CS/HB 1471

1	A bill to be entitled
2	An act relating to health care; amending s. 154.503, F.S.;
3	conforming a cross-reference; repealing s. 381.0053, F.S.,
4	relating to a comprehensive nutrition program; repealing
5	s. 381.0054, F.S., relating to healthy lifestyles
6	promotion; repealing ss. 381.732, 381.733, and 381.734,
7	F.S., relating to the Healthy Communities, Healthy People
8	Act; amending s. 381.006, F.S.; requiring the Department
9	of Health, when conducting an environmental health program
10	inspection of a certified domestic violence center to
11	limit the inspection of the domestic violence center to
12	the requirements set forth in the department's rules
13	applicable to community-based residential facilities with
14	five or fewer residents; requiring a report to the
15	Governor and Legislature prior to proceeding with nitrogen
16	reduction activities; ; amending s. 381.0072, F.S.;
17	requiring the Department of Health, when conducting a food
18	service inspection of a certified domestic violence center
19	to limit the inspection of the domestic violence center to
20	the requirements set forth in the department's rules
21	applicable to community-based residential facilities with
22	five or fewer residents; amending s. 381.0203, F.S.;
23	requiring certain state agencies to purchase drugs through
24	the statewide purchasing contract administered by the
25	Department of Health; providing an exception; requiring
26	the department to establish and maintain certain pharmacy
27	services program; transferring, renumbering, and amending
28	s. 381.84, F.S., relating to the Comprehensive Statewide
29	Tobacco Education and Use Prevention Program; revising
30	definitions; revising program components; requiring
31	program components to include efforts to educate youth and
32	their parents about tobacco use; requiring a youth-
33	directed focus in each program component; requiring the
34	Tobacco Education and Use Prevention Advisory Council to
35	adhere to state ethics laws; providing that meetings of
36	the council are subject to public-records and public-
37	meetings requirements; revising the duties of the council;
38	deleting a provision that prohibits a member of the
39	council from participating in a discussion or decision
40	with respect to a research proposal by a firm, entity, or
41	agency with which the member is associated as a member of
42	the governing body or as an employee or with which the
43	member has entered into a contractual arrangement;
44	revising the submission date of an annual report; deleting
45	an expired provision relating to rulemaking authority of
46	the department; transferring and renumbering s. 381.91,
47	F.S., relating to the Jessie Trice Cancer Prevention
48	Program; transferring, renumbering, and amending s.
49	381.911, F.S., relating to the Prostate Cancer Awareness
50	Program; revising the criteria for members of the prostate
51	cancer advisory committee; repealing s. 381.912, F.S.,
52	relating to the Cervical Cancer Elimination Task Force;
53	transferring and renumbering s. 381.92, F.S., relating to
54	the Florida Cancer Council; transferring and renumbering
55	s. 381.921, F.S., relating to the mission and duties of
56	the Florida Cancer Council; amending s. 381.922, F.S.;
57	conforming cross-references; transferring and renumbering
58	s. 381.93, F.S., relating to a breast and cervical cancer
59	early detection program; transferring and renumbering s.
60	381.931, F.S., relating to an annual report on Medicaid
61	expenditures; renaming ch. 385, F.S., as the "Healthy and
62	Fit Florida Act"; amending s. 385.101, F.S.; renaming the
63	"Chronic Diseases Act" as the "Healthy and Fit Florida
64	Act"; amending s. 385.102, F.S.; revising legislative
65	intent; creating s. 385.1021, F.S.; providing definitions;
66	creating s. 385.1022, F.S.; requiring the Department of
67	Health to support public health programs to reduce the
68	incidence of mortality and morbidity from chronic
69	diseases; creating s. 385.1023, F.S.; requiring the
70	department to create state-level programs that address the
71	risk factors of certain chronic diseases; providing
72	required activities of the state-level programs; amending
73	s. 385.103, F.S.; providing for community-level programs
74	for the prevention of chronic diseases; revising
75	definitions; requiring the department to develop and
76	implement a community-based chronic disease prevention and
77	health promotion program; providing the purpose of the
78	program; providing requirements for the program; creating
79	s. 385.105, F.S.; requiring the department to develop
80	programs to increase physical fitness, to work with school
81	districts, to develop partnerships that allow the public
82	to access recreational facilities and public land areas
83	suitable for physical activity, to work with the Executive
84	Office of the Governor and Volunteer Florida, Inc., to
85	promote school initiatives, and to collaborate with the
86	Department of Education in recognizing nationally accepted
87	best practices for improving physical education in
88	schools; requiring the Department of Health to promote
89	healthy lifestyles to reduce obesity; requiring the
90	department to promote optimal nutritional status in all
91	stages of people's lives, personal responsibility to
92	prevent chronic disease or slow its progression, and
93	regular health visits during a person's life span;
94	authorizing state agencies to conduct employee wellness
95	programs; requiring the department to serve as a model to
96	develop and implement employee wellness programs;
97	requiring the department to assist state agencies to
98	develop the employee wellness programs; providing equal
99	access to the programs by agency employees; requiring the
100	department to coordinate efforts with the Department of
101	Management Services and other state agencies; authorizing
102	each state agency to establish an employee wellness work
103	group to design the wellness program; requiring the
104	department to provide requirements for participation fees,
105	collaborations with businesses, and procurement of
106	equipment and incentives; amending s. 385.202, F.S.;
107	requiring facilities, laboratories, and practitioners to
108	report information; authorizing the department to adopt
109	rules regarding reporting requirements for the cancer
110	registry; providing immunity from liability for facilities
111	and practitioners reporting certain information; requiring
112	the department to adopt rules regarding the establishment
113	and operation of a statewide cancer registry program;
114	requiring the department or contractual designee operating
115	the statewide cancer registry program to use or publish
116	material only for the purpose of public health
117	surveillance and advancing medical research or medical
118	education in the interest of reducing morbidity or
119	mortality; authorizing the department to exchange personal
120	data with any agency or contractual designee for the
121	purpose of public health surveillance and medical or
122	scientific research under certain circumstances;
123	clarifying that the department may adopt rules regarding
124	the classifications of facilities related to reports made
125	to the cancer registry; requiring each facility and
126	practitioner that reports cancer cases to the department
127	to make their records available for onsite review;
128	amending s. 385.203, F.S.; increasing the size of the
129	Diabetes Advisory Council to include one representative of
130	the Florida Academy of Family Physicians; amending s.
131	385.206, F.S.; renaming the "hematology-oncology care
132	center program" as the "Pediatric Hematology-Oncology
133	Center Program"; revising definitions; authorizing the
134	department to designate centers and provide funding to
135	maintain programs for the care of patients with
136	hematologic and oncologic disorders; clarifying provisions
137	related to grant-funding agreements and grant
138	disbursements; revising the department's requirement to
139	evaluate services rendered by the centers; requiring data
140	from the centers and other sources relating to pediatric
141	cancer to be available to the department for program
142	planning and quality assurance initiatives; amending s.
143	385.207, F.S.; clarifying provisions that require the
144	department to collect information regarding the number of
145	clients served, the outcomes reached, the expense
146	incurred, and fees collected by providers of epilepsy
147	services; deleting the provision that requires the
148	department to limit administrative expenses from the
149	Epilepsy Services Trust Fund to a certain percentage of
150	annual receipts; amending s. 385.210, F.S.; revising
151	legislative findings regarding the economic costs of
152	treating arthritis and its complications; authorizing the
153	State Surgeon General to seek any federal waivers that may
154	be necessary to maximize funds from the Federal Government
155	to implement the Arthritis Prevention and Education
156	Program; creating s. 385.301, F.S.; authorizing the
157	department to adopt rules to administer the act; amending
158	s. 409.904, F.S.; conforming a cross-reference; creating
159	the Pharmacy and Therapeutic Advisory Council within the
160	Executive Office of the Governor; providing duties of the
161	council; providing for the appointment and qualification
162	of members; providing for the use of subject-matter
163	experts when necessary; providing requirements for voting
164	and a quorum; providing for quarterly meetings of the
165	council; providing for staffing; providing for
166	reimbursement of per diem and travel expenses for members
167	of the council; amending s. 499.003, F.S.; excluding from
168	the definition of "wholesale distribution" certain
169	activities of state agencies; providing an effective date.
170
171	Be It Enacted by the Legislature of the State of Florida:
172
173	Section 1.  Paragraph (e) of subsection (2) of section
174	154.503, Florida Statutes, is amended to read:
175	154.503  Primary Care for Children and Families Challenge
176	Grant Program; creation; administration.--
177	(2)  The department shall:
178	(e)  Coordinate with the primary care program developed
179	pursuant to s. 154.011, the Florida Healthy Kids Corporation
180	program created in s. 624.91, the school health services program
181	created in ss. 381.0056 and 381.0057, the Healthy Communities,
182	Healthy People Program created in s. 381.734, and the volunteer
183	health care provider program developed pursuant to s. 766.1115.
184	Section 2.  Sections 381.0053, 381.0054, 381.732, 381.733,
185	and 381.734, Florida Statutes, are repealed.
186	Section 3.  Subsection (16) of section 381.006, Florida
187	Statutes, is amended to read:
188	381.006  Environmental health.--The department shall
189	conduct an environmental health program as part of fulfilling
190	the state's public health mission. The purpose of this program
191	is to detect and prevent disease caused by natural and manmade
192	factors in the environment. The environmental health program
193	shall include, but not be limited to:
194	(16)  A group-care-facilities function, where a group care
195	facility means any public or private school, housing, building
196	or buildings, section of a building, or distinct part of a
197	building or other place, whether operated for profit or not,
198	which undertakes, through its ownership or management, to
199	provide one or more personal services, care, protection, and
200	supervision to persons who require such services and who are not
201	related to the owner or administrator. The department may adopt
202	rules necessary to protect the health and safety of residents,
203	staff, and patrons of group care facilities, such as child care
204	facilities, family day care homes, assisted living facilities,
205	adult day care centers, adult family care homes, hospices,
206	residential treatment facilities, crisis stabilization units,
207	pediatric extended care centers, intermediate care facilities
208	for the developmentally disabled, group care homes, and, jointly
209	with the Department of Education, private and public schools.
210	These rules may include definitions of terms; provisions
211	relating to operation and maintenance of facilities, buildings,
212	grounds, equipment, furnishings, and occupant-space
213	requirements; lighting; heating, cooling, and ventilation; food
214	service; water supply and plumbing; sewage; sanitary facilities;
215	insect and rodent control; garbage; safety; personnel health,
216	hygiene, and work practices; and other matters the department
217	finds are appropriate or necessary to protect the safety and
218	health of the residents, staff, or patrons. The department may
219	not adopt rules that conflict with rules adopted by the
220	licensing or certifying agency. The department may enter and
221	inspect at reasonable hours to determine compliance with
222	applicable statutes or rules. An environmental health program
223	inspection of a certified domestic violence center shall be
224	limited to the requirements set forth in the department's rules
225	applicable to community-based residential facilities with five
226	or fewer residents. In addition to any sanctions that the
227	department may impose for violations of rules adopted under this
228	section, the department shall also report such violations to any
229	agency responsible for licensing or certifying the group care
230	facility. The licensing or certifying agency may also impose any
231	sanction based solely on the findings of the department.
232	(17)  Upon completion of the department's study to develop
233	passive strategies for nitrogen reduction that complement use of
234	conventional onsite wastewater treatment systems, the department
235	shall submit a final report to the Executive Office of the
236	Governor, the President of the Senate, and the Speaker of the
237	House of Representatives prior to proceeding with any nitrogen
238	reduction activities.
239
240	The department may adopt rules to carry out the provisions of
241	this section.
242	Section 4.  Paragraph (a) of subsection (2) of section
243	381.0072, Florida Statutes, is amended to read:
244	381.0072  Food service protection.--It shall be the duty of
245	the Department of Health to adopt and enforce sanitation rules
246	consistent with law to ensure the protection of the public from
247	food-borne illness. These rules shall provide the standards and
248	requirements for the storage, preparation, serving, or display
249	of food in food service establishments as defined in this
250	section and which are not permitted or licensed under chapter
251	500 or chapter 509.
252	(2)  DUTIES.--
253	(a)  The department shall adopt rules, including
254	definitions of terms which are consistent with law prescribing
255	minimum sanitation standards and manager certification
256	requirements as prescribed in s. 509.039, and which shall be
257	enforced in food service establishments as defined in this
258	section. The sanitation standards must address the construction,
259	operation, and maintenance of the establishment; lighting,
260	ventilation, laundry rooms, lockers, use and storage of toxic
261	materials and cleaning compounds, and first-aid supplies; plan
262	review; design, construction, installation, location,
263	maintenance, sanitation, and storage of food equipment and
264	utensils; employee training, health, hygiene, and work
265	practices; food supplies, preparation, storage, transportation,
266	and service, including access to the areas where food is stored
267	or prepared; and sanitary facilities and controls, including
268	water supply and sewage disposal; plumbing and toilet
269	facilities; garbage and refuse collection, storage, and
270	disposal; and vermin control. Public and private schools, if the
271	food service is operated by school employees; hospitals licensed
272	under chapter 395; nursing homes licensed under part II of
273	chapter 400; child care facilities as defined in s. 402.301;
274	residential facilities colocated with a nursing home or
275	hospital, if all food is prepared in a central kitchen that
276	complies with nursing or hospital regulations; and bars and
277	lounges, as defined by department rule, are exempt from the
278	rules developed for manager certification. The department shall
279	administer a comprehensive inspection, monitoring, and sampling
280	program to ensure such standards are maintained. With respect to
281	food service establishments permitted or licensed under chapter
282	500 or chapter 509, the department shall assist the Division of
283	Hotels and Restaurants of the Department of Business and
284	Professional Regulation and the Department of Agriculture and
285	Consumer Services with rulemaking by providing technical
286	information. Food service inspections of a certified domestic
287	violence center shall be limited to the requirements set forth
288	in the department's rules applicable to community-based
289	residential facilities with five or fewer residents.
290	Section 5.  Subsection (1) and paragraph (a) of subsection
291	(2) of section 381.0203, Florida Statutes, are amended to read:
292	381.0203  Pharmacy services.--
293	(1)  The department must may contract on a statewide basis
294	for the purchase of drugs, as defined in s. 499.003, to be used
295	by state agencies and political subdivisions, and may adopt
296	rules to administer this section. Effective January 1, 2010, all
297	state agencies, except the Agency for Health Care
298	Administration, the Department of Veterans' Affairs, and the
299	Department of Management Services, must purchase drugs through
300	the statewide contract unless:
301	(a)  The Pharmacy and Therapeutic Advisory Council approves
302	a more cost-effective purchasing plan; or
303	(b)  The drugs required are not available through the
304	statewide purchasing contract.
305	(2)  The department must may establish and maintain a
306	pharmacy services program that includes, including, but is not
307	limited to:
308	(a)  A central pharmacy to support pharmaceutical services
309	provided by the county health departments, including
310	pharmaceutical repackaging, dispensing, and the purchase and
311	distribution of immunizations and other pharmaceuticals. Such
312	services shall be provided to other state agencies and political
313	subdivisions of the state upon written agreement. Cost savings
314	realized by the state through utilization of the central
315	pharmacy may be used by the department to offset additional
316	costs.
317	Section 6.  Section 381.84, Florida Statutes, is
318	transferred, renumbered as section 385.106, Florida Statutes,
319	and amended to read:
320	385.106 381.84  Comprehensive Statewide Tobacco Education
321	and Use Prevention Program.--
322	(1)  DEFINITIONS.--As used in this section and for purposes
323	of the provisions of s. 27, Art. X of the State Constitution,
324	the term:
325	(a)  "AHEC network" means an area health education center
326	network established under s. 381.0402.
327	(b)  "Best practices" means the Best Practices for
328	Comprehensive Tobacco Control Programs as established by the
329	CDC, as amended.
330	(c)(b)  "CDC" means the United States Centers for Disease
331	Control and Prevention.
332	(d)(c)  "Council" means the Tobacco Education and Use
333	Prevention Advisory Council.
334	(d)  "Department" means the Department of Health.
335	(e)  "Tobacco" means, without limitation, tobacco itself
336	and tobacco products that include tobacco and are intended or
337	expected for human use or consumption, including, but not
338	limited to, cigarettes, cigars, pipe tobacco, and smokeless
339	tobacco.
340	(f)  "Youth" means minors and young adults.
341	(2)  PURPOSE, FINDINGS, AND INTENT.--It is the purpose of
342	this section to implement s. 27, Art. X of the State
343	Constitution. The Legislature finds that s. 27, Art. X of the
344	State Constitution requires the funding of a statewide tobacco
345	education and use prevention program that focuses on tobacco use
346	by youth. The Legislature further finds that the primary goals
347	of the program are to reduce the prevalence of tobacco use among
348	youth, adults, and pregnant women; reduce per capita tobacco
349	consumption; and reduce exposure to environmental tobacco smoke.
350	Further, it is the intent of the Legislature to base increases
351	in funding for individual components of the program on the
352	results of assessments and evaluations. Recognizing that some
353	components will need to grow faster than inflation, it is the
354	intent of the Legislature to fund portions of the program on a
355	nonrecurring basis in the early years so that those components
356	that are most effective can be supported as the program matures.
357	(3)  PROGRAM COMPONENTS AND REQUIREMENTS.--The department
358	shall conduct a comprehensive, statewide tobacco education and
359	use prevention program consistent with the recommendations for
360	effective program components contained in the 1999 Best
361	Practices for Comprehensive Tobacco Control Programs of the CDC,
362	as amended by the CDC. The program shall include the following
363	components, each of which shall focus on educating people,
364	particularly youth and their parents, about the health hazards
365	of tobacco and discouraging the use of tobacco. All program
366	components shall include efforts to educate youth and their
367	parents about tobacco use, and a youth-directed focus shall
368	exist in all components outlined in this subsection.:
369	(a)  State and community interventions.--These
370	interventions shall include, but not be limited to, a statewide
371	tobacco control program that combines and coordinates community-
372	based interventions that focus on preventing initiation of
373	tobacco use among youth and young adults; promoting quitting
374	among adults, youth, and pregnant women; eliminating exposure to
375	secondhand smoke; identifying and eliminating tobacco-related
376	disparities among population groups; and promoting a range of
377	collaborations to prevent and alleviate the effects of chronic
378	diseases. Counter-marketing and advertising; cyberspace resource
379	center.--The counter-marketing and advertising campaign shall
380	include, at a minimum, Internet, print, radio, and television
381	advertising and shall be funded with a minimum of one-third of
382	the total annual appropriation required by s. 27, Art. X of the
383	State Constitution. A cyberspace resource center for copyrighted
384	materials and information concerning tobacco education and use
385	prevention, including cessation, shall be maintained by the
386	program. Such resource center must be accessible to the public,
387	including parents, teachers, and students, at each level of
388	public and private schools, universities, and colleges in the
389	state and shall provide links to other relevant resources. The
390	Internet address for the resource center must be incorporated in
391	all advertising. The information maintained in the resource
392	center shall be used by the other components of the program.
393	(b)  Health communication interventions.--Effective media
394	and health communication intervention efforts include, but are
395	not limited to, audience research to define themes and execute
396	messages for influential, high impact, and specifically targeted
397	campaigns; market research to identify the target market and the
398	behavioral theory motivating change; counter-marketing
399	surveillance; community tie-ins to support and reinforce the
400	statewide campaign; technologies such as viral marketing, social
401	networks, personal web pages, and web logs; traditional media;
402	process and outcome evaluation of the communication efforts; and
403	promotion of available services, including the state telephone
404	cessation quitline. Cessation programs, counseling, and
405	treatment.--This program component shall include two
406	subcomponents:
407	1.  A statewide toll-free cessation service, which may
408	include counseling, referrals to other local resources and
409	support services, and treatment to the extent funds are
410	available for treatment services; and
411	2.  A local community-based program to disseminate
412	information about smoking cessation, how smoking cessation
413	relates to prenatal care and obesity prevention, and other
414	chronic tobacco-related diseases.
415	(c)  Cessation interventions.--Cessation interventions
416	include, but are not limited to, sustaining, expanding, and
417	promoting the service through population-based counseling and
418	treatment programs; encouraging public and private insurance
419	coverage for counseling and FDA-approved medication treatments
420	for tobacco-use cessation; eliminating cost and other barriers
421	to treatment for underserved populations; and making health care
422	system changes. Youth interventions to prevent tobacco-use
423	initiation and encourage cessation among young people are needed
424	in order to reshape the environment so that it supports tobacco-
425	free norms. Because most people who start smoking are younger
426	than 18 years of age, intervening during adolescence is
427	critical. Community programs and school-based policies and
428	interventions should be a part of a comprehensive effort that is
429	implemented in coordination with community and school
430	environments and in conjunction with increasing the unit price
431	of tobacco products, sustaining anti-tobacco media campaigns,
432	making environments tobacco free, and engaging in other efforts
433	to create tobacco-free social norms. Surveillance and
434	evaluation.--The program shall conduct ongoing epidemiological
435	surveillance and shall contract for annual independent
436	evaluations of the effectiveness of the various components of
437	the program in meeting the goals as set forth in subsection (2).
438	(d)  Surveillance and evaluation.--The surveillance and
439	evaluation of all program components shall monitor and document
440	short-term, intermediate, and long-term intervention outcomes to
441	inform program and policy direction and ensure accountability.
442	The surveillance and evaluation must be conducted objectively
443	through scientifically sound methodology. Youth school
444	programs.--School and after-school programs shall use current
445	evidence-based curricula and programs that involve youth to
446	educate youth about the health hazards of tobacco, help youth
447	develop skills to refuse tobacco, and demonstrate to youth how
448	to stop using tobacco.
449	(e)  Administration and management.--Administration and
450	management activities include, but are not limited to, strategic
451	planning to guide program efforts and resources in order to
452	accomplish goals; recruiting and developing qualified and
453	diverse technical, program, and administrative staff; awarding
454	and monitoring program contracts and grants to coordinate
455	implementation across program areas; developing and maintaining
456	a fiscal-management system to track allocations and the
457	expenditure of funds; increasing capacity at the community level
458	through ongoing training and technical assistance; creating
459	effective communications internally among chronic disease
460	prevention programs and local coalitions and partners; and
461	educating the public and decisionmakers on the health effects of
462	tobacco and evidence-based effective program and policy
463	interventions. Community programs and chronic disease
464	prevention.--The department shall promote and support local
465	community-based partnerships that emphasize programs involving
466	youth, including programs for the prevention, detection, and
467	early intervention of smoking-related chronic diseases.
468	(f)  Training.--The program shall include the training of
469	health care practitioners, smoking-cessation counselors, and
470	teachers by health professional students and other tobacco-use
471	prevention specialists who are trained in preventing tobacco use
472	and health education. Smoking-cessation counselors shall be
473	trained by specialists who are certified in tobacco-use
474	cessation.
475	(g)  County health departments Administration, statewide
476	programs, and county health departments.--Each county health
477	department is eligible to receive a portion of the annual
478	appropriation, on a per capita basis, for coordinating tobacco
479	education and use prevention programs within that county.
480	Appropriated funds may be used to improve the infrastructure of
481	the county health department to implement the comprehensive,
482	statewide tobacco education and use prevention program. Each
483	county health department shall prominently display in all
484	treatment rooms and waiting rooms, counter-marketing and
485	advertisement materials in the form of wall posters, brochures,
486	television advertising if televisions are used in the lobby or
487	waiting room, and screensavers and Internet advertising if
488	computer kiosks are available for use or viewing by people at
489	the county health department.
490	(h)  Enforcement and awareness of related laws.--In
491	coordination with the Department of Business and Professional
492	Regulation, the program shall monitor the enforcement of laws,
493	rules, and policies prohibiting the sale or other provision of
494	tobacco to minors, as well as the continued enforcement of the
495	Clean Indoor Air Act prescribed in chapter 386. The
496	advertisements produced in accordance with paragraph (b)
497	paragraph (a) may also include information designed to make the
498	public aware of these related laws and rules. The departments
499	may enter into interagency agreements to carry out this program
500	component.
501	(i)  AHEC smoking-cessation initiative.--For the 2007-2008
502	and 2008-2009 fiscal years only, The AHEC network shall expand
503	the AHEC smoking-cessation initiative to each county within the
504	state and perform other activities as determined by the
505	department.
506	(4)  ADVISORY COUNCIL; MEMBERS, APPOINTMENTS, AND
507	MEETINGS.--The Tobacco Education and Use Prevention Advisory
508	Council is created within the department.
509	(a)  The council shall consist of 23 members, including:
510	1.  The State Surgeon General, who shall serve as the
511	chairperson.
512	2.  One county health department director, appointed by the
513	State Surgeon General.
514	3.  Two members appointed by the Commissioner of Education,
515	of whom one must be a school district superintendent.
516	4.  The chief executive officer of the Florida Division of
517	the American Cancer Society, or his or her designee.
518	5.  The chief executive officer of the Greater Southeast
519	Affiliate of the American Heart Association, or his or her
520	designee.
521	6.  The chief executive officer of the American Lung
522	Association of Florida, or his or her designee.
523	7.  The dean of the University of Miami School of Medicine,
524	or his or her designee.
525	8.  The dean of the University of Florida College of
526	Medicine, or his or her designee.
527	9.  The dean of the University of South Florida College of
528	Medicine, or his or her designee.
529	10.  The dean of the Florida State University College of
530	Medicine, or his or her designee.
531	11.  The dean of Nova Southeastern College of Osteopathic
532	Medicine, or his or her designee.
533	12.  The dean of the Lake Erie College of Osteopathic
534	Medicine in Bradenton, Florida, or his or her designee.
535	13.  The chief executive officer of the Campaign for
536	Tobacco Free Kids, or his or her designee.
537	14.  The chief executive officer of the Legacy Foundation,
538	or his or her designee.
539	15.  Four members appointed by the Governor, of whom two
540	must have expertise in the field of tobacco-use prevention and
541	education or smoking cessation and one individual who shall be
542	between the ages of 16 and 21 at the time of his or her
543	appointment.
544	16.  Two members appointed by the President of the Senate,
545	of whom one must have expertise in the field of tobacco-use
546	prevention and education or smoking cessation.
547	17.  Two members appointed by the Speaker of the House of
548	Representatives, of whom one must have expertise in the field of
549	tobacco-use prevention and education or smoking cessation.
550	(b)  The appointments shall be for 3-year terms and shall
551	reflect the diversity of the state's population. A vacancy shall
552	be filled by appointment by the original appointing authority
553	for the unexpired portion of the term.
554	(c)  An appointed member may not serve more than two
555	consecutive terms.
556	(d)  The council shall meet at least quarterly and upon the
557	call of the chairperson. Meetings may be held via teleconference
558	or other electronic means.
559	(e)  Members of the council shall serve without
560	compensation, but are entitled to reimbursement for per diem and
561	travel expenses pursuant to s. 112.061. Members who are state
562	officers or employees or who are appointed by state officers or
563	employees shall be reimbursed for per diem and travel expenses
564	pursuant to s. 112.061 from the state agency through which they
565	serve.
566	(f)  The council shall adhere to all state ethics laws.
567	Meetings of the council and the review panels are subject to
568	chapter 119, s. 286.011, and s. 24, Art. I of the State
569	Constitution. The department shall provide council members with
570	information and other assistance as is reasonably necessary to
571	assist the council in carrying out its responsibilities.
572	(5)  COUNCIL DUTIES AND RESPONSIBILITIES.--The council
573	shall advise the State Surgeon General as to the direction and
574	scope of the Comprehensive Statewide Tobacco Education and Use
575	Prevention Program. The responsibilities of the council may
576	include, but are not limited to:
577	(a)  Providing advice on program priorities and emphases.
578	(b)  Providing advice on the overall program budget.
579	(c)  Providing advice on copyrighted material, trademark,
580	and future transactions as they pertain to the tobacco education
581	and use prevention program.
582	(d)  Reviewing, as requested by the department, broadcast
583	material prepared for the Internet, portable media players,
584	radio, and television advertisement as it relates to the
585	advertising component of the tobacco education and use
586	prevention program.
587	(e)  Participating in periodic program evaluation, as
588	requested by the department.
589	(f)  Assisting the department in developing the development
590	of guidelines to ensure fairness, neutrality, and adherence to
591	the principles of merit and quality in the conduct of the
592	program.
593	(g)  Assisting the department in developing the development
594	of administrative procedures relating to solicitation, review,
595	and award of contracts and grants in order to ensure an
596	impartial, high-quality peer review system.
597	(h)  Assisting the department in developing panels to
598	review and evaluate potential fund recipients the development
599	and supervision of peer review panels.
600	(i)  Assisting the department in reviewing reports of peer
601	review panels and making recommendations for funding allocations
602	contracts and grants.
603	(j)  Assisting the department in reviewing the activities
604	and evaluating the performance of the AHEC network to avoid
605	duplicative efforts using state funds.
606	(k)  Recommending specific measureable outcomes meaningful
607	outcome measures through a regular review of evidence-based and
608	promising tobacco-use prevention and education strategies and
609	programs of other states and the Federal Government.
610	(l)  Recommending policies to encourage a coordinated
611	response to tobacco use in this state, focusing specifically on
612	creating partnerships within and between the public and private
613	sectors.
614	(6)  CONTRACT REQUIREMENTS.--Contracts or grants for the
615	program components or subcomponents described in paragraphs
616	(3)(a)-(f) shall be awarded by the State Surgeon General, after
617	consultation with the council, on the basis of merit, as
618	determined by an open, competitive, peer-reviewed process that
619	ensures objectivity, consistency, and high quality. The
620	department shall award such grants or contracts no later than
621	October 1 for each fiscal year. A recipient of a contract or
622	grant for the program component described in paragraph (3)(d)
623	(3)(c) is not eligible for a contract or grant award for any
624	other program component described in subsection (3) in the same
625	state fiscal year. A school or college of medicine that is
626	represented on the council is not eligible to receive a contract
627	or grant under this section. For the 2007-2008 and 2008-2009
628	fiscal years only, The department shall award a contract or
629	grant in the amount of $11 $10 million to the AHEC network for
630	the purpose of developing the components described in paragraph
631	(3)(i). The AHEC network may apply for a competitive contract or
632	grant after the 2008-2009 fiscal year.
633	(a)  In order to ensure that all proposals for funding are
634	appropriate and are evaluated fairly on the basis of merit, the
635	State Surgeon General, in consultation with the council, shall
636	appoint a peer review panel of independent, qualified experts in
637	the field of tobacco control to review the content of each
638	proposal and establish its priority score. The priority scores
639	shall be forwarded to the council and must be considered in
640	determining which proposals will be recommended for funding.
641	(b)  The council and the peer review panel shall establish
642	and follow rigorous guidelines for ethical conduct and adhere to
643	a strict policy with regard to conflicts of interest. Council
644	members are subject to the applicable provisions of chapter 112.
645	A member of the council or panel may not participate in any
646	discussion or decision with respect to a research proposal by
647	any firm, entity, or agency with which the member is associated
648	as a member of the governing body or as an employee or with
649	which the member has entered into a contractual arrangement.
650	Meetings of the council and the peer review panels are subject
651	to chapter 119, s. 286.011, and s. 24, Art. I of the State
652	Constitution.
653	(c)  In each contract or grant agreement, the department
654	shall limit the use of food and promotional items to no more
655	than 2.5 percent of the total amount of the contract or grant
656	and limit overhead or indirect costs to no more than 7.5 percent
657	of the total amount of the contract or grant. The department, in
658	consultation with the Department of Financial Services, shall
659	publish guidelines for appropriate food and promotional items.
660	(d)  In each advertising contract, the department shall
661	limit the total of production fees, buyer commissions, and
662	related costs to no more than 10 percent of the total contract
663	amount.
664	(e)  Notwithstanding the competitive process for contracts
665	prescribed in this subsection, each county health department is
666	eligible for core funding, on a per capita basis, to implement
667	tobacco education and use prevention activities within that
668	county.
669	(7)  ANNUAL REPORT REQUIRED.--By February 28 January 31 of
670	each year, the department shall provide to the Governor, the
671	President of the Senate, and the Speaker of the House of
672	Representatives a report that evaluates the program's
673	effectiveness in reducing and preventing tobacco use and that
674	recommends improvements to enhance the program's effectiveness.
675	The report must contain, at a minimum, an annual survey of youth
676	attitudes and behavior toward tobacco, as well as a description
677	of the progress in reducing the prevalence of tobacco use among
678	youth, adults, and pregnant women; reducing per capita tobacco
679	consumption; and reducing exposure to environmental tobacco
680	smoke.
681	(8)  LIMITATION ON ADMINISTRATIVE EXPENSES.--From the total
682	funds appropriated for the Comprehensive Statewide Tobacco
683	Education and Use Prevention Program in the General
684	Appropriations Act, an amount of up to 5 percent may be used by
685	the department for administrative expenses.
686	(9)  RULEMAKING AUTHORIZED.--By January 1, 2008, the
687	department shall adopt rules pursuant to ss. 120.536(1) and
688	120.54 to administer this section.
689	Section 7.  Section 381.91, Florida Statutes, is
690	transferred and renumbered as section 385.2024, Florida
691	Statutes, to read:
692	385.2024 381.91  Jessie Trice Cancer Prevention Program.--
693	(1)  It is the intent of the Legislature to:
694	(a)  Reduce the rates of illness and death from lung cancer
695	and other cancers and improve the quality of life among low-
696	income African-American and Hispanic populations through
697	increased access to early, effective screening and diagnosis,
698	education, and treatment programs.
699	(b)  Create a community faith-based disease-prevention
700	program in conjunction with the Health Choice Network and other
701	community health centers to build upon the natural referral and
702	education networks in place within minority communities and to
703	increase access to health service delivery in Florida.
704	(c)  Establish a funding source to build upon local private
705	participation to sustain the operation of the program.
706	(2)(a)  There is created the Jessie Trice Cancer Prevention
707	Program, to be located, for administrative purposes, within the
708	Department of Health, and operated from the community health
709	centers within the Health Choice Network in Florida.
710	(b)  Funding may be provided to develop contracts with
711	community health centers and local community faith-based
712	education programs to provide cancer screening, diagnosis,
713	education, and treatment services to low-income populations
714	throughout the state.
715	Section 8.  Section 381.911, Florida Statutes, is
716	transferred, renumbered as section 385.2023, Florida Statutes,
717	and amended to read:
718	385.2023 381.911  Prostate Cancer Awareness Program.--
719	(1)  To the extent that funds are specifically made
720	available for this purpose, the Prostate Cancer Awareness
721	Program is established within the Department of Health. The
722	purpose of this program is to implement the recommendations of
723	January 2000 of the Florida Prostate Cancer Task Force to
724	provide for statewide outreach and health education activities
725	to ensure that men are aware of and appropriately seek medical
726	counseling for prostate cancer as an early-detection health care
727	measure.
728	(2)  For purposes of implementing the program, the
729	Department of Health and the Florida Public Health Foundation,
730	Inc., may:
731	(a)  Conduct activities directly or enter into a contract
732	with a qualified nonprofit community education entity.
733	(b)  Seek any available gifts, grants, or funds from the
734	state, the Federal Government, philanthropic foundations, and
735	industry or business groups.
736	(3)  A prostate cancer advisory committee is created to
737	advise and assist the Department of Health and the Florida
738	Public Health Foundation, Inc., in implementing the program.
739	(a)  The State Surgeon General shall appoint the advisory
740	committee members, who shall consist of:
741	1.  Three persons from prostate cancer survivor groups or
742	cancer-related advocacy groups.
743	2.  Three persons who are scientists or clinicians from
744	public or nonpublic universities or research organizations.
745	3.  Three persons who are engaged in the practice of a
746	cancer-related medical specialty from health organizations
747	committed to cancer research and control.
748	(b)  Members shall serve without compensation but are
749	entitled to reimbursement, pursuant to s. 112.061, for per diem
750	and travel expenses incurred in the performance of their
751	official duties.
752	(4)  The program shall coordinate its efforts with those of
753	the Florida Public Health Foundation, Inc.
754	Section 9.  Section 381.912, Florida Statutes, is repealed.
755	Section 10.  Section 381.92, Florida Statutes, is
756	transferred and renumbered as section 385.2025, Florida
757	Statutes, to read:
758	385.2025 381.92  Florida Cancer Council.--
759	(1)  Effective July 1, 2004, the Florida Cancer Council
760	within the Department of Health is established for the purpose
761	of making the state a center of excellence for cancer research.
762	(2)(a)  The council shall be representative of the state's
763	cancer centers, hospitals, and patient groups and shall be
764	organized and shall operate in accordance with this act.
765	(b)  The Florida Cancer Council may create not-for-profit
766	corporate subsidiaries to fulfill its mission. The council and
767	its subsidiaries are authorized to receive, hold, invest, and
768	administer property and any moneys acquired from private, local,
769	state, and federal sources, as well as technical and
770	professional income generated or derived from the mission-
771	related activities of the council.
772	(c)  The members of the council shall consist of:
773	1.  The chair of the Florida Dialogue on Cancer, who shall
774	serve as the chair of the council;
775	2.  The State Surgeon General or his or her designee;
776	3.  The chief executive officer of the H. Lee Moffitt
777	Cancer Center or his or her designee;
778	4.  The director of the University of Florida Shands Cancer
779	Center or his or her designee;
780	5.  The chief executive officer of the University of Miami
781	Sylvester Comprehensive Cancer Center or his or her designee;
782	6.  The chief executive officer of the Mayo Clinic,
783	Jacksonville, or his or her designee;
784	7.  The chief executive officer of the American Cancer
785	Society, Florida Division, Inc., or his or her designee;
786	8.  The president of the American Cancer Society, Florida
787	Division, Inc., Board of Directors or his or her designee;
788	9.  The president of the Florida Society of Clinical
789	Oncology or his or her designee;
790	10.  The president of the American College of Surgeons,
791	Florida Chapter, or his or her designee;
792	11.  The chief executive officer of Enterprise Florida,
793	Inc., or his or her designee;
794	12.  Five representatives from cancer programs approved by
795	the American College of Surgeons. Three shall be appointed by
796	the Governor, one shall be appointed by the Speaker of the House
797	of Representatives, and one shall be appointed by the President
798	of the Senate;
799	13.  One member of the House of Representatives, to be
800	appointed by the Speaker of the House of Representatives; and
801	14.  One member of the Senate, to be appointed by the
802	President of the Senate.
803	(d)  Appointments made by the Speaker of the House of
804	Representatives and the President of the Senate pursuant to
805	paragraph (c) shall be for 2-year terms, concurrent with the
806	bienniums in which they serve as presiding officers.
807	(e)  Appointments made by the Governor pursuant to
808	paragraph (c) shall be for 2-year terms, although the Governor
809	may reappoint members.
810	(f)  Members of the council or any subsidiaries shall serve
811	without compensation, and each organization represented on the
812	council shall cover the expenses of its representatives.
813	(3)  The council shall issue an annual report to the Center
814	for Universal Research to Eradicate Disease, the Governor, the
815	Speaker of the House of Representatives, and the President of
816	the Senate by December 15 of each year, with policy and funding
817	recommendations regarding cancer research capacity in Florida
818	and related issues.
819	Section 11.  Section 381.921, Florida Statutes, is
820	transferred and renumbered as section 385.20251, Florida
821	Statutes, to read:
822	385.20251 381.921  Florida Cancer Council mission and
823	duties.--The council, which shall work in concert with the
824	Florida Center for Universal Research to Eradicate Disease to
825	ensure that the goals of the center are advanced, shall endeavor
826	to dramatically improve cancer research and treatment in this
827	state through:
828	(1)  Efforts to significantly expand cancer research
829	capacity in the state by:
830	(a)  Identifying ways to attract new research talent and
831	attendant national grant-producing researchers to cancer
832	research facilities in this state;
833	(b)  Implementing a peer-reviewed, competitive process to
834	identify and fund the best proposals to expand cancer research
835	institutes in this state;
836	(c)  Funding through available resources for those
837	proposals that demonstrate the greatest opportunity to attract
838	federal research grants and private financial support;
839	(d)  Encouraging the employment of bioinformatics in order
840	to create a cancer informatics infrastructure that enhances
841	information and resource exchange and integration through
842	researchers working in diverse disciplines, to facilitate the
843	full spectrum of cancer investigations;
844	(e)  Facilitating the technical coordination, business
845	development, and support of intellectual property as it relates
846	to the advancement of cancer research; and
847	(f)  Aiding in other multidisciplinary research-support
848	activities as they inure to the advancement of cancer research.
849	(2)  Efforts to improve both research and treatment through
850	greater participation in clinical trials networks by:
851	(a)  Identifying ways to increase adult enrollment in
852	cancer clinical trials;
853	(b)  Supporting public and private professional education
854	programs designed to increase the awareness and knowledge about
855	cancer clinical trials;
856	(c)  Providing tools to cancer patients and community-based
857	oncologists to aid in the identification of cancer clinical
858	trials available in the state; and
859	(d)  Creating opportunities for the state's academic cancer
860	centers to collaborate with community-based oncologists in
861	cancer clinical trials networks.
862	(3)  Efforts to reduce the impact of cancer on disparate
863	groups by:
864	(a)  Identifying those cancers that disproportionately
865	impact certain demographic groups; and
866	(b)  Building collaborations designed to reduce health
867	disparities as they relate to cancer.
868	Section 12.  Paragraph (a) of subsection (2) and subsection
869	(5) of section 381.922, Florida Statutes, as amended by section
870	2 of chapter 2009-5, Laws of Florida, is amended to read:
871	381.922  William G. "Bill" Bankhead, Jr., and David Coley
872	Cancer Research Program.--
873	(2)  The program shall provide grants for cancer research
874	to further the search for cures for cancer.
875	(a)  Emphasis shall be given to the goals enumerated in s.
876	385.20251 s. 381.921, as those goals support the advancement of
877	such cures.
878	(5)  For the 2008-2009 fiscal year and each fiscal year
879	thereafter, the sum of $6.75 million is appropriated annually
880	from recurring funds in the General Revenue Fund to the
881	Biomedical Research Trust Fund within the Department of Health
882	for purposes of the William G. "Bill" Bankhead, Jr., and David
883	Coley Cancer Research Program and shall be distributed pursuant
884	to this section to provide grants to researchers seeking cures
885	for cancer, with emphasis given to the goals enumerated in s.
886	385.20251 s. 381.921. From the total funds appropriated, an
887	amount of up to 10 percent may be used for administrative
888	expenses.
889	Section 13.  Section 381.93, Florida Statutes, is
890	transferred and renumbered as section 385.2021, Florida
891	Statutes, to read:
892	385.2021 381.93  Breast and cervical cancer early detection
893	program.--This section may be cited as the "Mary Brogan Breast
894	and Cervical Cancer Early Detection Program Act."
895	(1)  It is the intent of the Legislature to reduce the
896	rates of death due to breast and cervical cancer through early
897	diagnosis and increased access to early screening, diagnosis,
898	and treatment programs.
899	(2)  The Department of Health, using available federal
900	funds and state funds appropriated for that purpose, is
901	authorized to establish the Mary Brogan Breast and Cervical
902	Cancer Screening and Early Detection Program to provide
903	screening, diagnosis, evaluation, treatment, case management,
904	and followup and referral to the Agency for Health Care
905	Administration for coverage of treatment services.
906	(3)  The Mary Brogan Breast and Cervical Cancer Early
907	Detection Program shall be funded through grants for such
908	screening and early detection purposes from the federal Centers
909	for Disease Control and Prevention under Title XV of the Public
910	Health Service Act, 42 U.S.C. ss. 300k et seq.
911	(4)  The department shall limit enrollment in the program
912	to persons with incomes up to and including 200 percent of the
913	federal poverty level. The department shall establish an
914	eligibility process that includes an income-verification process
915	to ensure that persons served under the program meet income
916	guidelines.
917	(5)  The department may provide other breast and cervical
918	cancer screening and diagnostic services; however, such services
919	shall be funded separately through other sources than this act.
920	Section 14.  Section 381.931, Florida Statutes, is
921	transferred and renumbered as section 385.20211, Florida
922	Statutes, to read:
923	385.20211 381.931  Annual report on Medicaid
924	expenditures.--The Department of Health and the Agency for
925	Health Care Administration shall monitor the total Medicaid
926	expenditures for services made under this act. If Medicaid
927	expenditures are projected to exceed the amount appropriated by
928	the Legislature, the Department of Health shall limit the number
929	of screenings to ensure Medicaid expenditures do not exceed the
930	amount appropriated. The Department of Health, in cooperation
931	with the Agency for Health Care Administration, shall prepare an
932	annual report that must include the number of women screened;
933	the percentage of positive and negative outcomes; the number of
934	referrals to Medicaid and other providers for treatment
935	services; the estimated number of women who are not screened or
936	not served by Medicaid due to funding limitations, if any; the
937	cost of Medicaid treatment services; and the estimated cost of
938	treatment services for women who were not screened or referred
939	for treatment due to funding limitations. The report shall be
940	submitted to the President of the Senate, the Speaker of the
941	House of Representatives, and the Executive Office of the
942	Governor by March 1 of each year.
943	Section 15.  Chapter 385, Florida Statutes, entitled
944	"Chronic Diseases," is renamed the "Healthy and Fit Florida
945	Act."
946	Section 16.  Section 385.101, Florida Statutes, is amended
947	to read:
948	385.101  Short title.--This chapter Sections 385.101-
949	385.103 may be cited as the "Healthy and Fit Florida Chronic
950	Diseases Act."
951	Section 17.  Section 385.102, Florida Statutes, is amended
952	to read:
953	385.102  Legislative intent.--It is the finding of the
954	Legislature that:
955	(1)  Chronic diseases continue to be the leading cause of
956	death and disability in this state and the country exist in high
957	proportions among the people of this state. These Chronic
958	diseases include, but are not limited to, arthritis,
959	cardiovascular disease heart disease, hypertension, diabetes,
960	renal disease, cancer, and chronic obstructive lung disease.
961	These diseases are often have the same preventable risk factors
962	interrelated, and they directly and indirectly account for a
963	high rate of death, disability, and underlying costs to the
964	state's health care system illness.
965	(2)  Chronic diseases have a significant impact on quality
966	of life, not only for the individuals who experience their
967	painful symptoms and resulting disabilities, but also for family
968	members and caregivers.
969	(3)  Racial and ethnic minorities and other underserved
970	populations are disproportionately affected by chronic diseases.
971	(4)  There are enormous medical costs and lost wages
972	associated with chronic diseases and their complications.
973	(5)(2)  Advances in medical knowledge and technology assist
974	have assisted in the prevention, detection, and management of
975	chronic diseases. Comprehensive approaches that stress the
976	stressing application of current medical treatment, continuing
977	research, professional training, and patient education, and
978	community-level policy and environmental changes should be
979	implemented encouraged.
980	(6)(3)  A comprehensive program dealing with the early
981	detection and prevention of chronic diseases is required to make
982	knowledge and therapy available to all people of this state. The
983	mobilization of scientific, medical, and educational resources,
984	along with the implementation of community-based policy under
985	one comprehensive chronic disease law, act will facilitate the
986	prevention, early intervention, and management treatment of
987	chronic these diseases and their symptoms. This integration of
988	resources and policy will and result in a decline in death and
989	disability illness among the people of this state.
990	(7)  Chronic diseases account for 70 percent of all deaths
991	in the United States. The following chronic diseases are the
992	leading causes of death and disability:
993	(a)  Heart disease and stroke, which have remained the
994	first and third leading causes of death for both men and women
995	in the United States for over seven decades and account for
996	approximately one-third of total deaths each year in this state.
997	(b)  Cancer, which is the second leading cause of death and
998	is responsible for one in four deaths in this state.
999	(c)  Lung disease, which is the third leading cause of
1000	death and accounts for one in every six deaths in this state.
1001	(d)  Diabetes, which is the sixth leading cause of death in
1002	this state.
1003	(e)  Arthritis, which is the leading cause of disability in
1004	the United States, limiting daily activities for more than 19
1005	million citizens. In this state, arthritis limits daily
1006	activities for an estimated 1.3 million people.
1007	(8)  The department shall establish, promote, and maintain
1008	state-level and local-level programs for chronic disease
1009	prevention and health promotion to the extent that funds are
1010	specifically made available for this purpose.
1011	Section 18.  Section 385.1021, Florida Statutes, is created
1012	to read:
1013	385.1021  Definitions.--As used in this chapter, the term:
1014	(1)  "CDC" means the United States Centers for Disease
1015	Control and Prevention.
1016	(2)  "Chronic disease" means an illness that is prolonged,
1017	does not resolve spontaneously, and is rarely cured completely.
1018	(3)  "Department" means the Department of Health.
1019	(4)  "Environmental changes" means changes to the economic,
1020	social, or physical natural or built environments which
1021	encourage or enable behaviors.
1022	(5)  "Policy change" means altering an informal or formal
1023	agreement between public or private sectors which sets forth
1024	values, behaviors, or resource allocation in order to improve
1025	health.
1026	(6)  "Primary prevention" means an intervention that is
1027	directed toward healthy populations and focuses on avoiding
1028	disease before it occurs.
1029	(7)  "Risk factor" means a characteristic or condition
1030	identified during the course of an epidemiological study of a
1031	disease that appears to be statistically associated with a high
1032	incidence of that disease.
1033	(8)  "Secondary prevention" means an intervention that is
1034	designed to promote the early detection and management of
1035	diseases and reduce the risks experienced by at-risk
1036	populations.
1037	(9)  "System changes" means altering standard activities,
1038	protocols, policies, processes, and structures carried out in
1039	population-based settings, such as schools, worksites, health
1040	care facilities, faith-based organizations, and the overall
1041	community, which promote and support new behaviors.
1042	(10)  "Tertiary prevention" means an intervention that is
1043	directed at rehabilitating and minimizing the effects of disease
1044	in a chronically ill population.
1045	(11)  "Tobacco" means, without limitation, tobacco itself
1046	and tobacco products that include tobacco and are intended or
1047	expected for human use or consumption, including, but not
1048	limited to, cigarettes, cigars, pipe tobacco, and smokeless
1049	tobacco.
1050	(12)  "Wellness program" means a structured program that is
1051	designed or approved by the department to offer intervention
1052	activities on or off the worksite which help state employees
1053	change certain behaviors or adopt healthy lifestyles.
1054	(13)  "Youth" means children and young adults, up through
1055	24 years of age, inclusive.
1056	Section 19.  Section 385.1022, Florida Statutes, is created
1057	to read:
1058	385.1022  Chronic disease prevention program.--The
1059	department shall support public health programs to reduce the
1060	incidence of mortality and morbidity from diseases for which
1061	risk factors can be identified. Such risk factors include, but
1062	are not limited to, being overweight or obese, physical
1063	inactivity, poor nutrition and diet, tobacco use, sun exposure,
1064	and other practices that are detrimental to health. The programs
1065	shall educate and screen the general public as well as groups at
1066	particularly high risk of chronic diseases.
1067	Section 20.  Section 385.1023, Florida Statutes, is created
1068	to read:
1069	385.1023  State-level prevention programs for chronic
1070	disease.--
1071	(1)  The department shall create state-level programs that
1072	address the leading, preventable chronic disease risk factors of
1073	poor nutrition and obesity, tobacco use, sun exposure, and
1074	physical inactivity in order to decrease the incidence of
1075	arthritis, cancer, diabetes, heart disease, lung disease,
1076	stroke, and other chronic diseases.
1077	(2)  State-level programs shall address, but need not be
1078	limited to, the following activities:
1079	(a)  Monitoring specific causal and behavioral risk factors
1080	that affect the health of residents in the state.
1081	(b)  Analyzing data regarding chronic disease mortality and
1082	morbidity to track changes over time.
1083	(c)  Promoting public awareness and increasing knowledge
1084	concerning the causes of chronic diseases, the importance of
1085	early detection, diagnosis, and appropriate evidence-based
1086	prevention, management, and treatment strategies.
1087	(d)  Disseminating educational materials and information
1088	concerning evidence-based results, available services, and
1089	pertinent new research findings and prevention strategies to
1090	patients, health insurers, health professionals, and the public.
1091	(e)  Using education and training resources and services
1092	developed by organizations having appropriate expertise and
1093	knowledge of chronic diseases for technical assistance.
1094	(f)  Evaluating the quality and accessibility of existing
1095	community-based services for chronic disease.
1096	(g)  Increasing awareness among state and local officials
1097	involved in health and human services, health professionals and
1098	providers, and policymakers about evidence-based chronic-disease
1099	prevention, tobacco cessation, and treatment strategies and
1100	their benefits for people who have chronic diseases.
1101	(h)  Developing a partnership with state and local
1102	governments, voluntary health organizations, hospitals, health
1103	insurers, universities, medical centers, employer groups,
1104	private companies, and health care providers to address the
1105	burden of chronic disease in this state.
1106	(i)  Implementing and coordinating state-level policies in
1107	order to reduce the burden of chronic disease.
1108	(j)  Providing lasting improvements in the delivery of
1109	health care for individuals who have chronic disease and their
1110	families, thus improving their quality of life while also
1111	containing health care costs.
1112	Section 21.  Section 385.103, Florida Statutes, is amended
1113	to read:
1114	385.103  Community-level Community intervention programs
1115	for chronic disease prevention and health promotion.--
1116	(1)  DEFINITIONS.--As used in this section, the term:
1117	(a)  "Chronic disease prevention and health promotion
1118	control program" means a program that may include, but is not
1119	limited to, including a combination of the following elements:
1120	1.  Staff who are sufficiently trained and skilled in
1121	public health, community health, or school health education to
1122	facilitate the operation of the program Health screening;
1123	2.  Community input into the planning, implementation, and
1124	evaluation processes Risk factor detection;
1125	3.  Use of public health data to make decisions and to
1126	develop and prioritize community-based interventions focusing on
1127	chronic diseases and their risk factors; Appropriate
1128	intervention to enable and encourage changes in behaviors that
1129	create health risks; and
1130	4.  Adherence to a population-based approach by using a
1131	socioecological model that addresses the influence on individual
1132	behavior, interpersonal behavior, organizational behavior, the
1133	community, and public policy; Counseling in nutrition, physical
1134	activity, the effects of tobacco use, hypertension, blood
1135	pressure control, and diabetes control and the provision of
1136	other clinical prevention services.
1137	5.  Focus on at least the common preventable risk factors
1138	for chronic disease, such as physical inactivity, obesity, poor
1139	nutrition, and tobacco use;
1140	6.  Focus on developing and implementing interventions and
1141	activities through communities, schools, worksites, faith-based
1142	organizations, and health-care settings;
1143	7.  Use of evidence-based interventions as well as best and
1144	promising practices to guide specific activities and effect
1145	change, which may include guidelines developed by organizations,
1146	volunteer scientists, and health care professionals who write
1147	published medical, scientific statements on various chronic
1148	disease topics. The statements shall be supported by scientific
1149	studies published in recognized journals that have a rigorous
1150	review and approval process. Scientific statements generally
1151	include a review of data available on a specific subject and an
1152	evaluation of its relationship to overall chronic disease
1153	science;
1154	8.  Use of policy, system, and environmental changes that
1155	support healthy behaviors so as to affect large segments of the
1156	population and encourage healthy choices;
1157	9.  Development of extensive and comprehensive evaluation
1158	that is linked to program planning at the state level and the
1159	community level in order to determine the program's
1160	effectiveness or necessary program modifications; and
1161	10.  Reduction of duplication of efforts through
1162	coordination among appropriate entities for the efficient use of
1163	resources.
1164	(b)  "Community Health education program" means a program
1165	that follows involving the planned and coordinated use of the
1166	educational standards and teaching methods resources available
1167	in a community in an effort to provide:
1168	1.  Appropriate medical, research-based interventions to
1169	enable and encourage changes in behaviors which reduce or
1170	eliminate health risks;
1171	2.  Counseling in nutrition, weight management, physical
1172	inactivity, and tobacco-use prevention and cessation strategies;
1173	hypertension, blood pressure, high cholesterol, and diabetes
1174	control; and other clinical prevention services;
1175	3.1.  Motivation and assistance to individuals or groups in
1176	adopting and maintaining Motivate and assist citizens to adopt
1177	and maintain healthful practices and lifestyles; and
1178	4.2.  Make available Learning opportunities that which will
1179	increase the ability of people to make informed decisions
1180	affecting their personal, family, and community well-being and
1181	that which are designed to facilitate voluntary adoption of
1182	behavior that which will improve or maintain health.;
1183	3.  Reduce, through coordination among appropriate
1184	agencies, duplication of health education efforts; and
1185	4.  Facilitate collaboration among appropriate agencies for
1186	efficient use of scarce resources.
1187	(c)  "Community intervention program" means a program
1188	combining the required elements of a chronic disease prevention
1189	and health promotion control program and the principles of a
1190	community health education program that addresses system,
1191	policy, and environmental changes that ensure that communities
1192	provide support for healthy lifestyles into a unified program
1193	over which a single administrative entity has authority and
1194	responsibility.
1195	(d)  "Department" means the Department of Health.
1196	(e)  "Risk factor" means a factor identified during the
1197	course of an epidemiological study of a disease, which factor
1198	appears to be statistically associated with a high incidence of
1199	that disease.
1200	(2)  OPERATION OF COMMUNITY-LEVEL COMMUNITY INTERVENTION
1201	PROGRAMS FOR CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION.--
1202	(a)  The department shall develop and implement a
1203	comprehensive, community-based program for chronic disease
1204	prevention and health promotion. The program shall be designed
1205	to reduce major behavioral risk factors that are associated with
1206	chronic diseases by enhancing the knowledge, skills, motivation,
1207	and opportunities for individuals, organizations, health care
1208	providers, small businesses, health insurers, and communities to
1209	develop and maintain healthy lifestyles. The department shall
1210	assist the county health departments in developing and operating
1211	community intervention programs throughout the state. At a
1212	minimum, the community intervention programs shall address one
1213	to three of the following chronic diseases: cancer, diabetes,
1214	heart disease, stroke, hypertension, renal disease, and chronic
1215	obstructive lung disease.
1216	(b)  The program shall include:
1217	1.  Countywide assessments of specific, causal, and
1218	behavioral risk factors that affect the health of residents;
1219	2.  The development of community-based programs for chronic
1220	disease prevention and health promotion which incorporate health
1221	promotion and preventive care practices that are supported in
1222	scientific and medical literature;
1223	3.  The development and implementation of statewide age-
1224	specific, disease-specific, and community-specific health
1225	promotion and preventive care strategies using primary,
1226	secondary, and tertiary prevention interventions;
1227	4.  The promotion of community, research-based health-
1228	promotion model programs that meet specific criteria, address
1229	major risk factors, and motivate individuals to permanently
1230	adopt healthy behaviors and increase social and personal
1231	responsibilities;
1232	5.  The development of policies that encourage the use of
1233	alternative community delivery sites for health promotion,
1234	disease prevention, and preventive care programs and promote the
1235	use of neighborhood delivery sites that are close to work, home,
1236	and school; and
1237	6.  An emphasis on the importance of healthy and physically
1238	active lifestyles to build self-esteem and reduce morbidity and
1239	mortality associated with chronic disease and being overweight
1240	or obese. Existing community resources, when available, shall be
1241	used to support the programs. The department shall seek funding
1242	for the programs from federal and state financial assistance
1243	programs which presently exist or which may be hereafter
1244	created. Additional services, as appropriate, may be
1245	incorporated into a program to the extent that resources are
1246	available. The department may accept gifts and grants in order
1247	to carry out a program.
1248	(c)  Volunteers shall be used to the maximum extent
1249	possible in carrying out the programs. The department shall
1250	contract for the necessary insurance coverage to protect
1251	volunteers from personal liability while acting within the scope
1252	of their volunteer assignments under a program.
1253	(d)  The department may contract for the provision of all
1254	or any portion of the services required by a program, and shall
1255	so contract whenever the services so provided are more cost-
1256	efficient than those provided by the department.
1257	(e)  If the department determines that it is necessary for
1258	clients to help pay for services provided by a program, the
1259	department may require clients to make contribution therefor in
1260	either money or personal services. The amount of money or value
1261	of the personal services shall be fixed according to a fee
1262	schedule established by the department or by the entity
1263	developing the program. In establishing the fee schedule, the
1264	department or the entity developing the program shall take into
1265	account the expenses and resources of a client and his or her
1266	overall ability to pay for the services.
1267	Section 22.  Section 385.105, Florida Statutes, is created
1268	to read:
1269	385.105  Physical activity, obesity prevention, nutrition,
1270	other health-promotion services, and wellness programs.--
1271	(1)  PHYSICAL ACTIVITY--.
1272	(a)  The department shall develop programs for people at
1273	every stage of their lives to increase physical fitness and
1274	promote behavior changes.
1275	(b)  The department shall work with school health advisory
1276	or wellness committees in each school district as established in
1277	s. 381.0056.
1278	(c)  The department shall develop public and private
1279	partnerships that allow the public to easily access recreational
1280	facilities and public land areas that are suitable for physical
1281	activity.
1282	(d)  The department shall work in collaboration with the
1283	Executive Office of the Governor and Volunteer Florida, Inc., to
1284	promote school initiatives, such as the Governor's Fitness
1285	Challenge.
1286	(e)  The department shall collaborate with the Department
1287	of Education in recognizing nationally accepted best practices
1288	for improving physical education in schools.
1289	(2)  OBESITY PREVENTION.--The department shall promote
1290	healthy lifestyles to reduce the prevalence of excess weight
1291	gain and being overweight or obese through programs that are
1292	directed towards all residents of this state by:
1293	(a)  Using all appropriate media to promote maximum public
1294	awareness of the latest research on healthy lifestyles and
1295	chronic diseases and disseminating relevant information through
1296	a statewide clearinghouse relating to wellness, physical
1297	activity, and nutrition and the effect of these factors on
1298	chronic diseases and disabling conditions.
1299	(b)  Providing technical assistance, training, and
1300	resources on healthy lifestyles and chronic diseases to the
1301	public, health care providers, school districts, and other
1302	persons or entities, including faith-based organizations that
1303	request such assistance to promote physical activity, nutrition,
1304	and healthy lifestyle programs.
1305	(c)  Developing, implementing, and using all available
1306	research methods to collect data, including, but not limited to,
1307	population-specific data, and tracking the incidence and effects
1308	of weight gain, obesity, and related chronic diseases. The
1309	department shall include an evaluation and data-collection
1310	component in all programs as appropriate. All research conducted
1311	under this paragraph is subject to review and approval as
1312	required by the department's institutional review board under s.
1313	381.86.
1314	(d)  Entering into partnerships with the Department of
1315	Education, local communities, school districts, and other
1316	entities to encourage schools in this state to promote
1317	activities during and after school to help students meet a
1318	minimum goal of 30 minutes of physical activity or physical
1319	fitness per day.
1320	(e)  Entering into partnerships with the Department of
1321	Education, school districts, and the Florida Sports Foundation
1322	to develop a programs recognizing the schools at which students
1323	demonstrate excellent physical fitness or fitness improvement.
1324	(f)  Collaborating with other state agencies to develop
1325	policies and strategies for preventing and treating obesity,
1326	which shall be incorporated into programs administered by each
1327	agency and shall include promoting healthy lifestyles of
1328	employees of each agency.
1329	(g)  Advising, in accordance with s. 456.081, health care
1330	practitioners about the morbidity, mortality, and costs
1331	associated with being overweight or obese, informing such
1332	practitioners of promising clinical practices for preventing and
1333	treating obesity, and encouraging practitioners to counsel their
1334	patients regarding the adoption of healthy lifestyles.
1335	(h)  Maximizing all local, state, and federal funding
1336	sources, including grants, public-private partnerships, and
1337	other mechanisms to strengthen the department's programs
1338	promoting physical activity and nutrition.
1339	(3)  NUTRITION.--The department shall promote optimal
1340	nutritional status in all stages of people's lives by developing
1341	strategies to:
1342	(a)  Promote and maintain optimal nutritional status in the
1343	population through activities, including, but not limited to:
1344	1.  Nutrition screening and assessment and nutrition
1345	counseling, including nutrition therapy, followup, case
1346	management, and referrals for persons who have medical
1347	conditions or nutrition-risk factors and who are provided health
1348	services through public health programs or through referrals
1349	from private health care providers or facilities;
1350	2.  Nutrition education to assist residents of the state in
1351	achieving optimal health and preventing chronic disease; and
1352	3.  Consultative nutrition services to group facilities
1353	which promote the provision of safe and nutritionally adequate
1354	diets.
1355	(b)  Monitor and conduct surveillance of the nutritional
1356	status of this state's population.
1357	(c)  Conduct or support research or evaluations related to
1358	public health nutrition. All research conducted under this
1359	paragraph is subject to review and approval as required by the
1360	department's institutional review board under s. 381.86.
1361	(d)  Establish policies and standards for public health
1362	nutrition practices.
1363	(e)  Promote interagency cooperation, professional
1364	education, and consultation.
1365	(f)  Provide technical assistance and advise state
1366	agencies, private institutions, and local organizations
1367	regarding public health nutrition standards.
1368	(g)  Work with the Department of Agriculture and Consumer
1369	Services, the Department of Education, and the Department of
1370	Management Services to further the use of fresh produce from
1371	this state in schools and encourage the development of community
1372	gardens. Nutritional services shall be available to eligible
1373	persons in accordance with eligibility criteria adopted by the
1374	department. The department shall provide by rule requirements
1375	for the service fees, when applicable, which may not exceed the
1376	department's actual costs.
1377
1378	The department may adopt rules to administer this subsection.
1379	(4)  OTHER HEALTH-PROMOTION SERVICES.--
1380	(a)  The department shall promote personal responsibility
1381	by encouraging residents of this state to be informed, follow
1382	health recommendations, seek medical consultations and health
1383	assessments, take healthy precautions, and comply with medical
1384	guidelines, including those that lead to earlier detection of
1385	chronic diseases in order to prevent chronic diseases or slow
1386	the progression of established chronic diseases.
1387	(b)  The department shall promote regular health visits
1388	during a person's lifetime, including annual physical
1389	examinations that include measuring body mass index and vital
1390	signs, blood work, immunizations, screenings, and dental
1391	examinations in order to reduce the financial, social, and
1392	personal burden of chronic disease.
1393	(5)  WELLNESS PROGRAMS.--
1394	(a)  Each state agency may conduct employee wellness
1395	programs in buildings and lands owned or leased by the state.
1396	The department shall serve as a model to develop and implement
1397	employee wellness programs that may include physical fitness,
1398	healthy nutrition, self-management of disease, education, and
1399	behavioral change. The department shall assist other state
1400	agencies to develop and implement employee wellness programs.
1401	These programs shall use existing resources, facilities, and
1402	programs or resources procured through grant funding and
1403	donations that are obtained in accordance with state ethics and
1404	procurement policies, and shall provide equal access to any such
1405	programs, resources, and facilities to all state employees.
1406	(b)  The department shall coordinate its efforts with the
1407	Department of Management Services and other state agencies.
1408	(c)  Each agency may establish an employee wellness work
1409	group to design the program. The department shall be available
1410	to provide policy guidance and assist in identifying effective
1411	wellness program strategies.
1412	(d)  The department shall provide by rule requirements for
1413	nominal participation fees, when applicable, which may not
1414	exceed the department's actual costs; collaborations with
1415	businesses; and the procurement of equipment and incentives.
1416	Section 23.  Section 385.202, Florida Statutes, is amended
1417	to read:
1418	385.202  Statewide cancer registry.--
1419	(1)  Each facility, laboratory, or practitioner licensed
1420	under chapter 395, chapter 458, chapter 459, chapter 464,
1421	chapter 483, and each freestanding radiation therapy center as
1422	defined in s. 408.07, shall report to the department of Health
1423	such information, specified by the department, by rule. The
1424	department may adopt rules regarding reporting requirements for
1425	the cancer registry, which shall include the data required, the
1426	timeframe for reporting, and those professionals who are
1427	responsible for ensuring compliance with reporting requirements,
1428	which indicates diagnosis, stage of disease, medical history,
1429	laboratory data, tissue diagnosis, and radiation, surgical, or
1430	other methods of diagnosis or treatment for each cancer
1431	diagnosed or treated by the facility or center. Failure to
1432	comply with this requirement may be cause for registration or
1433	licensure suspension or revocation.
1434	(2)  The department shall establish, or cause to have
1435	established, by contract with a recognized medical organization
1436	in this state and its affiliated institutions, a statewide
1437	cancer registry program to ensure that cancer reports required
1438	under this section shall be maintained and available for use in
1439	the course of public health surveillance and any study for the
1440	purpose of reducing morbidity or mortality; and no liability of
1441	any kind or character for damages or other relief shall arise or
1442	be enforced against any facility or practitioner hospital by
1443	reason of having provided such information or material to the
1444	department.
1445	(3)  The department may adopt rules regarding the
1446	establishment and operation of a statewide cancer registry
1447	program.
1448	(4)(3)  The department or a contractual designee operating
1449	the statewide cancer registry program required by this section
1450	shall use or publish said material only for the purpose of
1451	public health surveillance and advancing medical research or
1452	medical education in the interest of reducing morbidity or
1453	mortality, except that a summary of such studies may be released
1454	for general publication. Information which discloses or could
1455	lead to the disclosure of the identity of any person whose
1456	condition or treatment has been reported and studied shall be
1457	confidential and exempt from the provisions of s. 119.07(1),
1458	except that:
1459	(a)  Release may be made with the written consent of all
1460	persons to whom the information applies;
1461	(b)  The department or a contractual designee may contact
1462	individuals for the purpose of epidemiologic investigation and
1463	monitoring, provided information that is confidential under this
1464	section is not further disclosed; or
1465	(c)  The department may exchange personal data with any
1466	other governmental agency or a contractual designee for the
1467	purpose of public health surveillance and medical or scientific
1468	research, if provided such governmental agency or contractual
1469	designee does shall not further disclose information that is
1470	confidential under this section.
1471	(5)(4)  Funds appropriated for this section shall be used
1472	for establishing, administering, compiling, processing, and
1473	providing biometric and statistical analyses to the reporting
1474	facilities and practitioners. Funds may also be used to ensure
1475	the quality and accuracy of the information reported and to
1476	provide management information to the reporting facilities and
1477	practitioners.
1478	(6)(5)  The department may adopt rules regarding the
1479	classifications of, by rule, classify facilities that are
1480	responsible for making reports to the cancer registry, the
1481	content and frequency of the reports, and the penalty for
1482	failure to comply with these requirements for purposes of
1483	reports made to the cancer registry and specify the content and
1484	frequency of the reports. In classifying facilities, the
1485	department shall exempt certain facilities from reporting cancer
1486	information that was previously reported to the department or
1487	retrieved from existing state reports made to the department or
1488	the Agency for Health Care Administration. The provisions of
1489	This section does shall not apply to any facility whose primary
1490	function is to provide psychiatric care to its patients.
1491	(7)  Notwithstanding subsection (1), each facility and
1492	practitioner that reports cancer cases to the department shall
1493	make their records available for onsite review by the department
1494	or its authorized representative.
1495	Section 24.  Subsection (3) of section 385.203, Florida
1496	Statutes, is amended to read:
1497	385.203  Diabetes Advisory Council; creation; function;
1498	membership.--
1499	(3)  The council shall be composed of 26 25 citizens of the
1500	state who have knowledge of, or work in, the area of diabetes
1501	mellitus as follows:
1502	(a)  Five interested citizens, three of whom are affected
1503	by diabetes.
1504	(b)  Twenty-one Twenty members, who must include one
1505	representative from each of the following areas: nursing with
1506	diabetes-educator certification; dietary with diabetes educator
1507	certification; podiatry; ophthalmology or optometry; psychology;
1508	pharmacy; adult endocrinology; pediatric endocrinology; the
1509	American Diabetes Association (ADA); the Juvenile Diabetes
1510	Foundation (JDF); the Florida Academy of Family Physicians; a
1511	community health center; a county health department; an American
1512	Diabetes Association recognized community education program;
1513	each medical school in the state; an osteopathic medical school;
1514	the insurance industry; a Children's Medical Services diabetes
1515	regional program; and an employer.
1516	(c)  One or more representatives from the Department of
1517	Health, who shall serve on the council as ex officio members.
1518	Section 25.  Section 385.206, Florida Statutes, is amended
1519	to read:
1520	385.206  Pediatric Hematology-Oncology care Center
1521	Program.--
1522	(1)  DEFINITIONS.--As used in this section, the term:
1523	(a)  "Department" means the Department of Health.
1524	(b)  "Hematology" means the study, diagnosis, and treatment
1525	of blood and blood-forming tissues.
1526	(c)  "Oncology" means the study, diagnosis, and treatment
1527	of malignant neoplasms or cancer.
1528	(d)  "Hemophilia" or "other hemostatic disorder" means a
1529	bleeding disorder resulting from a genetic abnormality of
1530	mechanisms related to the control of bleeding.
1531	(e)  "Sickle-cell anemia or other hemoglobinopathy" means
1532	an hereditary, chronic disease caused by an abnormal type of
1533	hemoglobin.
1534	(f)  "Patient" means a person under the age of 21 who is in
1535	need of hematologic-oncologic services and who is enrolled in
1536	the Children's Medical Services Network declared medically and
1537	financially eligible by the department; or a person who received
1538	such services prior to age 21 and who requires long-term
1539	monitoring and evaluation to ascertain the sequelae and the
1540	effectiveness of treatment.
1541	(g)  "Center" means a facility designated by the department
1542	as having a program specifically designed to provide a full
1543	range of medical and specialty services to patients with
1544	hematologic and oncologic disorders.
1545	(2)  PEDIATRIC HEMATOLOGY-ONCOLOGY CARE CENTER PROGRAM;
1546	AUTHORITY.--The department may designate is authorized to make
1547	grants and reimbursements to designated centers and provide
1548	funding to establish and maintain programs for the care of
1549	patients with hematologic and oncologic disorders. Program
1550	administration costs shall be paid by the department from funds
1551	appropriated for this purpose.
1552	(3)  GRANT FUNDING CONTRACTS GRANT AGREEMENTS;
1553	CONDITIONS.--
1554	(a)  Funding provided A grant made under this section shall
1555	be pursuant to a contract contractual agreement made between a
1556	center and the department. Each contract agreement shall provide
1557	that patients will receive services specified types of treatment
1558	and care from the center without additional charge to the
1559	patients or their parents or guardians. Grants shall be
1560	disbursed in accordance with conditions set forth in the
1561	disbursement guidelines.
1562	(4)  GRANT DISBURSEMENTS AND SPECIAL DISBURSEMENTS FOR
1563	LOCAL PROGRAMS.--
1564	(b)(a)  Funding may be provided Grant disbursements may be
1565	made to centers that which meet the following criteria:
1566	1.  The personnel shall include at least one board-
1567	certified pediatric hematologist-oncologist, at least one board-
1568	certified pediatric surgeon, at least one board-certified
1569	radiotherapist, and at least one board-certified pathologist.
1570	2.  As approved by the department, The center shall
1571	actively participate in a national children's cancer study
1572	group, maintain a pediatric tumor registry, have a
1573	multidisciplinary pediatric tumor board, and meet other
1574	guidelines for development, including, but not limited to,
1575	guidelines from such organizations as the American Academy of
1576	Pediatrics and the American Pediatric Surgical Association.
1577	(b)  Programs shall also be established to provide care to
1578	hematology-oncology patients within each district of the
1579	department. The guidelines for local programs shall be
1580	formulated by the department. Special disbursements may be made
1581	by the program office to centers for educational programs
1582	designed for the districts of the department. These programs may
1583	include teaching total supportive care of the dying patient and
1584	his or her family, home therapy to hemophiliacs and patients
1585	with other hemostatic disorders, and screening and counseling
1586	for patients with sickle-cell anemia or other
1587	hemoglobinopathies.
1588	(4)(5)  PROGRAM AND PEER REVIEW.--The department shall
1589	evaluate at least annually during the grant period the services
1590	rendered by the centers and the districts of the department.
1591	Data from the centers and other sources relating to pediatric
1592	cancer shall be reviewed annually by the Florida Association of
1593	Pediatric Tumor Programs, Inc.; and a written report with
1594	recommendations shall be made to the department. This database
1595	will be available to the department for program planning and
1596	quality assurance initiatives formulation of its annual program
1597	and financial evaluation report. A portion of the funds
1598	appropriated for this section may be used to provide statewide
1599	consultation, supervision, and evaluation of the programs of the
1600	centers, as well as central program office support personnel.
1601	Section 26.  Paragraph (g) of subsection (2) and subsection
1602	(7) of section 385.207, Florida Statutes, are amended to read:
1603	385.207  Care and assistance of persons with epilepsy;
1604	establishment of programs in epilepsy control.--
1605	(2)  The Department of Health shall:
1606	(g)  Continue current programs and develop cooperative
1607	programs and services designed to enhance the vocational
1608	rehabilitation of epilepsy clients, including the current jobs
1609	programs. The department shall, as part of its contract with a
1610	provider of epilepsy services, collect information regarding the
1611	number of clients served, the outcomes reached, the expenses
1612	incurred, and the fees collected by such providers for the
1613	provision of services keep and make this information available
1614	to the Governor and the Legislature upon request information
1615	regarding the number of clients served, the outcome reached, and
1616	the expense incurred by such programs and services.
1617	(7)  The department shall limit total administrative
1618	expenditures from the Epilepsy Services Trust Fund to 5 percent
1619	of annual receipts.
1620	Section 27.  Paragraphs (b), (d), and (g) of subsection (2)
1621	and paragraph (b) of subsection (5) of section 385.210, Florida
1622	Statutes, are amended to read:
1623	385.210  Arthritis prevention and education.--
1624	(2)  LEGISLATIVE FINDINGS.--The Legislature finds the
1625	following:
1626	(b)  Arthritis is the leading cause of disability in the
1627	United States, limiting daily activities for more than 19 7
1628	million citizens.
1629	(d)  There are enormous economic and social costs
1630	associated with treating arthritis and its complications; the
1631	economic costs are estimated at over $128 billion (2003) $116
1632	billion (1997) annually in the United States.
1633	(g)  The National Arthritis Foundation, the CDC Centers for
1634	Disease Control and Prevention, and the Association of State and
1635	Territorial Health Officials have led the development of a
1636	public health strategy, the National Arthritis Action Plan, to
1637	respond to this challenge.
1638	(5)  FUNDING.--
1639	(b)  The State Surgeon General may shall seek any federal
1640	waiver or waivers that may be necessary to maximize funds from
1641	the Federal Government to implement this program.
1642	Section 28.  Section 385.301, Florida Statutes, is created
1643	to read:
1644	385.301  Rulemaking authority.--The department may adopt
1645	rules pursuant to chapter 120 to administer this chapter.
1646	Section 29.  Subsection (9) of section 409.904, Florida
1647	Statutes, is amended to read:
1648	409.904  Optional payments for eligible persons.--The
1649	agency may make payments for medical assistance and related
1650	services on behalf of the following persons who are determined
1651	to be eligible subject to the income, assets, and categorical
1652	eligibility tests set forth in federal and state law. Payment on
1653	behalf of these Medicaid eligible persons is subject to the
1654	availability of moneys and any limitations established by the
1655	General Appropriations Act or chapter 216.
1656	(9)  Eligible women with incomes at or below 200 percent of
1657	the federal poverty level and under age 65, for cancer treatment
1658	pursuant to the federal Breast and Cervical Cancer Prevention
1659	and Treatment Act of 2000, screened through the Mary Brogan
1660	Breast and Cervical Cancer Early Detection Program established
1661	under s. 385.2021 s. 381.93.
1662	Section 30.  The Pharmacy and Therapeutic Advisory
1663	Council.--
1664	(1)  The Pharmacy and Therapeutic Advisory Council is
1665	created within the Executive Office of the Governor to serve in
1666	an advisory capacity to the Department of Health and other
1667	governmental agencies. The council may not interfere with
1668	existing mandated Medicaid services and may not develop or
1669	implement new ones. Specifically, the council may not interfere
1670	with the work of the Agency for Health Care Administration as it
1671	complies with federal and state statutory obligations to develop
1672	a preferred drug list, to negotiate rebate agreements for
1673	medications included in the preferred drug list, and to protect
1674	the confidentiality of rebate agreements. The council may not
1675	interfere with the Medicaid Pharmacy and Therapeutics Committee
1676	or the Drug Utilization Review Board, which oversee clinical
1677	activities within the Bureau of Pharmacy Services if such
1678	interference would violate any federal or state statutory
1679	obligations.
1680	(2)  The Pharmacy and Therapeutic Advisory Council shall
1681	use Medicaid processes within the existing Medicaid structure of
1682	the Agency for Health Care Administration as a guide for
1683	assisting state agencies in:
1684	(a)  Developing an unbiased clinical perspective on drug
1685	evaluations and utilization protocols that are relevant to
1686	patient care provided through programs administered by state
1687	agencies.
1688	(b)  Developing drug-utilization-review processes that are
1689	relevant to the agencies and those receiving care through
1690	programs administered by the agencies.
1691	(c)  Building a formulary structure that enforces formulary
1692	compliance or adherence within each agency.
1693	(d)  Performing pharmacoeconomic analyses on formulary
1694	management so that the state maximizes the cost-effectiveness of
1695	its pharmaceutical purchasing.
1696	(e)  Reviewing new and existing therapies using criteria
1697	established for efficacy, safety, and quality in order to
1698	maximize cost-effective purchasing.
1699	(f)  Reviewing state agency proposals to maximize the cost-
1700	effectiveness of pharmaceutical purchasing in compliance with s.
1701	381.0203.
1702	(3) The council shall verify the cost-effectiveness and
1703	clinical efficacy of any state contracts under s. 381.0203(1),
1704	Florida Statutes, no less than once every 2 years.
1705	(4)  The members of the council and the chair shall be
1706	appointed by the Governor to 4-year staggered terms or until
1707	their successors are appointed. Members may be appointed to more
1708	than one term. The Governor shall fill any vacancies for the
1709	remainder of the unexpired term in the same manner as the
1710	original appointment.
1711	(5)  The council shall include voting and nonvoting
1712	members, and the chair, who is a voting member, must be a
1713	pharmacist employed by a state agency.
1714	(a)  The voting members shall represent:
1715	1.  The Agency for Health Care Administration.
1716	2.  The Agency for Persons with Disabilities.
1717	3.  The Department of Children and Family Services.
1718	4.  The Department of Corrections.
1719	5.  The Department of Elderly Affairs.
1720	6.  The Department of Health.
1721	7.  The Department of Juvenile Justice.
1722	8.  The Bureau of Pharmacy Services within the Agency for
1723	Health Care Administration, which shall be represented by the
1724	bureau chief.
1725	9.  The Bureau of Statewide Pharmaceutical Services within
1726	the Department of Health, which shall be represented by the
1727	bureau chief.
1728	(b)  The nonvoting members shall be:
1729	1.  A representative from the Agency for Health Care
1730	Administration's drug contracting program.
1731	2.  The contracting officer for the Department of Health's
1732	drug procurement program.
1733	3.  A clinical pharmacy program manager from the Agency for
1734	Health Care Administration.
1735	4.  The chair of the Department of Health's Pharmacy and
1736	Therapeutics Committee.
1737	5.  The general counsel for the Agency for Health Care
1738	Administration or his or her designee.
1739	6.  The general counsel for a state agency in the executive
1740	branch of state government, or his or her designee.
1741	7.  A representative from the Executive Office of the
1742	Governor.
1743	8.  The statewide pharmacy director of the Department of
1744	Corrections' Office of Health Services.
1745	(6)  Members of the council shall consist of at least one
1746	physician licensed under chapter 458 or chapter 459, Florida
1747	Statutes, at least one pharmacist licensed under chapter 465,
1748	Florida Statutes, and at least one registered nurse licensed
1749	under chapter 464, Florida Statutes. Each member designated in
1750	this subsection must have an active license in his or her
1751	profession and may not have been the subject of any agency
1752	disciplinary action.
1753	(7)  Members, who must be residents of this state, shall be
1754	selected on the basis of specialty, board certification, prior
1755	pharmacy and therapeutic experience, experience treating medical
1756	assistance recipients, ability to represent a broad base of
1757	constituents, and number of years of practice. Members must not
1758	have any conflicts of interest due to their service on the
1759	council.
1760	(8)  The council may request the participation of
1761	additional subject-matter experts to address specific drug,
1762	therapeutic, or drug-procurement issues under review by the
1763	council.
1764	(9)  A majority of the members of the council constitutes a
1765	quorum, and an affirmative vote of a majority of the voting
1766	members is necessary to take action.
1767	(10)  The council shall meet quarterly or at the call of
1768	the chair.
1769	(11)  The council shall be staffed by the chair's
1770	department or agency.
1771	(12)  The council members shall serve without compensation,
1772	but are entitled to reimbursement for travel and per diem
1773	expenses incurred in the performance of their duties in
1774	accordance with s. 112.061, Florida Statutes.
1775	Section 31.  Paragraph (g) is added to subsection (53) of
1776	section 499.003, Florida Statutes, to read:
1777	499.003  Definitions of terms used in this part.--As used
1778	in this part, the term:
1779	(53)  "Wholesale distribution" means distribution of
1780	prescription drugs to persons other than a consumer or patient,
1781	but does not include:
1782	(g)  The sale, purchase, trade, or transfer of a
1783	prescription drug among agencies and health care entities of the
1784	state to complete the dispensing of the prescription drug to a
1785	patient under the care of a state agency or health care entity,
1786	or to a patient for whom the state is responsible for providing
1787	or arranging health care services. The agency or health care
1788	entity that received the prescription drug on behalf of the
1789	patient is deemed the patient's agent under s. 465.003(6).
1790	Section 32.  This act shall take effect July 1, 2009.

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