CS/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. 385.203, F.S.; increasing the membership of
111	the Diabetes Advisory Council; amending s. 385.206, F.S.;
112	renaming the "hematology-oncology care center program" as
113	the "Pediatric Hematology-Oncology Center Program";
114	revising definitions; authorizing the department to
115	designate centers and provide funding to maintain programs
116	for the care of patients with hematologic and oncologic
117	disorders; clarifying provisions related to grant-funding
118	agreements and grant disbursements; revising the
119	department's requirement to evaluate services rendered by
120	the centers; requiring data from the centers and other
121	sources relating to pediatric cancer to be available to
122	the department for program planning and quality assurance
123	initiatives; amending s. 385.207, F.S.; clarifying
124	provisions that require the department to collect
125	information regarding the number of clients served, the
126	outcomes reached, the expense incurred, and fees collected
127	by providers of epilepsy services; deleting the provision
128	that requires the department to limit administrative
129	expenses from the Epilepsy Services Trust Fund to a
130	certain percentage of annual receipts; amending s.
131	385.210, F.S.; revising legislative findings regarding the
132	economic costs of treating arthritis and its
133	complications; authorizing the State Surgeon General to
134	seek any federal waivers that may be necessary to maximize
135	funds from the Federal Government to implement the
136	Arthritis Prevention and Education Program; creating s.
137	385.301, F.S.; authorizing the department to adopt rules
138	to administer the act; amending s. 409.904, F.S.;
139	conforming a cross-reference; providing an effective date.
140
141	Be It Enacted by the Legislature of the State of Florida:
142
143	Section 1.  Paragraph (e) of subsection (2) of section
144	154.503, Florida Statutes, is amended to read:
145	154.503  Primary Care for Children and Families Challenge
146	Grant Program; creation; administration.--
147	(2)  The department shall:
148	(e)  Coordinate with the primary care program developed
149	pursuant to s. 154.011, the Florida Healthy Kids Corporation
150	program created in s. 624.91, the school health services program
151	created in ss. 381.0056 and 381.0057, the Healthy Communities,
152	Healthy People Program created in s. 381.734, and the volunteer
153	health care provider program developed pursuant to s. 766.1115.
154	Section 2.  Sections 381.0053, 381.0054, 381.732, 381.733,
155	and 381.734, Florida Statutes, are repealed.
156	Section 3.  Section 381.84, Florida Statutes, is
157	transferred, renumbered as section 385.106, Florida Statutes,
158	and amended to read:
159	385.106 381.84  Comprehensive Statewide Tobacco Education
160	and Use Prevention Program.--
161	(1)  DEFINITIONS.--As used in this section and for purposes
162	of the provisions of s. 27, Art. X of the State Constitution,
163	the term:
164	(a)  "AHEC network" means an area health education center
165	network established under s. 381.0402.
166	(b)  "Best practices" means the Best Practices for
167	Comprehensive Tobacco Control Programs as established by the
168	CDC, as amended.
169	(c)(b)  "CDC" means the United States Centers for Disease
170	Control and Prevention.
171	(d)(c)  "Council" means the Tobacco Education and Use
172	Prevention Advisory Council.
173	(d)  "Department" means the Department of Health.
174	(e)  "Tobacco" means, without limitation, tobacco itself
175	and tobacco products that include tobacco and are intended or
176	expected for human use or consumption, including, but not
177	limited to, cigarettes, cigars, pipe tobacco, and smokeless
178	tobacco.
179	(f)  "Youth" means minors and young adults.
180	(2)  PURPOSE, FINDINGS, AND INTENT.--It is the purpose of
181	this section to implement s. 27, Art. X of the State
182	Constitution. The Legislature finds that s. 27, Art. X of the
183	State Constitution requires the funding of a statewide tobacco
184	education and use prevention program that focuses on tobacco use
185	by youth. The Legislature further finds that the primary goals
186	of the program are to reduce the prevalence of tobacco use among
187	youth, adults, and pregnant women; reduce per capita tobacco
188	consumption; and reduce exposure to environmental tobacco smoke.
189	Further, it is the intent of the Legislature to base increases
190	in funding for individual components of the program on the
191	results of assessments and evaluations. Recognizing that some
192	components will need to grow faster than inflation, it is the
193	intent of the Legislature to fund portions of the program on a
194	nonrecurring basis in the early years so that those components
195	that are most effective can be supported as the program matures.
196	(3)  PROGRAM COMPONENTS AND REQUIREMENTS.--The department
197	shall conduct a comprehensive, statewide tobacco education and
198	use prevention program consistent with the recommendations for
199	effective program components contained in the 1999 Best
200	Practices for Comprehensive Tobacco Control Programs of the CDC,
201	as amended by the CDC. The program shall include the following
202	components, each of which shall focus on educating people,
203	particularly youth and their parents, about the health hazards
204	of tobacco and discouraging the use of tobacco. All program
205	components shall include efforts to educate youth and their
206	parents about tobacco use, and a youth-directed focus shall
207	exist in all components outlined in this subsection.:
208	(a)  State and community interventions.--These
209	interventions shall include, but not be limited to, a statewide
210	tobacco control program that combines and coordinates community-
211	based interventions that focus on preventing initiation of
212	tobacco use among youth and young adults; promoting quitting
213	among adults, youth, and pregnant women; eliminating exposure to
214	secondhand smoke; identifying and eliminating tobacco-related
215	disparities among population groups; and promoting a range of
216	collaborations to prevent and alleviate the effects of chronic
217	diseases. Counter-marketing and advertising; cyberspace resource
218	center.--The counter-marketing and advertising campaign shall
219	include, at a minimum, Internet, print, radio, and television
220	advertising and shall be funded with a minimum of one-third of
221	the total annual appropriation required by s. 27, Art. X of the
222	State Constitution. A cyberspace resource center for copyrighted
223	materials and information concerning tobacco education and use
224	prevention, including cessation, shall be maintained by the
225	program. Such resource center must be accessible to the public,
226	including parents, teachers, and students, at each level of
227	public and private schools, universities, and colleges in the
228	state and shall provide links to other relevant resources. The
229	Internet address for the resource center must be incorporated in
230	all advertising. The information maintained in the resource
231	center shall be used by the other components of the program.
232	(b)  Health communication interventions.--Effective media
233	and health communication intervention efforts include, but are
234	not limited to, audience research to define themes and execute
235	messages for influential, high impact, and specifically targeted
236	campaigns; market research to identify the target market and the
237	behavioral theory motivating change; counter-marketing
238	surveillance; community tie-ins to support and reinforce the
239	statewide campaign; technologies such as viral marketing, social
240	networks, personal web pages, and web logs; traditional media;
241	process and outcome evaluation of the communication efforts; and
242	promotion of available services, including the state telephone
243	cessation quitline. Cessation programs, counseling, and
244	treatment.--This program component shall include two
245	subcomponents:
246	1.  A statewide toll-free cessation service, which may
247	include counseling, referrals to other local resources and
248	support services, and treatment to the extent funds are
249	available for treatment services; and
250	2.  A local community-based program to disseminate
251	information about smoking cessation, how smoking cessation
252	relates to prenatal care and obesity prevention, and other
253	chronic tobacco-related diseases.
254	(c)  Cessation interventions.--Cessation interventions
255	include, but are not limited to, sustaining, expanding, and
256	promoting the service through population-based counseling and
257	treatment programs; encouraging public and private insurance
258	coverage for counseling and FDA-approved medication treatments
259	for tobacco-use cessation; eliminating cost and other barriers
260	to treatment for underserved populations; and making health care
261	system changes. Youth interventions to prevent tobacco-use
262	initiation and encourage cessation among young people are needed
263	in order to reshape the environment so that it supports tobacco-
264	free norms. Because most people who start smoking are younger
265	than 18 years of age, intervening during adolescence is
266	critical. Community programs and school-based policies and
267	interventions should be a part of a comprehensive effort that is
268	implemented in coordination with community and school
269	environments and in conjunction with increasing the unit price
270	of tobacco products, sustaining anti-tobacco media campaigns,
271	making environments tobacco free, and engaging in other efforts
272	to create tobacco-free social norms. Surveillance and
273	evaluation.--The program shall conduct ongoing epidemiological
274	surveillance and shall contract for annual independent
275	evaluations of the effectiveness of the various components of
276	the program in meeting the goals as set forth in subsection (2).
277	(d)  Surveillance and evaluation.--The surveillance and
278	evaluation of all program components shall monitor and document
279	short-term, intermediate, and long-term intervention outcomes to
280	inform program and policy direction and ensure accountability.
281	The surveillance and evaluation must be conducted objectively
282	through scientifically sound methodology. Youth school
283	programs.--School and after-school programs shall use current
284	evidence-based curricula and programs that involve youth to
285	educate youth about the health hazards of tobacco, help youth
286	develop skills to refuse tobacco, and demonstrate to youth how
287	to stop using tobacco.
288	(e)  Administration and management.--Administration and
289	management activities include, but are not limited to, strategic
290	planning to guide program efforts and resources in order to
291	accomplish goals; recruiting and developing qualified and
292	diverse technical, program, and administrative staff; awarding
293	and monitoring program contracts and grants to coordinate
294	implementation across program areas; developing and maintaining
295	a fiscal-management system to track allocations and the
296	expenditure of funds; increasing capacity at the community level
297	through ongoing training and technical assistance; creating
298	effective communications internally among chronic disease
299	prevention programs and local coalitions and partners; and
300	educating the public and decisionmakers on the health effects of
301	tobacco and evidence-based effective program and policy
302	interventions. Community programs and chronic disease
303	prevention.--The department shall promote and support local
304	community-based partnerships that emphasize programs involving
305	youth, including programs for the prevention, detection, and
306	early intervention of smoking-related chronic diseases.
307	(f)  Training.--The program shall include the training of
308	health care practitioners, smoking-cessation counselors, and
309	teachers by health professional students and other tobacco-use
310	prevention specialists who are trained in preventing tobacco use
311	and health education. Smoking-cessation counselors shall be
312	trained by specialists who are certified in tobacco-use
313	cessation.
314	(g)  County health departments Administration, statewide
315	programs, and county health departments.--Each county health
316	department is eligible to receive a portion of the annual
317	appropriation, on a per capita basis, for coordinating tobacco
318	education and use prevention programs within that county.
319	Appropriated funds may be used to improve the infrastructure of
320	the county health department to implement the comprehensive,
321	statewide tobacco education and use prevention program. Each
322	county health department shall prominently display in all
323	treatment rooms and waiting rooms, counter-marketing and
324	advertisement materials in the form of wall posters, brochures,
325	television advertising if televisions are used in the lobby or
326	waiting room, and screensavers and Internet advertising if
327	computer kiosks are available for use or viewing by people at
328	the county health department.
329	(h)  Enforcement and awareness of related laws.--In
330	coordination with the Department of Business and Professional
331	Regulation, the program shall monitor the enforcement of laws,
332	rules, and policies prohibiting the sale or other provision of
333	tobacco to minors, as well as the continued enforcement of the
334	Clean Indoor Air Act prescribed in chapter 386. The
335	advertisements produced in accordance with paragraph (b)
336	paragraph (a) may also include information designed to make the
337	public aware of these related laws and rules. The departments
338	may enter into interagency agreements to carry out this program
339	component.
340	(i)  AHEC smoking-cessation initiative.--For the 2007-2008
341	and 2008-2009 fiscal years only, the AHEC network shall expand
342	the AHEC smoking-cessation initiative to each county within the
343	state and perform other activities as determined by the
344	department.
345	(4)  ADVISORY COUNCIL; MEMBERS, APPOINTMENTS, AND
346	MEETINGS.--The Tobacco Education and Use Prevention Advisory
347	Council is created within the department.
348	(a)  The council shall consist of 23 members, including:
349	1.  The State Surgeon General, who shall serve as the
350	chairperson.
351	2.  One county health department director, appointed by the
352	State Surgeon General.
353	3.  Two members appointed by the Commissioner of Education,
354	of whom one must be a school district superintendent.
355	4.  The chief executive officer of the Florida Division of
356	the American Cancer Society, or his or her designee.
357	5.  The chief executive officer of the Greater Southeast
358	Affiliate of the American Heart Association, or his or her
359	designee.
360	6.  The chief executive officer of the American Lung
361	Association of Florida, or his or her designee.
362	7.  The dean of the University of Miami School of Medicine,
363	or his or her designee.
364	8.  The dean of the University of Florida College of
365	Medicine, or his or her designee.
366	9.  The dean of the University of South Florida College of
367	Medicine, or his or her designee.
368	10.  The dean of the Florida State University College of
369	Medicine, or his or her designee.
370	11.  The dean of Nova Southeastern College of Osteopathic
371	Medicine, or his or her designee.
372	12.  The dean of the Lake Erie College of Osteopathic
373	Medicine in Bradenton, Florida, or his or her designee.
374	13.  The chief executive officer of the Campaign for
375	Tobacco Free Kids, or his or her designee.
376	14.  The chief executive officer of the Legacy Foundation,
377	or his or her designee.
378	15.  Four members appointed by the Governor, of whom two
379	must have expertise in the field of tobacco-use prevention and
380	education or smoking cessation and one individual who shall be
381	between the ages of 16 and 21 at the time of his or her
382	appointment.
383	16.  Two members appointed by the President of the Senate,
384	of whom one must have expertise in the field of tobacco-use
385	prevention and education or smoking cessation.
386	17.  Two members appointed by the Speaker of the House of
387	Representatives, of whom one must have expertise in the field of
388	tobacco-use prevention and education or smoking cessation.
389	(b)  The appointments shall be for 3-year terms and shall
390	reflect the diversity of the state's population. A vacancy shall
391	be filled by appointment by the original appointing authority
392	for the unexpired portion of the term.
393	(c)  An appointed member may not serve more than two
394	consecutive terms.
395	(d)  The council shall meet at least quarterly and upon the
396	call of the chairperson. Meetings may be held via teleconference
397	or other electronic means.
398	(e)  Members of the council shall serve without
399	compensation, but are entitled to reimbursement for per diem and
400	travel expenses pursuant to s. 112.061. Members who are state
401	officers or employees or who are appointed by state officers or
402	employees shall be reimbursed for per diem and travel expenses
403	pursuant to s. 112.061 from the state agency through which they
404	serve.
405	(f)  The council shall adhere to all state ethics laws.
406	Meetings of the council and the review panels are subject to
407	chapter 119, s. 286.011, and s. 24, Art. I of the State
408	Constitution. The department shall provide council members with
409	information and other assistance as is reasonably necessary to
410	assist the council in carrying out its responsibilities.
411	(5)  COUNCIL DUTIES AND RESPONSIBILITIES.--The council
412	shall advise the State Surgeon General as to the direction and
413	scope of the Comprehensive Statewide Tobacco Education and Use
414	Prevention Program. The responsibilities of the council may
415	include, but are not limited to:
416	(a)  Providing advice on program priorities and emphases.
417	(b)  Providing advice on the overall program budget.
418	(c)  Providing advice on copyrighted material, trademark,
419	and future transactions as they pertain to the tobacco education
420	and use prevention program.
421	(d)  Reviewing, as requested by the department, broadcast
422	material prepared for the Internet, portable media players,
423	radio, and television advertisement as it relates to the
424	advertising component of the tobacco education and use
425	prevention program.
426	(e)  Participating in periodic program evaluation, as
427	requested by the department.
428	(f)  Assisting the department in developing the development
429	of guidelines to ensure fairness, neutrality, and adherence to
430	the principles of merit and quality in the conduct of the
431	program.
432	(g)  Assisting the department in developing the development
433	of administrative procedures relating to solicitation, review,
434	and award of contracts and grants in order to ensure an
435	impartial, high-quality peer review system.
436	(h)  Assisting the department in developing panels to
437	review and evaluate potential fund recipients the development
438	and supervision of peer review panels.
439	(i)  Assisting the department in reviewing reports of peer
440	review panels and making recommendations for funding allocations
441	contracts and grants.
442	(j)  Assisting the department in reviewing the activities
443	and evaluating the performance of the AHEC network to avoid
444	duplicative efforts using state funds.
445	(k)  Recommending specific measureable outcomes meaningful
446	outcome measures through a regular review of evidence-based and
447	promising tobacco-use prevention and education strategies and
448	programs of other states and the Federal Government.
449	(l)  Recommending policies to encourage a coordinated
450	response to tobacco use in this state, focusing specifically on
451	creating partnerships within and between the public and private
452	sectors.
453	(6)  CONTRACT REQUIREMENTS.--Contracts or grants for the
454	program components or subcomponents described in paragraphs
455	(3)(a)-(f) shall be awarded by the State Surgeon General, after
456	consultation with the council, on the basis of merit, as
457	determined by an open, competitive, peer-reviewed process that
458	ensures objectivity, consistency, and high quality. The
459	department shall award such grants or contracts no later than
460	October 1 for each fiscal year. A recipient of a contract or
461	grant for the program component described in paragraph (3)(d)
462	(3)(c) is not eligible for a contract or grant award for any
463	other program component described in subsection (3) in the same
464	state fiscal year. A school or college of medicine that is
465	represented on the council is not eligible to receive a contract
466	or grant under this section. For the 2007-2008 and 2008-2009
467	fiscal years only, the department shall award a contract or
468	grant in the amount of $10 million to the AHEC network for the
469	purpose of developing the components described in paragraph
470	(3)(i). The AHEC network may apply for a competitive contract or
471	grant after the 2008-2009 fiscal year.
472	(a)  In order to ensure that all proposals for funding are
473	appropriate and are evaluated fairly on the basis of merit, the
474	State Surgeon General, in consultation with the council, shall
475	appoint a peer review panel of independent, qualified experts in
476	the field of tobacco control to review the content of each
477	proposal and establish its priority score. The priority scores
478	shall be forwarded to the council and must be considered in
479	determining which proposals will be recommended for funding.
480	(b)  The council and the peer review panel shall establish
481	and follow rigorous guidelines for ethical conduct and adhere to
482	a strict policy with regard to conflicts of interest. Council
483	members are subject to the applicable provisions of chapter 112.
484	A member of the council or panel may not participate in any
485	discussion or decision with respect to a research proposal by
486	any firm, entity, or agency with which the member is associated
487	as a member of the governing body or as an employee or with
488	which the member has entered into a contractual arrangement.
489	Meetings of the council and the peer review panels are subject
490	to chapter 119, s. 286.011, and s. 24, Art. I of the State
491	Constitution.
492	(c)  In each contract or grant agreement, the department
493	shall limit the use of food and promotional items to no more
494	than 2.5 percent of the total amount of the contract or grant
495	and limit overhead or indirect costs to no more than 7.5 percent
496	of the total amount of the contract or grant. The department, in
497	consultation with the Department of Financial Services, shall
498	publish guidelines for appropriate food and promotional items.
499	(d)  In each advertising contract, the department shall
500	limit the total of production fees, buyer commissions, and
501	related costs to no more than 10 percent of the total contract
502	amount.
503	(e)  Notwithstanding the competitive process for contracts
504	prescribed in this subsection, each county health department is
505	eligible for core funding, on a per capita basis, to implement
506	tobacco education and use prevention activities within that
507	county.
508	(7)  ANNUAL REPORT REQUIRED.--By February 28 January 31 of
509	each year, the department shall provide to the Governor, the
510	President of the Senate, and the Speaker of the House of
511	Representatives a report that evaluates the program's
512	effectiveness in reducing and preventing tobacco use and that
513	recommends improvements to enhance the program's effectiveness.
514	The report must contain, at a minimum, an annual survey of youth
515	attitudes and behavior toward tobacco, as well as a description
516	of the progress in reducing the prevalence of tobacco use among
517	youth, adults, and pregnant women; reducing per capita tobacco
518	consumption; and reducing exposure to environmental tobacco
519	smoke.
520	(8)  LIMITATION ON ADMINISTRATIVE EXPENSES.--From the total
521	funds appropriated for the Comprehensive Statewide Tobacco
522	Education and Use Prevention Program in the General
523	Appropriations Act, an amount of up to 5 percent may be used by
524	the department for administrative expenses.
525	(9)  RULEMAKING AUTHORIZED.--By January 1, 2008, the
526	department shall adopt rules pursuant to ss. 120.536(1) and
527	120.54 to administer this section.
528	Section 4.  Section 381.91, Florida Statutes, is
529	transferred and renumbered as section 385.2024, Florida
530	Statutes, to read:
531	385.2024 381.91  Jessie Trice Cancer Prevention Program.--
532	(1)  It is the intent of the Legislature to:
533	(a)  Reduce the rates of illness and death from lung cancer
534	and other cancers and improve the quality of life among low-
535	income African-American and Hispanic populations through
536	increased access to early, effective screening and diagnosis,
537	education, and treatment programs.
538	(b)  Create a community faith-based disease-prevention
539	program in conjunction with the Health Choice Network and other
540	community health centers to build upon the natural referral and
541	education networks in place within minority communities and to
542	increase access to health service delivery in Florida.
543	(c)  Establish a funding source to build upon local private
544	participation to sustain the operation of the program.
545	(2)(a)  There is created the Jessie Trice Cancer Prevention
546	Program, to be located, for administrative purposes, within the
547	Department of Health, and operated from the community health
548	centers within the Health Choice Network in Florida.
549	(b)  Funding may be provided to develop contracts with
550	community health centers and local community faith-based
551	education programs to provide cancer screening, diagnosis,
552	education, and treatment services to low-income populations
553	throughout the state.
554	Section 5.  Section 381.911, Florida Statutes, is
555	transferred, renumbered as section 385.2023, Florida Statutes,
556	and amended to read:
557	385.2023 381.911  Prostate Cancer Awareness Program.--
558	(1)  To the extent that funds are specifically made
559	available for this purpose, the Prostate Cancer Awareness
560	Program is established within the Department of Health. The
561	purpose of this program is to implement the recommendations of
562	January 2000 of the Florida Prostate Cancer Task Force to
563	provide for statewide outreach and health education activities
564	to ensure that men are aware of and appropriately seek medical
565	counseling for prostate cancer as an early-detection health care
566	measure.
567	(2)  For purposes of implementing the program, the
568	Department of Health and the Florida Public Health Foundation,
569	Inc., may:
570	(a)  Conduct activities directly or enter into a contract
571	with a qualified nonprofit community education entity.
572	(b)  Seek any available gifts, grants, or funds from the
573	state, the Federal Government, philanthropic foundations, and
574	industry or business groups.
575	(3)  A prostate cancer advisory committee is created to
576	advise and assist the Department of Health and the Florida
577	Public Health Foundation, Inc., in implementing the program.
578	(a)  The State Surgeon General shall appoint the advisory
579	committee members, who shall consist of:
580	1.  Three persons from prostate cancer survivor groups or
581	cancer-related advocacy groups.
582	2.  Three persons who are scientists or clinicians from
583	public or nonpublic universities or research organizations.
584	3.  Three persons who are engaged in the practice of a
585	cancer-related medical specialty from health organizations
586	committed to cancer research and control.
587	(b)  Members shall serve without compensation but are
588	entitled to reimbursement, pursuant to s. 112.061, for per diem
589	and travel expenses incurred in the performance of their
590	official duties.
591	(4)  The program shall coordinate its efforts with those of
592	the Florida Public Health Foundation, Inc.
593	Section 6.  Section 381.912, Florida Statutes, is repealed.
594	Section 7.  Section 381.92, Florida Statutes, is
595	transferred and renumbered as section 385.2025, Florida
596	Statutes, to read:
597	385.2025 381.92  Florida Cancer Council.--
598	(1)  Effective July 1, 2004, the Florida Cancer Council
599	within the Department of Health is established for the purpose
600	of making the state a center of excellence for cancer research.
601	(2)(a)  The council shall be representative of the state's
602	cancer centers, hospitals, and patient groups and shall be
603	organized and shall operate in accordance with this act.
604	(b)  The Florida Cancer Council may create not-for-profit
605	corporate subsidiaries to fulfill its mission. The council and
606	its subsidiaries are authorized to receive, hold, invest, and
607	administer property and any moneys acquired from private, local,
608	state, and federal sources, as well as technical and
609	professional income generated or derived from the mission-
610	related activities of the council.
611	(c)  The members of the council shall consist of:
612	1.  The chair of the Florida Dialogue on Cancer, who shall
613	serve as the chair of the council;
614	2.  The State Surgeon General or his or her designee;
615	3.  The chief executive officer of the H. Lee Moffitt
616	Cancer Center or his or her designee;
617	4.  The director of the University of Florida Shands Cancer
618	Center or his or her designee;
619	5.  The chief executive officer of the University of Miami
620	Sylvester Comprehensive Cancer Center or his or her designee;
621	6.  The chief executive officer of the Mayo Clinic,
622	Jacksonville, or his or her designee;
623	7.  The chief executive officer of the American Cancer
624	Society, Florida Division, Inc., or his or her designee;
625	8.  The president of the American Cancer Society, Florida
626	Division, Inc., Board of Directors or his or her designee;
627	9.  The president of the Florida Society of Clinical
628	Oncology or his or her designee;
629	10.  The president of the American College of Surgeons,
630	Florida Chapter, or his or her designee;
631	11.  The chief executive officer of Enterprise Florida,
632	Inc., or his or her designee;
633	12.  Five representatives from cancer programs approved by
634	the American College of Surgeons. Three shall be appointed by
635	the Governor, one shall be appointed by the Speaker of the House
636	of Representatives, and one shall be appointed by the President
637	of the Senate;
638	13.  One member of the House of Representatives, to be
639	appointed by the Speaker of the House of Representatives; and
640	14.  One member of the Senate, to be appointed by the
641	President of the Senate.
642	(d)  Appointments made by the Speaker of the House of
643	Representatives and the President of the Senate pursuant to
644	paragraph (c) shall be for 2-year terms, concurrent with the
645	bienniums in which they serve as presiding officers.
646	(e)  Appointments made by the Governor pursuant to
647	paragraph (c) shall be for 2-year terms, although the Governor
648	may reappoint members.
649	(f)  Members of the council or any subsidiaries shall serve
650	without compensation, and each organization represented on the
651	council shall cover the expenses of its representatives.
652	(3)  The council shall issue an annual report to the Center
653	for Universal Research to Eradicate Disease, the Governor, the
654	Speaker of the House of Representatives, and the President of
655	the Senate by December 15 of each year, with policy and funding
656	recommendations regarding cancer research capacity in Florida
657	and related issues.
658	Section 8.  Section 381.921, Florida Statutes, is
659	transferred and renumbered as section 385.20251, Florida
660	Statutes, to read:
661	385.20251 381.921  Florida Cancer Council mission and
662	duties.--The council, which shall work in concert with the
663	Florida Center for Universal Research to Eradicate Disease to
664	ensure that the goals of the center are advanced, shall endeavor
665	to dramatically improve cancer research and treatment in this
666	state through:
667	(1)  Efforts to significantly expand cancer research
668	capacity in the state by:
669	(a)  Identifying ways to attract new research talent and
670	attendant national grant-producing researchers to cancer
671	research facilities in this state;
672	(b)  Implementing a peer-reviewed, competitive process to
673	identify and fund the best proposals to expand cancer research
674	institutes in this state;
675	(c)  Funding through available resources for those
676	proposals that demonstrate the greatest opportunity to attract
677	federal research grants and private financial support;
678	(d)  Encouraging the employment of bioinformatics in order
679	to create a cancer informatics infrastructure that enhances
680	information and resource exchange and integration through
681	researchers working in diverse disciplines, to facilitate the
682	full spectrum of cancer investigations;
683	(e)  Facilitating the technical coordination, business
684	development, and support of intellectual property as it relates
685	to the advancement of cancer research; and
686	(f)  Aiding in other multidisciplinary research-support
687	activities as they inure to the advancement of cancer research.
688	(2)  Efforts to improve both research and treatment through
689	greater participation in clinical trials networks by:
690	(a)  Identifying ways to increase adult enrollment in
691	cancer clinical trials;
692	(b)  Supporting public and private professional education
693	programs designed to increase the awareness and knowledge about
694	cancer clinical trials;
695	(c)  Providing tools to cancer patients and community-based
696	oncologists to aid in the identification of cancer clinical
697	trials available in the state; and
698	(d)  Creating opportunities for the state's academic cancer
699	centers to collaborate with community-based oncologists in
700	cancer clinical trials networks.
701	(3)  Efforts to reduce the impact of cancer on disparate
702	groups by:
703	(a)  Identifying those cancers that disproportionately
704	impact certain demographic groups; and
705	(b)  Building collaborations designed to reduce health
706	disparities as they relate to cancer.
707	Section 9.  Paragraph (a) of subsection (2) and subsection
708	(5) of section 381.922, Florida Statutes, as amended by section
709	2 of chapter 2009-5, Laws of Florida, is amended to read:
710	381.922  William G. "Bill" Bankhead, Jr., and David Coley
711	Cancer Research Program.--
712	(2)  The program shall provide grants for cancer research
713	to further the search for cures for cancer.
714	(a)  Emphasis shall be given to the goals enumerated in s.
715	385.20251 s. 381.921, as those goals support the advancement of
716	such cures.
717	(5)  For the 2008-2009 fiscal year and each fiscal year
718	thereafter, the sum of $6.75 million is appropriated annually
719	from recurring funds in the General Revenue Fund to the
720	Biomedical Research Trust Fund within the Department of Health
721	for purposes of the William G. "Bill" Bankhead, Jr., and David
722	Coley Cancer Research Program and shall be distributed pursuant
723	to this section to provide grants to researchers seeking cures
724	for cancer, with emphasis given to the goals enumerated in s.
725	385.20251 s. 381.921. From the total funds appropriated, an
726	amount of up to 10 percent may be used for administrative
727	expenses.
728	Section 10.  Section 381.93, Florida Statutes, is
729	transferred and renumbered as section 385.2021, Florida
730	Statutes, to read:
731	385.2021 381.93  Breast and cervical cancer early detection
732	program.--This section may be cited as the "Mary Brogan Breast
733	and Cervical Cancer Early Detection Program Act."
734	(1)  It is the intent of the Legislature to reduce the
735	rates of death due to breast and cervical cancer through early
736	diagnosis and increased access to early screening, diagnosis,
737	and treatment programs.
738	(2)  The Department of Health, using available federal
739	funds and state funds appropriated for that purpose, is
740	authorized to establish the Mary Brogan Breast and Cervical
741	Cancer Screening and Early Detection Program to provide
742	screening, diagnosis, evaluation, treatment, case management,
743	and followup and referral to the Agency for Health Care
744	Administration for coverage of treatment services.
745	(3)  The Mary Brogan Breast and Cervical Cancer Early
746	Detection Program shall be funded through grants for such
747	screening and early detection purposes from the federal Centers
748	for Disease Control and Prevention under Title XV of the Public
749	Health Service Act, 42 U.S.C. ss. 300k et seq.
750	(4)  The department shall limit enrollment in the program
751	to persons with incomes up to and including 200 percent of the
752	federal poverty level. The department shall establish an
753	eligibility process that includes an income-verification process
754	to ensure that persons served under the program meet income
755	guidelines.
756	(5)  The department may provide other breast and cervical
757	cancer screening and diagnostic services; however, such services
758	shall be funded separately through other sources than this act.
759	Section 11.  Section 381.931, Florida Statutes, is
760	transferred and renumbered as section 385.20211, Florida
761	Statutes, to read:
762	385.20211 381.931  Annual report on Medicaid
763	expenditures.--The Department of Health and the Agency for
764	Health Care Administration shall monitor the total Medicaid
765	expenditures for services made under this act. If Medicaid
766	expenditures are projected to exceed the amount appropriated by
767	the Legislature, the Department of Health shall limit the number
768	of screenings to ensure Medicaid expenditures do not exceed the
769	amount appropriated. The Department of Health, in cooperation
770	with the Agency for Health Care Administration, shall prepare an
771	annual report that must include the number of women screened;
772	the percentage of positive and negative outcomes; the number of
773	referrals to Medicaid and other providers for treatment
774	services; the estimated number of women who are not screened or
775	not served by Medicaid due to funding limitations, if any; the
776	cost of Medicaid treatment services; and the estimated cost of
777	treatment services for women who were not screened or referred
778	for treatment due to funding limitations. The report shall be
779	submitted to the President of the Senate, the Speaker of the
780	House of Representatives, and the Executive Office of the
781	Governor by March 1 of each year.
782	Section 12.  Chapter 385, Florida Statutes, entitled
783	"Chronic Diseases," is renamed the "Healthy and Fit Florida
784	Act."
785	Section 13.  Section 385.101, Florida Statutes, is amended
786	to read:
787	385.101  Short title.--This chapter Sections 385.101-
788	385.103 may be cited as the "Healthy and Fit Florida Chronic
789	Diseases Act."
790	Section 14.  Section 385.102, Florida Statutes, is amended
791	to read:
792	385.102  Legislative intent.--It is the finding of the
793	Legislature that:
794	(1)  Chronic diseases continue to be the leading cause of
795	death and disability in this state and the country exist in high
796	proportions among the people of this state. These Chronic
797	diseases include, but are not limited to, arthritis,
798	cardiovascular disease heart disease, hypertension, diabetes,
799	renal disease, cancer, and chronic obstructive lung disease.
800	These diseases are often have the same preventable risk factors
801	interrelated, and they directly and indirectly account for a
802	high rate of death, disability, and underlying costs to the
803	state's health care system illness.
804	(2)  Chronic diseases have a significant impact on quality
805	of life, not only for the individuals who experience their
806	painful symptoms and resulting disabilities, but also for family
807	members and caregivers.
808	(3)  Racial and ethnic minorities and other underserved
809	populations are disproportionately affected by chronic diseases.
810	(4)  There are enormous medical costs and lost wages
811	associated with chronic diseases and their complications.
812	(5)(2)  Advances in medical knowledge and technology assist
813	have assisted in the prevention, detection, and management of
814	chronic diseases. Comprehensive approaches that stress the
815	stressing application of current medical treatment, continuing
816	research, professional training, and patient education, and
817	community-level policy and environmental changes should be
818	implemented encouraged.
819	(6)(3)  A comprehensive program dealing with the early
820	detection and prevention of chronic diseases is required to make
821	knowledge and therapy available to all people of this state. The
822	mobilization of scientific, medical, and educational resources,
823	along with the implementation of community-based policy under
824	one comprehensive chronic disease law, act will facilitate the
825	prevention, early intervention, and management treatment of
826	chronic these diseases and their symptoms. This integration of
827	resources and policy will and result in a decline in death and
828	disability illness among the people of this state.
829	(7)  Chronic diseases account for 70 percent of all deaths
830	in the United States. The following chronic diseases are the
831	leading causes of death and disability:
832	(a)  Heart disease and stroke, which have remained the
833	first and third leading causes of death for both men and women
834	in the United States for over seven decades and account for
835	approximately one-third of total deaths each year in this state.
836	(b)  Cancer, which is the second leading cause of death and
837	is responsible for one in four deaths in this state.
838	(c)  Lung disease, which is the third leading cause of
839	death and accounts for one in every six deaths in this state.
840	(d)  Diabetes, which is the sixth leading cause of death in
841	this state.
842	(e)  Arthritis, which is the leading cause of disability in
843	the United States, limiting daily activities for more than 19
844	million citizens. In this state, arthritis limits daily
845	activities for an estimated 1.3 million people.
846	(8)  The department shall establish, promote, and maintain
847	state-level and local-level programs for chronic disease
848	prevention and health promotion to the extent that funds are
849	specifically made available for this purpose.
850	Section 15.  Section 385.1021, Florida Statutes, is created
851	to read:
852	385.1021  Definitions.--As used in this chapter, the term:
853	(1)  "CDC" means the United States Centers for Disease
854	Control and Prevention.
855	(2)  "Chronic disease" means an illness that is prolonged,
856	does not resolve spontaneously, and is rarely cured completely.
857	(3)  "Department" means the Department of Health.
858	(4)  "Environmental changes" means changes to the economic,
859	social, or physical natural or built environments which
860	encourage or enable behaviors.
861	(5)  "Policy change" means altering an informal or formal
862	agreement between public or private sectors which sets forth
863	values, behaviors, or resource allocation in order to improve
864	health.
865	(6)  "Primary prevention" means an intervention that is
866	directed toward healthy populations and focuses on avoiding
867	disease before it occurs.
868	(7)  "Risk factor" means a characteristic or condition
869	identified during the course of an epidemiological study of a
870	disease that appears to be statistically associated with a high
871	incidence of that disease.
872	(8)  "Secondary prevention" means an intervention that is
873	designed to promote the early detection and management of
874	diseases and reduce the risks experienced by at-risk
875	populations.
876	(9)  "System changes" means altering standard activities,
877	protocols, policies, processes, and structures carried out in
878	population-based settings, such as schools, worksites, health
879	care facilities, faith-based organizations, and the overall
880	community, which promote and support new behaviors.
881	(10)  "Tertiary prevention" means an intervention that is
882	directed at rehabilitating and minimizing the effects of disease
883	in a chronically ill population.
884	(11)  "Tobacco" means, without limitation, tobacco itself
885	and tobacco products that include tobacco and are intended or
886	expected for human use or consumption, including, but not
887	limited to, cigarettes, cigars, pipe tobacco, and smokeless
888	tobacco.
889	(12)  "Wellness program" means a structured program that is
890	designed or approved by the department to offer intervention
891	activities on or off the worksite which help state employees
892	change certain behaviors or adopt healthy lifestyles.
893	(13)  "Youth" means children and young adults, up through
894	24 years of age, inclusive.
895	Section 16.  Section 385.1022, Florida Statutes, is created
896	to read:
897	385.1022  Chronic disease prevention program.--The
898	department shall support public health programs to reduce the
899	incidence of mortality and morbidity from diseases for which
900	risk factors can be identified. Such risk factors include, but
901	are not limited to, being overweight or obese, physical
902	inactivity, poor nutrition and diet, tobacco use, sun exposure,
903	and other practices that are detrimental to health. The programs
904	shall educate and screen the general public as well as groups at
905	particularly high risk of chronic diseases.
906	Section 17.  Section 385.1023, Florida Statutes, is created
907	to read:
908	385.1023  State-level prevention programs for chronic
909	disease.--
910	(1)  The department shall create state-level programs that
911	address the leading, preventable chronic disease risk factors of
912	poor nutrition and obesity, tobacco use, sun exposure, and
913	physical inactivity in order to decrease the incidence of
914	arthritis, cancer, diabetes, heart disease, lung disease,
915	stroke, and other chronic diseases.
916	(2)  State-level programs shall address, but need not be
917	limited to, the following activities:
918	(a)  Monitoring specific causal and behavioral risk factors
919	that affect the health of residents in the state.
920	(b)  Analyzing data regarding chronic disease mortality and
921	morbidity to track changes over time.
922	(c)  Promoting public awareness and increasing knowledge
923	concerning the causes of chronic diseases, the importance of
924	early detection, diagnosis, and appropriate evidence-based
925	prevention, management, and treatment strategies.
926	(d)  Disseminating educational materials and information
927	concerning evidence-based results, available services, and
928	pertinent new research findings and prevention strategies to
929	patients, health insurers, health professionals, and the public.
930	(e)  Using education and training resources and services
931	developed by organizations having appropriate expertise and
932	knowledge of chronic diseases for technical assistance.
933	(f)  Evaluating the quality and accessibility of existing
934	community-based services for chronic disease.
935	(g)  Increasing awareness among state and local officials
936	involved in health and human services, health professionals and
937	providers, and policymakers about evidence-based chronic-disease
938	prevention, tobacco cessation, and treatment strategies and
939	their benefits for people who have chronic diseases.
940	(h)  Developing a partnership with state and local
941	governments, voluntary health organizations, hospitals, health
942	insurers, universities, medical centers, employer groups,
943	private companies, and health care providers to address the
944	burden of chronic disease in this state.
945	(i)  Implementing and coordinating state-level policies in
946	order to reduce the burden of chronic disease.
947	(j)  Providing lasting improvements in the delivery of
948	health care for individuals who have chronic disease and their
949	families, thus improving their quality of life while also
950	containing health care costs.
951	Section 18.  Section 385.103, Florida Statutes, is amended
952	to read:
953	385.103  Community-level Community intervention programs
954	for chronic disease prevention and health promotion.--
955	(1)  DEFINITIONS.--As used in this section, the term:
956	(a)  "Chronic disease prevention and health promotion
957	control program" means a program that may include, but is not
958	limited to, including a combination of the following elements:
959	1.  Staff who are sufficiently trained and skilled in
960	public health, community health, or school health education to
961	facilitate the operation of the program Health screening;
962	2.  Community input into the planning, implementation, and
963	evaluation processes Risk factor detection;
964	3.  Use of public health data to make decisions and to
965	develop and prioritize community-based interventions focusing on
966	chronic diseases and their risk factors; Appropriate
967	intervention to enable and encourage changes in behaviors that
968	create health risks; and
969	4.  Adherence to a population-based approach by using a
970	socioecological model that addresses the influence on individual
971	behavior, interpersonal behavior, organizational behavior, the
972	community, and public policy; Counseling in nutrition, physical
973	activity, the effects of tobacco use, hypertension, blood
974	pressure control, and diabetes control and the provision of
975	other clinical prevention services.
976	5.  Focus on at least the common preventable risk factors
977	for chronic disease, such as physical inactivity, obesity, poor
978	nutrition, and tobacco use;
979	6.  Focus on developing and implementing interventions and
980	activities through communities, schools, worksites, faith-based
981	organizations, and health-care settings;
982	7.  Use of evidence-based interventions as well as best and
983	promising practices to guide specific activities and effect
984	change, which may include guidelines developed by organizations,
985	volunteer scientists, and health care professionals who write
986	published medical, scientific statements on various chronic
987	disease topics. The statements shall be supported by scientific
988	studies published in recognized journals that have a rigorous
989	review and approval process. Scientific statements generally
990	include a review of data available on a specific subject and an
991	evaluation of its relationship to overall chronic disease
992	science;
993	8.  Use of policy, system, and environmental changes that
994	support healthy behaviors so as to affect large segments of the
995	population and encourage healthy choices;
996	9.  Development of extensive and comprehensive evaluation
997	that is linked to program planning at the state level and the
998	community level in order to determine the program's
999	effectiveness or necessary program modifications; and
1000	10.  Reduction of duplication of efforts through
1001	coordination among appropriate entities for the efficient use of
1002	resources.
1003	(b)  "Community Health education program" means a program
1004	that follows involving the planned and coordinated use of the
1005	educational standards and teaching methods resources available
1006	in a community in an effort to provide:
1007	1.  Appropriate medical, research-based interventions to
1008	enable and encourage changes in behaviors which reduce or
1009	eliminate health risks;
1010	2.  Counseling in nutrition, weight management, physical
1011	inactivity, and tobacco-use prevention and cessation strategies;
1012	hypertension, blood pressure, high cholesterol, and diabetes
1013	control; and other clinical prevention services;
1014	3.1.  Motivation and assistance to individuals or groups in
1015	adopting and maintaining Motivate and assist citizens to adopt
1016	and maintain healthful practices and lifestyles; and
1017	4.2.  Make available Learning opportunities that which will
1018	increase the ability of people to make informed decisions
1019	affecting their personal, family, and community well-being and
1020	that which are designed to facilitate voluntary adoption of
1021	behavior that which will improve or maintain health.;
1022	3.  Reduce, through coordination among appropriate
1023	agencies, duplication of health education efforts; and
1024	4.  Facilitate collaboration among appropriate agencies for
1025	efficient use of scarce resources.
1026	(c)  "Community intervention program" means a program
1027	combining the required elements of a chronic disease chronic
1028	disease prevention and health promotion control program and the
1029	principles of a community health education program that
1030	addresses system, policy, and environmental changes that ensure
1031	that communities provide support for healthy lifestyles into a
1032	unified program over which a single administrative entity has
1033	authority and responsibility.
1034	(d)  "Department" means the Department of Health.
1035	(e)  "Risk factor" means a factor identified during the
1036	course of an epidemiological study of a disease, which factor
1037	appears to be statistically associated with a high incidence of
1038	that disease.
1039	(2)  OPERATION OF COMMUNITY-LEVEL COMMUNITY INTERVENTION
1040	PROGRAMS FOR CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION.--
1041	(a)  The department shall develop and implement a
1042	comprehensive, community-based program for chronic disease
1043	prevention and health promotion. The program shall be designed
1044	to reduce major behavioral risk factors that are associated with
1045	chronic diseases by enhancing the knowledge, skills, motivation,
1046	and opportunities for individuals, organizations, health care
1047	providers, small businesses, health insurers, and communities to
1048	develop and maintain healthy lifestyles. The department shall
1049	assist the county health departments in developing and operating
1050	community intervention programs throughout the state. At a
1051	minimum, the community intervention programs shall address one
1052	to three of the following chronic diseases: cancer, diabetes,
1053	heart disease, stroke, hypertension, renal disease, and chronic
1054	obstructive lung disease.
1055	(b)  The program shall include:
1056	1.  Countywide assessments of specific, causal, and
1057	behavioral risk factors that affect the health of residents;
1058	2.  The development of community-based programs for chronic
1059	disease prevention and health promotion which incorporate health
1060	promotion and preventive care practices that are supported in
1061	scientific and medical literature;
1062	3.  The development and implementation of statewide age-
1063	specific, disease-specific, and community-specific health
1064	promotion and preventive care strategies using primary,
1065	secondary, and tertiary prevention interventions;
1066	4.  The promotion of community, research-based health-
1067	promotion model programs that meet specific criteria, address
1068	major risk factors, and motivate individuals to permanently
1069	adopt healthy behaviors and increase social and personal
1070	responsibilities;
1071	5.  The development of policies that encourage the use of
1072	alternative community delivery sites for health promotion,
1073	disease prevention, and preventive care programs and promote the
1074	use of neighborhood delivery sites that are close to work, home,
1075	and school; and
1076	6.  An emphasis on the importance of healthy and physically
1077	active lifestyles to build self-esteem and reduce morbidity and
1078	mortality associated with chronic disease and being overweight
1079	or obese. Existing community resources, when available, shall be
1080	used to support the programs. The department shall seek funding
1081	for the programs from federal and state financial assistance
1082	programs which presently exist or which may be hereafter
1083	created. Additional services, as appropriate, may be
1084	incorporated into a program to the extent that resources are
1085	available. The department may accept gifts and grants in order
1086	to carry out a program.
1087	(c)  Volunteers shall be used to the maximum extent
1088	possible in carrying out the programs. The department shall
1089	contract for the necessary insurance coverage to protect
1090	volunteers from personal liability while acting within the scope
1091	of their volunteer assignments under a program.
1092	(d)  The department may contract for the provision of all
1093	or any portion of the services required by a program, and shall
1094	so contract whenever the services so provided are more cost-
1095	efficient than those provided by the department.
1096	(e)  If the department determines that it is necessary for
1097	clients to help pay for services provided by a program, the
1098	department may require clients to make contribution therefor in
1099	either money or personal services. The amount of money or value
1100	of the personal services shall be fixed according to a fee
1101	schedule established by the department or by the entity
1102	developing the program. In establishing the fee schedule, the
1103	department or the entity developing the program shall take into
1104	account the expenses and resources of a client and his or her
1105	overall ability to pay for the services.
1106	Section 19.  Section 385.105, Florida Statutes, is created
1107	to read:
1108	385.105  Physical activity, obesity prevention, nutrition,
1109	other health-promotion services, and wellness programs.--
1110	(1)  PHYSICAL ACTIVITY.--
1111	(a)  The department shall develop programs for people at
1112	every stage of their lives to increase physical fitness and
1113	promote behavior changes.
1114	(b)  The department shall work with school health advisory
1115	or wellness committees in each school district as established in
1116	s. 381.0056.
1117	(c)  The department shall develop public and private
1118	partnerships that allow the public to easily access recreational
1119	facilities and public land areas that are suitable for physical
1120	activity.
1121	(d)  The department shall work in collaboration with the
1122	Executive Office of the Governor and Volunteer Florida, Inc., to
1123	promote school initiatives, such as the Governor's Fitness
1124	Challenge.
1125	(e)  The department shall collaborate with the Department
1126	of Education in recognizing nationally accepted best practices
1127	for improving physical education in schools.
1128	(2)  OBESITY PREVENTION.--The department shall promote
1129	healthy lifestyles to reduce the prevalence of excess weight
1130	gain and being overweight or obese through programs that are
1131	directed towards all residents of this state by:
1132	(a)  Using all appropriate media to promote maximum public
1133	awareness of the latest research on healthy lifestyles and
1134	chronic diseases and disseminating relevant information through
1135	a statewide clearinghouse relating to wellness, physical
1136	activity, and nutrition and the effect of these factors on
1137	chronic diseases and disabling conditions.
1138	(b)  Providing technical assistance, training, and
1139	resources on healthy lifestyles and chronic diseases to the
1140	public, health care providers, school districts, and other
1141	persons or entities, including faith-based organizations that
1142	request such assistance to promote physical activity, nutrition,
1143	and healthy lifestyle programs.
1144	(c)  Developing, implementing, and using all available
1145	research methods to collect data, including, but not limited to,
1146	population-specific data, and tracking the incidence and effects
1147	of weight gain, obesity, and related chronic diseases. The
1148	department shall include an evaluation and data-collection
1149	component in all programs as appropriate. All research conducted
1150	under this paragraph is subject to review and approval as
1151	required by the department's institutional review board under s.
1152	381.86.
1153	(d)  Entering into partnerships with the Department of
1154	Education, local communities, school districts, and other
1155	entities to encourage schools in this state to promote
1156	activities during and after school to help students meet a
1157	minimum goal of 30 minutes of physical activity or physical
1158	fitness per day.
1159	(e)  Entering into partnerships with the Department of
1160	Education, school districts, and the Florida Sports Foundation
1161	to develop a programs recognizing the schools at which students
1162	demonstrate excellent physical fitness or fitness improvement.
1163	(f)  Collaborating with other state agencies to develop
1164	policies and strategies for preventing and treating obesity,
1165	which shall be incorporated into programs administered by each
1166	agency and shall include promoting healthy lifestyles of
1167	employees of each agency.
1168	(g)  Advising, in accordance with s. 456.081, health care
1169	practitioners about the morbidity, mortality, and costs
1170	associated with being overweight or obese, informing such
1171	practitioners of promising clinical practices for preventing and
1172	treating obesity, and encouraging practitioners to counsel their
1173	patients regarding the adoption of healthy lifestyles.
1174	(h)  Maximizing all local, state, and federal funding
1175	sources, including grants, public-private partnerships, and
1176	other mechanisms to strengthen the department's programs
1177	promoting physical activity and nutrition.
1178	(3)  NUTRITION.--The department shall promote optimal
1179	nutritional status in all stages of people's lives by developing
1180	strategies to:
1181	(a)  Promote and maintain optimal nutritional status in the
1182	population through activities, including, but not limited to:
1183	1.  Nutrition screening and assessment and nutrition
1184	counseling, including nutrition therapy, followup, case
1185	management, and referrals for persons who have medical
1186	conditions or nutrition-risk factors and who are provided health
1187	services through public health programs or through referrals
1188	from private health care providers or facilities;
1189	2.  Nutrition education to assist residents of the state in
1190	achieving optimal health and preventing chronic disease; and
1191	3.  Consultative nutrition services to group facilities
1192	which promote the provision of safe and nutritionally adequate
1193	diets.
1194	(b)  Monitor and conduct surveillance of the nutritional
1195	status of this state's population.
1196	(c)  Conduct or support research or evaluations related to
1197	public health nutrition. All research conducted under this
1198	paragraph is subject to review and approval as required by the
1199	department's institutional review board under s. 381.86.
1200	(d)  Establish policies and standards for public health
1201	nutrition practices.
1202	(e)  Promote interagency cooperation, professional
1203	education, and consultation.
1204	(f)  Provide technical assistance and advise state
1205	agencies, private institutions, and local organizations
1206	regarding public health nutrition standards.
1207	(g)  Work with the Department of Agriculture and Consumer
1208	Services, the Department of Education, and the Department of
1209	Management Services to further the use of fresh produce from
1210	this state in schools and encourage the development of community
1211	gardens. Nutritional services shall be available to eligible
1212	persons in accordance with eligibility criteria adopted by the
1213	department. The department shall provide by rule requirements
1214	for the service fees, when applicable, which may not exceed the
1215	department's actual costs.
1216
1217	The department may adopt rules to administer this subsection.
1218	(4)  OTHER HEALTH-PROMOTION SERVICES.--
1219	(a)  The department shall promote personal responsibility
1220	by encouraging residents of this state to be informed, follow
1221	health recommendations, seek medical consultations and health
1222	assessments, take healthy precautions, and comply with medical
1223	guidelines, including those that lead to earlier detection of
1224	chronic diseases in order to prevent chronic diseases or slow
1225	the progression of established chronic diseases.
1226	(b)  The department shall promote regular health visits
1227	during a person's lifetime, including annual physical
1228	examinations that include measuring body mass index and vital
1229	signs, blood work, immunizations, screenings, and dental
1230	examinations in order to reduce the financial, social, and
1231	personal burden of chronic disease.
1232	(5)  WELLNESS PROGRAMS.--
1233	(a)  Each state agency may conduct employee wellness
1234	programs in buildings and lands owned or leased by the state.
1235	The department shall serve as a model to develop and implement
1236	employee wellness programs that may include physical fitness,
1237	healthy nutrition, self-management of disease, education, and
1238	behavioral change. The department shall assist other state
1239	agencies to develop and implement employee wellness programs.
1240	These programs shall use existing resources, facilities, and
1241	programs or resources procured through grant funding and
1242	donations that are obtained in accordance with state ethics and
1243	procurement policies, and shall provide equal access to any such
1244	programs, resources, and facilities to all state employees.
1245	(b)  The department shall coordinate its efforts with the
1246	Department of Management Services and other state agencies.
1247	(c)  Each agency may establish an employee wellness work
1248	group to design the program. The department shall be available
1249	to provide policy guidance and assist in identifying effective
1250	wellness program strategies.
1251	(d)  The department shall provide by rule requirements for
1252	nominal participation fees, when applicable, which may not
1253	exceed the department's actual costs; collaborations with
1254	businesses; and the procurement of equipment and incentives.
1255	Section 20.  Section 385.202, Florida Statutes, is amended
1256	to read:
1257	385.202  Statewide cancer registry.--
1258	(1)  Each facility, laboratory, or practitioner licensed
1259	under chapter 395, chapter 459, chapter 464, chapter 483,
1260	chapter 485, and each freestanding radiation therapy center as
1261	defined in s. 408.07, shall report to the department of Health
1262	such information, specified by the department, by rule. The
1263	department may adopt rules regarding reporting requirements for
1264	the cancer registry, which shall include the data required, the
1265	timeframe for reporting, and those professionals who are
1266	responsible for ensuring compliance with reporting requirements,
1267	which indicates diagnosis, stage of disease, medical history,
1268	laboratory data, tissue diagnosis, and radiation, surgical, or
1269	other methods of diagnosis or treatment for each cancer
1270	diagnosed or treated by the facility or center. Failure to
1271	comply with this requirement may be cause for registration or
1272	licensure suspension or revocation.
1273	(2)  The department shall establish, or cause to have
1274	established, by contract with a recognized medical organization
1275	in this state and its affiliated institutions, a statewide
1276	cancer registry program to ensure that cancer reports required
1277	under this section shall be maintained and available for use in
1278	the course of public health surveillance and any study for the
1279	purpose of reducing morbidity or mortality; and no liability of
1280	any kind or character for damages or other relief shall arise or
1281	be enforced against any facility or practitioner hospital by
1282	reason of having provided such information or material to the
1283	department.
1284	(3)  The department may adopt rules regarding the
1285	establishment and operation of a statewide cancer registry
1286	program.
1287	(4)(3)  The department or a contractual designee operating
1288	the statewide cancer registry program required by this section
1289	shall use or publish said material only for the purpose of
1290	public health surveillance and advancing medical research or
1291	medical education in the interest of reducing morbidity or
1292	mortality, except that a summary of such studies may be released
1293	for general publication. Information which discloses or could
1294	lead to the disclosure of the identity of any person whose
1295	condition or treatment has been reported and studied shall be
1296	confidential and exempt from the provisions of s. 119.07(1),
1297	except that:
1298	(a)  Release may be made with the written consent of all
1299	persons to whom the information applies;
1300	(b)  The department or a contractual designee may contact
1301	individuals for the purpose of epidemiologic investigation and
1302	monitoring, provided information that is confidential under this
1303	section is not further disclosed; or
1304	(c)  The department may exchange personal data with any
1305	other governmental agency or a contractual designee for the
1306	purpose of public health surveillance and medical or scientific
1307	research, if provided such governmental agency or contractual
1308	designee does shall not further disclose information that is
1309	confidential under this section.
1310	(5)(4)  Funds appropriated for this section shall be used
1311	for establishing, administering, compiling, processing, and
1312	providing biometric and statistical analyses to the reporting
1313	facilities and practitioners. Funds may also be used to ensure
1314	the quality and accuracy of the information reported and to
1315	provide management information to the reporting facilities and
1316	practitioners.
1317	(6)(5)  The department may adopt rules regarding the
1318	classifications of, by rule, classify facilities that are
1319	responsible for making reports to the cancer registry, the
1320	content and frequency of the reports, and the penalty for
1321	failure to comply with these requirements for purposes of
1322	reports made to the cancer registry and specify the content and
1323	frequency of the reports. In classifying facilities, the
1324	department shall exempt certain facilities from reporting cancer
1325	information that was previously reported to the department or
1326	retrieved from existing state reports made to the department or
1327	the Agency for Health Care Administration. The provisions of
1328	this section shall not apply to any facility whose primary
1329	function is to provide psychiatric care to its patients.
1330	(7)  Notwithstanding subsection (1), each facility and
1331	practitioner that reports cancer cases to the department shall
1332	make their records available for onsite review by the department
1333	or its authorized representative.
1334	Section 21.  Subsection (3) of section 385.203, Florida
1335	Statutes, is amended to read:
1336	385.203  Diabetes Advisory Council; creation; function;
1337	membership.--
1338	(3)  The council shall be composed of 26 25 citizens of the
1339	state who have knowledge of, or work in, the area of diabetes
1340	mellitus as follows:
1341	(a)  Five interested citizens, three of whom are affected
1342	by diabetes.
1343	(b)  Twenty-one Twenty members, who must include one
1344	representative from each of the following areas: nursing with
1345	diabetes-educator certification; dietary with diabetes educator
1346	certification; podiatry; ophthalmology or optometry; psychology;
1347	pharmacy; adult endocrinology; pediatric endocrinology; the
1348	American Diabetes Association (ADA); the Juvenile Diabetes
1349	Foundation (JDF); the Florida Academy of Family Physicians; a
1350	community health center; a county health department; an American
1351	Diabetes Association recognized community education program;
1352	each medical school in the state; an osteopathic medical school;
1353	the insurance industry; a Children's Medical Services diabetes
1354	regional program; and an employer.
1355	(c)  One or more representatives from the Department of
1356	Health, who shall serve on the council as ex officio members.
1357	Section 22.  Section 385.206, Florida Statutes, is amended
1358	to read:
1359	385.206  Pediatric Hematology-Oncology care Center
1360	Program.--
1361	(1)  DEFINITIONS.--As used in this section, the term:
1362	(a)  "Department" means the Department of Health.
1363	(b)  "Hematology" means the study, diagnosis, and treatment
1364	of blood and blood-forming tissues.
1365	(c)  "Oncology" means the study, diagnosis, and treatment
1366	of malignant neoplasms or cancer.
1367	(d)  "Hemophilia" or "other hemostatic disorder" means a
1368	bleeding disorder resulting from a genetic abnormality of
1369	mechanisms related to the control of bleeding.
1370	(e)  "Sickle-cell anemia or other hemoglobinopathy" means
1371	an hereditary, chronic disease caused by an abnormal type of
1372	hemoglobin.
1373	(f)  "Patient" means a person under the age of 21 who is in
1374	need of hematologic-oncologic services and who is enrolled in
1375	the Children's Medical Services Network declared medically and
1376	financially eligible by the department; or a person who received
1377	such services prior to age 21 and who requires long-term
1378	monitoring and evaluation to ascertain the sequelae and the
1379	effectiveness of treatment.
1380	(g)  "Center" means a facility designated by the department
1381	as having a program specifically designed to provide a full
1382	range of medical and specialty services to patients with
1383	hematologic and oncologic disorders.
1384	(2)  PEDIATRIC HEMATOLOGY-ONCOLOGY CARE CENTER PROGRAM;
1385	AUTHORITY.--The department may designate is authorized to make
1386	grants and reimbursements to designated centers and provide
1387	funding to establish and maintain programs for the care of
1388	patients with hematologic and oncologic disorders. Program
1389	administration costs shall be paid by the department from funds
1390	appropriated for this purpose.
1391	(3)  GRANT FUNDING CONTRACTS GRANT AGREEMENTS;
1392	CONDITIONS.--
1393	(a)  Funding provided A grant made under this section shall
1394	be pursuant to a contract contractual agreement made between a
1395	center and the department. Each contract agreement shall provide
1396	that patients will receive services specified types of treatment
1397	and care from the center without additional charge to the
1398	patients or their parents or guardians. Grants shall be
1399	disbursed in accordance with conditions set forth in the
1400	disbursement guidelines.
1401	(4)  GRANT DISBURSEMENTS AND SPECIAL DISBURSEMENTS FOR
1402	LOCAL PROGRAMS.--
1403	(b)(a)  Funding may be provided Grant disbursements may be
1404	made to centers that which meet the following criteria:
1405	1.  The personnel shall include at least one board-
1406	certified pediatric hematologist-oncologist, at least one board-
1407	certified pediatric surgeon, at least one board-certified
1408	radiotherapist, and at least one board-certified pathologist.
1409	2.  As approved by the department, The center shall
1410	actively participate in a national children's cancer study
1411	group, maintain a pediatric tumor registry, have a
1412	multidisciplinary pediatric tumor board, and meet other
1413	guidelines for development, including, but not limited to,
1414	guidelines from such organizations as the American Academy of
1415	Pediatrics and the American Pediatric Surgical Association.
1416	(b)  Programs shall also be established to provide care to
1417	hematology-oncology patients within each district of the
1418	department. The guidelines for local programs shall be
1419	formulated by the department. Special disbursements may be made
1420	by the program office to centers for educational programs
1421	designed for the districts of the department. These programs may
1422	include teaching total supportive care of the dying patient and
1423	his or her family, home therapy to hemophiliacs and patients
1424	with other hemostatic disorders, and screening and counseling
1425	for patients with sickle-cell anemia or other
1426	hemoglobinopathies.
1427	(4)(5)  PROGRAM AND PEER REVIEW.--The department shall
1428	evaluate at least annually during the grant period the services
1429	rendered by the centers and the districts of the department.
1430	Data from the centers and other sources relating to pediatric
1431	cancer shall be reviewed annually by the Florida Association of
1432	Pediatric Tumor Programs, Inc.; and a written report with
1433	recommendations shall be made to the department. This database
1434	will be available to the department for program planning and
1435	quality assurance initiatives formulation of its annual program
1436	and financial evaluation report. A portion of the funds
1437	appropriated for this section may be used to provide statewide
1438	consultation, supervision, and evaluation of the programs of the
1439	centers, as well as central program office support personnel.
1440	Section 23.  Paragraph (g) of subsection (2) and subsection
1441	(7) of section 385.207, Florida Statutes, are amended to read:
1442	385.207  Care and assistance of persons with epilepsy;
1443	establishment of programs in epilepsy control.--
1444	(2)  The Department of Health shall:
1445	(g)  Continue current programs and develop cooperative
1446	programs and services designed to enhance the vocational
1447	rehabilitation of epilepsy clients, including the current jobs
1448	programs. The department shall, as part of its contract with a
1449	provider of epilepsy services, collect information regarding the
1450	number of clients served, the outcomes reached, the expenses
1451	incurred, and the fees collected by such providers for the
1452	provision of services keep and make this information available
1453	to the Governor and the Legislature upon request information
1454	regarding the number of clients served, the outcome reached, and
1455	the expense incurred by such programs and services.
1456	(7)  The department shall limit total administrative
1457	expenditures from the Epilepsy Services Trust Fund to 5 percent
1458	of annual receipts.
1459	Section 24.  Paragraphs (b), (d), and (g) of subsection (2)
1460	and paragraph (b) of subsection (5) of section 385.210, Florida
1461	Statutes, are amended to read:
1462	385.210  Arthritis prevention and education.--
1463	(2)  LEGISLATIVE FINDINGS.--The Legislature finds the
1464	following:
1465	(b)  Arthritis is the leading cause of disability in the
1466	United States, limiting daily activities for more than 19 7
1467	million citizens.
1468	(d)  There are enormous economic and social costs
1469	associated with treating arthritis and its complications; the
1470	economic costs are estimated at over $128 billion (2003) $116
1471	billion (1997) annually in the United States.
1472	(g)  The National Arthritis Foundation, the CDC Centers for
1473	Disease Control and Prevention, and the Association of State and
1474	Territorial Health Officials have led the development of a
1475	public health strategy, the National Arthritis Action Plan, to
1476	respond to this challenge.
1477	(5)  FUNDING.--
1478	(b)  The State Surgeon General may shall seek any federal
1479	waiver or waivers that may be necessary to maximize funds from
1480	the Federal Government to implement this program.
1481	Section 25.  Section 385.301, Florida Statutes, is created
1482	to read:
1483	385.301  Rulemaking authority.--The department may adopt
1484	rules pursuant to chapter 120 to administer this chapter.
1485	Section 26.  Subsection (9) of section 409.904, Florida
1486	Statutes, is amended to read:
1487	409.904  Optional payments for eligible persons.--The
1488	agency may make payments for medical assistance and related
1489	services on behalf of the following persons who are determined
1490	to be eligible subject to the income, assets, and categorical
1491	eligibility tests set forth in federal and state law. Payment on
1492	behalf of these Medicaid eligible persons is subject to the
1493	availability of moneys and any limitations established by the
1494	General Appropriations Act or chapter 216.
1495	(9)  Eligible women with incomes at or below 200 percent of
1496	the federal poverty level and under age 65, for cancer treatment
1497	pursuant to the federal Breast and Cervical Cancer Prevention
1498	and Treatment Act of 2000, screened through the Mary Brogan
1499	Breast and Cervical Cancer Early Detection Program established
1500	under s. 385.2021 s. 381.93.
1501	Section 27.  This act shall take effect July 1, 2009.

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