Senate Bill 2494

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    Florida Senate - 2000                                  SB 2494

    By Senator Diaz de la Portilla





    34-1478-00

  1                      A bill to be entitled

  2         An act relating to racial and ethnic health

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

  4         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         creating a grant program; providing for

  9         administration; creating s. 381.7354, F.S.;

10         providing for eligibility; creating s.

11         381.7355, F.S.; providing project requirements,

12         including contents of proposals; creating s.

13         381.7356, F.S.; limiting grant awards;

14         requiring local matching funds; providing an

15         appropriation; providing an effective date.

16

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

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20         WHEREAS, the Legislature finds that the death rate from

21  cancer among African-American men is about 50 percent higher

22  than for white men, and

23         WHEREAS, the Legislature finds that African-Americans

24  are nearly twice as likely to die of stroke as whites, and

25         WHEREAS, the Legislature finds that African-American

26  women are 50 percent more likely and Hispanic women are 30

27  percent more likely than non-Hispanic white women to be

28  diagnosed with breast cancer at a late stage, and

29         WHEREAS, the Legislature finds that the death rate for

30  coronary heart disease is 6 percent greater for African

31  Americans compared to white Americans, and

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  1         WHEREAS, the Legislature finds that during the first

  2  year of life, the rate of death for African-American babies is

  3  twice that for white babies, and that African-Americans are

  4  twice as likely to have a low-birthweight baby as are whites,

  5  and

  6         WHEREAS, the Legislature finds that African-Americans

  7  are twice as likely to have diabetes as whites, and Hispanic

  8  whites are 25 percent more likely than non-Hispanic whites to

  9  have diabetes, and

10         WHEREAS, the Legislature finds that Hispanics are

11  26-percent and African-Americans are 77-percent more likely

12  than non-Hispanic whites to suffer from obesity, and

13         WHEREAS, the Legislature finds that Native-American

14  youth are 34-percent more likely to be current smokers than

15  non-Hispanic white youth, and

16         WHEREAS, the Legislature finds that Hispanic and

17  African-American adults are 60-percent more likely than

18  non-Hispanic white adults to be physically inactive, and

19         WHEREAS, the Legislature finds that African-Americans

20  are nearly six times as likely to die of AIDS as whites, and

21         WHEREAS, the Legislature finds that immunization

22  against vaccine-preventable diseases saves millions of dollars

23  in health care costs and reduces the number of absences from

24  school and work, thereby creating environments for children

25  and adults to succeed, and

26         WHEREAS, the Legislature finds that to promote good

27  health practices, a community must develop systems that

28  support healthy behaviors and address the real causes of death

29  and illnesses, and

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  1         WHEREAS, the Legislature recognizes that health

  2  promotion and disease prevention are less costly than

  3  treatment of disease, and

  4         WHEREAS, the Legislature supports the principle of

  5  "Front Porch Florida" and finds that residents can work with

  6  government to identify resources both inside and outside the

  7  community and create neighborhood networks empowered to

  8  address racial and ethnic disparities in health specific to

  9  their community, and

10         WHEREAS, the Legislature intends to close the

11  health-status gap between racial and ethnic populations by

12  making available grants to fund local projects addressing the

13  real causes of death and illness, increasing public awareness

14  of the impact of unhealthy lifestyles, increasing

15  community-based health promotion activities, and increasing

16  community-based disease prevention activities, NOW, THEREFORE,

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

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21         Section 1.  Section 381.7351, Florida Statutes, is

22  created to read:

23         381.7351  Short title.--Sections 381.7351-381.7356 may

24  be cited as the "Reducing Racial and Ethnic Health

25  Disparities--Closing the Gap Act."

26         Section 2.  Section 381.7352, Florida Statutes, is

27  created to read:

28         381.7352  Legislative findings and intent.--

29         (1)  The Legislature finds that despite state

30  investments in health care programs certain racial and ethnic

31  populations in this state continue to have significantly

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  1  poorer health outcomes when compared to non-Hispanic whites.

  2  The Legislature finds that local solutions to health care

  3  problems can have a dramatic and positive effect on the

  4  health-status of these populations. Local governments and

  5  communities are best equipped to identify the health

  6  education, health promotion, and disease prevention needs of

  7  the racial and ethnic populations in their communities, to

  8  mobilize the community to address health outcome disparities,

  9  to enlist and organize local public and private resources to

10  address these disparities, and to evaluate the effectiveness

11  of interventions.

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

13  provide to counties and neighborhoods in this state funds in

14  the form of "Reducing Racial and Ethnic Health

15  Disparities--Closing the Gap" grants to stimulate the

16  development of community-based and neighborhood-based projects

17  that will improve the health outcomes of racial and ethnic

18  populations. Further, it is the intent of the Legislature that

19  these programs foster the development of coordinated,

20  collaborative, and broad-based participation by public and

21  private entities. Finally, it is the intent of the Legislature

22  that the grant program function as a partnership between state

23  and local governments and private-sector health care

24  providers, including managed care, voluntary health care

25  resources, social service providers, and nontraditional

26  partners.

27         Section 3.  Section 381.7353, Florida Statutes, is

28  created to read:

29         381.7353  Reducing Racial and Ethnic Health

30  Disparities--Closing the Gap Program; administration;

31  department duties.--

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  1         (1)  The Department of Health shall administer the

  2  Reducing Racial and Ethnic Health Disparities--Closing the Gap

  3  grant program.

  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 KidCare Program, the

19  HIV/AIDS program, immunization program, and other related

20  programs at the state and local levels to avoid duplication of

21  effort and promote consistency.

22         (3)  Pursuant to s. 20.43, the Secretary of Health may

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

24  public awareness, public education, research and coordination

25  regarding racial and ethnic health outcome disparities are

26  lacking; consider access and transportation issues that

27  contribute to health-status disparities; and make

28  recommendations for closing gaps in health outcomes and for

29  increasing public awareness and understanding of health

30  disparities that exist for 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 to develop community

  8  partnerships necessary to implement the grant.

  9         (2)  Adjoining counties having populations of less than

10  100,000, based on the annual estimates produced by the

11  Population Program of the University of Florida Bureau of

12  Economic and Business Research, may jointly submit a

13  multicounty Closing the Gap grant proposal. However, the

14  proposal must clearly identify a single lead agency with

15  respect to program accountability and administration.

16         (3)  In addition to county grants, no more than 20

17  percent of the funding for the Reducing Racial and Ethnic

18  Health Disparities--Closing the Gap grant program may be

19  dedicated to projects that address improving racial and ethnic

20  health-status within a specific neighborhood. Priority must be

21  given to communities or neighborhoods that have been

22  designated as "Front Porch Communities."

23         (4)  Sections 381.7351-381.7356 do not prevent a county

24  or group of counties from separately contracting for the

25  provision of racial and ethnic health promotion, health

26  awareness, and disease prevention services.

27         Section 5.  Section 381.7355, Florida Statutes, is

28  created to read:

29         381.7355  Project requirements; contents of

30  proposals.--

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

  2  to the Department of Health for review.

  3         (2)  The proposal must include the following elements:

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

  5  including identification of the particular racial or ethnic

  6  disparity the project will address. The proposal must address

  7  one or more of the following priority areas;

  8         1.  Decreasing racial and ethnic disparities in

  9  maternal and infant mortality rates;

10         2.  Decreasing racial and ethnic disparities in

11  morbidity and mortality rates relating to cancer;

12         3.  Decreasing racial and ethnic disparities in

13  morbidity and mortality relating to HIV/AIDS;

14         4.  Decreasing racial and ethnic disparities in

15  morbidity and mortality rates relating to cardiovascular

16  disease;

17         5.  Decreasing racial and ethnic disparities in

18  morbidity and mortality relating to diabetes; and

19         6.  Increasing adult and child immunization rates in

20  the racial and ethnic population.

21         (b)  Identification and relevance of the target

22  population.

23         (c)  Methods for obtaining baseline health status data

24  and assessment of community health needs.

25         (d)  Mechanisms for mobilizing the community resources

26  and gaining local commitment.

27         (e)  Development and implementation of health promotion

28  and disease prevention interventions.

29         (f)  Mechanisms and strategies for evaluating project

30  objectives, procedures, and outcomes.

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  1         (g)  A proposed workplan, including a timeline for

  2  having the project operational.

  3         (h)  Likelihood of project activities occurring and

  4  continuing in the absence of funding.

  5         (3)  Priority will be given to proposals that:

  6         (a)  Represent areas with the greatest documented

  7  racial and ethnic health status disparities.

  8         (b)  Exceed the minimum local contribution requirements

  9  specified in s. 385.306.

10         (c)  Demonstrate broad-based local support and

11  commitment from entities representing racial and ethnic

12  populations including non-Hispanic whites. Indicators of

13  support and commitment may include agreements to participate

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

15  interagency agreements, or other forms of support.

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

17  health care community in clinical preventive service

18  activities and community-based health promotion and disease

19  prevention interventions.

20         (e)  Are submitted by counties that have a high

21  proportion of residents who live in poverty and exhibit poor

22  health status indicators.

23         (g)  Demonstrate a coordinated community approach to

24  addressing racial and ethnic health issues with existing

25  publicly financed health care programs.

26         (h)  Incorporate intervention mechanisms that have a

27  high probability for improving the targeted population's

28  health status.

29         (i)  Demonstrate a commitment to quality management in

30  all aspects of project administration and implementation.

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  1         Section 6.  Section 381.7356, Florida Statutes, is

  2  created to read:

  3         381.7356  Local matching funds; grant awards.--

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

  5  per county or to a group of counties applying jointly.

  6  However, neighborhood grants may be awarded in a county or

  7  counties that are also receiving a grant.

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

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

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

11  that:

12         (a)  In counties having populations greater than

13  50,000, up to 50 percent of the local match may be in-kind in

14  the form of free services or human resources. At least 50

15  percent of the local match must be in the form of cash.

16         (b)  A county having a population of less than 50,000

17  may provide the required local matching funds entirely through

18  in-kind contributions.

19         (c)  Neighborhood grants do not entail a matching

20  requirement.

21         (3)  The amount of the grant award must be based on a

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

23  population of a group of counties applying for a singe grant,

24  and on other factors determined by the department.

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

26  than January 1, 2001.

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

28  and may be renewed annually upon application to and approval

29  by the department, subject to the meeting of quality

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

31  funds.

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  1         (6)  Implementation of the grant program is contingent

  2  upon a specific appropriation's being provided in the General

  3  Appropriations Act.

  4         Section 7.  The sum of $10 million is appropriated from

  5  the General Revenue Fund to the Department of Health to be

  6  used to establish and implement the Reducing Racial and Ethnic

  7  Health Disparities--Closing the Gap Act, including funding one

  8  full-time-equivalent position.

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

10  law.

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12            *****************************************

13                          SENATE SUMMARY

14    Creates the "Reducing Racial and Ethnic Health
      Disparities--Closing the Gap Act." Provides legislative
15    findings and intent. Provides for a grant program to be
      administered by the Department of Health. Provides
16    requirements for receiving grants, including contents of
      proposals. Limits grant awards. Requires local matching
17    funds, except for neighborhood grants. Provides an
      appropriation.
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