House Bill 1125

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    Florida House of Representatives - 2000                HB 1125

        By Representative Bradley






  1                      A bill to be entitled

  2         An act relating to improving racial and ethnic

  3         health outcomes; creating s. 381.7351, F.S.;

  4         creating the "Reducing Racial and Ethnic Health

  5         Disparities: Closing the Gap Act"; creating s.

  6         381.7352, F.S.; providing legislative findings

  7         and intent; creating s. 381.7353, F.S.;

  8         providing for the creation of the Reducing

  9         Racial and Ethnic Health Disparities: Closing

10         the Gap grant program, to be administered by

11         the Department of Health; providing department

12         duties and responsibilities; authorizing

13         appointment of an advisory committee; creating

14         s. 381.7354, F.S.; providing eligibility for

15         grant awards; creating s. 381.7355, F.S.;

16         providing project requirements, an application

17         process, and review criteria; creating s.

18         381.7356, F.S.; providing for Closing the Gap

19         grant awards; providing for local matching

20         funds; providing factors for determination of

21         the amount of grant awards; providing for award

22         of grants to begin by a specified date, subject

23         to specific appropriation; providing for annual

24         renewal of grants; providing an appropriation;

25         providing an effective date.

26

27         WHEREAS, the death rate for cancer among African

28  American men is approximately 50 percent higher than for white

29  men, and

30         WHEREAS, African Americans are nearly twice as likely

31  to die of stroke as whites, and

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  1         WHEREAS, African American women are 50 percent more

  2  likely, and Hispanic women are 30 percent more likely, than

  3  non-Hispanic white women to be diagnosed with late-stage

  4  breast cancer, and

  5         WHEREAS, the death rate for coronary heart disease is 6

  6  percent higher for African Americans than for whites, and

  7         WHEREAS, during the first year of life, the rate of

  8  death for African American babies is twice that of white

  9  babies, and African Americans are twice as likely as whites to

10  have low birthweight babies, and

11         WHEREAS, African Americans are twice as likely to have

12  diabetes as whites, and Hispanic whites are 25 percent more

13  likely than non-Hispanic whites to have diabetes, and

14         WHEREAS, African Americans are 77 percent more likely,

15  and Hispanics are 26 percent more likely, than non-Hispanic

16  whites to suffer from obesity, and

17         WHEREAS, Native American youth are 34 percent more

18  likely to be current smokers than non-Hispanic white youth,

19  and

20         WHEREAS, African American and Hispanic adults are 60

21  percent more likely than non-Hispanic white adults to be

22  physically inactive, and

23         WHEREAS, African Americans are nearly six times as

24  likely to die of AIDS as whites, and

25         WHEREAS, immunization against vaccine-preventable

26  diseases saves millions of dollars in health care costs and

27  reduces the number of absences from school and work, thereby

28  creating environments in which children and adults can

29  succeed, and

30

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  1         WHEREAS, to promote good health practices, a community

  2  must develop systems that support healthy behaviors and

  3  address the real causes of death and illness, and

  4         WHEREAS, health promotion and disease prevention are

  5  less costly than treatment of disease, and

  6         WHEREAS, the Legislature supports the principle of the

  7  Front Porch Florida initiative and finds that residents can

  8  work with government to identify resources both inside and

  9  outside the community, and create neighborhood networks

10  empowered to address racial and ethnic disparities in health

11  specific to their communities, and

12         WHEREAS, the Legislature intends to close the health

13  status gap between racial and ethnic populations by making

14  available grants to fund local projects addressing the real

15  causes of death and illness, increasing public awareness of

16  the impact of unhealthy lifestyles, increasing community-based

17  health promotion activities, and increasing community-based

18  disease prevention activities, NOW, THEREFORE,

19

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

21

22         Section 1.  Section 381.7351, Florida Statutes, is

23  created to read:

24         381.7351  Short title.--Sections 381.7351-381.7356 may

25  be cited as the "Reducing Racial and Ethnic Health

26  Disparities:  Closing the Gap Act." 

27         Section 2.  Section 381.7352, Florida Statutes, is

28  created to read:

29         381.7352  Legislative findings and intent.--

30         (1)  The Legislature finds that despite state

31  investments in health care programs, certain racial and ethnic

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  1  populations in Florida continue to have significantly poorer

  2  health outcomes when compared to non-Hispanic whites.  The

  3  Legislature finds that local solutions to health care problems

  4  can have a dramatic and positive effect on the health status

  5  of these populations.  Local governments and communities are

  6  best equipped to identify the health education, health

  7  promotion, and disease prevention needs of the racial and

  8  ethnic populations in their communities, mobilize the

  9  community to address health outcome disparities, enlist and

10  organize local public and private resources to address these

11  disparities, and evaluate the effectiveness of interventions.

12         (2)  It is therefore the intent of the Legislature to

13  provide funds within Florida counties and neighborhoods, in

14  the form of Reducing Racial and Ethnic Health Disparities:

15  Closing the Gap grants, to stimulate the development of

16  community-based and neighborhood-based projects which will

17  improve the health outcomes of racial and ethnic populations.

18  Further, it is the intent of the Legislature that these

19  programs foster the development of coordinated, collaborative,

20  and broad-based participation by public and private entities.

21  Finally, it is the intent of the Legislature that the grant

22  program function as a partnership between state and local

23  governments and private-sector health care providers,

24  including managed care, voluntary health care resources,

25  social service providers, and nontraditional partners.

26         Section 3.  Section 381.7353, Florida Statutes, is

27  created to read:

28         381.7353  Reducing Racial and Ethnic Health

29  Disparities:  Closing the Gap grant program; administration;

30  department duties.--

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  1         (1)  The Reducing Racial and Ethnic Health Disparities:

  2  Closing the Gap grant program shall be administered by the

  3  Department of Health.

  4         (2)  The department shall:

  5         (a)  Publicize the availability of funds and establish

  6  an application process for submitting a grant proposal.

  7         (b)  Provide technical assistance and training,

  8  including a statewide meeting promoting best practice

  9  programs, as requested, to grant recipients.

10         (c)  Develop uniform data reporting requirements for

11  the purpose of evaluating the performance of the grant

12  recipients and demonstrating improved health outcomes.

13         (d)  Develop a monitoring process to evaluate progress

14  toward meeting grant objectives.

15         (e)  Coordinate with existing community-based programs,

16  such as chronic disease community intervention programs,

17  cancer prevention and control programs, diabetes control

18  programs, the Healthy Start program, the Florida KidCare

19  Program, the HIV/AIDS program, immunization programs, and

20  other related programs at the state and local levels, to avoid

21  duplication of effort and promote consistency.

22         (3)  Pursuant to s. 20.43(6), the secretary may appoint

23  an ad hoc advisory committee to: examine areas where public

24  awareness, public education, research, and coordination

25  regarding racial and ethnic health outcome disparities are

26  lacking; consider access and transportation issues which

27  contribute to health status disparities; and make

28  recommendations for closing gaps in health outcomes and

29  increasing the public's awareness and understanding of health

30  disparities that exist between racial and ethnic populations.

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  1         Section 4.  Section 381.7354, Florida Statutes, is

  2  created to read:

  3         381.7354  Eligibility.--

  4         (1)  Any person, entity, or organization within a

  5  single county may apply for a Closing the Gap grant and shall

  6  serve as the lead agency to administer and coordinate project

  7  activities within that county and develop community

  8  partnerships necessary to implement the grant.

  9         (2)  Persons, entities, or organizations within

10  adjoining counties with populations of less than 100,000,

11  based on the annual estimates produced by the Population

12  Program of the University of Florida Bureau of Economic and

13  Business Research, may jointly submit a multicounty Closing

14  the Gap grant proposal.  However, the proposal must clearly

15  identify a single lead agency with respect to program

16  accountability and administration.

17         (3)  In addition to the grants awarded under

18  subsections (1) and (2), up to 20 percent of the funding for

19  the Reducing Racial and Ethnic Health Disparities: Closing the

20  Gap grant program shall be dedicated to projects that address

21  improving racial and ethnic health status within a specific

22  neighborhood.  Specific priority shall be given to communities

23  or neighborhoods that have been designated as Front Porch

24  Florida Communities.

25         (4)  Nothing in ss. 381.7351-381.7356 shall prevent a

26  person, entity, or organization within a county or group of

27  counties from separately contracting for the provision of

28  racial and ethnic health promotion, health awareness, and

29  disease prevention services.

30         Section 5.  Section 381.7355, Florida Statutes, is

31  created to read:

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  1         381.7355  Project requirements; review criteria.--

  2         (1)  Closing the Gap grant proposals shall be submitted

  3  to the Department of Health for review.

  4         (2)  A proposal must include each of the following

  5  elements:

  6         (a)  The purpose and objectives of the proposal,

  7  including identification of the particular racial or ethnic

  8  disparity the project will address. The proposal must address

  9  one or more of the following priority areas:

10         1.  Decreasing racial and ethnic disparities in

11  maternal and infant mortality rates.

12         2.  Decreasing racial and ethnic disparities in

13  morbidity and mortality rates relating to cancer.

14         3.  Decreasing racial and ethnic disparities in

15  morbidity and mortality rates relating to HIV/AIDS.

16         4.  Decreasing racial and ethnic disparities in

17  morbidity and mortality rates relating to cardiovascular

18  disease.

19         5.  Decreasing racial and ethnic disparities in

20  morbidity and mortality rates relating to diabetes.

21         6.  Increasing adult and child immunization rates in

22  certain racial and ethnic populations.

23         (b)  Identification and relevance of the target

24  population.

25         (c)  Methods for obtaining baseline health status data

26  and assessment of community health needs.

27         (d)  Mechanisms for mobilizing community resources and

28  gaining local commitment.

29         (e)  Development and implementation of health promotion

30  and disease prevention interventions.

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  1         (f)  Mechanisms and strategies for evaluating the

  2  project's objectives, procedures, and outcomes.

  3         (g)  A proposed work plan, including a timeline for

  4  implementing the project.

  5         (h)  Likelihood that project activities will occur and

  6  continue in the absence of funding.

  7         (3) Priority shall be given to proposals that:

  8         (a)  Represent areas with the greatest documented

  9  racial and ethnic health status disparities.

10         (b)  Exceed the minimum local contribution requirements

11  specified in s. 381.7356.

12         (c)  Demonstrate broad-based local support and

13  commitment from entities representing racial and ethnic

14  populations, including non-Hispanic whites. Indicators of

15  support and commitment may include agreements to participate

16  in the program, letters of endorsement, letters of commitment,

17  interagency agreements, or other forms of support.

18         (d)  Demonstrate a high degree of participation by the

19  health care community in clinical preventive service

20  activities and community-based health promotion and disease

21  prevention interventions.

22         (e)  Have been submitted from counties with a high

23  proportion of residents living in poverty and with poor health

24  status indicators.

25         (f)  Demonstrate a coordinated community approach to

26  addressing racial and ethnic health issues within existing

27  publicly financed health care programs.

28         (g)  Incorporate intervention mechanisms which have a

29  high probability of improving the targeted population's health

30  status.

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  1         (h)  Demonstrate a commitment to quality management in

  2  all aspects of project administration and implementation.

  3         Section 6.  Section 381.7356, Florida Statutes, is

  4  created to read:

  5         381.7356  Local matching funds; grant awards.--

  6         (1)  Only one Closing the Gap grant shall be awarded in

  7  a county, or in a group of adjoining counties from which a

  8  multicounty application is submitted. However, neighborhood

  9  grants may be awarded in a county or group of adjoining

10  counties that is also receiving a grant award.

11         (2)  Closing the Gap grants shall be awarded on a

12  matching basis.  One dollar in local matching funds must be

13  provided for each $3 grant payment made by the state, except

14  that:

15         (a)  In counties with populations greater than 50,000,

16  up to 50 percent of the local match may be in-kind in the form

17  of free services or human resources. Fifty percent of the

18  local match must be in the form of cash.

19         (b)  In counties with populations of 50,000 or less,

20  the required local matching funds may be provided entirely

21  through in-kind contributions.

22         (c)  Grant awards to neighborhoods shall not be

23  required to have a matching requirement.

24         (3)  The amount of the grant award shall be based on

25  the county or neighborhood's population, or on the combined

26  population in a group of adjoining counties from which a

27  multicounty application is submitted, and on other factors, as

28  determined by the department.

29         (4)  Dissemination of grant awards shall begin no later

30  than January 1, 2001.

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  1         (5)  A Closing the Gap grant shall be funded for 1 year

  2  and may be renewed annually upon application to and approval

  3  by the department, subject to the achievement of quality

  4  standards, objectives, and outcomes and to the availability of

  5  funds.

  6         (6)  Implementation of the Reducing Racial and Ethnic

  7  Health Disparities: Closing the Gap grant program shall be

  8  subject to a specific appropriation provided in the General

  9  Appropriations Act.

10         Section 7.  There is appropriated from the General

11  Revenue Fund to the Department of Health the sum of $10

12  million to be used to establish and implement the Reducing

13  Racial and Ethnic Health Disparities: Closing the Gap grant

14  program, including funding for one full-time-equivalent

15  position.

16         Section 8.  This act shall take effect upon becoming a

17  law.

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19            *****************************************

20                          HOUSE SUMMARY

21
      Creates the "Reducing Racial and Ethnic Health
22    Disparities: Closing the Gap Act." Provides legislative
      findings and intent. Creates the Reducing Racial and
23    Ethnic Health Disparities: Closing the Gap grant program,
      to be administered by the Department of Health. Provides
24    duties and responsibilities of the department. Authorizes
      appointment of an ad hoc advisory committee by the
25    department secretary. Provides eligibility, requirements,
      and procedures for award of grants to local individuals,
26    entities, and organizations to address disparities in
      racial and ethnic health outcomes. Requires local
27    matching funds or in-kind contributions. Provides for
      dissemination of 1-year grant awards beginning no later
28    than January 1, 2001, subject to specific appropriation.
      Provides for annual applications for grant renewal.
29    Provides an appropriation.

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