HB 0913

CS

CHAMBER ACTION

1	The Committee on Health Care recommends the following:
2
3	Committee Substitute
4	Remove the entire bill and insert:
5	A bill to be entitled
6	An act relating to public health care; amending s.
7	381.0012, F.S.; expanding the environmental health
8	enforcement authority of the Department of Health;
9	authorizing the department to issue citations or order
10	payment of fines; providing requirements and limitations;
11	providing a criminal penalty; providing for deposit and
12	use of fines; amending s. 381.004, F.S.; providing
13	additional criteria for release of HIV preliminary test
14	results; amending s. 381.006, F.S.; establishing
15	permitting procedures for group care facilities; providing
16	requirements and limitations; providing for fees;
17	providing fee exemptions for foster homes and certain
18	homes for persons with developmental disabilities;
19	providing fee limitations; providing authority to the
20	department to take adverse action on permits under certain
21	circumstances; amending s. 381.0065, F.S.; modifying
22	standards for rulemaking applicable to regulation of
23	onsite sewage treatment and disposal systems; revising
24	research award qualifications; providing for an extended
25	right of entry; amending s. 381.0101, F.S.; revising
26	definitions; revising environmental health professional
27	certification requirements; clarifying exemptions;
28	creating s. 381.104, F.S.; creating an employee health and
29	wellness program; providing requirements; authorizing
30	state agencies to undertake certain activities relating to
31	agency resources for program purposes; requiring each
32	participating agency to make an annual report; providing
33	duties of the department; amending s. 384.25, F.S.;
34	revising reporting requirements for sexually transmissible
35	diseases; authorizing the department to adopt rules;
36	amending s. 384.31, F.S.; revising sexually transmissible
37	disease testing requirements for pregnant women; providing
38	notice requirements; creating s. 385.104, F.S.;
39	establishing the Health Promotion and Health Education
40	Statewide Initiative for certain purposes; providing
41	requirements; authorizing the department to award funding
42	to county health departments for certain purposes;
43	providing funding requirements; providing participation
44	requirements for county health departments; creating s.
45	458.3215, F.S.; providing for reactivation of licenses of
46	certain physicians for certain limited purposes; providing
47	for a reactivation fee; amending s. 945.601, F.S.;
48	revising a cross reference, to conform; creating s.
49	945.6038, F.S.; authorizing the State of Florida
50	Correctional Medical Authority to enter into agreements
51	with other state agencies to provide additional medical
52	services; providing a limitation; providing an effective
53	date.
54
55	Be It Enacted by the Legislature of the State of Florida:
56
57	Section 1.  Subsections (6) and (7) are added to section
58	381.0012, Florida Statutes, to read:
59	381.0012  Enforcement authority.--
60	(6)  When a violation of s. 386.01, s. 386.041, or
61	environmental health rules adopted under this chapter occurs,
62	and such violation is enforceable by administrative or civil
63	remedy or is a second degree misdemeanor, the department may
64	issue a citation that contains an order of correction, an order
65	to pay a fine, or both. A citation issued under this subsection
66	constitutes a notice of proposed agency action.
67	(a)  Citations must be in writing and must describe the
68	particular nature of the violation, including specific reference
69	to the provision of statute or rule allegedly violated.
70	(b)  The fines imposed may not exceed $500 for each
71	violation. Each day constitutes a separate violation for which a
72	citation may be issued.
73	(c)  The citing official shall inform the recipient, by
74	written notice pursuant to ss. 120.569 and 120.57, of the right
75	to an administrative hearing. The citation must contain a
76	conspicuous statement that failure to pay the fine within the
77	allotted time, or failure to appear to contest the citation
78	after having requested a hearing, constitutes a waiver of the
79	right to contest the citation.
80	(d)  The department may reduce or waive the fine imposed by
81	the citation after giving due consideration to such factors as
82	the gravity of the violation, the good faith of the person who
83	has allegedly committed the violation, and the person's history
84	of previous violations, including violations for which
85	enforcement actions were taken under this section or other
86	provisions of law.
87	(e)  Any person who willfully refuses to sign and accept a
88	citation issued by the department commits a misdemeanor of the
89	second degree, punishable as provided in s. 775.082 or s.
90	775.083.
91	(f)  The department shall deposit all fines collected under
92	the authority of this subsection in the County Health Department
93	Trust Fund for use in the environmental health program under
94	which the fine was issued and shall use such fines to improve
95	the respective programs or to provide training to the regulated
96	industry and department staff working in such programs.
97	(g)  The provisions of this subsection are an alternative
98	means of enforcing environmental health requirements which does
99	not prohibit the department from using other means of
100	enforcement. However, the department shall use only one method
101	of enforcement for a single violation.
102	(7)  The department may use positive means of enforcement
103	to ensure compliance with environmental health requirements
104	specified in this chapter, ss. 386.01 and 386.041, or
105	environmental health rules adopted under the authority of this
106	chapter. Such means of enforcement may include requiring
107	attendance at training courses applicable to the violations
108	committed and requiring the use of best management practices
109	currently used or recognized by the appropriate regulated
110	industry or governmental agency.
111	Section 2.  Paragraph (d) of subsection (3) of section
112	381.004, Florida Statutes, is amended to read:
113	381.004  HIV testing.--
114	(3)  HUMAN IMMUNODEFICIENCY VIRUS TESTING; INFORMED
115	CONSENT; RESULTS; COUNSELING; CONFIDENTIALITY.--
116	(d)  No test result shall be determined as positive, and no
117	positive test result shall be revealed to any person, without
118	corroborating or confirmatory tests being conducted except in
119	the following situations:
120	1.  Preliminary test results may be released to licensed
121	physicians or the medical or nonmedical personnel subject to the
122	significant exposure for purposes of subparagraphs (h)10., 11.,
123	and 12.
124	2.  Preliminary test results may be released to health care
125	providers and to the person tested when decisions about medical
126	care or treatment of, or recommendation to, the person tested
127	and, in the case of an intrapartum or postpartum woman, when
128	care, treatment, or recommendations regarding her newborn,
129	cannot await the results of confirmatory testing. Positive
130	preliminary HIV test results shall not be characterized to the
131	patient as a diagnosis of HIV infection. Justification for the
132	use of preliminary test results must be documented in the
133	medical record by the health care provider who ordered the test.
134	This subparagraph does not authorize the release of preliminary
135	test results for the purpose of routine identification of HIV-
136	infected individuals or when HIV testing is incidental to the
137	preliminary diagnosis or care of a patient. Corroborating or
138	confirmatory testing must be conducted as followup to a positive
139	preliminary test. Results shall be communicated to the patient
140	according to statute regardless of the outcome. Except as
141	provided in this section, test results are confidential and
142	exempt from the provisions of s. 119.07(1).
143	3.  Positive rapid test results are considered preliminary
144	and may be released in accordance with the manufacturer's
145	instructions as approved by the United States Food and Drug
146	Administration. Positive rapid test results require confirmatory
147	testing for diagnosis and reporting of HIV infection.
148	Section 3.  Subsection (16) of section 381.006, Florida
149	Statutes, is amended to read:
150	381.006  Environmental health.--The department shall
151	conduct an environmental health program as part of fulfilling
152	the state's public health mission. The purpose of this program
153	is to detect and prevent disease caused by natural and manmade
154	factors in the environment. The environmental health program
155	shall include, but not be limited to:
156	(16)  A group care facilities group-care-facilities
157	function, where a group care group-care facility means any
158	public or private school, housing, building or buildings,
159	section of a building, or distinct part of a building or other
160	place, whether operated for profit or not, which undertakes,
161	through its ownership or management, to provide one or more
162	personal services, care, protection, and supervision to persons
163	who require such services and who are not related to the owner
164	or administrator. The department may adopt rules necessary to
165	protect the health and safety of residents, staff, and patrons
166	of group care group-care facilities, such as child care
167	facilities, family day care day-care homes, assisted living
168	assisted-living facilities, adult day care day-care centers,
169	adult family-care homes, hospices, residential treatment
170	facilities, crisis stabilization crisis-stabilization units,
171	pediatric extended care extended-care centers, intermediate care
172	intermediate-care facilities for the developmentally disabled,
173	group care group-care homes, and, jointly with the Department of
174	Education, private and public schools. These rules may include
175	definitions of terms; provisions relating to operation and
176	maintenance of facilities, buildings, grounds, equipment,
177	furnishings, and occupant-space requirements; lighting; heating,
178	cooling, and ventilation; food service; water supply and
179	plumbing; sewage; sanitary facilities; insect and rodent
180	control; garbage; safety; personnel health, hygiene, and work
181	practices; permits and fees; and other matters the department
182	finds are appropriate or necessary to protect the safety and
183	health of the residents, staff, or patrons. The department may
184	not adopt rules that conflict with rules adopted by the
185	licensing or certifying agency. The department may enter and
186	inspect at reasonable hours to determine compliance with
187	applicable statutes or rules. In addition to any sanctions that
188	the department may impose for violations of rules adopted under
189	this section, the department shall also report such violations
190	to any agency responsible for licensing or certifying the group
191	care group-care facility. The licensing or certifying agency may
192	also impose any sanction based solely on the findings of the
193	department.
194	(a)  Each group care facility regulated under this section
195	shall obtain a permit from the department annually. Group care
196	facility permits shall expire annually and shall not be
197	transferable from one place or individual to another. An annual
198	application for permit renewal shall not be required. In new
199	facilities, or when the ownership, control, address, or name of
200	a group care facility is changed, the owner, or the owner's
201	designee, shall apply to the department for issuance of a permit
202	in the manner prescribed by the department.
203	(b)  The department shall establish procedures for the
204	issuance and annual renewal of permits and shall establish
205	annual permit and renewal fees by rule in an amount necessary to
206	cover the expenses of administering this section. Effective
207	October 1, 2004, and until such fees are established by rule,
208	the annual permit fee shall be as follows:
209	1.  Nonresidential facilities, including, but not limited
210	to, child care centers, public schools, and private schools,
211	shall pay an annual fee based on a rate of $3.50 per student for
212	the maximum authorized capacity. The total permit fee shall not
213	be less than $110 nor more than $300.
214	2.  Residential facilities, including, but not limited to,
215	assisted living facilities, group homes, residential treatment
216	facilities, and other residential facilities, shall pay an
217	annual fee based on a rate of $15.50 per bed for the maximum
218	authorized capacity. The total permit fee shall not be less than
219	$110 nor more than $600, except for adult family care homes,
220	which shall pay a flat fee of $60. Foster homes and homes of
221	three or fewer beds for persons with developmental disabilities
222	shall be exempt from payment of such fees.
223	(c)  The annual permit and renewal fees established and
224	adopted by rule shall not be less than $60 nor more than $600
225	per group care facility. Foster homes and homes of three or
226	fewer beds for persons with developmental disabilities shall be
227	exempt from payment of such fees.
228	(d)  Permit fees shall be prorated quarterly to reflect the
229	actual number of quarters per calendar year the permit is valid.
230	(e)  The department may refuse to issue a permit to or
231	renew a permit for any facility that is not constructed or
232	maintained in accordance with the rules of the department. The
233	department may cancel, revoke, or suspend a permit to operate a
234	group care facility if the permittee:
235	1.  Fails to pay any fee required by this section;
236	2.  Obtains or attempts to obtain a permit by fraud; or
237	3.  Violates a provision of this section.
238
239	The department may adopt rules to carry out the provisions of
240	this section.
241	Section 4.  Paragraphs (a) and (j) of subsection (3) of
242	section 381.0065, Florida Statutes, are amended, and paragraph
243	(c) is added to subsection (5) of said section, to read:
244	381.0065  Onsite sewage treatment and disposal systems;
245	regulation.--
246	(3)  DUTIES AND POWERS OF THE DEPARTMENT OF HEALTH.--The
247	department shall:
248	(a)  Adopt rules to administer ss. 381.0065-381.0067,
249	including definitions that are consistent with the definitions
250	in this section, decreases to setback requirements where no
251	health hazard exists, increases for the lot-flow allowance for
252	performance-based systems, requirements for separation from
253	water table elevation during the wettest season, requirements
254	for the design and construction of any component part of an
255	onsite sewage treatment and disposal system, application and
256	permit requirements for persons who maintain an onsite sewage
257	treatment and disposal system, requirements for maintenance and
258	service agreements for aerobic treatment units and performance-
259	based treatment systems, and recommended standards, including
260	disclosure requirements, for voluntary system inspections to be
261	performed by individuals who are authorized by law to perform
262	such inspections and who shall inform a person having ownership,
263	control, or use of an onsite sewage treatment and disposal
264	system of the inspection standards and of that person's
265	authority to request an inspection based on all or part of the
266	standards, and requirements for implementation of the United
267	States Environmental Protection Agency's voluntary national
268	guidelines for management of onsite and clustered or
269	decentralized wastewater treatment systems.
270	(j)  Supervise research on, demonstration of, and training
271	on the performance, environmental impact, and public health
272	impact of onsite sewage treatment and disposal systems within
273	this state. Research fees collected under s. 381.0066(2)(k) must
274	be used to develop and fund hands-on training centers designed
275	to provide practical information about onsite sewage treatment
276	and disposal systems to septic tank contractors, master septic
277	tank contractors, contractors, inspectors, engineers, and the
278	public and must also be used to fund research projects which
279	focus on improvements of onsite sewage treatment and disposal
280	systems, including use of performance-based standards and
281	reduction of environmental impact. Research projects shall be
282	initially approved by the technical advisory panel and shall be
283	applicable to and reflect the soil conditions specific to
284	Florida. Such projects shall be awarded through competitive
285	negotiation, using the procedures provided in s. 287.055, to
286	public or private entities that have experience in onsite sewage
287	treatment and disposal systems in Florida and that are
288	principally located in Florida. Research projects shall not be
289	awarded to firms or entities that employ or are associated with
290	persons who serve on either the technical advisory panel or the
291	research review and advisory committee.
292	(5)  ENFORCEMENT; RIGHT OF ENTRY; CITATIONS.--
293	(c)  Department personnel may enter the premises of others
294	when necessary to conduct site evaluations and inspections
295	relating to the permitting of onsite sewage treatment and
296	disposal systems. Such entry does not constitute trespass, and
297	department personnel making such entry are not subject to arrest
298	or to a civil action by reason of such entry. This paragraph
299	does not authorize a department employee to destroy, injure,
300	damage, or move anything on premises of another without the
301	written permission of the landowner.
302	Section 5.  Subsections (1), (2), (3), and (6) and
303	paragraph (a) of subsection (5) of section 381.0101, Florida
304	Statutes, are amended to read:
305	381.0101  Environmental health professionals.--
306	(1)  LEGISLATIVE INTENT.--Persons responsible for providing
307	technical and scientific evaluations of environmental health and
308	sanitary conditions in business establishments and communities
309	throughout the state may create a danger to the public health if
310	they are not skilled or competent to perform such evaluations.
311	The public relies on the judgment of environmental health
312	professionals employed by both government agencies and private
313	industries to assure them that environmental hazards are
314	identified and removed before they endanger the health or safety
315	of the public. The purpose of this section is to assure the
316	public that persons specifically responsible for performing
317	environmental health and sanitary evaluations have been
318	certified by examination as competent to perform such work.
319	(2)  DEFINITIONS.--As used in this section:
320	(a)  "Accredited" means recognized by the American Council
321	on Education as meeting acceptable levels of quality and
322	performance.
323	(b)(a)  "Board" means the Environmental Health
324	Professionals Advisory Board.
325	(c)(b)  "Department" means the Department of Health.
326	(d)(c)  "Environmental health" means that segment of public
327	health work which deals with the examination of those factors in
328	the human environment which may impact adversely on the health
329	status of an individual or the public.
330	(e)(d)  "Environmental health professional" means a person
331	who is employed or assigned the responsibility for assessing the
332	environmental health or sanitary conditions, as defined by the
333	department, within a building, on an individual's property, or
334	within the community at large, and who has the knowledge,
335	skills, and abilities to carry out these tasks. Environmental
336	health professionals may be either field, supervisory, or
337	administrative staff members.
338	(f)(e)  "Certified" means a person who has displayed
339	competency to perform evaluations of environmental or sanitary
340	conditions through examination.
341	(g)(f)  "Registered sanitarian," "R.S.," "Registered
342	Environmental Health Specialist," or "R.E.H.S." means a person
343	who has been certified by either the National Environmental
344	Health Association or the Florida Environmental Health
345	Association as knowledgeable in the environmental health
346	profession.
347	(h)(g)  "Primary environmental health program" means those
348	programs determined by the department to be essential for
349	providing basic environmental and sanitary protection to the
350	public. These programs shall be established by rule and, at a
351	minimum, these programs shall include food protection program
352	work and onsite sewage treatment and disposal systems program
353	work system evaluations.
354	(3)  CERTIFICATION REQUIRED.--No person shall perform
355	environmental health or sanitary evaluations in any primary
356	program area of environmental health without being certified by
357	the department as competent to perform such evaluations. The
358	requirements of this section shall not be mandatory for persons
359	performing inspections of public or retail food service
360	establishments licensed under chapter 500 or chapter 509.
361	(5)  STANDARDS FOR CERTIFICATION.--The department shall
362	adopt rules that establish definitions of terms and minimum
363	standards of education, training, or experience for those
364	persons subject to this section. The rules must also address the
365	process for application, examination, issuance, expiration, and
366	renewal of certification and ethical standards of practice for
367	the profession.
368	(a)  Persons employed as environmental health professionals
369	shall exhibit a knowledge of rules and principles of
370	environmental and public health law in Florida through
371	examination. A person may not conduct environmental health
372	evaluations in a primary program area unless he or she is
373	currently certified in that program area or works under the
374	direct supervision, during his or her initial probationary
375	period for that position, of a certified environmental health
376	professional.
377	1.  All persons who begin employment in a primary
378	environmental health program on or after September 21, 1994,
379	must be certified in that program within the initial
380	probationary period for that position 6 months after employment.
381	2.  Persons employed in the primary environmental health
382	programs program of a food protection program or an onsite
383	sewage treatment and disposal systems system prior to September
384	21, 1994, shall be considered certified while employed in that
385	position and shall be required to adhere to any professional
386	standards established by the department pursuant to paragraph
387	(b), complete any continuing education requirements imposed
388	under paragraph (d), and pay the certificate renewal fee imposed
389	under subsection (7).
390	3.  Persons employed in the primary environmental health
391	programs program of a food protection program or an onsite
392	sewage treatment and disposal systems system prior to September
393	21, 1994, who change positions or program areas and transfer
394	into another primary environmental health program area on or
395	after September 21, 1994, must be certified by examination in
396	that program within 6 months after such transfer, except that
397	they will not be required to possess the college degree required
398	under paragraph (e).
399	4.  Registered sanitarians shall be considered certified
400	and shall be required to adhere to any professional standards
401	established by the department pursuant to paragraph (b).
402	(6)  EXEMPTIONS.--A person who conducts primary
403	environmental evaluation activities and maintains a current
404	registration or certification from another state agency which
405	examined the person's knowledge of the primary program area and
406	requires comparable continuing education to maintain the
407	certificate shall not be required to be certified by this
408	section. Examples of persons not subject to certification are
409	physicians, registered dietitians, certified laboratory
410	personnel, and nurses.
411	Section 6.  Section 381.104, Florida Statutes, is created
412	to read:
413	381.104  Employee health and wellness program.--
414	(1)  Each state agency may allocate, from existing
415	resources, the necessary funding and facilities for the
416	development and maintenance of an employee health and wellness
417	program and may seek additional funding from other sources to
418	support the program for the benefit of the agency's employees.
419	(2)  Each state agency may dedicate resources to develop
420	and coordinate an employee health and wellness program or
421	arrange to cooperate with other agencies within such agency's
422	geographic proximity for program coordination, including
423	providers of state employee benefits.
424	(3)  Each state agency electing to participate shall
425	establish an employee health and wellness coordinator and
426	advisory committee to guide the development of an operational
427	plan, including the collection of data and development of goals
428	and objectives, and to oversee program evaluation and use of any
429	agency-allocated funds.
430	(4)  Each state agency may conduct and dedicate resources
431	toward an employee needs assessment to ascertain the health-and-
432	wellness-related needs of its employees.
433	(5)  Each state agency may establish policies that allow
434	employees no more than 30 minutes of work time three times each
435	week, as individual workload allows, to use for the purpose of
436	engaging in health and wellness activities which may include
437	physical activity, stress reduction, tobacco cessation, personal
438	training, nutrition counseling, or weight reduction and control.
439	Such 30-minute periods may be used to modify the start or end of
440	the workday or to extend the lunch hour.
441	(6)  Each state agency shall use an employee health and
442	wellness activity agreement form, developed by the Department of
443	Health, to be completed by the employee, signed by both the
444	employee and the employee's immediate supervisor, and kept in
445	the employee's personnel file prior to the employee's
446	participation in any activity. It is the responsibility of the
447	employee to complete the form and submit it to the personnel
448	office. Any change to the employee's activities requires
449	submission of a revised form. An employee found to be in
450	violation of the submitted agreement form is not allowed further
451	participation in the program.
452	(7)  Each state agency may designate up to 1 hour each
453	month for the purpose of providing inservice health and wellness
454	training for its employees.
455	(8)  Each state agency may use electronic mail and other
456	communication systems to promote the agency's employee health
457	and wellness activities.
458	(9)  Each state agency may, and is encouraged to:
459	(a)  Enter into an agreement or contract with other public
460	or private entities to collaborate or participate jointly in
461	health or wellness education or activity programs.
462	(b)  Implement health education activities that focus on
463	skill development and lifestyle behavior change along with
464	information dissemination and awareness building, preferably
465	tailored to the employees' interests and needs.
466	(c)  Review and offer recommendations to agency leadership
467	on environmental and social support policies that pertain to
468	improving the health of employees.
469	(d)  Link the employee health and wellness program to other
470	programs such as the employee assistance program and other
471	related programs to help employees balance work and family.
472	(e)  Offer free, low-cost, or employee-fee-based programs
473	on site, including the designation of rooms for the express
474	purpose of physical activity, nutrition, stress reduction, and
475	weight control activities. Participating agencies with
476	established employee health and wellness programs may purchase
477	exercise equipment to be used in the room designated for this
478	purpose.
479	(10)  Each state agency that develops and implements an
480	employee health and wellness program shall include and document
481	an evaluation and improvement process in an annual report to
482	help enhance the program's efficiency and effectiveness. The
483	annual report shall be submitted to the Department of Health on
484	July 1 of each year. Agencies shall use an annual report
485	template provided by the Department of Health to ensure
486	consistency in the presentation of data and other evaluation
487	results.
488	(11)  The Department of Health shall provide employee
489	health and wellness model program guidelines and ongoing
490	technical assistance to other state agencies to assist in the
491	development of each agency's employee health and wellness
492	program.
493	Section 7.  Section 384.25, Florida Statutes, is amended to
494	read:
495	384.25  Reporting required.--
496	(1)  Each person who makes a diagnosis of or treats a
497	person with a sexually transmissible disease, including, but not
498	limited to, HIV and AIDS, and each laboratory that performs a
499	test for a sexually transmissible disease, including, but not
500	limited to, HIV, which concludes with a positive result shall
501	report such facts as may be required by the department by rule,
502	within a time period as specified by rule of the department, but
503	in no case to exceed 2 weeks.
504	(a)(2)  The department shall adopt rules specifying the
505	information required in and a maximum minimum time period for
506	reporting a sexually transmissible disease, including, but not
507	limited to, HIV and AIDS. In adopting such rules, the department
508	shall consider the need for information, protections for the
509	privacy and confidentiality of the patient, and the practical
510	ability of persons and laboratories to report in a reasonable
511	fashion. To ensure the confidentiality of persons infected with
512	HIV the human immunodeficiency virus (HIV), reporting of HIV
513	infection and AIDS acquired immune deficiency syndrome (AIDS)
514	must be conducted using a system the HIV/AIDS Reporting System
515	(HARS) developed by the Centers for Disease Control and
516	Prevention of the United States Public Health Service or an
517	equivalent system.
518	(3)  The department shall require reporting of physician
519	diagnosed cases of AIDS based upon diagnostic criteria from the
520	Centers for Disease Control and Prevention.
521	(b)(4)  The department may require physician and laboratory
522	reporting of HIV infection. However, only reports of HIV
523	infection identified on or after the effective date of the rule
524	developed by the department pursuant to this subsection shall be
525	accepted. The Reporting may not affect or relate to anonymous
526	HIV testing programs conducted pursuant to s. 381.004(4) or to
527	university-based medical research protocols as determined by the
528	department.
529	(2)(5)  After notification of the test subject under
530	subsection (4), the department may, with the consent of the test
531	subject, notify school superintendents of students and school
532	personnel whose HIV tests are positive.
533	(3)  The department shall adopt rules requiring each
534	physician and laboratory to report any newborn or infant up to
535	18 months of age who has been exposed to HIV. The rules may
536	include the method and time period for reporting, information to
537	be included in the report, requirements for enforcement, and
538	followup activities by the department.
539	(4)(6)  The department shall by February 1 of each year
540	submit to the Legislature an annual report relating to all
541	information obtained pursuant to this section.
542	(5)(7)  Each person who violates the provisions of this
543	section or the rules adopted hereunder may be fined by the
544	department up to $500 for each offense. The department shall
545	report each violation of this section to the regulatory agency
546	responsible for licensing each health care professional and each
547	laboratory to which these provisions apply.
548	Section 8.  Section 384.31, Florida Statutes, is amended to
549	read:
550	384.31  Serological Testing of pregnant women; duty of the
551	attendant.--
552	(1)  Every person, including every physician licensed under
553	chapter 458 or chapter 459 or midwife licensed under part I of
554	chapter 464 or chapter 467, attending a pregnant woman for
555	conditions relating to pregnancy during the period of gestation
556	and delivery shall take or cause the woman to be tested for
557	sexually transmissible diseases, including, but not limited to,
558	HIV, as required by rule of the department, notwithstanding s.
559	381.004(3)(a), taken a sample of venous blood at a time or times
560	specified by the department. The tests Each sample of blood
561	shall be performed tested by a laboratory approved for such
562	purposes under part I of chapter 483 for sexually transmissible
563	diseases as required by rule of the department. Pregnant women
564	shall be notified of the tests that will be conducted and of
565	their right to refuse testing. If a woman objects to testing, a
566	written statement of objection, signed by the patient, shall be
567	placed in the patient's medical record and no testing shall
568	occur.
569	(2)  At the time the venous blood sample is taken, testing
570	for human immunodeficiency virus (HIV) infection shall be
571	offered to each pregnant woman. The prevailing professional
572	standard of care in this state requires each health care
573	provider and midwife who attends a pregnant woman to counsel the
574	woman to be tested for human immunodeficiency virus (HIV).
575	Counseling shall include a discussion of the availability of
576	treatment if the pregnant woman tests HIV positive. If a
577	pregnant woman objects to HIV testing, reasonable steps shall be
578	taken to obtain a written statement of such objection, signed by
579	the patient, which shall be placed in the patient's medical
580	record. Every person, including every physician licensed under
581	chapter 458 or chapter 459 or midwife licensed under part I of
582	chapter 464 or chapter 467, who attends a pregnant woman who has
583	been offered and objects to HIV testing shall be immune from
584	liability arising out of or related to the contracting of HIV
585	infection or acquired immune deficiency syndrome (AIDS) by the
586	child from the mother.
587	Section 9.  Section 385.104, Florida Statutes, is created
588	to read:
589	385.104  Health Promotion and Health Education Statewide
590	Initiative.--
591	(1)  The Department of Health shall establish the Health
592	Promotion and Health Education Statewide Initiative to provide a
593	comprehensive and community-based health promotion and education
594	program. The program is designed to provide funding to counties
595	in this state to improve individual and community health, aimed
596	specifically at preventing and reducing the impact of chronic
597	diseases and promoting healthy lifestyles.
598	(2)  The program's targeted diseases include, but are not
599	limited to, diabetes, heart disease, stroke, asthma, and cancer,
600	with a focus on the preventable risk factors of tobacco use,
601	physical inactivity, and poor nutrition.
602	(3)  The implementation of these activities shall be
603	coordinated with and linked to existing state plans and national
604	priorities, focusing on evidence-based programs and population-
605	based efforts that specifically address social and environmental
606	policy strategies.
607	(4)  Subject to the availability of funds, the Department
608	of Health may award funding to county health departments for
609	purposes of improving individual and community health by
610	expanding and improving the health infrastructure through
611	environmental and policy changes aimed specifically at
612	preventing and reducing the impact of chronic diseases and
613	promoting healthy lifestyles.
614	(5)  To be eligible to receive funding under this section,
615	a county health department shall submit an application to the
616	secretary of the Department of Health containing information as
617	required, including:
618	(a)  A description of the proposed activities and how they
619	promote tobacco cessation, healthy eating, or physical fitness
620	and address the health and social consequences to residents of
621	this state that have chronic diseases.
622	(b)  Information describing how health promotion and
623	education activities are to be coordinated at the local level
624	with other health activities conducted by other education,
625	health, and agricultural agencies.
626	(c)  Information describing how local health promotion and
627	education activities reflect state and national objectives for
628	health.
629	(d)  A description of the collaborative process that the
630	county health department employed in the development of the
631	health promotion and education program, including consultations
632	with individuals and organizations with expertise in promoting
633	public health, nutrition, or physical activity.
634	(e)  A description of how the county health department will
635	evaluate the effectiveness of its program.
636	(6)  Subject to the availability of funds, a county health
637	department receiving funds under this section shall, pending
638	successful implementation or evaluation as determined by
639	department headquarters staff, conduct the project for at least
640	a period of 3 consecutive years.
641	(7)  A county health department that receives funds under
642	this section may use the funds to carry out one or more of the
643	following activities:
644	(a)  Collect, analyze, and disseminate data related to
645	diabetes, heart disease, stroke, asthma, and cancer, with a
646	focus on the preventable risk factors of tobacco use, physical
647	inactivity, and poor nutrition.
648	(b)  Develop and implement activities to create a
649	comprehensive, coordinated nutrition and physical fitness
650	awareness and chronic disease prevention program.
651	(c)  Develop and implement programs in schools and
652	worksites to increase physical fitness and to enhance the
653	nutritional status of residents of this state.
654	(d)  Develop and implement policy and environmental changes
655	related to the cessation of tobacco, healthful nutrition, and
656	physical education.
657	(e)  Collaborate with community-based organizations,
658	volunteer organizations, state medical associations, and public
659	health groups to develop and implement health education and
660	promotion activities.
661	(f)  Collaborate with public and private organizations that
662	have a mission to increase public awareness of the importance of
663	a balanced diet and an active lifestyle.
664	Section 10.  Section 458.3215, Florida Statutes, is created
665	to read:
666	458.3215  Reactivation of license for clinical research
667	purposes.--
668	(1)  Any person who left the practice of medicine for
669	purposes of retirement and who, at the time of retirement, was
670	in good standing with the board may apply to have his or her
671	license reactivated, without examination, for purposes of seeing
672	patients solely in a clinical research setting. Such person must
673	not have been out of the practice of medicine for more than 10
674	years at the time of application under this section.
675	(2)  The board shall by rule set the reactivation fee, not
676	to exceed $300, and develop criteria for reactivation of a
677	license under this section, including appropriate continuing
678	education requirements, not to exceed those prescribed in s.
679	458.321 for reactivation of a license.
680	Section 11.  Section 945.601, Florida Statutes, is amended
681	to read:
682	945.601  Correctional Medical Authority; ss. 945.601-
683	945.6038; 945.601-945.6035, definitions.--As used in this act:
684	(1)  "Authority" means the State of Florida Correctional
685	Medical Authority created in this act.
686	(2)  "Health care provider" means:
687	(a)  A regional research hospital or research center which
688	is authorized by law to provide hospital services in accordance
689	with chapter 395, which has a contractual or operating
690	arrangement with a regional school of medicine, and which is
691	located at that regional school of medicine;
692	(b)  Any entity which has agreed to provide hospital
693	services to inmates in the Department of Corrections; or
694	(c)  Any entity licensed to provide hospital services in
695	accordance with chapter 395.
696	(3)  "Project" means any structure, facility, machinery,
697	equipment, or other property suitable for use by a health
698	facility in connection with its operations or proposed
699	operations, including, without limitation, real property
700	therefor; a clinic, computer facility, dining hall, firefighting
701	facility, fire prevention facility, long-term care facility,
702	hospital, interns' residence, laboratory, laundry, maintenance
703	facility, nurses' residence, office, parking area, pharmacy,
704	recreational facility, research facility, storage facility,
705	utility, or X-ray facility, or any combination of the foregoing;
706	and other structure or facility related thereto or required or
707	useful for health care purposes, the conducting of research, or
708	the operation of a health facility, including a facility or
709	structure essential or convenient for the orderly conduct of the
710	health facility and other similar items necessary or convenient
711	for the operation of a particular facility or structure in the
712	manner for which its use is intended. "Project" does not include
713	such items as fuel, supplies, or other items which are
714	customarily deemed to result in a current operating charge.
715	(4)  "Quality management program" means to monitor and
716	evaluate inmate health care and includes the following
717	objectives:
718	(a)  Assuring that all inmates receive appropriate and
719	timely services in a safe environment.
720	(b)  Assuring systematic monitoring of the treatment
721	environment.
722	(c)  Assisting in the reduction of professional and general
723	liability risks.
724	(d)  Enhancing efficient utilization of resources.
725	(e)  Assisting in credential review and privilege
726	delineation.
727	(f)  Enhancing the identification of continuing educational
728	needs.
729	(g)  Facilitating the identification of strengths,
730	weaknesses, and opportunities for improvement.
731	(h)  Facilitating the coordination and integration of
732	information systems.
733	(i)  Assuring the resolution of identified problems.
734	(5)  "Real property" includes all lands, including
735	buildings, structures, improvements, and fixtures thereon; any
736	property of any nature appurtenant thereto or used in connection
737	therewith; and every estate, interest, and right, legal or
738	equitable, therein, including any such interest for a term of
739	years.
740	Section 12.  Section 945.6038, Florida Statutes, is created
741	to read:
742	945.6038  Additional services.--The authority is authorized
743	to enter into an agreement or may contract with the Department
744	of Children and Family Services, subject to the availability of
745	funding, to conduct surveys of medical services and to provide
746	medical quality assurance and improvement assistance at secure
747	confinement and treatment facilities for persons confined under
748	part V of chapter 394. The authority may enter into similar
749	agreements with other state agencies, subject to the
750	availability of funds. The authority may not enter into any such
751	agreement if doing so would impair the authority's ability to
752	fulfill its obligations with regard to the Department of
753	Corrections as set forth in this chapter.
754	Section 13.  This act shall take effect upon becoming a
755	law.

CODING: Words stricken are deletions; words underlined are additions.