains in the home.

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

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

17  suspected.

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

19  is providing certain services to abused, abandoned, or

20  neglected children, other offices and units of the Department

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

22  and Family Services, shall avoid duplicating the provision of

23  those services.

24         Section 42.  Subsection (3) of section 385.203, Florida

25  Statutes, is amended to read:

26         385.203  Diabetes Advisory Council; creation; function;

27  membership.--

28         (3)  The council shall be composed of 18 citizens of

29  the state as follows:  four practicing physicians; one

30  representative from each medical school; seven interested

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

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

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

  3  representative from the Division of Children's Medical

  4  Services of the Department of Health who represents Children's

  5  Medical Services; and one professor of nutrition.

  6         Section 43.  Subsection (8) of section 391.021, Florida

  7  Statutes, 1998 Supplement, is amended to read:

  8         391.021  Definitions.--When used in this act, unless

  9  the context clearly indicates otherwise:

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

11  program established in the Division of Children's Medical

12  Services of the department.

13         Section 44.  Paragraph (b) of subsection (1) of section

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

15  read:

16         391.221  Statewide Children's Medical Services Network

17  Advisory Council.--

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

19  Statewide Children's Medical Services Network Advisory Council

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

21  department.  Specifically, the duties of the council shall

22  include, but not be limited to:

23         (b)  Making recommendations to the director of the

24  Division of Children's Medical Services concerning the

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

26  Services network.

27         Section 45.  Subsection (1) of section 391.222, Florida

28  Statutes, 1998 Supplement, is amended to read:

29         391.222  Cardiac Advisory Council.--

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

31  Cardiac Advisory Council for the purpose of acting as the

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  1  advisory body to the Department of Health Division of

  2  Children's Medical Services in the delivery of cardiac

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

  4  shall include, but not be limited to:

  5         (a)  Recommending standards for personnel and

  6  facilities rendering cardiac services for the Division of

  7  Children's Medical Services;

  8         (b)  Receiving reports of the periodic review of

  9  cardiac personnel and facilities to determine if established

10  standards for the Division of Children's Medical Services

11  cardiac services are met;

12         (c)  Making recommendations to the division director as

13  to the approval or disapproval of reviewed personnel and

14  facilities;

15         (d)  Making recommendations as to the intervals for

16  reinspection of approved personnel and facilities; and

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

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

19  cardiac programs, including the rulemaking process.

20         Section 46.  Section 391.223, Florida Statutes, 1998

21  Supplement, is amended to read:

22         391.223  Technical advisory panels.--The secretary of

23  the department may establish technical advisory panels to

24  assist the Division of Children's Medical Services in

25  developing specific policies and procedures for the Children's

26  Medical Services program.

27         Section 47.  Subsection (4) of section 63.162, Florida

28  Statutes, is amended to read:

29         63.162  Hearings and records in adoption proceedings;

30  confidential nature.--

31

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

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

  3  adoptee unless:

  4         (a)  The birth parent authorizes in writing the release

  5  of his or her name;

  6         (b)  The adoptee, if 18 or more years of age,

  7  authorizes in writing the release of his or her name; or, if

  8  the adoptee is less than 18 years of age, written consent to

  9  disclose the adoptee's name is obtained from an adoptive

10  parent;

11         (c)  The adoptive parent authorizes in writing the

12  release of his or her name; or

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

14  pursuant to a petition filed in accordance with subsection

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

16  shall give primary consideration to the best interests of the

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

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

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

20  limited to:

21         1.  The reason the information is sought;

22         2.  The existence of means available to obtain the

23  desired information without disclosing the identity of the

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

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

26  child-placing agency contact the birth parents and request

27  specific information;

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

29  the adoptive parents, and the birth parents;

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

31  the adoptee; and

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  1         5.  The recommendation of the department, licensed

  2  child-placing agency, or professional which prepared the

  3  preliminary study and home investigation, or the department if

  4  no such study was prepared, concerning the advisability of

  5  disclosure.

  6         Section 48.  Subsection (3) of section 381.731, Florida

  7  Statutes, as amended by section 2 of chapter 98-224, Laws of

  8  Florida, is repealed.

  9         Section 49.  Subsection (5) of section 383.307, Florida

10  Statutes, is repealed.

11         Section 50.  Subsection (7) of section 404.20, Florida

12  Statutes, is repealed.

13         Section 51.  Section 409.9125, Florida Statutes, is

14  repealed.

15         Section 52.  The building that is known as the "1911

16  State Board of Health Building" which is part of a

17  multi-building complex with the address of 1217 Pearl Street,

18  Jacksonville, Florida, shall be known as the "Wilson T.

19  Sowder, M.D., Building."

20         Section 53.  The building authorized by chapter 98-307,

21  Laws of Florida, which will be located on Seagrape Drive on

22  the Tampa Campus of the University of South Florida which will

23  house laboratory facilities for the Department of Health shall

24  be known as the "William G. 'Doc' Myers, M.D., Building."

25         Section 54.  The Department of Health headquarters

26  building which will comprise approximately 100,000 square feet

27  which is authorized by Specific Appropriation 1986 in the

28  1998-1999 General Appropriations Act shall be known as the "E.

29  Charlton Prather, M.D., Building."

30         Section 55.  The Department of Health is authorized to

31  apply for and become a National Environmental Laboratory

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  1  Accreditation program accrediting authority. It is the

  2  specific intent of the Legislature that the Department of

  3  Health shall have the authority to adopt rules to implement

  4  standards of the National Environmental Laboratory

  5  Accreditation Program, as appropriate, and rules to implement

  6  this section, including but not limited to, fees, application

  7  processing, and compliance. All standards applicable to

  8  laboratories and all other rules pursuant to this section

  9  shall be adopted pursuant to chapter 120, Florida Statutes.

10         Section 56.  This act shall take effect July 1, 1999.

11

12          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
13                         Senate Bill 2220

14

15  The committee substitute authorizes the Department of Health
    to adopt rules to inspect certain group facilities and to
16  impose fines for violations of its rules. The bill revises the
    membership of the Diabetes Advisory Council. The bill revises
17  the implementation of a plan to reimburse providers through
    the Children's Medical Services program for services provided
18  to Medicaid eligible children with special health care needs
    on a capitated basis. The bill gives the Department of Health
19  specific statutory authority to approve training programs for
    emergency medical technicians and paramedics and to establish
20  minimum requirements for the staffing of permitted emergency
    medical vehicles; patient records; the security and storage of
21  medications, controlled substances, and fluid on permitted
    emergency medical vehicles; and documents that must be
22  submitted to the department under oath. The bill authorizes
    licensed nursing homes to administer medical oxygen to their
23  residents without being a licensed pharmacy. The bill
    authorizes the Department of Health to apply for and become a
24  National Environmental Laboratory Accreditation program
    accrediting authority.
25

26

27

28

29

30

31

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