HB 1471

1	A bill to be entitled
2	An act relating to the Healthy and Fit Florida Act;
3	amending s. 154.503, F.S.; conforming a cross-reference;
4	repealing s. 381.0053, F.S., relating to a comprehensive
5	nutrition program; repealing s. 381.0054, F.S., relating
6	to healthy lifestyles promotion; repealing ss. 381.732,
7	381.733, and 381.734, F.S., relating to the Healthy
8	Communities, Healthy People Act; transferring,
9	renumbering, and amending s. 381.84, F.S., relating to the
10	Comprehensive Statewide Tobacco Education and Use
11	Prevention Program; revising definitions; revising program
12	components; requiring program components to include
13	efforts to educate youth and their parents about tobacco
14	use; requiring a youth-directed focus in each program
15	component; requiring the Tobacco Education and Use
16	Prevention Advisory Council to adhere to state ethics
17	laws; providing that meetings of the council are subject
18	to public-records and public-meetings requirements;
19	revising the duties of the council; deleting a provision
20	that prohibits a member of the council from participating
21	in a discussion or decision with respect to a research
22	proposal by a firm, entity, or agency with which the
23	member is associated as a member of the governing body or
24	as an employee or with which the member has entered into a
25	contractual arrangement; revising the submission date of
26	an annual report; deleting an expired provision relating
27	to rulemaking authority of the department; transferring
28	and renumbering s. 381.91, F.S., relating to the Jessie
29	Trice Cancer Prevention Program; transferring,
30	renumbering, and amending s. 381.911, F.S., relating to
31	the Prostate Cancer Awareness Program; revising the
32	criteria for members of the prostate cancer advisory
33	committee; repealing s. 381.912, F.S., relating to the
34	Cervical Cancer Elimination Task Force; transferring and
35	renumbering s. 381.92, F.S., relating to the Florida
36	Cancer Council; transferring and renumbering s. 381.921,
37	F.S., relating to the mission and duties of the Florida
38	Cancer Council; amending s. 381.922, F.S.; conforming
39	cross-references; transferring and renumbering s. 381.93
40	F.S., relating to a breast and cervical cancer early
41	detection program; transferring and renumbering s.
42	381.931, F.S., relating to an annual report on Medicaid
43	expenditures; renaming ch. 385, F.S., as the "Healthy and
44	Fit Florida Act"; amending s. 385.101, F.S.; renaming the
45	"Chronic Diseases Act" as the "Healthy and Fit Florida
46	Act"; amending s. 385.102, F.S.; revising legislative
47	intent; creating s. 385.1021, F.S.; providing definitions;
48	creating s. 385.1022, F.S.; requiring the Department of
49	Health to support public health programs to reduce the
50	incidence of mortality and morbidity from chronic
51	diseases; creating s. 385.1023, F.S.; requiring the
52	department to create state-level programs that address the
53	risk factors of certain chronic diseases; providing
54	required activities of the state-level programs; amending
55	s. 385.103, F.S.; providing for community-level programs
56	for the prevention of chronic diseases; revising
57	definitions; requiring the department to develop and
58	implement a community-based chronic disease prevention and
59	health promotion program; providing the purpose of the
60	program; providing requirements for the program; creating
61	s. 385.105, F.S.; requiring the department to develop
62	programs to increase physical fitness, to work with school
63	districts, to develop partnerships that allow the public
64	to access recreational facilities and public land areas
65	suitable for physical activity, to work with the Executive
66	Office of the Governor and Volunteer Florida, Inc., to
67	promote school initiatives, and to collaborate with the
68	Department of Education in recognizing nationally accepted
69	best practices for improving physical education in
70	schools; requiring the Department of Health to promote
71	healthy lifestyles to reduce obesity; requiring the
72	department to promote optimal nutritional status in all
73	stages of people's lives, personal responsibility to
74	prevent chronic disease or slow its progression, and
75	regular health visits during a person's life span;
76	authorizing state agencies to conduct employee wellness
77	programs; requiring the department to serve as a model to
78	develop and implement employee wellness programs;
79	requiring the department to assist state agencies to
80	develop the employee wellness programs; providing equal
81	access to the programs by agency employees; requiring the
82	department to coordinate efforts with the Department of
83	Management Services and other state agencies; authorizing
84	each state agency to establish an employee wellness work
85	group to design the wellness program; requiring the
86	department to provide requirements for participation fees,
87	collaborations with businesses, and procurement of
88	equipment and incentives; amending s. 385.202, F.S.;
89	requiring facilities, laboratories, and practitioners to
90	report information; authorizing the department to adopt
91	rules regarding reporting requirements for the cancer
92	registry; providing immunity from liability for facilities
93	and practitioners reporting certain information; requiring
94	the department to adopt rules regarding the establishment
95	and operation of a statewide cancer registry program;
96	requiring the department or contractual designee operating
97	the statewide cancer registry program to use or publish
98	material only for the purpose of public health
99	surveillance and advancing medical research or medical
100	education in the interest of reducing morbidity or
101	mortality; authorizing the department to exchange personal
102	data with any agency or contractual designee for the
103	purpose of public health surveillance and medical or
104	scientific research under certain circumstances;
105	clarifying that the department may adopt rules regarding
106	the classifications of facilities related to reports made
107	to the cancer registry; requiring each facility and
108	practitioner that reports cancer cases to the department
109	to make their records available for onsite review;
110	amending s. 385.206, F.S.; renaming the "hematology-
111	oncology care center program" as the "Pediatric
112	Hematology-Oncology Center Program"; revising definitions;
113	authorizing the department to designate centers and
114	provide funding to maintain programs for the care of
115	patients with hematologic and oncologic disorders;
116	clarifying provisions related to grant-funding agreements
117	and grant disbursements; revising the department's
118	requirement to evaluate services rendered by the centers;
119	requiring data from the centers and other sources relating
120	to pediatric cancer to be available to the department for
121	program planning and quality assurance initiatives;
122	amending s. 385.207, F.S.; clarifying provisions that
123	require the department to collect information regarding
124	the number of clients served, the outcomes reached, the
125	expense incurred, and fees collected by providers of
126	epilepsy services; deleting the provision that requires
127	the department to limit administrative expenses from the
128	Epilepsy Services Trust Fund to a certain percentage of
129	annual receipts; amending s. 385.210, F.S.; revising
130	legislative findings regarding the economic costs of
131	treating arthritis and its complications; authorizing the
132	State Surgeon General to seek any federal waivers that may
133	be necessary to maximize funds from the Federal Government
134	to implement the Arthritis Prevention and Education
135	Program; creating s. 385.301, F.S.; authorizing the
136	department to adopt rules to administer the act; amending
137	s. 409.904, F.S.; conforming a cross-reference; providing
138	an effective date.
139
140	Be It Enacted by the Legislature of the State of Florida:
141
142	Section 1.  Paragraph (e) of subsection (2) of section
143	154.503, Florida Statutes, is amended to read:
144	154.503  Primary Care for Children and Families Challenge
145	Grant Program; creation; administration.--
146	(2)  The department shall:
147	(e)  Coordinate with the primary care program developed
148	pursuant to s. 154.011, the Florida Healthy Kids Corporation
149	program created in s. 624.91, the school health services program
150	created in ss. 381.0056 and 381.0057, the Healthy Communities,
151	Healthy People Program created in s. 381.734, and the volunteer
152	health care provider program developed pursuant to s. 766.1115.
153	Section 2.  Sections 381.0053, 381.0054, 381.732, 381.733,
154	and 381.734, Florida Statutes, are repealed.
155	Section 3.  Section 381.84, Florida Statutes, is
156	transferred, renumbered as section 385.106, Florida Statutes,
157	and amended to read:
158	385.106 381.84  Comprehensive Statewide Tobacco Education
159	and Use Prevention Program.--
160	(1)  DEFINITIONS.--As used in this section and for purposes
161	of the provisions of s. 27, Art. X of the State Constitution,
162	the term:
163	(a)  "AHEC network" means an area health education center
164	network established under s. 381.0402.
165	(b)  "Best practices" means the Best Practices for
166	Comprehensive Tobacco Control Programs as established by the
167	CDC, as amended.
168	(c)(b)  "CDC" means the United States Centers for Disease
169	Control and Prevention.
170	(d)(c)  "Council" means the Tobacco Education and Use
171	Prevention Advisory Council.
172	(d)  "Department" means the Department of Health.
173	(e)  "Tobacco" means, without limitation, tobacco itself
174	and tobacco products that include tobacco and are intended or
175	expected for human use or consumption, including, but not
176	limited to, cigarettes, cigars, pipe tobacco, and smokeless
177	tobacco.
178	(f)  "Youth" means minors and young adults.
179	(2)  PURPOSE, FINDINGS, AND INTENT.--It is the purpose of
180	this section to implement s. 27, Art. X of the State
181	Constitution. The Legislature finds that s. 27, Art. X of the
182	State Constitution requires the funding of a statewide tobacco
183	education and use prevention program that focuses on tobacco use
184	by youth. The Legislature further finds that the primary goals
185	of the program are to reduce the prevalence of tobacco use among
186	youth, adults, and pregnant women; reduce per capita tobacco
187	consumption; and reduce exposure to environmental tobacco smoke.
188	Further, it is the intent of the Legislature to base increases
189	in funding for individual components of the program on the
190	results of assessments and evaluations. Recognizing that some
191	components will need to grow faster than inflation, it is the
192	intent of the Legislature to fund portions of the program on a
193	nonrecurring basis in the early years so that those components
194	that are most effective can be supported as the program matures.
195	(3)  PROGRAM COMPONENTS AND REQUIREMENTS.--The department
196	shall conduct a comprehensive, statewide tobacco education and
197	use prevention program consistent with the recommendations for
198	effective program components contained in the 1999 Best
199	Practices for Comprehensive Tobacco Control Programs of the CDC,
200	as amended by the CDC. The program shall include the following
201	components, each of which shall focus on educating people,
202	particularly youth and their parents, about the health hazards
203	of tobacco and discouraging the use of tobacco. All program
204	components shall include efforts to educate youth and their
205	parents about tobacco use, and a youth-directed focus shall
206	exist in all components outlined in this subsection.:
207	(a)  State and community interventions.--These
208	interventions shall include, but not be limited to, a statewide
209	tobacco control program that combines and coordinates community-
210	based interventions that focus on preventing initiation of
211	tobacco use among youth and young adults; promoting quitting
212	among adults, youth, and pregnant women; eliminating exposure to
213	secondhand smoke; identifying and eliminating tobacco-related
214	disparities among population groups; and promoting a range of
215	collaborations to prevent and alleviate the effects of chronic
216	diseases. Counter-marketing and advertising; cyberspace resource
217	center.--The counter-marketing and advertising campaign shall
218	include, at a minimum, Internet, print, radio, and television
219	advertising and shall be funded with a minimum of one-third of
220	the total annual appropriation required by s. 27, Art. X of the
221	State Constitution. A cyberspace resource center for copyrighted
222	materials and information concerning tobacco education and use
223	prevention, including cessation, shall be maintained by the
224	program. Such resource center must be accessible to the public,
225	including parents, teachers, and students, at each level of
226	public and private schools, universities, and colleges in the
227	state and shall provide links to other relevant resources. The
228	Internet address for the resource center must be incorporated in
229	all advertising. The information maintained in the resource
230	center shall be used by the other components of the program.
231	(b)  Health communication interventions.--Effective media
232	and health communication intervention efforts include, but are
233	not limited to, audience research to define themes and execute
234	messages for influential, high impact, and specifically targeted
235	campaigns; market research to identify the target market and the
236	behavioral theory motivating change; counter-marketing
237	surveillance; community tie-ins to support and reinforce the
238	statewide campaign; technologies such as viral marketing, social
239	networks, personal web pages, and web logs; traditional media;
240	process and outcome evaluation of the communication efforts; and
241	promotion of available services, including the state telephone
242	cessation quitline. Cessation programs, counseling, and
243	treatment.--This program component shall include two
244	subcomponents:
245	1.  A statewide toll-free cessation service, which may
246	include counseling, referrals to other local resources and
247	support services, and treatment to the extent funds are
248	available for treatment services; and
249	2.  A local community-based program to disseminate
250	information about smoking cessation, how smoking cessation
251	relates to prenatal care and obesity prevention, and other
252	chronic tobacco-related diseases.
253	(c)  Cessation interventions.--Cessation interventions
254	include, but are not limited to, sustaining, expanding, and
255	promoting the service through population-based counseling and
256	treatment programs; encouraging public and private insurance
257	coverage for counseling and FDA-approved medication treatments
258	for tobacco-use cessation; eliminating cost and other barriers
259	to treatment for underserved populations; and making health care
260	system changes. Youth interventions to prevent tobacco-use
261	initiation and encourage cessation among young people are needed
262	in order to reshape the environment so that it supports tobacco-
263	free norms. Because most people who start smoking are younger
264	than 18 years of age, intervening during adolescence is
265	critical. Community programs and school-based policies and
266	interventions should be a part of a comprehensive effort that is
267	implemented in coordination with community and school
268	environments and in conjunction with increasing the unit price
269	of tobacco products, sustaining anti-tobacco media campaigns,
270	making environments tobacco free, and engaging in other efforts
271	to create tobacco-free social norms. Surveillance and
272	evaluation.--The program shall conduct ongoing epidemiological
273	surveillance and shall contract for annual independent
274	evaluations of the effectiveness of the various components of
275	the program in meeting the goals as set forth in subsection (2).
276	(d)  Surveillance and evaluation.--The surveillance and
277	evaluation of all program components shall monitor and document
278	short-term, intermediate, and long-term intervention outcomes to
279	inform program and policy direction and ensure accountability.
280	The surveillance and evaluation must be conducted objectively
281	through scientifically sound methodology. Youth school
282	programs.--School and after-school programs shall use current
283	evidence-based curricula and programs that involve youth to
284	educate youth about the health hazards of tobacco, help youth
285	develop skills to refuse tobacco, and demonstrate to youth how
286	to stop using tobacco.
287	(e)  Administration and management.--Administration and
288	management activities include, but are not limited to, strategic
289	planning to guide program efforts and resources in order to
290	accomplish goals; recruiting and developing qualified and
291	diverse technical, program, and administrative staff; awarding
292	and monitoring program contracts and grants to coordinate
293	implementation across program areas; developing and maintaining
294	a fiscal-management system to track allocations and the
295	expenditure of funds; increasing capacity at the community level
296	through ongoing training and technical assistance; creating
297	effective communications internally among chronic disease
298	prevention programs and local coalitions and partners; and
299	educating the public and decisionmakers on the health effects of
300	tobacco and evidence-based effective program and policy
301	interventions. Community programs and chronic disease
302	prevention.--The department shall promote and support local
303	community-based partnerships that emphasize programs involving
304	youth, including programs for the prevention, detection, and
305	early intervention of smoking-related chronic diseases.
306	(f)  Training.--The program shall include the training of
307	health care practitioners, smoking-cessation counselors, and
308	teachers by health professional students and other tobacco-use
309	prevention specialists who are trained in preventing tobacco use
310	and health education. Smoking-cessation counselors shall be
311	trained by specialists who are certified in tobacco-use
312	cessation.
313	(g)  County health departments Administration, statewide
314	programs, and county health departments.--Each county health
315	department is eligible to receive a portion of the annual
316	appropriation, on a per capita basis, for coordinating tobacco
317	education and use prevention programs within that county.
318	Appropriated funds may be used to improve the infrastructure of
319	the county health department to implement the comprehensive,
320	statewide tobacco education and use prevention program. Each
321	county health department shall prominently display in all
322	treatment rooms and waiting rooms, counter-marketing and
323	advertisement materials in the form of wall posters, brochures,
324	television advertising if televisions are used in the lobby or
325	waiting room, and screensavers and Internet advertising if
326	computer kiosks are available for use or viewing by people at
327	the county health department.
328	(h)  Enforcement and awareness of related laws.--In
329	coordination with the Department of Business and Professional
330	Regulation, the program shall monitor the enforcement of laws,
331	rules, and policies prohibiting the sale or other provision of
332	tobacco to minors, as well as the continued enforcement of the
333	Clean Indoor Air Act prescribed in chapter 386. The
334	advertisements produced in accordance with paragraph (b)
335	paragraph (a) may also include information designed to make the
336	public aware of these related laws and rules. The departments
337	may enter into interagency agreements to carry out this program
338	component.
339	(i)  AHEC smoking-cessation initiative.--For the 2007-2008
340	and 2008-2009 fiscal years only, the AHEC network shall expand
341	the AHEC smoking-cessation initiative to each county within the
342	state and perform other activities as determined by the
343	department.
344	(4)  ADVISORY COUNCIL; MEMBERS, APPOINTMENTS, AND
345	MEETINGS.--The Tobacco Education and Use Prevention Advisory
346	Council is created within the department.
347	(a)  The council shall consist of 23 members, including:
348	1.  The State Surgeon General, who shall serve as the
349	chairperson.
350	2.  One county health department director, appointed by the
351	State Surgeon General.
352	3.  Two members appointed by the Commissioner of Education,
353	of whom one must be a school district superintendent.
354	4.  The chief executive officer of the Florida Division of
355	the American Cancer Society, or his or her designee.
356	5.  The chief executive officer of the Greater Southeast
357	Affiliate of the American Heart Association, or his or her
358	designee.
359	6.  The chief executive officer of the American Lung
360	Association of Florida, or his or her designee.
361	7.  The dean of the University of Miami School of Medicine,
362	or his or her designee.
363	8.  The dean of the University of Florida College of
364	Medicine, or his or her designee.
365	9.  The dean of the University of South Florida College of
366	Medicine, or his or her designee.
367	10.  The dean of the Florida State University College of
368	Medicine, or his or her designee.
369	11.  The dean of Nova Southeastern College of Osteopathic
370	Medicine, or his or her designee.
371	12.  The dean of the Lake Erie College of Osteopathic
372	Medicine in Bradenton, Florida, or his or her designee.
373	13.  The chief executive officer of the Campaign for
374	Tobacco Free Kids, or his or her designee.
375	14.  The chief executive officer of the Legacy Foundation,
376	or his or her designee.
377	15.  Four members appointed by the Governor, of whom two
378	must have expertise in the field of tobacco-use prevention and
379	education or smoking cessation and one individual who shall be
380	between the ages of 16 and 21 at the time of his or her
381	appointment.
382	16.  Two members appointed by the President of the Senate,
383	of whom one must have expertise in the field of tobacco-use
384	prevention and education or smoking cessation.
385	17.  Two members appointed by the Speaker of the House of
386	Representatives, of whom one must have expertise in the field of
387	tobacco-use prevention and education or smoking cessation.
388	(b)  The appointments shall be for 3-year terms and shall
389	reflect the diversity of the state's population. A vacancy shall
390	be filled by appointment by the original appointing authority
391	for the unexpired portion of the term.
392	(c)  An appointed member may not serve more than two
393	consecutive terms.
394	(d)  The council shall meet at least quarterly and upon the
395	call of the chairperson. Meetings may be held via teleconference
396	or other electronic means.
397	(e)  Members of the council shall serve without
398	compensation, but are entitled to reimbursement for per diem and
399	travel expenses pursuant to s. 112.061. Members who are state
400	officers or employees or who are appointed by state officers or
401	employees shall be reimbursed for per diem and travel expenses
402	pursuant to s. 112.061 from the state agency through which they
403	serve.
404	(f)  The council shall adhere to all state ethics laws.
405	Meetings of the council and the review panels are subject to
406	chapter 119, s. 286.011, and s. 24, Art. I of the State
407	Constitution. The department shall provide council members with
408	information and other assistance as is reasonably necessary to
409	assist the council in carrying out its responsibilities.
410	(5)  COUNCIL DUTIES AND RESPONSIBILITIES.--The council
411	shall advise the State Surgeon General as to the direction and
412	scope of the Comprehensive Statewide Tobacco Education and Use
413	Prevention Program. The responsibilities of the council may
414	include, but are not limited to:
415	(a)  Providing advice on program priorities and emphases.
416	(b)  Providing advice on the overall program budget.
417	(c)  Providing advice on copyrighted material, trademark,
418	and future transactions as they pertain to the tobacco education
419	and use prevention program.
420	(d)  Reviewing, as requested by the department, broadcast
421	material prepared for the Internet, portable media players,
422	radio, and television advertisement as it relates to the
423	advertising component of the tobacco education and use
424	prevention program.
425	(e)  Participating in periodic program evaluation, as
426	requested by the department.
427	(f)  Assisting the department in developing the development
428	of guidelines to ensure fairness, neutrality, and adherence to
429	the principles of merit and quality in the conduct of the
430	program.
431	(g)  Assisting the department in developing the development
432	of administrative procedures relating to solicitation, review,
433	and award of contracts and grants in order to ensure an
434	impartial, high-quality peer review system.
435	(h)  Assisting the department in developing panels to
436	review and evaluate potential fund recipients the development
437	and supervision of peer review panels.
438	(i)  Assisting the department in reviewing reports of peer
439	review panels and making recommendations for funding allocations
440	contracts and grants.
441	(j)  Assisting the department in reviewing the activities
442	and evaluating the performance of the AHEC network to avoid
443	duplicative efforts using state funds.
444	(k)  Recommending specific measureable outcomes meaningful
445	outcome measures through a regular review of evidence-based and
446	promising tobacco-use prevention and education strategies and
447	programs of other states and the Federal Government.
448	(l)  Recommending policies to encourage a coordinated
449	response to tobacco use in this state, focusing specifically on
450	creating partnerships within and between the public and private
451	sectors.
452	(6)  CONTRACT REQUIREMENTS.--Contracts or grants for the
453	program components or subcomponents described in paragraphs
454	(3)(a)-(f) shall be awarded by the State Surgeon General, after
455	consultation with the council, on the basis of merit, as
456	determined by an open, competitive, peer-reviewed process that
457	ensures objectivity, consistency, and high quality. The
458	department shall award such grants or contracts no later than
459	October 1 for each fiscal year. A recipient of a contract or
460	grant for the program component described in paragraph (3)(d)
461	(3)(c) is not eligible for a contract or grant award for any
462	other program component described in subsection (3) in the same
463	state fiscal year. A school or college of medicine that is
464	represented on the council is not eligible to receive a contract
465	or grant under this section. For the 2007-2008 and 2008-2009
466	fiscal years only, the department shall award a contract or
467	grant in the amount of $10 million to the AHEC network for the
468	purpose of developing the components described in paragraph
469	(3)(i). The AHEC network may apply for a competitive contract or
470	grant after the 2008-2009 fiscal year.
471	(a)  In order to ensure that all proposals for funding are
472	appropriate and are evaluated fairly on the basis of merit, the
473	State Surgeon General, in consultation with the council, shall
474	appoint a peer review panel of independent, qualified experts in
475	the field of tobacco control to review the content of each
476	proposal and establish its priority score. The priority scores
477	shall be forwarded to the council and must be considered in
478	determining which proposals will be recommended for funding.
479	(b)  The council and the peer review panel shall establish
480	and follow rigorous guidelines for ethical conduct and adhere to
481	a strict policy with regard to conflicts of interest. Council
482	members are subject to the applicable provisions of chapter 112.
483	A member of the council or panel may not participate in any
484	discussion or decision with respect to a research proposal by
485	any firm, entity, or agency with which the member is associated
486	as a member of the governing body or as an employee or with
487	which the member has entered into a contractual arrangement.
488	Meetings of the council and the peer review panels are subject
489	to chapter 119, s. 286.011, and s. 24, Art. I of the State
490	Constitution.
491	(c)  In each contract or grant agreement, the department
492	shall limit the use of food and promotional items to no more
493	than 2.5 percent of the total amount of the contract or grant
494	and limit overhead or indirect costs to no more than 7.5 percent
495	of the total amount of the contract or grant. The department, in
496	consultation with the Department of Financial Services, shall
497	publish guidelines for appropriate food and promotional items.
498	(d)  In each advertising contract, the department shall
499	limit the total of production fees, buyer commissions, and
500	related costs to no more than 10 percent of the total contract
501	amount.
502	(e)  Notwithstanding the competitive process for contracts
503	prescribed in this subsection, each county health department is
504	eligible for core funding, on a per capita basis, to implement
505	tobacco education and use prevention activities within that
506	county.
507	(7)  ANNUAL REPORT REQUIRED.--By February 28 January 31 of
508	each year, the department shall provide to the Governor, the
509	President of the Senate, and the Speaker of the House of
510	Representatives a report that evaluates the program's
511	effectiveness in reducing and preventing tobacco use and that
512	recommends improvements to enhance the program's effectiveness.
513	The report must contain, at a minimum, an annual survey of youth
514	attitudes and behavior toward tobacco, as well as a description
515	of the progress in reducing the prevalence of tobacco use among
516	youth, adults, and pregnant women; reducing per capita tobacco
517	consumption; and reducing exposure to environmental tobacco
518	smoke.
519	(8)  LIMITATION ON ADMINISTRATIVE EXPENSES.--From the total
520	funds appropriated for the Comprehensive Statewide Tobacco
521	Education and Use Prevention Program in the General
522	Appropriations Act, an amount of up to 5 percent may be used by
523	the department for administrative expenses.
524	(9)  RULEMAKING AUTHORIZED.--By January 1, 2008, the
525	department shall adopt rules pursuant to ss. 120.536(1) and
526	120.54 to administer this section.
527	Section 4.  Section 381.91, Florida Statutes, is
528	transferred and renumbered as section 385.2024, Florida
529	Statutes, to read:
530	385.2024 381.91  Jessie Trice Cancer Prevention Program.--
531	(1)  It is the intent of the Legislature to:
532	(a)  Reduce the rates of illness and death from lung cancer
533	and other cancers and improve the quality of life among low-
534	income African-American and Hispanic populations through
535	increased access to early, effective screening and diagnosis,
536	education, and treatment programs.
537	(b)  Create a community faith-based disease-prevention
538	program in conjunction with the Health Choice Network and other
539	community health centers to build upon the natural referral and
540	education networks in place within minority communities and to
541	increase access to health service delivery in Florida.
542	(c)  Establish a funding source to build upon local private
543	participation to sustain the operation of the program.
544	(2)(a)  There is created the Jessie Trice Cancer Prevention
545	Program, to be located, for administrative purposes, within the
546	Department of Health, and operated from the community health
547	centers within the Health Choice Network in Florida.
548	(b)  Funding may be provided to develop contracts with
549	community health centers and local community faith-based
550	education programs to provide cancer screening, diagnosis,
551	education, and treatment services to low-income populations
552	throughout the state.
553	Section 5.  Section 381.911, Florida Statutes, is
554	transferred, renumbered as section 385.2023, Florida Statutes,
555	and amended to read:
556	385.2023 381.911  Prostate Cancer Awareness Program.--
557	(1)  To the extent that funds are specifically made
558	available for this purpose, the Prostate Cancer Awareness
559	Program is established within the Department of Health. The
560	purpose of this program is to implement the recommendations of
561	January 2000 of the Florida Prostate Cancer Task Force to
562	provide for statewide outreach and health education activities
563	to ensure that men are aware of and appropriately seek medical
564	counseling for prostate cancer as an early-detection health care
565	measure.
566	(2)  For purposes of implementing the program, the
567	Department of Health and the Florida Public Health Foundation,
568	Inc., may:
569	(a)  Conduct activities directly or enter into a contract
570	with a qualified nonprofit community education entity.
571	(b)  Seek any available gifts, grants, or funds from the
572	state, the Federal Government, philanthropic foundations, and
573	industry or business groups.
574	(3)  A prostate cancer advisory committee is created to
575	advise and assist the Department of Health and the Florida
576	Public Health Foundation, Inc., in implementing the program.
577	(a)  The State Surgeon General shall appoint the advisory
578	committee members, who shall consist of:
579	1.  Three persons from prostate cancer survivor groups or
580	cancer-related advocacy groups.
581	2.  Three persons who are scientists or clinicians from
582	public or nonpublic universities or research organizations.
583	3.  Three persons who are engaged in the practice of a
584	cancer-related medical specialty from health organizations
585	committed to cancer research and control.
586	(b)  Members shall serve without compensation but are
587	entitled to reimbursement, pursuant to s. 112.061, for per diem
588	and travel expenses incurred in the performance of their
589	official duties.
590	(4)  The program shall coordinate its efforts with those of
591	the Florida Public Health Foundation, Inc.
592	Section 6.  Section 381.912, Florida Statutes, is repealed.
593	Section 7.  Section 381.92, Florida Statutes, is
594	transferred and renumbered as section 385.2025, Florida
595	Statutes, to read:
596	385.2025 381.92  Florida Cancer Council.--
597	(1)  Effective July 1, 2004, the Florida Cancer Council
598	within the Department of Health is established for the purpose
599	of making the state a center of excellence for cancer research.
600	(2)(a)  The council shall be representative of the state's
601	cancer centers, hospitals, and patient groups and shall be
602	organized and shall operate in accordance with this act.
603	(b)  The Florida Cancer Council may create not-for-profit
604	corporate subsidiaries to fulfill its mission. The council and
605	its subsidiaries are authorized to receive, hold, invest, and
606	administer property and any moneys acquired from private, local,
607	state, and federal sources, as well as technical and
608	professional income generated or derived from the mission-
609	related activities of the council.
610	(c)  The members of the council shall consist of:
611	1.  The chair of the Florida Dialogue on Cancer, who shall
612	serve as the chair of the council;
613	2.  The State Surgeon General or his or her designee;
614	3.  The chief executive officer of the H. Lee Moffitt
615	Cancer Center or his or her designee;
616	4.  The director of the University of Florida Shands Cancer
617	Center or his or her designee;
618	5.  The chief executive officer of the University of Miami
619	Sylvester Comprehensive Cancer Center or his or her designee;
620	6.  The chief executive officer of the Mayo Clinic,
621	Jacksonville, or his or her designee;
622	7.  The chief executive officer of the American Cancer
623	Society, Florida Division, Inc., or his or her designee;
624	8.  The president of the American Cancer Society, Florida
625	Division, Inc., Board of Directors or his or her designee;
626	9.  The president of the Florida Society of Clinical
627	Oncology or his or her designee;
628	10.  The president of the American College of Surgeons,
629	Florida Chapter, or his or her designee;
630	11.  The chief executive officer of Enterprise Florida,
631	Inc., or his or her designee;
632	12.  Five representatives from cancer programs approved by
633	the American College of Surgeons. Three shall be appointed by
634	the Governor, one shall be appointed by the Speaker of the House
635	of Representatives, and one shall be appointed by the President
636	of the Senate;
637	13.  One member of the House of Representatives, to be
638	appointed by the Speaker of the House of Representatives; and
639	14.  One member of the Senate, to be appointed by the
640	President of the Senate.
641	(d)  Appointments made by the Speaker of the House of
642	Representatives and the President of the Senate pursuant to
643	paragraph (c) shall be for 2-year terms, concurrent with the
644	bienniums in which they serve as presiding officers.
645	(e)  Appointments made by the Governor pursuant to
646	paragraph (c) shall be for 2-year terms, although the Governor
647	may reappoint members.
648	(f)  Members of the council or any subsidiaries shall serve
649	without compensation, and each organization represented on the
650	council shall cover the expenses of its representatives.
651	(3)  The council shall issue an annual report to the Center
652	for Universal Research to Eradicate Disease, the Governor, the
653	Speaker of the House of Representatives, and the President of
654	the Senate by December 15 of each year, with policy and funding
655	recommendations regarding cancer research capacity in Florida
656	and related issues.
657	Section 8.  Section 381.921, Florida Statutes, is
658	transferred and renumbered as section 385.20251, Florida
659	Statutes, to read:
660	385.20251 381.921  Florida Cancer Council mission and
661	duties.--The council, which shall work in concert with the
662	Florida Center for Universal Research to Eradicate Disease to
663	ensure that the goals of the center are advanced, shall endeavor
664	to dramatically improve cancer research and treatment in this
665	state through:
666	(1)  Efforts to significantly expand cancer research
667	capacity in the state by:
668	(a)  Identifying ways to attract new research talent and
669	attendant national grant-producing researchers to cancer
670	research facilities in this state;
671	(b)  Implementing a peer-reviewed, competitive process to
672	identify and fund the best proposals to expand cancer research
673	institutes in this state;
674	(c)  Funding through available resources for those
675	proposals that demonstrate the greatest opportunity to attract
676	federal research grants and private financial support;
677	(d)  Encouraging the employment of bioinformatics in order
678	to create a cancer informatics infrastructure that enhances
679	information and resource exchange and integration through
680	researchers working in diverse disciplines, to facilitate the
681	full spectrum of cancer investigations;
682	(e)  Facilitating the technical coordination, business
683	development, and support of intellectual property as it relates
684	to the advancement of cancer research; and
685	(f)  Aiding in other multidisciplinary research-support
686	activities as they inure to the advancement of cancer research.
687	(2)  Efforts to improve both research and treatment through
688	greater participation in clinical trials networks by:
689	(a)  Identifying ways to increase adult enrollment in
690	cancer clinical trials;
691	(b)  Supporting public and private professional education
692	programs designed to increase the awareness and knowledge about
693	cancer clinical trials;
694	(c)  Providing tools to cancer patients and community-based
695	oncologists to aid in the identification of cancer clinical
696	trials available in the state; and
697	(d)  Creating opportunities for the state's academic cancer
698	centers to collaborate with community-based oncologists in
699	cancer clinical trials networks.
700	(3)  Efforts to reduce the impact of cancer on disparate
701	groups by:
702	(a)  Identifying those cancers that disproportionately
703	impact certain demographic groups; and
704	(b)  Building collaborations designed to reduce health
705	disparities as they relate to cancer.
706	Section 9.  Paragraph (a) of subsection (2) and subsection
707	(5) of section 381.922, Florida Statutes, as amended by section
708	2 of chapter 2009-5, Laws of Florida, is amended to read:
709	381.922  William G. "Bill" Bankhead, Jr., and David Coley
710	Cancer Research Program.--
711	(2)  The program shall provide grants for cancer research
712	to further the search for cures for cancer.
713	(a)  Emphasis shall be given to the goals enumerated in s.
714	385.20251 s. 381.921, as those goals support the advancement of
715	such cures.
716	(5)  For the 2008-2009 fiscal year and each fiscal year
717	thereafter, the sum of $6.75 million is appropriated annually
718	from recurring funds in the General Revenue Fund to the
719	Biomedical Research Trust Fund within the Department of Health
720	for purposes of the William G. "Bill" Bankhead, Jr., and David
721	Coley Cancer Research Program and shall be distributed pursuant
722	to this section to provide grants to researchers seeking cures
723	for cancer, with emphasis given to the goals enumerated in s.
724	385.20251 s. 381.921. From the total funds appropriated, an
725	amount of up to 10 percent may be used for administrative
726	expenses.
727	Section 10.  Section 381.93, Florida Statutes, is
728	transferred and renumbered as section 385.2021, Florida
729	Statutes, to read:
730	385.2021 381.93  Breast and cervical cancer early detection
731	program.--This section may be cited as the "Mary Brogan Breast
732	and Cervical Cancer Early Detection Program Act."
733	(1)  It is the intent of the Legislature to reduce the
734	rates of death due to breast and cervical cancer through early
735	diagnosis and increased access to early screening, diagnosis,
736	and treatment programs.
737	(2)  The Department of Health, using available federal
738	funds and state funds appropriated for that purpose, is
739	authorized to establish the Mary Brogan Breast and Cervical
740	Cancer Screening and Early Detection Program to provide
741	screening, diagnosis, evaluation, treatment, case management,
742	and followup and referral to the Agency for Health Care
743	Administration for coverage of treatment services.
744	(3)  The Mary Brogan Breast and Cervical Cancer Early
745	Detection Program shall be funded through grants for such
746	screening and early detection purposes from the federal Centers
747	for Disease Control and Prevention under Title XV of the Public
748	Health Service Act, 42 U.S.C. ss. 300k et seq.
749	(4)  The department shall limit enrollment in the program
750	to persons with incomes up to and including 200 percent of the
751	federal poverty level. The department shall establish an
752	eligibility process that includes an income-verification process
753	to ensure that persons served under the program meet income
754	guidelines.
755	(5)  The department may provide other breast and cervical
756	cancer screening and diagnostic services; however, such services
757	shall be funded separately through other sources than this act.
758	Section 11.  Section 381.931, Florida Statutes, is
759	transferred and renumbered as section 385.20211, Florida
760	Statutes, to read:
761	385.20211 381.931  Annual report on Medicaid
762	expenditures.--The Department of Health and the Agency for
763	Health Care Administration shall monitor the total Medicaid
764	expenditures for services made under this act. If Medicaid
765	expenditures are projected to exceed the amount appropriated by
766	the Legislature, the Department of Health shall limit the number
767	of screenings to ensure Medicaid expenditures do not exceed the
768	amount appropriated. The Department of Health, in cooperation
769	with the Agency for Health Care Administration, shall prepare an
770	annual report that must include the number of women screened;
771	the percentage of positive and negative outcomes; the number of
772	referrals to Medicaid and other providers for treatment
773	services; the estimated number of women who are not screened or
774	not served by Medicaid due to funding limitations, if any; the
775	cost of Medicaid treatment services; and the estimated cost of
776	treatment services for women who were not screened or referred
777	for treatment due to funding limitations. The report shall be
778	submitted to the President of the Senate, the Speaker of the
779	House of Representatives, and the Executive Office of the
780	Governor by March 1 of each year.
781	Section 12.  Chapter 385, Florida Statutes, entitled
782	"Chronic Diseases," is renamed the "Healthy and Fit Florida
783	Act."
784	Section 13.  Section 385.101, Florida Statutes, is amended
785	to read:
786	385.101  Short title.--This chapter Sections 385.101-
787	385.103 may be cited as the "Healthy and Fit Florida Chronic
788	Diseases Act."
789	Section 14.  Section 385.102, Florida Statutes, is amended
790	to read:
791	385.102  Legislative intent.--It is the finding of the
792	Legislature that:
793	(1)  Chronic diseases continue to be the leading cause of
794	death and disability in this state and the country exist in high
795	proportions among the people of this state. These Chronic
796	diseases include, but are not limited to, arthritis,
797	cardiovascular disease heart disease, hypertension, diabetes,
798	renal disease, cancer, and chronic obstructive lung disease.
799	These diseases are often have the same preventable risk factors
800	interrelated, and they directly and indirectly account for a
801	high rate of death, disability, and underlying costs to the
802	state's health care system illness.
803	(2)  Chronic diseases have a significant impact on quality
804	of life, not only for the individuals who experience their
805	painful symptoms and resulting disabilities, but also for family
806	members and caregivers.
807	(3)  Racial and ethnic minorities and other underserved
808	populations are disproportionately affected by chronic diseases.
809	(4)  There are enormous medical costs and lost wages
810	associated with chronic diseases and their complications.
811	(5)(2)  Advances in medical knowledge and technology assist
812	have assisted in the prevention, detection, and management of
813	chronic diseases. Comprehensive approaches that stress the
814	stressing application of current medical treatment, continuing
815	research, professional training, and patient education, and
816	community-level policy and environmental changes should be
817	implemented encouraged.
818	(6)(3)  A comprehensive program dealing with the early
819	detection and prevention of chronic diseases is required to make
820	knowledge and therapy available to all people of this state. The
821	mobilization of scientific, medical, and educational resources,
822	along with the implementation of community-based policy under
823	one comprehensive chronic disease law, act will facilitate the
824	prevention, early intervention, and management treatment of
825	chronic these diseases and their symptoms. This integration of
826	resources and policy will and result in a decline in death and
827	disability illness among the people of this state.
828	(7)  Chronic diseases account for 70 percent of all deaths
829	in the United States. The following chronic diseases are the
830	leading causes of death and disability:
831	(a)  Heart disease and stroke, which have remained the
832	first and third leading causes of death for both men and women
833	in the United States for over seven decades and account for
834	approximately one-third of total deaths each year in this state.
835	(b)  Cancer, which is the second leading cause of death and
836	is responsible for one in four deaths in this state.
837	(c)  Lung disease, which is the third leading cause of
838	death and accounts for one in every six deaths in this state.
839	(d)  Diabetes, which is the sixth leading cause of death in
840	this state.
841	(e)  Arthritis, which is the leading cause of disability in
842	the United States, limiting daily activities for more than 19
843	million citizens. In this state, arthritis limits daily
844	activities for an estimated 1.3 million people.
845	(8)  The department shall establish, promote, and maintain
846	state-level and local-level programs for chronic disease
847	prevention and health promotion to the extent that funds are
848	specifically made available for this purpose.
849	Section 15.  Section 385.1021, Florida Statutes, is created
850	to read:
851	385.1021  Definitions.--As used in this chapter, the term:
852	(1)  "CDC" means the United States Centers for Disease
853	Control and Prevention.
854	(2)  "Chronic disease" means an illness that is prolonged,
855	does not resolve spontaneously, and is rarely cured completely.
856	(3)  "Department" means the Department of Health.
857	(4)  "Environmental changes" means changes to the economic,
858	social, or physical natural or built environments which
859	encourage or enable behaviors.
860	(5)  "Policy change" means altering an informal or formal
861	agreement between public or private sectors which sets forth
862	values, behaviors, or resource allocation in order to improve
863	health.
864	(6)  "Primary prevention" means an intervention that is
865	directed toward healthy populations and focuses on avoiding
866	disease before it occurs.
867	(7)  "Risk factor" means a characteristic or condition
868	identified during the course of an epidemiological study of a
869	disease that appears to be statistically associated with a high
870	incidence of that disease.
871	(8)  "Secondary prevention" means an intervention that is
872	designed to promote the early detection and management of
873	diseases and reduce the risks experienced by at-risk
874	populations.
875	(9)  "System changes" means altering standard activities,
876	protocols, policies, processes, and structures carried out in
877	population-based settings, such as schools, worksites, health
878	care facilities, faith-based organizations, and the overall
879	community, which promote and support new behaviors.
880	(10)  "Tertiary prevention" means an intervention that is
881	directed at rehabilitating and minimizing the effects of disease
882	in a chronically ill population.
883	(11)  "Tobacco" means, without limitation, tobacco itself
884	and tobacco products that include tobacco and are intended or
885	expected for human use or consumption, including, but not
886	limited to, cigarettes, cigars, pipe tobacco, and smokeless
887	tobacco.
888	(12)  "Wellness program" means a structured program that is
889	designed or approved by the department to offer intervention
890	activities on or off the worksite which help state employees
891	change certain behaviors or adopt healthy lifestyles.
892	(13)  "Youth" means children and young adults, up through
893	24 years of age, inclusive.
894	Section 16.  Section 385.1022, Florida Statutes, is created
895	to read:
896	385.1022  Chronic disease prevention program.--The
897	department shall support public health programs to reduce the
898	incidence of mortality and morbidity from diseases for which
899	risk factors can be identified. Such risk factors include, but
900	are not limited to, being overweight or obese, physical
901	inactivity, poor nutrition and diet, tobacco use, sun exposure,
902	and other practices that are detrimental to health. The programs
903	shall educate and screen the general public as well as groups at
904	particularly high risk of chronic diseases.
905	Section 17.  Section 385.1023, Florida Statutes, is created
906	to read:
907	385.1023  State-level prevention programs for chronic
908	disease.--
909	(1)  The department shall create state-level programs that
910	address the leading, preventable chronic disease risk factors of
911	poor nutrition and obesity, tobacco use, sun exposure, and
912	physical inactivity in order to decrease the incidence of
913	arthritis, cancer, diabetes, heart disease, lung disease,
914	stroke, and other chronic diseases.
915	(2)  State-level programs shall address, but need not be
916	limited to, the following activities:
917	(a)  Monitoring specific causal and behavioral risk factors
918	that affect the health of residents in the state.
919	(b)  Analyzing data regarding chronic disease mortality and
920	morbidity to track changes over time.
921	(c)  Promoting public awareness and increasing knowledge
922	concerning the causes of chronic diseases, the importance of
923	early detection, diagnosis, and appropriate evidence-based
924	prevention, management, and treatment strategies.
925	(d)  Disseminating educational materials and information
926	concerning evidence-based results, available services, and
927	pertinent new research findings and prevention strategies to
928	patients, health insurers, health professionals, and the public.
929	(e)  Using education and training resources and services
930	developed by organizations having appropriate expertise and
931	knowledge of chronic diseases for technical assistance.
932	(f)  Evaluating the quality and accessibility of existing
933	community-based services for chronic disease.
934	(g)  Increasing awareness among state and local officials
935	involved in health and human services, health professionals and
936	providers, and policymakers about evidence-based chronic-disease
937	prevention, tobacco cessation, and treatment strategies and
938	their benefits for people who have chronic diseases.
939	(h)  Developing a partnership with state and local
940	governments, voluntary health organizations, hospitals, health
941	insurers, universities, medical centers, employer groups,
942	private companies, and health care providers to address the
943	burden of chronic disease in this state.
944	(i)  Implementing and coordinating state-level policies in
945	order to reduce the burden of chronic disease.
946	(j)  Providing lasting improvements in the delivery of
947	health care for individuals who have chronic disease and their
948	families, thus improving their quality of life while also
949	containing health care costs.
950	Section 18.  Section 385.103, Florida Statutes, is amended
951	to read:
952	385.103  Community-level Community intervention programs
953	for chronic disease prevention and health promotion.--
954	(1)  DEFINITIONS.--As used in this section, the term:
955	(a)  "Chronic disease prevention and health promotion
956	control program" means a program that may include, but is not
957	limited to, including a combination of the following elements:
958	1.  Staff who are sufficiently trained and skilled in
959	public health, community health, or school health education to
960	facilitate the operation of the program Health screening;
961	2.  Community input into the planning, implementation, and
962	evaluation processes Risk factor detection;
963	3.  Use of public health data to make decisions and to
964	develop and prioritize community-based interventions focusing on
965	chronic diseases and their risk factors; Appropriate
966	intervention to enable and encourage changes in behaviors that
967	create health risks; and
968	4.  Adherence to a population-based approach by using a
969	socioecological model that addresses the influence on individual
970	behavior, interpersonal behavior, organizational behavior, the
971	community, and public policy; Counseling in nutrition, physical
972	activity, the effects of tobacco use, hypertension, blood
973	pressure control, and diabetes control and the provision of
974	other clinical prevention services.
975	5.  Focus on at least the common preventable risk factors
976	for chronic disease, such as physical inactivity, obesity, poor
977	nutrition, and tobacco use;
978	6.  Focus on developing and implementing interventions and
979	activities through communities, schools, worksites, faith-based
980	organizations, and health-care settings;
981	7.  Use of evidence-based interventions as well as best and
982	promising practices to guide specific activities and effect
983	change, which may include guidelines developed by organizations,
984	volunteer scientists, and health care professionals who write
985	published medical, scientific statements on various chronic
986	disease topics. The statements shall be supported by scientific
987	studies published in recognized journals that have a rigorous
988	review and approval process. Scientific statements generally
989	include a review of data available on a specific subject and an
990	evaluation of its relationship to overall chronic disease
991	science;
992	8.  Use of policy, system, and environmental changes that
993	support healthy behaviors so as to affect large segments of the
994	population and encourage healthy choices;
995	9.  Development of extensive and comprehensive evaluation
996	that is linked to program planning at the state level and the
997	community level in order to determine the program's
998	effectiveness or necessary program modifications; and
999	10.  Reduction of duplication of efforts through
1000	coordination among appropriate entities for the efficient use of
1001	resources.
1002	(b)  "Community Health education program" means a program
1003	that follows involving the planned and coordinated use of the
1004	educational standards and teaching methods resources available
1005	in a community in an effort to provide:
1006	1.  Appropriate medical, research-based interventions to
1007	enable and encourage changes in behaviors which reduce or
1008	eliminate health risks;
1009	2.  Counseling in nutrition, weight management, physical
1010	inactivity, and tobacco-use prevention and cessation strategies;
1011	hypertension, blood pressure, high cholesterol, and diabetes
1012	control; and other clinical prevention services;
1013	3.1.  Motivation and assistance to individuals or groups in
1014	adopting and maintaining Motivate and assist citizens to adopt
1015	and maintain healthful practices and lifestyles; and
1016	4.2.  Make available Learning opportunities that which will
1017	increase the ability of people to make informed decisions
1018	affecting their personal, family, and community well-being and
1019	that which are designed to facilitate voluntary adoption of
1020	behavior that which will improve or maintain health.;
1021	3.  Reduce, through coordination among appropriate
1022	agencies, duplication of health education efforts; and
1023	4.  Facilitate collaboration among appropriate agencies for
1024	efficient use of scarce resources.
1025	(c)  "Community intervention program" means a program
1026	combining the required elements of a chronic disease chronic
1027	disease prevention and health promotion control program and the
1028	principles of a community health education program that
1029	addresses system, policy, and environmental changes that ensure
1030	that communities provide support for healthy lifestyles into a
1031	unified program over which a single administrative entity has
1032	authority and responsibility.
1033	(d)  "Department" means the Department of Health.
1034	(e)  "Risk factor" means a factor identified during the
1035	course of an epidemiological study of a disease, which factor
1036	appears to be statistically associated with a high incidence of
1037	that disease.
1038	(2)  OPERATION OF COMMUNITY-LEVEL COMMUNITY INTERVENTION
1039	PROGRAMS FOR CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION.--
1040	(a)  The department shall develop and implement a
1041	comprehensive, community-based program for chronic disease
1042	prevention and health promotion. The program shall be designed
1043	to reduce major behavioral risk factors that are associated with
1044	chronic diseases by enhancing the knowledge, skills, motivation,
1045	and opportunities for individuals, organizations, health care
1046	providers, small businesses, health insurers, and communities to
1047	develop and maintain healthy lifestyles. The department shall
1048	assist the county health departments in developing and operating
1049	community intervention programs throughout the state. At a
1050	minimum, the community intervention programs shall address one
1051	to three of the following chronic diseases: cancer, diabetes,
1052	heart disease, stroke, hypertension, renal disease, and chronic
1053	obstructive lung disease.
1054	(b)  The program shall include:
1055	1.  Countywide assessments of specific, causal, and
1056	behavioral risk factors that affect the health of residents;
1057	2.  The development of community-based programs for chronic
1058	disease prevention and health promotion which incorporate health
1059	promotion and preventive care practices that are supported in
1060	scientific and medical literature;
1061	3.  The development and implementation of statewide age-
1062	specific, disease-specific, and community-specific health
1063	promotion and preventive care strategies using primary,
1064	secondary, and tertiary prevention interventions;
1065	4.  The promotion of community, research-based health-
1066	promotion model programs that meet specific criteria, address
1067	major risk factors, and motivate individuals to permanently
1068	adopt healthy behaviors and increase social and personal
1069	responsibilities;
1070	5.  The development of policies that encourage the use of
1071	alternative community delivery sites for health promotion,
1072	disease prevention, and preventive care programs and promote the
1073	use of neighborhood delivery sites that are close to work, home,
1074	and school; and
1075	6.  An emphasis on the importance of healthy and physically
1076	active lifestyles to build self-esteem and reduce morbidity and
1077	mortality associated with chronic disease and being overweight
1078	or obese. Existing community resources, when available, shall be
1079	used to support the programs. The department shall seek funding
1080	for the programs from federal and state financial assistance
1081	programs which presently exist or which may be hereafter
1082	created. Additional services, as appropriate, may be
1083	incorporated into a program to the extent that resources are
1084	available. The department may accept gifts and grants in order
1085	to carry out a program.
1086	(c)  Volunteers shall be used to the maximum extent
1087	possible in carrying out the programs. The department shall
1088	contract for the necessary insurance coverage to protect
1089	volunteers from personal liability while acting within the scope
1090	of their volunteer assignments under a program.
1091	(d)  The department may contract for the provision of all
1092	or any portion of the services required by a program, and shall
1093	so contract whenever the services so provided are more cost-
1094	efficient than those provided by the department.
1095	(e)  If the department determines that it is necessary for
1096	clients to help pay for services provided by a program, the
1097	department may require clients to make contribution therefor in
1098	either money or personal services. The amount of money or value
1099	of the personal services shall be fixed according to a fee
1100	schedule established by the department or by the entity
1101	developing the program. In establishing the fee schedule, the
1102	department or the entity developing the program shall take into
1103	account the expenses and resources of a client and his or her
1104	overall ability to pay for the services.
1105	Section 19.  Section 385.105, Florida Statutes, is created
1106	to read:
1107	385.105  Physical activity, obesity prevention, nutrition,
1108	other health-promotion services, and wellness programs.--
1109	(1)  PHYSICAL ACTIVITY.--
1110	(a)  The department shall develop programs for people at
1111	every stage of their lives to increase physical fitness and
1112	promote behavior changes.
1113	(b)  The department shall work with school health advisory
1114	or wellness committees in each school district as established in
1115	s. 381.0056.
1116	(c)  The department shall develop public and private
1117	partnerships that allow the public to easily access recreational
1118	facilities and public land areas that are suitable for physical
1119	activity.
1120	(d)  The department shall work in collaboration with the
1121	Executive Office of the Governor and Volunteer Florida, Inc., to
1122	promote school initiatives, such as the Governor's Fitness
1123	Challenge.
1124	(e)  The department shall collaborate with the Department
1125	of Education in recognizing nationally accepted best practices
1126	for improving physical education in schools.
1127	(2)  OBESITY PREVENTION.--The department shall promote
1128	healthy lifestyles to reduce the prevalence of excess weight
1129	gain and being overweight or obese through programs that are
1130	directed towards all residents of this state by:
1131	(a)  Using all appropriate media to promote maximum public
1132	awareness of the latest research on healthy lifestyles and
1133	chronic diseases and disseminating relevant information through
1134	a statewide clearinghouse relating to wellness, physical
1135	activity, and nutrition and the effect of these factors on
1136	chronic diseases and disabling conditions.
1137	(b)  Providing technical assistance, training, and
1138	resources on healthy lifestyles and chronic diseases to the
1139	public, health care providers, school districts, and other
1140	persons or entities, including faith-based organizations that
1141	request such assistance to promote physical activity, nutrition,
1142	and healthy lifestyle programs.
1143	(c)  Developing, implementing, and using all available
1144	research methods to collect data, including, but not limited to,
1145	population-specific data, and tracking the incidence and effects
1146	of weight gain, obesity, and related chronic diseases. The
1147	department shall include an evaluation and data-collection
1148	component in all programs as appropriate. All research conducted
1149	under this paragraph is subject to review and approval as
1150	required by the department's institutional review board under s.
1151	381.86.
1152	(d)  Entering into partnerships with the Department of
1153	Education, local communities, school districts, and other
1154	entities to encourage schools in this state to promote
1155	activities during and after school to help students meet a
1156	minimum goal of 30 minutes of physical activity or physical
1157	fitness per day.
1158	(e)  Entering into partnerships with the Department of
1159	Education, school districts, and the Florida Sports Foundation
1160	to develop a programs recognizing the schools at which students
1161	demonstrate excellent physical fitness or fitness improvement.
1162	(f)  Collaborating with other state agencies to develop
1163	policies and strategies for preventing and treating obesity,
1164	which shall be incorporated into programs administered by each
1165	agency and shall include promoting healthy lifestyles of
1166	employees of each agency.
1167	(g)  Advising, in accordance with s. 456.081, health care
1168	practitioners about the morbidity, mortality, and costs
1169	associated with being overweight or obese, informing such
1170	practitioners of promising clinical practices for preventing and
1171	treating obesity, and encouraging practitioners to counsel their
1172	patients regarding the adoption of healthy lifestyles.
1173	(h)  Maximizing all local, state, and federal funding
1174	sources, including grants, public-private partnerships, and
1175	other mechanisms to strengthen the department's programs
1176	promoting physical activity and nutrition.
1177	(3)  NUTRITION.--The department shall promote optimal
1178	nutritional status in all stages of people's lives by developing
1179	strategies to:
1180	(a)  Promote and maintain optimal nutritional status in the
1181	population through activities, including, but not limited to:
1182	1.  Nutrition screening and assessment and nutrition
1183	counseling, including nutrition therapy, followup, case
1184	management, and referrals for persons who have medical
1185	conditions or nutrition-risk factors and who are provided health
1186	services through public health programs or through referrals
1187	from private health care providers or facilities;
1188	2.  Nutrition education to assist residents of the state in
1189	achieving optimal health and preventing chronic disease; and
1190	3.  Consultative nutrition services to group facilities
1191	which promote the provision of safe and nutritionally adequate
1192	diets.
1193	(b)  Monitor and conduct surveillance of the nutritional
1194	status of this state's population.
1195	(c)  Conduct or support research or evaluations related to
1196	public health nutrition. All research conducted under this
1197	paragraph is subject to review and approval as required by the
1198	department's institutional review board under s. 381.86.
1199	(d)  Establish policies and standards for public health
1200	nutrition practices.
1201	(e)  Promote interagency cooperation, professional
1202	education, and consultation.
1203	(f)  Provide technical assistance and advise state
1204	agencies, private institutions, and local organizations
1205	regarding public health nutrition standards.
1206	(g)  Work with the Department of Agriculture and Consumer
1207	Services, the Department of Education, and the Department of
1208	Management Services to further the use of fresh produce from
1209	this state in schools and encourage the development of community
1210	gardens. Nutritional services shall be available to eligible
1211	persons in accordance with eligibility criteria adopted by the
1212	department. The department shall provide by rule requirements
1213	for the service fees, when applicable, which may not exceed the
1214	department's actual costs.
1215
1216	The department may adopt rules to administer this subsection.
1217	(4)  OTHER HEALTH-PROMOTION SERVICES.--
1218	(a)  The department shall promote personal responsibility
1219	by encouraging residents of this state to be informed, follow
1220	health recommendations, seek medical consultations and health
1221	assessments, take healthy precautions, and comply with medical
1222	guidelines, including those that lead to earlier detection of
1223	chronic diseases in order to prevent chronic diseases or slow
1224	the progression of established chronic diseases.
1225	(b)  The department shall promote regular health visits
1226	during a person's lifetime, including annual physical
1227	examinations that include measuring body mass index and vital
1228	signs, blood work, immunizations, screenings, and dental
1229	examinations in order to reduce the financial, social, and
1230	personal burden of chronic disease.
1231	(5)  WELLNESS PROGRAMS.--
1232	(a)  Each state agency may conduct employee wellness
1233	programs in buildings and lands owned or leased by the state.
1234	The department shall serve as a model to develop and implement
1235	employee wellness programs that may include physical fitness,
1236	healthy nutrition, self-management of disease, education, and
1237	behavioral change. The department shall assist other state
1238	agencies to develop and implement employee wellness programs.
1239	These programs shall use existing resources, facilities, and
1240	programs or resources procured through grant funding and
1241	donations that are obtained in accordance with state ethics and
1242	procurement policies, and shall provide equal access to any such
1243	programs, resources, and facilities to all state employees.
1244	(b)  The department shall coordinate its efforts with the
1245	Department of Management Services and other state agencies.
1246	(c)  Each agency may establish an employee wellness work
1247	group to design the program. The department shall be available
1248	to provide policy guidance and assist in identifying effective
1249	wellness program strategies.
1250	(d)  The department shall provide by rule requirements for
1251	nominal participation fees, when applicable, which may not
1252	exceed the department's actual costs; collaborations with
1253	businesses; and the procurement of equipment and incentives.
1254	Section 20.  Section 385.202, Florida Statutes, is amended
1255	to read:
1256	385.202  Statewide cancer registry.--
1257	(1)  Each facility, laboratory, or practitioner licensed
1258	under chapter 395, chapter 459, chapter 464, chapter 483,
1259	chapter 485, and each freestanding radiation therapy center as
1260	defined in s. 408.07, shall report to the department of Health
1261	such information, specified by the department, by rule. The
1262	department may adopt rules regarding reporting requirements for
1263	the cancer registry, which shall include the data required, the
1264	timeframe for reporting, and those professionals who are
1265	responsible for ensuring compliance with reporting requirements,
1266	which indicates diagnosis, stage of disease, medical history,
1267	laboratory data, tissue diagnosis, and radiation, surgical, or
1268	other methods of diagnosis or treatment for each cancer
1269	diagnosed or treated by the facility or center. Failure to
1270	comply with this requirement may be cause for registration or
1271	licensure suspension or revocation.
1272	(2)  The department shall establish, or cause to have
1273	established, by contract with a recognized medical organization
1274	in this state and its affiliated institutions, a statewide
1275	cancer registry program to ensure that cancer reports required
1276	under this section shall be maintained and available for use in
1277	the course of public health surveillance and any study for the
1278	purpose of reducing morbidity or mortality; and no liability of
1279	any kind or character for damages or other relief shall arise or
1280	be enforced against any facility or practitioner hospital by
1281	reason of having provided such information or material to the
1282	department.
1283	(3)  The department may adopt rules regarding the
1284	establishment and operation of a statewide cancer registry
1285	program.
1286	(4)(3)  The department or a contractual designee operating
1287	the statewide cancer registry program required by this section
1288	shall use or publish said material only for the purpose of
1289	public health surveillance and advancing medical research or
1290	medical education in the interest of reducing morbidity or
1291	mortality, except that a summary of such studies may be released
1292	for general publication. Information which discloses or could
1293	lead to the disclosure of the identity of any person whose
1294	condition or treatment has been reported and studied shall be
1295	confidential and exempt from the provisions of s. 119.07(1),
1296	except that:
1297	(a)  Release may be made with the written consent of all
1298	persons to whom the information applies;
1299	(b)  The department or a contractual designee may contact
1300	individuals for the purpose of epidemiologic investigation and
1301	monitoring, provided information that is confidential under this
1302	section is not further disclosed; or
1303	(c)  The department may exchange personal data with any
1304	other governmental agency or a contractual designee for the
1305	purpose of public health surveillance and medical or scientific
1306	research, if provided such governmental agency or contractual
1307	designee does shall not further disclose information that is
1308	confidential under this section.
1309	(5)(4)  Funds appropriated for this section shall be used
1310	for establishing, administering, compiling, processing, and
1311	providing biometric and statistical analyses to the reporting
1312	facilities and practitioners. Funds may also be used to ensure
1313	the quality and accuracy of the information reported and to
1314	provide management information to the reporting facilities and
1315	practitioners.
1316	(6)(5)  The department may adopt rules regarding the
1317	classifications of, by rule, classify facilities that are
1318	responsible for making reports to the cancer registry, the
1319	content and frequency of the reports, and the penalty for
1320	failure to comply with these requirements for purposes of
1321	reports made to the cancer registry and specify the content and
1322	frequency of the reports. In classifying facilities, the
1323	department shall exempt certain facilities from reporting cancer
1324	information that was previously reported to the department or
1325	retrieved from existing state reports made to the department or
1326	the Agency for Health Care Administration. The provisions of
1327	this section shall not apply to any facility whose primary
1328	function is to provide psychiatric care to its patients.
1329	(7)  Notwithstanding subsection (1), each facility and
1330	practitioner that reports cancer cases to the department shall
1331	make their records available for onsite review by the department
1332	or its authorized representative.
1333	Section 21.  Section 385.206, Florida Statutes, is amended
1334	to read:
1335	385.206  Pediatric Hematology-Oncology care Center
1336	Program.--
1337	(1)  DEFINITIONS.--As used in this section, the term:
1338	(a)  "Department" means the Department of Health.
1339	(b)  "Hematology" means the study, diagnosis, and treatment
1340	of blood and blood-forming tissues.
1341	(c)  "Oncology" means the study, diagnosis, and treatment
1342	of malignant neoplasms or cancer.
1343	(d)  "Hemophilia" or "other hemostatic disorder" means a
1344	bleeding disorder resulting from a genetic abnormality of
1345	mechanisms related to the control of bleeding.
1346	(e)  "Sickle-cell anemia or other hemoglobinopathy" means
1347	an hereditary, chronic disease caused by an abnormal type of
1348	hemoglobin.
1349	(f)  "Patient" means a person under the age of 21 who is in
1350	need of hematologic-oncologic services and who is enrolled in
1351	the Children's Medical Services Network declared medically and
1352	financially eligible by the department; or a person who received
1353	such services prior to age 21 and who requires long-term
1354	monitoring and evaluation to ascertain the sequelae and the
1355	effectiveness of treatment.
1356	(g)  "Center" means a facility designated by the department
1357	as having a program specifically designed to provide a full
1358	range of medical and specialty services to patients with
1359	hematologic and oncologic disorders.
1360	(2)  PEDIATRIC HEMATOLOGY-ONCOLOGY CARE CENTER PROGRAM;
1361	AUTHORITY.--The department may designate is authorized to make
1362	grants and reimbursements to designated centers and provide
1363	funding to establish and maintain programs for the care of
1364	patients with hematologic and oncologic disorders. Program
1365	administration costs shall be paid by the department from funds
1366	appropriated for this purpose.
1367	(3)  GRANT FUNDING CONTRACTS GRANT AGREEMENTS;
1368	CONDITIONS.--
1369	(a)  Funding provided A grant made under this section shall
1370	be pursuant to a contract contractual agreement made between a
1371	center and the department. Each contract agreement shall provide
1372	that patients will receive services specified types of treatment
1373	and care from the center without additional charge to the
1374	patients or their parents or guardians. Grants shall be
1375	disbursed in accordance with conditions set forth in the
1376	disbursement guidelines.
1377	(4)  GRANT DISBURSEMENTS AND SPECIAL DISBURSEMENTS FOR
1378	LOCAL PROGRAMS.--
1379	(b)(a)  Funding may be provided Grant disbursements may be
1380	made to centers that which meet the following criteria:
1381	1.  The personnel shall include at least one board-
1382	certified pediatric hematologist-oncologist, at least one board-
1383	certified pediatric surgeon, at least one board-certified
1384	radiotherapist, and at least one board-certified pathologist.
1385	2.  As approved by the department, The center shall
1386	actively participate in a national children's cancer study
1387	group, maintain a pediatric tumor registry, have a
1388	multidisciplinary pediatric tumor board, and meet other
1389	guidelines for development, including, but not limited to,
1390	guidelines from such organizations as the American Academy of
1391	Pediatrics and the American Pediatric Surgical Association.
1392	(b)  Programs shall also be established to provide care to
1393	hematology-oncology patients within each district of the
1394	department. The guidelines for local programs shall be
1395	formulated by the department. Special disbursements may be made
1396	by the program office to centers for educational programs
1397	designed for the districts of the department. These programs may
1398	include teaching total supportive care of the dying patient and
1399	his or her family, home therapy to hemophiliacs and patients
1400	with other hemostatic disorders, and screening and counseling
1401	for patients with sickle-cell anemia or other
1402	hemoglobinopathies.
1403	(4)(5)  PROGRAM AND PEER REVIEW.--The department shall
1404	evaluate at least annually during the grant period the services
1405	rendered by the centers and the districts of the department.
1406	Data from the centers and other sources relating to pediatric
1407	cancer shall be reviewed annually by the Florida Association of
1408	Pediatric Tumor Programs, Inc.; and a written report with
1409	recommendations shall be made to the department. This database
1410	will be available to the department for program planning and
1411	quality assurance initiatives formulation of its annual program
1412	and financial evaluation report. A portion of the funds
1413	appropriated for this section may be used to provide statewide
1414	consultation, supervision, and evaluation of the programs of the
1415	centers, as well as central program office support personnel.
1416	Section 22.  Paragraph (g) of subsection (2) and subsection
1417	(7) of section 385.207, Florida Statutes, are amended to read:
1418	385.207  Care and assistance of persons with epilepsy;
1419	establishment of programs in epilepsy control.--
1420	(2)  The Department of Health shall:
1421	(g)  Continue current programs and develop cooperative
1422	programs and services designed to enhance the vocational
1423	rehabilitation of epilepsy clients, including the current jobs
1424	programs. The department shall, as part of its contract with a
1425	provider of epilepsy services, collect information regarding the
1426	number of clients served, the outcomes reached, the expenses
1427	incurred, and the fees collected by such providers for the
1428	provision of services keep and make this information available
1429	to the Governor and the Legislature upon request information
1430	regarding the number of clients served, the outcome reached, and
1431	the expense incurred by such programs and services.
1432	(7)  The department shall limit total administrative
1433	expenditures from the Epilepsy Services Trust Fund to 5 percent
1434	of annual receipts.
1435	Section 23.  Paragraphs (b), (d), and (g) of subsection (2)
1436	and paragraph (b) of subsection (5) of section 385.210, Florida
1437	Statutes, are amended to read:
1438	385.210  Arthritis prevention and education.--
1439	(2)  LEGISLATIVE FINDINGS.--The Legislature finds the
1440	following:
1441	(b)  Arthritis is the leading cause of disability in the
1442	United States, limiting daily activities for more than 19 7
1443	million citizens.
1444	(d)  There are enormous economic and social costs
1445	associated with treating arthritis and its complications; the
1446	economic costs are estimated at over $128 billion (2003) $116
1447	billion (1997) annually in the United States.
1448	(g)  The National Arthritis Foundation, the CDC Centers for
1449	Disease Control and Prevention, and the Association of State and
1450	Territorial Health Officials have led the development of a
1451	public health strategy, the National Arthritis Action Plan, to
1452	respond to this challenge.
1453	(5)  FUNDING.--
1454	(b)  The State Surgeon General may shall seek any federal
1455	waiver or waivers that may be necessary to maximize funds from
1456	the Federal Government to implement this program.
1457	Section 24.  Section 385.301, Florida Statutes, is created
1458	to read:
1459	385.301  Rulemaking authority.--The department may adopt
1460	rules pursuant to chapter 120 to administer this chapter.
1461	Section 25.  Subsection (9) of section 409.904, Florida
1462	Statutes, is amended to read:
1463	409.904  Optional payments for eligible persons.--The
1464	agency may make payments for medical assistance and related
1465	services on behalf of the following persons who are determined
1466	to be eligible subject to the income, assets, and categorical
1467	eligibility tests set forth in federal and state law. Payment on
1468	behalf of these Medicaid eligible persons is subject to the
1469	availability of moneys and any limitations established by the
1470	General Appropriations Act or chapter 216.
1471	(9)  Eligible women with incomes at or below 200 percent of
1472	the federal poverty level and under age 65, for cancer treatment
1473	pursuant to the federal Breast and Cervical Cancer Prevention
1474	and Treatment Act of 2000, screened through the Mary Brogan
1475	Breast and Cervical Cancer Early Detection Program established
1476	under s. 385.2021 s. 381.93.
1477	Section 26.  This act shall take effect July 1, 2009.

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