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 and
11	certain residential child-caring agencies to limit the
12	inspection of the domestic violence center or residential
13	child-caring agency to the requirements set forth in the
14	department's rules applicable to community-based
15	residential facilities with five or fewer residents;
16	requiring a report to the Governor and Legislature prior
17	to proceeding with nitrogen reduction activities; ;
18	amending s. 381.0072, F.S.; requiring the Department of
19	Health, when conducting a food service inspection of a
20	certified domestic violence center to limit the inspection
21	of the domestic violence center to the requirements set
22	forth in the department's rules applicable to community-
23	based residential facilities with five or fewer residents;
24	amending s. 381.0203, F.S.; requiring certain state
25	agencies to purchase drugs through the statewide
26	purchasing contract administered by the Department of
27	Health; providing an exception; requiring the department
28	to establish and maintain certain pharmacy services
29	program; transferring, renumbering, and amending s.
30	381.84, F.S., relating to the Comprehensive Statewide
31	Tobacco Education and Use Prevention Program; revising
32	definitions; revising program components; requiring
33	program components to include efforts to educate youth and
34	their parents about tobacco use; requiring a youth-
35	directed focus in each program component; deleting an
36	obsolete provision relating to the AHEC smoking-cessation
37	initiative; requiring the Tobacco Education and Use
38	Prevention Advisory Council to adhere to state ethics
39	laws; providing that meetings of the council are subject
40	to public-records and public-meetings requirements;
41	revising the duties of the council; deleting a provision
42	that prohibits a member of the council from participating
43	in a discussion or decision with respect to a research
44	proposal by a firm, entity, or agency with which the
45	member is associated as a member of the governing body or
46	as an employee or with which the member has entered into a
47	contractual arrangement; revising the submission date of
48	an annual report; deleting an expired provision relating
49	to rulemaking authority of the department; transferring
50	and renumbering s. 381.91, F.S., relating to the Jessie
51	Trice Cancer Prevention Program; transferring,
52	renumbering, and amending s. 381.911, F.S., relating to
53	the Prostate Cancer Awareness Program; revising the
54	criteria for members of the prostate cancer advisory
55	committee; repealing s. 381.912, F.S., relating to the
56	Cervical Cancer Elimination Task Force; transferring and
57	renumbering s. 381.92, F.S., relating to the Florida
58	Cancer Council; transferring and renumbering s. 381.921,
59	F.S., relating to the mission and duties of the Florida
60	Cancer Council; amending s. 381.922, F.S.; conforming
61	cross-references; transferring and renumbering s. 381.93,
62	F.S., relating to a breast and cervical cancer early
63	detection program; transferring and renumbering s.
64	381.931, F.S., relating to an annual report on Medicaid
65	expenditures; renaming ch. 385, F.S., as the "Healthy and
66	Fit Florida Act"; amending s. 385.101, F.S.; renaming the
67	"Chronic Diseases Act" as the "Healthy and Fit Florida
68	Act"; amending s. 385.102, F.S.; revising legislative
69	intent; creating s. 385.1021, F.S.; providing definitions;
70	creating s. 385.1022, F.S.; requiring the Department of
71	Health to support public health programs to reduce the
72	incidence of mortality and morbidity from chronic
73	diseases; creating s. 385.1023, F.S.; requiring the
74	department to create state-level programs that address the
75	risk factors of certain chronic diseases; providing
76	required activities of the state-level programs; amending
77	s. 385.103, F.S.; providing for community-level programs
78	for the prevention of chronic diseases; revising
79	definitions; requiring the department to develop and
80	implement a community-based chronic disease prevention and
81	health promotion program; providing the purpose of the
82	program; providing requirements for the program; creating
83	s. 385.105, F.S.; requiring the department to develop
84	programs to increase physical fitness, to work with school
85	districts, to develop partnerships that allow the public
86	to access recreational facilities and public land areas
87	suitable for physical activity, to work with the Executive
88	Office of the Governor and Volunteer Florida, Inc., to
89	promote school initiatives, and to collaborate with the
90	Department of Education in recognizing nationally accepted
91	best practices for improving physical education in
92	schools; requiring the Department of Health to promote
93	healthy lifestyles to reduce obesity; requiring the
94	department to promote optimal nutritional status in all
95	stages of people's lives, personal responsibility to
96	prevent chronic disease or slow its progression, and
97	regular health visits during a person's life span;
98	authorizing state agencies to conduct employee wellness
99	programs; requiring the department to serve as a model to
100	develop and implement employee wellness programs;
101	requiring the department to assist state agencies to
102	develop the employee wellness programs; providing equal
103	access to the programs by agency employees; requiring the
104	department to coordinate efforts with the Department of
105	Management Services and other state agencies; authorizing
106	each state agency to establish an employee wellness work
107	group to design the wellness program; requiring the
108	department to provide requirements for participation fees,
109	collaborations with businesses, and procurement of
110	equipment and incentives; amending s. 385.202, F.S.;
111	requiring facilities, laboratories, and practitioners to
112	report information; authorizing the department to adopt
113	rules regarding reporting requirements for the cancer
114	registry; providing immunity from liability for facilities
115	and practitioners reporting certain information; requiring
116	the department to adopt rules regarding the establishment
117	and operation of a statewide cancer registry program;
118	requiring the department or contractual designee operating
119	the statewide cancer registry program to use or publish
120	material only for the purpose of public health
121	surveillance and advancing medical research or medical
122	education in the interest of reducing morbidity or
123	mortality; authorizing the department to exchange personal
124	data with any agency or contractual designee for the
125	purpose of public health surveillance and medical or
126	scientific research under certain circumstances;
127	clarifying that the department may adopt rules regarding
128	the classifications of facilities related to reports made
129	to the cancer registry; requiring each facility and
130	practitioner that reports cancer cases to the department
131	to make their records available for onsite review;
132	amending s. 385.203, F.S.; increasing the size of the
133	Diabetes Advisory Council to include one representative of
134	the Florida Academy of Family Physicians; amending s.
135	385.206, F.S.; renaming the "hematology-oncology care
136	center program" as the "Pediatric Hematology-Oncology
137	Center Program"; revising definitions; authorizing the
138	department to designate centers and provide funding to
139	maintain programs for the care of patients with
140	hematologic and oncologic disorders; clarifying provisions
141	related to grant-funding agreements and grant
142	disbursements; revising the department's requirement to
143	evaluate services rendered by the centers; requiring data
144	from the centers and other sources relating to pediatric
145	cancer to be available to the department for program
146	planning and quality assurance initiatives; amending s.
147	385.207, F.S.; clarifying provisions that require the
148	department to collect information regarding the number of
149	clients served, the outcomes reached, the expense
150	incurred, and fees collected by providers of epilepsy
151	services; deleting the provision that requires the
152	department to limit administrative expenses from the
153	Epilepsy Services Trust Fund to a certain percentage of
154	annual receipts; amending s. 385.210, F.S.; revising
155	legislative findings regarding the economic costs of
156	treating arthritis and its complications; authorizing the
157	State Surgeon General to seek any federal waivers that may
158	be necessary to maximize funds from the Federal Government
159	to implement the Arthritis Prevention and Education
160	Program; creating s. 385.301, F.S.; authorizing the
161	department to adopt rules to administer the act; amending
162	s. 409.904, F.S.; conforming a cross-reference; creating
163	the Pharmacy and Therapeutic Advisory Council within the
164	Executive Office of the Governor; providing duties of the
165	council; providing for the appointment and qualification
166	of members; providing for the use of subject-matter
167	experts when necessary; providing requirements for voting
168	and a quorum; providing for quarterly meetings of the
169	council; providing for staffing; providing for
170	reimbursement of per diem and travel expenses for members
171	of the council; amending s. 499.003, F.S.; excluding from
172	the definition of "wholesale distribution" certain
173	activities of state agencies; providing an effective date.
174
175	Be It Enacted by the Legislature of the State of Florida:
176
177	Section 1.  Paragraph (e) of subsection (2) of section
178	154.503, Florida Statutes, is amended to read:
179	154.503  Primary Care for Children and Families Challenge
180	Grant Program; creation; administration.--
181	(2)  The department shall:
182	(e)  Coordinate with the primary care program developed
183	pursuant to s. 154.011, the Florida Healthy Kids Corporation
184	program created in s. 624.91, the school health services program
185	created in ss. 381.0056 and 381.0057, the Healthy Communities,
186	Healthy People Program created in s. 381.734, and the volunteer
187	health care provider program developed pursuant to s. 766.1115.
188	Section 2.  Sections 381.0053, 381.0054, 381.732, 381.733,
189	and 381.734, Florida Statutes, are repealed.
190	Section 3.  Subsection (16) of section 381.006, Florida
191	Statutes, is amended to read:
192	381.006  Environmental health.--The department shall
193	conduct an environmental health program as part of fulfilling
194	the state's public health mission. The purpose of this program
195	is to detect and prevent disease caused by natural and manmade
196	factors in the environment. The environmental health program
197	shall include, but not be limited to:
198	(16)  A group-care-facilities function, where a group care
199	facility means any public or private school, housing, building
200	or buildings, section of a building, or distinct part of a
201	building or other place, whether operated for profit or not,
202	which undertakes, through its ownership or management, to
203	provide one or more personal services, care, protection, and
204	supervision to persons who require such services and who are not
205	related to the owner or administrator. The department may adopt
206	rules necessary to protect the health and safety of residents,
207	staff, and patrons of group care facilities, such as child care
208	facilities, family day care homes, assisted living facilities,
209	adult day care centers, adult family care homes, hospices,
210	residential treatment facilities, crisis stabilization units,
211	pediatric extended care centers, intermediate care facilities
212	for the developmentally disabled, group care homes, and, jointly
213	with the Department of Education, private and public schools.
214	These rules may include definitions of terms; provisions
215	relating to operation and maintenance of facilities, buildings,
216	grounds, equipment, furnishings, and occupant-space
217	requirements; lighting; heating, cooling, and ventilation; food
218	service; water supply and plumbing; sewage; sanitary facilities;
219	insect and rodent control; garbage; safety; personnel health,
220	hygiene, and work practices; and other matters the department
221	finds are appropriate or necessary to protect the safety and
222	health of the residents, staff, or patrons. The department may
223	not adopt rules that conflict with rules adopted by the
224	licensing or certifying agency. The department may enter and
225	inspect at reasonable hours to determine compliance with
226	applicable statutes or rules. An environmental health program
227	inspection of a certified domestic violence center or
228	residential child-caring agency licensed by the Department of
229	Children and Family Services pursuant to chapter 409 shall be
230	limited to the requirements set forth in the department's rules
231	applicable to community-based residential facilities with five
232	or fewer residents. In addition to any sanctions that the
233	department may impose for violations of rules adopted under this
234	section, the department shall also report such violations to any
235	agency responsible for licensing or certifying the group care
236	facility. The licensing or certifying agency may also impose any
237	sanction based solely on the findings of the department.
238	(17)  Upon completion of the department's study to develop
239	passive strategies for nitrogen reduction that complement use of
240	conventional onsite wastewater treatment systems, the department
241	shall submit a final report to the Executive Office of the
242	Governor, the President of the Senate, and the Speaker of the
243	House of Representatives prior to proceeding with any nitrogen
244	reduction activities.
245
246	The department may adopt rules to carry out the provisions of
247	this section.
248	Section 4.  Paragraph (a) of subsection (2) of section
249	381.0072, Florida Statutes, is amended to read:
250	381.0072  Food service protection.--It shall be the duty of
251	the Department of Health to adopt and enforce sanitation rules
252	consistent with law to ensure the protection of the public from
253	food-borne illness. These rules shall provide the standards and
254	requirements for the storage, preparation, serving, or display
255	of food in food service establishments as defined in this
256	section and which are not permitted or licensed under chapter
257	500 or chapter 509.
258	(2)  DUTIES.--
259	(a)  The department shall adopt rules, including
260	definitions of terms which are consistent with law prescribing
261	minimum sanitation standards and manager certification
262	requirements as prescribed in s. 509.039, and which shall be
263	enforced in food service establishments as defined in this
264	section. The sanitation standards must address the construction,
265	operation, and maintenance of the establishment; lighting,
266	ventilation, laundry rooms, lockers, use and storage of toxic
267	materials and cleaning compounds, and first-aid supplies; plan
268	review; design, construction, installation, location,
269	maintenance, sanitation, and storage of food equipment and
270	utensils; employee training, health, hygiene, and work
271	practices; food supplies, preparation, storage, transportation,
272	and service, including access to the areas where food is stored
273	or prepared; and sanitary facilities and controls, including
274	water supply and sewage disposal; plumbing and toilet
275	facilities; garbage and refuse collection, storage, and
276	disposal; and vermin control. Public and private schools, if the
277	food service is operated by school employees; hospitals licensed
278	under chapter 395; nursing homes licensed under part II of
279	chapter 400; child care facilities as defined in s. 402.301;
280	residential facilities colocated with a nursing home or
281	hospital, if all food is prepared in a central kitchen that
282	complies with nursing or hospital regulations; and bars and
283	lounges, as defined by department rule, are exempt from the
284	rules developed for manager certification. The department shall
285	administer a comprehensive inspection, monitoring, and sampling
286	program to ensure such standards are maintained. With respect to
287	food service establishments permitted or licensed under chapter
288	500 or chapter 509, the department shall assist the Division of
289	Hotels and Restaurants of the Department of Business and
290	Professional Regulation and the Department of Agriculture and
291	Consumer Services with rulemaking by providing technical
292	information. Food service inspections of a certified domestic
293	violence center shall be limited to the requirements set forth
294	in the department's rules applicable to community-based
295	residential facilities with five or fewer residents.
296	Section 5.  Subsection (1) and paragraph (a) of subsection
297	(2) of section 381.0203, Florida Statutes, are amended to read:
298	381.0203  Pharmacy services.--
299	(1)  The department must may contract on a statewide basis
300	for the purchase of drugs, as defined in s. 499.003, to be used
301	by state agencies and political subdivisions, and may adopt
302	rules to administer this section. Effective January 1, 2010, all
303	state agencies, except the Agency for Health Care
304	Administration, the Department of Veterans' Affairs, and the
305	Department of Management Services, must purchase drugs through
306	the statewide contract unless:
307	(a)  The Pharmacy and Therapeutic Advisory Council approves
308	a more cost-effective purchasing plan; or
309	(b)  The drugs required are not available through the
310	statewide purchasing contract.
311	(2)  The department must may establish and maintain a
312	pharmacy services program that includes, including, but is not
313	limited to:
314	(a)  A central pharmacy to support pharmaceutical services
315	provided by the county health departments, including
316	pharmaceutical repackaging, dispensing, and the purchase and
317	distribution of immunizations and other pharmaceuticals. Such
318	services shall be provided to other state agencies and political
319	subdivisions of the state upon written agreement. Cost savings
320	realized by the state through utilization of the central
321	pharmacy may be used by the department to offset additional
322	costs.
323	Section 6.  Section 381.84, Florida Statutes, is
324	transferred, renumbered as section 385.106, Florida Statutes,
325	and amended to read:
326	385.106 381.84  Comprehensive Statewide Tobacco Education
327	and Use Prevention Program.--
328	(1)  DEFINITIONS.--As used in this section and for purposes
329	of the provisions of s. 27, Art. X of the State Constitution,
330	the term:
331	(a)  "AHEC network" means an area health education center
332	network established under s. 381.0402.
333	(b)  "Best practices" means the Best Practices for
334	Comprehensive Tobacco Control Programs as established by the
335	CDC, as amended.
336	(c)(b)  "CDC" means the United States Centers for Disease
337	Control and Prevention.
338	(d)(c)  "Council" means the Tobacco Education and Use
339	Prevention Advisory Council.
340	(d)  "Department" means the Department of Health.
341	(e)  "Tobacco" means, without limitation, tobacco itself
342	and tobacco products that include tobacco and are intended or
343	expected for human use or consumption, including, but not
344	limited to, cigarettes, cigars, pipe tobacco, and smokeless
345	tobacco.
346	(f)  "Youth" means minors and young adults.
347	(2)  PURPOSE, FINDINGS, AND INTENT.--It is the purpose of
348	this section to implement s. 27, Art. X of the State
349	Constitution. The Legislature finds that s. 27, Art. X of the
350	State Constitution requires the funding of a statewide tobacco
351	education and use prevention program that focuses on tobacco use
352	by youth. The Legislature further finds that the primary goals
353	of the program are to reduce the prevalence of tobacco use among
354	youth, adults, and pregnant women; reduce per capita tobacco
355	consumption; and reduce exposure to environmental tobacco smoke.
356	Further, it is the intent of the Legislature to base increases
357	in funding for individual components of the program on the
358	results of assessments and evaluations. Recognizing that some
359	components will need to grow faster than inflation, it is the
360	intent of the Legislature to fund portions of the program on a
361	nonrecurring basis in the early years so that those components
362	that are most effective can be supported as the program matures.
363	(3)  PROGRAM COMPONENTS AND REQUIREMENTS.--The department
364	shall conduct a comprehensive, statewide tobacco education and
365	use prevention program consistent with the recommendations for
366	effective program components contained in the 1999 Best
367	Practices for Comprehensive Tobacco Control Programs of the CDC,
368	as amended by the CDC. The program shall include the following
369	components, each of which shall focus on educating people,
370	particularly youth and their parents, about the health hazards
371	of tobacco and discouraging the use of tobacco. All program
372	components shall include efforts to educate youth and their
373	parents about tobacco use, and a youth-directed focus shall
374	exist in all components outlined in this subsection.:
375	(a)  State and community interventions.--These
376	interventions shall include, but not be limited to, a statewide
377	tobacco control program that combines and coordinates community-
378	based interventions that focus on preventing initiation of
379	tobacco use among youth and young adults; promoting quitting
380	among adults, youth, and pregnant women; eliminating exposure to
381	secondhand smoke; identifying and eliminating tobacco-related
382	disparities among population groups; and promoting a range of
383	collaborations to prevent and alleviate the effects of chronic
384	diseases. Counter-marketing and advertising; cyberspace resource
385	center.--The counter-marketing and advertising campaign shall
386	include, at a minimum, Internet, print, radio, and television
387	advertising and shall be funded with a minimum of one-third of
388	the total annual appropriation required by s. 27, Art. X of the
389	State Constitution. A cyberspace resource center for copyrighted
390	materials and information concerning tobacco education and use
391	prevention, including cessation, shall be maintained by the
392	program. Such resource center must be accessible to the public,
393	including parents, teachers, and students, at each level of
394	public and private schools, universities, and colleges in the
395	state and shall provide links to other relevant resources. The
396	Internet address for the resource center must be incorporated in
397	all advertising. The information maintained in the resource
398	center shall be used by the other components of the program.
399	(b)  Health communication interventions.--Effective media
400	and health communication intervention efforts include, but are
401	not limited to, audience research to define themes and execute
402	messages for influential, high impact, and specifically targeted
403	campaigns; market research to identify the target market and the
404	behavioral theory motivating change; counter-marketing
405	surveillance; community tie-ins to support and reinforce the
406	statewide campaign; technologies such as viral marketing, social
407	networks, personal web pages, and web logs; traditional media;
408	process and outcome evaluation of the communication efforts; and
409	promotion of available services, including the state telephone
410	cessation quitline. Cessation programs, counseling, and
411	treatment.--This program component shall include two
412	subcomponents:
413	1.  A statewide toll-free cessation service, which may
414	include counseling, referrals to other local resources and
415	support services, and treatment to the extent funds are
416	available for treatment services; and
417	2.  A local community-based program to disseminate
418	information about smoking cessation, how smoking cessation
419	relates to prenatal care and obesity prevention, and other
420	chronic tobacco-related diseases.
421	(c)  Cessation interventions.--Cessation interventions
422	include, but are not limited to, sustaining, expanding, and
423	promoting the service through population-based counseling and
424	treatment programs; encouraging public and private insurance
425	coverage for counseling and FDA-approved medication treatments
426	for tobacco-use cessation; eliminating cost and other barriers
427	to treatment for underserved populations; and making health care
428	system changes. Youth interventions to prevent tobacco-use
429	initiation and encourage cessation among young people are needed
430	in order to reshape the environment so that it supports tobacco-
431	free norms. Because most people who start smoking are younger
432	than 18 years of age, intervening during adolescence is
433	critical. Community programs and school-based policies and
434	interventions should be a part of a comprehensive effort that is
435	implemented in coordination with community and school
436	environments and in conjunction with increasing the unit price
437	of tobacco products, sustaining anti-tobacco media campaigns,
438	making environments tobacco free, and engaging in other efforts
439	to create tobacco-free social norms. Surveillance and
440	evaluation.--The program shall conduct ongoing epidemiological
441	surveillance and shall contract for annual independent
442	evaluations of the effectiveness of the various components of
443	the program in meeting the goals as set forth in subsection (2).
444	(d)  Surveillance and evaluation.--The surveillance and
445	evaluation of all program components shall monitor and document
446	short-term, intermediate, and long-term intervention outcomes to
447	inform program and policy direction and ensure accountability.
448	The surveillance and evaluation must be conducted objectively
449	through scientifically sound methodology. Youth school
450	programs.--School and after-school programs shall use current
451	evidence-based curricula and programs that involve youth to
452	educate youth about the health hazards of tobacco, help youth
453	develop skills to refuse tobacco, and demonstrate to youth how
454	to stop using tobacco.
455	(e)  Administration and management.--Administration and
456	management activities include, but are not limited to, strategic
457	planning to guide program efforts and resources in order to
458	accomplish goals; recruiting and developing qualified and
459	diverse technical, program, and administrative staff; awarding
460	and monitoring program contracts and grants to coordinate
461	implementation across program areas; developing and maintaining
462	a fiscal-management system to track allocations and the
463	expenditure of funds; increasing capacity at the community level
464	through ongoing training and technical assistance; creating
465	effective communications internally among chronic disease
466	prevention programs and local coalitions and partners; and
467	educating the public and decisionmakers on the health effects of
468	tobacco and evidence-based effective program and policy
469	interventions. Community programs and chronic disease
470	prevention.--The department shall promote and support local
471	community-based partnerships that emphasize programs involving
472	youth, including programs for the prevention, detection, and
473	early intervention of smoking-related chronic diseases.
474	(f)  Training.--The program shall include the training of
475	health care practitioners, smoking-cessation counselors, and
476	teachers by health professional students and other tobacco-use
477	prevention specialists who are trained in preventing tobacco use
478	and health education. Smoking-cessation counselors shall be
479	trained by specialists who are certified in tobacco-use
480	cessation.
481	(g)  County health departments Administration, statewide
482	programs, and county health departments.--Each county health
483	department is eligible to receive a portion of the annual
484	appropriation, on a per capita basis, for coordinating tobacco
485	education and use prevention programs within that county.
486	Appropriated funds may be used to improve the infrastructure of
487	the county health department to implement the comprehensive,
488	statewide tobacco education and use prevention program. Each
489	county health department shall prominently display in all
490	treatment rooms and waiting rooms, counter-marketing and
491	advertisement materials in the form of wall posters, brochures,
492	television advertising if televisions are used in the lobby or
493	waiting room, and screensavers and Internet advertising if
494	computer kiosks are available for use or viewing by people at
495	the county health department.
496	(h)  Enforcement and awareness of related laws.--In
497	coordination with the Department of Business and Professional
498	Regulation, the program shall monitor the enforcement of laws,
499	rules, and policies prohibiting the sale or other provision of
500	tobacco to minors, as well as the continued enforcement of the
501	Clean Indoor Air Act prescribed in chapter 386. The
502	advertisements produced in accordance with paragraph (b)
503	paragraph (a) may also include information designed to make the
504	public aware of these related laws and rules. The departments
505	may enter into interagency agreements to carry out this program
506	component.
507	(i)  AHEC smoking-cessation initiative.--For the 2007-2008
508	and 2008-2009 fiscal years only, the AHEC network shall expand
509	the AHEC smoking-cessation initiative to each county within the
510	state and perform other activities as determined by the
511	department.
512	(4)  ADVISORY COUNCIL; MEMBERS, APPOINTMENTS, AND
513	MEETINGS.--The Tobacco Education and Use Prevention Advisory
514	Council is created within the department.
515	(a)  The council shall consist of 23 members, including:
516	1.  The State Surgeon General, who shall serve as the
517	chairperson.
518	2.  One county health department director, appointed by the
519	State Surgeon General.
520	3.  Two members appointed by the Commissioner of Education,
521	of whom one must be a school district superintendent.
522	4.  The chief executive officer of the Florida Division of
523	the American Cancer Society, or his or her designee.
524	5.  The chief executive officer of the Greater Southeast
525	Affiliate of the American Heart Association, or his or her
526	designee.
527	6.  The chief executive officer of the American Lung
528	Association of Florida, or his or her designee.
529	7.  The dean of the University of Miami School of Medicine,
530	or his or her designee.
531	8.  The dean of the University of Florida College of
532	Medicine, or his or her designee.
533	9.  The dean of the University of South Florida College of
534	Medicine, or his or her designee.
535	10.  The dean of the Florida State University College of
536	Medicine, or his or her designee.
537	11.  The dean of Nova Southeastern College of Osteopathic
538	Medicine, or his or her designee.
539	12.  The dean of the Lake Erie College of Osteopathic
540	Medicine in Bradenton, Florida, or his or her designee.
541	13.  The chief executive officer of the Campaign for
542	Tobacco Free Kids, or his or her designee.
543	14.  The chief executive officer of the Legacy Foundation,
544	or his or her designee.
545	15.  Four members appointed by the Governor, of whom two
546	must have expertise in the field of tobacco-use prevention and
547	education or smoking cessation and one individual who shall be
548	between the ages of 16 and 21 at the time of his or her
549	appointment.
550	16.  Two members appointed by the President of the Senate,
551	of whom one must have expertise in the field of tobacco-use
552	prevention and education or smoking cessation.
553	17.  Two members appointed by the Speaker of the House of
554	Representatives, of whom one must have expertise in the field of
555	tobacco-use prevention and education or smoking cessation.
556	(b)  The appointments shall be for 3-year terms and shall
557	reflect the diversity of the state's population. A vacancy shall
558	be filled by appointment by the original appointing authority
559	for the unexpired portion of the term.
560	(c)  An appointed member may not serve more than two
561	consecutive terms.
562	(d)  The council shall meet at least quarterly and upon the
563	call of the chairperson. Meetings may be held via teleconference
564	or other electronic means.
565	(e)  Members of the council shall serve without
566	compensation, but are entitled to reimbursement for per diem and
567	travel expenses pursuant to s. 112.061. Members who are state
568	officers or employees or who are appointed by state officers or
569	employees shall be reimbursed for per diem and travel expenses
570	pursuant to s. 112.061 from the state agency through which they
571	serve.
572	(f)  The council shall adhere to all state ethics laws.
573	Meetings of the council and the review panels are subject to
574	chapter 119, s. 286.011, and s. 24, Art. I of the State
575	Constitution. The department shall provide council members with
576	information and other assistance as is reasonably necessary to
577	assist the council in carrying out its responsibilities.
578	(5)  COUNCIL DUTIES AND RESPONSIBILITIES.--The council
579	shall advise the State Surgeon General as to the direction and
580	scope of the Comprehensive Statewide Tobacco Education and Use
581	Prevention Program. The responsibilities of the council may
582	include, but are not limited to:
583	(a)  Providing advice on program priorities and emphases.
584	(b)  Providing advice on the overall program budget.
585	(c)  Providing advice on copyrighted material, trademark,
586	and future transactions as they pertain to the tobacco education
587	and use prevention program.
588	(d)  Reviewing, as requested by the department, broadcast
589	material prepared for the Internet, portable media players,
590	radio, and television advertisement as it relates to the
591	advertising component of the tobacco education and use
592	prevention program.
593	(e)  Participating in periodic program evaluation, as
594	requested by the department.
595	(f)  Assisting the department in developing the development
596	of guidelines to ensure fairness, neutrality, and adherence to
597	the principles of merit and quality in the conduct of the
598	program.
599	(g)  Assisting the department in developing the development
600	of administrative procedures relating to solicitation, review,
601	and award of contracts and grants in order to ensure an
602	impartial, high-quality peer review system.
603	(h)  Assisting the department in developing panels to
604	review and evaluate potential fund recipients the development
605	and supervision of peer review panels.
606	(i)  Assisting the department in reviewing reports of peer
607	review panels and making recommendations for funding allocations
608	contracts and grants.
609	(j)  Assisting the department in reviewing the activities
610	and evaluating the performance of the AHEC network to avoid
611	duplicative efforts using state funds.
612	(k)  Recommending specific measureable outcomes meaningful
613	outcome measures through a regular review of evidence-based and
614	promising tobacco-use prevention and education strategies and
615	programs of other states and the Federal Government.
616	(l)  Recommending policies to encourage a coordinated
617	response to tobacco use in this state, focusing specifically on
618	creating partnerships within and between the public and private
619	sectors.
620	(6)  CONTRACT REQUIREMENTS.--Contracts or grants for the
621	program components or subcomponents described in paragraphs
622	(3)(a)-(f) shall be awarded by the State Surgeon General, after
623	consultation with the council, on the basis of merit, as
624	determined by an open, competitive, peer-reviewed process that
625	ensures objectivity, consistency, and high quality. The
626	department shall award such grants or contracts no later than
627	October 1 for each fiscal year. A recipient of a contract or
628	grant for the program component described in paragraph (3)(d)
629	(3)(c) is not eligible for a contract or grant award for any
630	other program component described in subsection (3) in the same
631	state fiscal year. A school or college of medicine that is
632	represented on the council is not eligible to receive a contract
633	or grant under this section. For the 2007-2008 and 2008-2009
634	fiscal years only, the department shall award a contract or
635	grant in the amount of $10 million to the AHEC network for the
636	purpose of developing the components described in paragraph
637	(3)(i). The AHEC network may apply for a competitive contract or
638	grant after the 2008-2009 fiscal year.
639	(a)  In order to ensure that all proposals for funding are
640	appropriate and are evaluated fairly on the basis of merit, the
641	State Surgeon General, in consultation with the council, shall
642	appoint a peer review panel of independent, qualified experts in
643	the field of tobacco control to review the content of each
644	proposal and establish its priority score. The priority scores
645	shall be forwarded to the council and must be considered in
646	determining which proposals will be recommended for funding.
647	(b)  The council and the peer review panel shall establish
648	and follow rigorous guidelines for ethical conduct and adhere to
649	a strict policy with regard to conflicts of interest. Council
650	members are subject to the applicable provisions of chapter 112.
651	A member of the council or panel may not participate in any
652	discussion or decision with respect to a research proposal by
653	any firm, entity, or agency with which the member is associated
654	as a member of the governing body or as an employee or with
655	which the member has entered into a contractual arrangement.
656	Meetings of the council and the peer review panels are subject
657	to chapter 119, s. 286.011, and s. 24, Art. I of the State
658	Constitution.
659	(c)  In each contract or grant agreement, the department
660	shall limit the use of food and promotional items to no more
661	than 2.5 percent of the total amount of the contract or grant
662	and limit overhead or indirect costs to no more than 7.5 percent
663	of the total amount of the contract or grant. The department, in
664	consultation with the Department of Financial Services, shall
665	publish guidelines for appropriate food and promotional items.
666	(d)  In each advertising contract, the department shall
667	limit the total of production fees, buyer commissions, and
668	related costs to no more than 10 percent of the total contract
669	amount.
670	(e)  Notwithstanding the competitive process for contracts
671	prescribed in this subsection, each county health department is
672	eligible for core funding, on a per capita basis, to implement
673	tobacco education and use prevention activities within that
674	county.
675	(7)  ANNUAL REPORT REQUIRED.--By February 28 January 31 of
676	each year, the department shall provide to the Governor, the
677	President of the Senate, and the Speaker of the House of
678	Representatives a report that evaluates the program's
679	effectiveness in reducing and preventing tobacco use and that
680	recommends improvements to enhance the program's effectiveness.
681	The report must contain, at a minimum, an annual survey of youth
682	attitudes and behavior toward tobacco, as well as a description
683	of the progress in reducing the prevalence of tobacco use among
684	youth, adults, and pregnant women; reducing per capita tobacco
685	consumption; and reducing exposure to environmental tobacco
686	smoke.
687	(8)  LIMITATION ON ADMINISTRATIVE EXPENSES.--From the total
688	funds appropriated for the Comprehensive Statewide Tobacco
689	Education and Use Prevention Program in the General
690	Appropriations Act, an amount of up to 5 percent may be used by
691	the department for administrative expenses.
692	(9)  RULEMAKING AUTHORIZED.--By January 1, 2008, the
693	department shall adopt rules pursuant to ss. 120.536(1) and
694	120.54 to administer this section.
695	Section 7.  Section 381.91, Florida Statutes, is
696	transferred and renumbered as section 385.2024, Florida
697	Statutes, to read:
698	385.2024 381.91  Jessie Trice Cancer Prevention Program.--
699	(1)  It is the intent of the Legislature to:
700	(a)  Reduce the rates of illness and death from lung cancer
701	and other cancers and improve the quality of life among low-
702	income African-American and Hispanic populations through
703	increased access to early, effective screening and diagnosis,
704	education, and treatment programs.
705	(b)  Create a community faith-based disease-prevention
706	program in conjunction with the Health Choice Network and other
707	community health centers to build upon the natural referral and
708	education networks in place within minority communities and to
709	increase access to health service delivery in Florida.
710	(c)  Establish a funding source to build upon local private
711	participation to sustain the operation of the program.
712	(2)(a)  There is created the Jessie Trice Cancer Prevention
713	Program, to be located, for administrative purposes, within the
714	Department of Health, and operated from the community health
715	centers within the Health Choice Network in Florida.
716	(b)  Funding may be provided to develop contracts with
717	community health centers and local community faith-based
718	education programs to provide cancer screening, diagnosis,
719	education, and treatment services to low-income populations
720	throughout the state.
721	Section 8.  Section 381.911, Florida Statutes, is
722	transferred, renumbered as section 385.2023, Florida Statutes,
723	and amended to read:
724	385.2023 381.911  Prostate Cancer Awareness Program.--
725	(1)  To the extent that funds are specifically made
726	available for this purpose, the Prostate Cancer Awareness
727	Program is established within the Department of Health. The
728	purpose of this program is to implement the recommendations of
729	January 2000 of the Florida Prostate Cancer Task Force to
730	provide for statewide outreach and health education activities
731	to ensure that men are aware of and appropriately seek medical
732	counseling for prostate cancer as an early-detection health care
733	measure.
734	(2)  For purposes of implementing the program, the
735	Department of Health and the Florida Public Health Foundation,
736	Inc., may:
737	(a)  Conduct activities directly or enter into a contract
738	with a qualified nonprofit community education entity.
739	(b)  Seek any available gifts, grants, or funds from the
740	state, the Federal Government, philanthropic foundations, and
741	industry or business groups.
742	(3)  A prostate cancer advisory committee is created to
743	advise and assist the Department of Health and the Florida
744	Public Health Foundation, Inc., in implementing the program.
745	(a)  The State Surgeon General shall appoint the advisory
746	committee members, who shall consist of:
747	1.  Three persons from prostate cancer survivor groups or
748	cancer-related advocacy groups.
749	2.  Three persons who are scientists or clinicians from
750	public or nonpublic universities or research organizations.
751	3.  Three persons who are engaged in the practice of a
752	cancer-related medical specialty from health organizations
753	committed to cancer research and control.
754	(b)  Members shall serve without compensation but are
755	entitled to reimbursement, pursuant to s. 112.061, for per diem
756	and travel expenses incurred in the performance of their
757	official duties.
758	(4)  The program shall coordinate its efforts with those of
759	the Florida Public Health Foundation, Inc.
760	Section 9.  Section 381.912, Florida Statutes, is repealed.
761	Section 10.  Section 381.92, Florida Statutes, is
762	transferred and renumbered as section 385.2025, Florida
763	Statutes, to read:
764	385.2025 381.92  Florida Cancer Council.--
765	(1)  Effective July 1, 2004, the Florida Cancer Council
766	within the Department of Health is established for the purpose
767	of making the state a center of excellence for cancer research.
768	(2)(a)  The council shall be representative of the state's
769	cancer centers, hospitals, and patient groups and shall be
770	organized and shall operate in accordance with this act.
771	(b)  The Florida Cancer Council may create not-for-profit
772	corporate subsidiaries to fulfill its mission. The council and
773	its subsidiaries are authorized to receive, hold, invest, and
774	administer property and any moneys acquired from private, local,
775	state, and federal sources, as well as technical and
776	professional income generated or derived from the mission-
777	related activities of the council.
778	(c)  The members of the council shall consist of:
779	1.  The chair of the Florida Dialogue on Cancer, who shall
780	serve as the chair of the council;
781	2.  The State Surgeon General or his or her designee;
782	3.  The chief executive officer of the H. Lee Moffitt
783	Cancer Center or his or her designee;
784	4.  The director of the University of Florida Shands Cancer
785	Center or his or her designee;
786	5.  The chief executive officer of the University of Miami
787	Sylvester Comprehensive Cancer Center or his or her designee;
788	6.  The chief executive officer of the Mayo Clinic,
789	Jacksonville, or his or her designee;
790	7.  The chief executive officer of the American Cancer
791	Society, Florida Division, Inc., or his or her designee;
792	8.  The president of the American Cancer Society, Florida
793	Division, Inc., Board of Directors or his or her designee;
794	9.  The president of the Florida Society of Clinical
795	Oncology or his or her designee;
796	10.  The president of the American College of Surgeons,
797	Florida Chapter, or his or her designee;
798	11.  The chief executive officer of Enterprise Florida,
799	Inc., or his or her designee;
800	12.  Five representatives from cancer programs approved by
801	the American College of Surgeons. Three shall be appointed by
802	the Governor, one shall be appointed by the Speaker of the House
803	of Representatives, and one shall be appointed by the President
804	of the Senate;
805	13.  One member of the House of Representatives, to be
806	appointed by the Speaker of the House of Representatives; and
807	14.  One member of the Senate, to be appointed by the
808	President of the Senate.
809	(d)  Appointments made by the Speaker of the House of
810	Representatives and the President of the Senate pursuant to
811	paragraph (c) shall be for 2-year terms, concurrent with the
812	bienniums in which they serve as presiding officers.
813	(e)  Appointments made by the Governor pursuant to
814	paragraph (c) shall be for 2-year terms, although the Governor
815	may reappoint members.
816	(f)  Members of the council or any subsidiaries shall serve
817	without compensation, and each organization represented on the
818	council shall cover the expenses of its representatives.
819	(3)  The council shall issue an annual report to the Center
820	for Universal Research to Eradicate Disease, the Governor, the
821	Speaker of the House of Representatives, and the President of
822	the Senate by December 15 of each year, with policy and funding
823	recommendations regarding cancer research capacity in Florida
824	and related issues.
825	Section 11.  Section 381.921, Florida Statutes, is
826	transferred and renumbered as section 385.20251, Florida
827	Statutes, to read:
828	385.20251 381.921  Florida Cancer Council mission and
829	duties.--The council, which shall work in concert with the
830	Florida Center for Universal Research to Eradicate Disease to
831	ensure that the goals of the center are advanced, shall endeavor
832	to dramatically improve cancer research and treatment in this
833	state through:
834	(1)  Efforts to significantly expand cancer research
835	capacity in the state by:
836	(a)  Identifying ways to attract new research talent and
837	attendant national grant-producing researchers to cancer
838	research facilities in this state;
839	(b)  Implementing a peer-reviewed, competitive process to
840	identify and fund the best proposals to expand cancer research
841	institutes in this state;
842	(c)  Funding through available resources for those
843	proposals that demonstrate the greatest opportunity to attract
844	federal research grants and private financial support;
845	(d)  Encouraging the employment of bioinformatics in order
846	to create a cancer informatics infrastructure that enhances
847	information and resource exchange and integration through
848	researchers working in diverse disciplines, to facilitate the
849	full spectrum of cancer investigations;
850	(e)  Facilitating the technical coordination, business
851	development, and support of intellectual property as it relates
852	to the advancement of cancer research; and
853	(f)  Aiding in other multidisciplinary research-support
854	activities as they inure to the advancement of cancer research.
855	(2)  Efforts to improve both research and treatment through
856	greater participation in clinical trials networks by:
857	(a)  Identifying ways to increase adult enrollment in
858	cancer clinical trials;
859	(b)  Supporting public and private professional education
860	programs designed to increase the awareness and knowledge about
861	cancer clinical trials;
862	(c)  Providing tools to cancer patients and community-based
863	oncologists to aid in the identification of cancer clinical
864	trials available in the state; and
865	(d)  Creating opportunities for the state's academic cancer
866	centers to collaborate with community-based oncologists in
867	cancer clinical trials networks.
868	(3)  Efforts to reduce the impact of cancer on disparate
869	groups by:
870	(a)  Identifying those cancers that disproportionately
871	impact certain demographic groups; and
872	(b)  Building collaborations designed to reduce health
873	disparities as they relate to cancer.
874	Section 12.  Paragraph (a) of subsection (2) and subsection
875	(5) of section 381.922, Florida Statutes, as amended by section
876	2 of chapter 2009-5, Laws of Florida, is amended to read:
877	381.922  William G. "Bill" Bankhead, Jr., and David Coley
878	Cancer Research Program.--
879	(2)  The program shall provide grants for cancer research
880	to further the search for cures for cancer.
881	(a)  Emphasis shall be given to the goals enumerated in s.
882	385.20251 s. 381.921, as those goals support the advancement of
883	such cures.
884	(5)  For the 2008-2009 fiscal year and each fiscal year
885	thereafter, the sum of $6.75 million is appropriated annually
886	from recurring funds in the General Revenue Fund to the
887	Biomedical Research Trust Fund within the Department of Health
888	for purposes of the William G. "Bill" Bankhead, Jr., and David
889	Coley Cancer Research Program and shall be distributed pursuant
890	to this section to provide grants to researchers seeking cures
891	for cancer, with emphasis given to the goals enumerated in s.
892	385.20251 s. 381.921. From the total funds appropriated, an
893	amount of up to 10 percent may be used for administrative
894	expenses.
895	Section 13.  Section 381.93, Florida Statutes, is
896	transferred and renumbered as section 385.2021, Florida
897	Statutes, to read:
898	385.2021 381.93  Breast and cervical cancer early detection
899	program.--This section may be cited as the "Mary Brogan Breast
900	and Cervical Cancer Early Detection Program Act."
901	(1)  It is the intent of the Legislature to reduce the
902	rates of death due to breast and cervical cancer through early
903	diagnosis and increased access to early screening, diagnosis,
904	and treatment programs.
905	(2)  The Department of Health, using available federal
906	funds and state funds appropriated for that purpose, is
907	authorized to establish the Mary Brogan Breast and Cervical
908	Cancer Screening and Early Detection Program to provide
909	screening, diagnosis, evaluation, treatment, case management,
910	and followup and referral to the Agency for Health Care
911	Administration for coverage of treatment services.
912	(3)  The Mary Brogan Breast and Cervical Cancer Early
913	Detection Program shall be funded through grants for such
914	screening and early detection purposes from the federal Centers
915	for Disease Control and Prevention under Title XV of the Public
916	Health Service Act, 42 U.S.C. ss. 300k et seq.
917	(4)  The department shall limit enrollment in the program
918	to persons with incomes up to and including 200 percent of the
919	federal poverty level. The department shall establish an
920	eligibility process that includes an income-verification process
921	to ensure that persons served under the program meet income
922	guidelines.
923	(5)  The department may provide other breast and cervical
924	cancer screening and diagnostic services; however, such services
925	shall be funded separately through other sources than this act.
926	Section 14.  Section 381.931, Florida Statutes, is
927	transferred and renumbered as section 385.20211, Florida
928	Statutes, to read:
929	385.20211 381.931  Annual report on Medicaid
930	expenditures.--The Department of Health and the Agency for
931	Health Care Administration shall monitor the total Medicaid
932	expenditures for services made under this act. If Medicaid
933	expenditures are projected to exceed the amount appropriated by
934	the Legislature, the Department of Health shall limit the number
935	of screenings to ensure Medicaid expenditures do not exceed the
936	amount appropriated. The Department of Health, in cooperation
937	with the Agency for Health Care Administration, shall prepare an
938	annual report that must include the number of women screened;
939	the percentage of positive and negative outcomes; the number of
940	referrals to Medicaid and other providers for treatment
941	services; the estimated number of women who are not screened or
942	not served by Medicaid due to funding limitations, if any; the
943	cost of Medicaid treatment services; and the estimated cost of
944	treatment services for women who were not screened or referred
945	for treatment due to funding limitations. The report shall be
946	submitted to the President of the Senate, the Speaker of the
947	House of Representatives, and the Executive Office of the
948	Governor by March 1 of each year.
949	Section 15.  Chapter 385, Florida Statutes, entitled
950	"Chronic Diseases," is renamed the "Healthy and Fit Florida
951	Act."
952	Section 16.  Section 385.101, Florida Statutes, is amended
953	to read:
954	385.101  Short title.--This chapter Sections 385.101-
955	385.103 may be cited as the "Healthy and Fit Florida Chronic
956	Diseases Act."
957	Section 17.  Section 385.102, Florida Statutes, is amended
958	to read:
959	385.102  Legislative intent.--It is the finding of the
960	Legislature that:
961	(1)  Chronic diseases continue to be the leading cause of
962	death and disability in this state and the country exist in high
963	proportions among the people of this state. These Chronic
964	diseases include, but are not limited to, arthritis,
965	cardiovascular disease heart disease, hypertension, diabetes,
966	renal disease, cancer, and chronic obstructive lung disease.
967	These diseases are often have the same preventable risk factors
968	interrelated, and they directly and indirectly account for a
969	high rate of death, disability, and underlying costs to the
970	state's health care system illness.
971	(2)  Chronic diseases have a significant impact on quality
972	of life, not only for the individuals who experience their
973	painful symptoms and resulting disabilities, but also for family
974	members and caregivers.
975	(3)  Racial and ethnic minorities and other underserved
976	populations are disproportionately affected by chronic diseases.
977	(4)  There are enormous medical costs and lost wages
978	associated with chronic diseases and their complications.
979	(5)(2)  Advances in medical knowledge and technology assist
980	have assisted in the prevention, detection, and management of
981	chronic diseases. Comprehensive approaches that stress the
982	stressing application of current medical treatment, continuing
983	research, professional training, and patient education, and
984	community-level policy and environmental changes should be
985	implemented encouraged.
986	(6)(3)  A comprehensive program dealing with the early
987	detection and prevention of chronic diseases is required to make
988	knowledge and therapy available to all people of this state. The
989	mobilization of scientific, medical, and educational resources,
990	along with the implementation of community-based policy under
991	one comprehensive chronic disease law, act will facilitate the
992	prevention, early intervention, and management treatment of
993	chronic these diseases and their symptoms. This integration of
994	resources and policy will and result in a decline in death and
995	disability illness among the people of this state.
996	(7)  Chronic diseases account for 70 percent of all deaths
997	in the United States. The following chronic diseases are the
998	leading causes of death and disability:
999	(a)  Heart disease and stroke, which have remained the
1000	first and third leading causes of death for both men and women
1001	in the United States for over seven decades and account for
1002	approximately one-third of total deaths each year in this state.
1003	(b)  Cancer, which is the second leading cause of death and
1004	is responsible for one in four deaths in this state.
1005	(c)  Lung disease, which is the third leading cause of
1006	death and accounts for one in every six deaths in this state.
1007	(d)  Diabetes, which is the sixth leading cause of death in
1008	this state.
1009	(e)  Arthritis, which is the leading cause of disability in
1010	the United States, limiting daily activities for more than 19
1011	million citizens. In this state, arthritis limits daily
1012	activities for an estimated 1.3 million people.
1013	(8)  The department shall establish, promote, and maintain
1014	state-level and local-level programs for chronic disease
1015	prevention and health promotion to the extent that funds are
1016	specifically made available for this purpose.
1017	Section 18.  Section 385.1021, Florida Statutes, is created
1018	to read:
1019	385.1021  Definitions.--As used in this chapter, the term:
1020	(1)  "CDC" means the United States Centers for Disease
1021	Control and Prevention.
1022	(2)  "Chronic disease" means an illness that is prolonged,
1023	does not resolve spontaneously, and is rarely cured completely.
1024	(3)  "Department" means the Department of Health.
1025	(4)  "Environmental changes" means changes to the economic,
1026	social, or physical natural or built environments which
1027	encourage or enable behaviors.
1028	(5)  "Policy change" means altering an informal or formal
1029	agreement between public or private sectors which sets forth
1030	values, behaviors, or resource allocation in order to improve
1031	health.
1032	(6)  "Primary prevention" means an intervention that is
1033	directed toward healthy populations and focuses on avoiding
1034	disease before it occurs.
1035	(7)  "Risk factor" means a characteristic or condition
1036	identified during the course of an epidemiological study of a
1037	disease that appears to be statistically associated with a high
1038	incidence of that disease.
1039	(8)  "Secondary prevention" means an intervention that is
1040	designed to promote the early detection and management of
1041	diseases and reduce the risks experienced by at-risk
1042	populations.
1043	(9)  "System changes" means altering standard activities,
1044	protocols, policies, processes, and structures carried out in
1045	population-based settings, such as schools, worksites, health
1046	care facilities, faith-based organizations, and the overall
1047	community, which promote and support new behaviors.
1048	(10)  "Tertiary prevention" means an intervention that is
1049	directed at rehabilitating and minimizing the effects of disease
1050	in a chronically ill population.
1051	(11)  "Tobacco" means, without limitation, tobacco itself
1052	and tobacco products that include tobacco and are intended or
1053	expected for human use or consumption, including, but not
1054	limited to, cigarettes, cigars, pipe tobacco, and smokeless
1055	tobacco.
1056	(12)  "Wellness program" means a structured program that is
1057	designed or approved by the department to offer intervention
1058	activities on or off the worksite which help state employees
1059	change certain behaviors or adopt healthy lifestyles.
1060	(13)  "Youth" means children and young adults, up through
1061	24 years of age, inclusive.
1062	Section 19.  Section 385.1022, Florida Statutes, is created
1063	to read:
1064	385.1022  Chronic disease prevention program.--The
1065	department shall support public health programs to reduce the
1066	incidence of mortality and morbidity from diseases for which
1067	risk factors can be identified. Such risk factors include, but
1068	are not limited to, being overweight or obese, physical
1069	inactivity, poor nutrition and diet, tobacco use, sun exposure,
1070	and other practices that are detrimental to health. The programs
1071	shall educate and screen the general public as well as groups at
1072	particularly high risk of chronic diseases.
1073	Section 20.  Section 385.1023, Florida Statutes, is created
1074	to read:
1075	385.1023  State-level prevention programs for chronic
1076	disease.--
1077	(1)  The department shall create state-level programs that
1078	address the leading, preventable chronic disease risk factors of
1079	poor nutrition and obesity, tobacco use, sun exposure, and
1080	physical inactivity in order to decrease the incidence of
1081	arthritis, cancer, diabetes, heart disease, lung disease,
1082	stroke, and other chronic diseases.
1083	(2)  State-level programs shall address, but need not be
1084	limited to, the following activities:
1085	(a)  Monitoring specific causal and behavioral risk factors
1086	that affect the health of residents in the state.
1087	(b)  Analyzing data regarding chronic disease mortality and
1088	morbidity to track changes over time.
1089	(c)  Promoting public awareness and increasing knowledge
1090	concerning the causes of chronic diseases, the importance of
1091	early detection, diagnosis, and appropriate evidence-based
1092	prevention, management, and treatment strategies.
1093	(d)  Disseminating educational materials and information
1094	concerning evidence-based results, available services, and
1095	pertinent new research findings and prevention strategies to
1096	patients, health insurers, health professionals, and the public.
1097	(e)  Using education and training resources and services
1098	developed by organizations having appropriate expertise and
1099	knowledge of chronic diseases for technical assistance.
1100	(f)  Evaluating the quality and accessibility of existing
1101	community-based services for chronic disease.
1102	(g)  Increasing awareness among state and local officials
1103	involved in health and human services, health professionals and
1104	providers, and policymakers about evidence-based chronic-disease
1105	prevention, tobacco cessation, and treatment strategies and
1106	their benefits for people who have chronic diseases.
1107	(h)  Developing a partnership with state and local
1108	governments, voluntary health organizations, hospitals, health
1109	insurers, universities, medical centers, employer groups,
1110	private companies, and health care providers to address the
1111	burden of chronic disease in this state.
1112	(i)  Implementing and coordinating state-level policies in
1113	order to reduce the burden of chronic disease.
1114	(j)  Providing lasting improvements in the delivery of
1115	health care for individuals who have chronic disease and their
1116	families, thus improving their quality of life while also
1117	containing health care costs.
1118	Section 21.  Section 385.103, Florida Statutes, is amended
1119	to read:
1120	385.103  Community-level Community intervention programs
1121	for chronic disease prevention and health promotion.--
1122	(1)  DEFINITIONS.--As used in this section, the term:
1123	(a)  "Chronic disease prevention and health promotion
1124	control program" means a program that may include, but is not
1125	limited to, including a combination of the following elements:
1126	1.  Staff who are sufficiently trained and skilled in
1127	public health, community health, or school health education to
1128	facilitate the operation of the program Health screening;
1129	2.  Community input into the planning, implementation, and
1130	evaluation processes Risk factor detection;
1131	3.  Use of public health data to make decisions and to
1132	develop and prioritize community-based interventions focusing on
1133	chronic diseases and their risk factors; Appropriate
1134	intervention to enable and encourage changes in behaviors that
1135	create health risks; and
1136	4.  Adherence to a population-based approach by using a
1137	socioecological model that addresses the influence on individual
1138	behavior, interpersonal behavior, organizational behavior, the
1139	community, and public policy; Counseling in nutrition, physical
1140	activity, the effects of tobacco use, hypertension, blood
1141	pressure control, and diabetes control and the provision of
1142	other clinical prevention services.
1143	5.  Focus on at least the common preventable risk factors
1144	for chronic disease, such as physical inactivity, obesity, poor
1145	nutrition, and tobacco use;
1146	6.  Focus on developing and implementing interventions and
1147	activities through communities, schools, worksites, faith-based
1148	organizations, and health-care settings;
1149	7.  Use of evidence-based interventions as well as best and
1150	promising practices to guide specific activities and effect
1151	change, which may include guidelines developed by organizations,
1152	volunteer scientists, and health care professionals who write
1153	published medical, scientific statements on various chronic
1154	disease topics. The statements shall be supported by scientific
1155	studies published in recognized journals that have a rigorous
1156	review and approval process. Scientific statements generally
1157	include a review of data available on a specific subject and an
1158	evaluation of its relationship to overall chronic disease
1159	science;
1160	8.  Use of policy, system, and environmental changes that
1161	support healthy behaviors so as to affect large segments of the
1162	population and encourage healthy choices;
1163	9.  Development of extensive and comprehensive evaluation
1164	that is linked to program planning at the state level and the
1165	community level in order to determine the program's
1166	effectiveness or necessary program modifications; and
1167	10.  Reduction of duplication of efforts through
1168	coordination among appropriate entities for the efficient use of
1169	resources.
1170	(b)  "Community Health education program" means a program
1171	that follows involving the planned and coordinated use of the
1172	educational standards and teaching methods resources available
1173	in a community in an effort to provide:
1174	1.  Appropriate medical, research-based interventions to
1175	enable and encourage changes in behaviors which reduce or
1176	eliminate health risks;
1177	2.  Counseling in nutrition, weight management, physical
1178	inactivity, and tobacco-use prevention and cessation strategies;
1179	hypertension, blood pressure, high cholesterol, and diabetes
1180	control; and other clinical prevention services;
1181	3.1.  Motivation and assistance to individuals or groups in
1182	adopting and maintaining Motivate and assist citizens to adopt
1183	and maintain healthful practices and lifestyles; and
1184	4.2.  Make available Learning opportunities that which will
1185	increase the ability of people to make informed decisions
1186	affecting their personal, family, and community well-being and
1187	that which are designed to facilitate voluntary adoption of
1188	behavior that which will improve or maintain health.;
1189	3.  Reduce, through coordination among appropriate
1190	agencies, duplication of health education efforts; and
1191	4.  Facilitate collaboration among appropriate agencies for
1192	efficient use of scarce resources.
1193	(c)  "Community intervention program" means a program
1194	combining the required elements of a chronic disease prevention
1195	and health promotion control program and the principles of a
1196	community health education program that addresses system,
1197	policy, and environmental changes that ensure that communities
1198	provide support for healthy lifestyles into a unified program
1199	over which a single administrative entity has authority and
1200	responsibility.
1201	(d)  "Department" means the Department of Health.
1202	(e)  "Risk factor" means a factor identified during the
1203	course of an epidemiological study of a disease, which factor
1204	appears to be statistically associated with a high incidence of
1205	that disease.
1206	(2)  OPERATION OF COMMUNITY-LEVEL COMMUNITY INTERVENTION
1207	PROGRAMS FOR CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION.--
1208	(a)  The department shall develop and implement a
1209	comprehensive, community-based program for chronic disease
1210	prevention and health promotion. The program shall be designed
1211	to reduce major behavioral risk factors that are associated with
1212	chronic diseases by enhancing the knowledge, skills, motivation,
1213	and opportunities for individuals, organizations, health care
1214	providers, small businesses, health insurers, and communities to
1215	develop and maintain healthy lifestyles. The department shall
1216	assist the county health departments in developing and operating
1217	community intervention programs throughout the state. At a
1218	minimum, the community intervention programs shall address one
1219	to three of the following chronic diseases: cancer, diabetes,
1220	heart disease, stroke, hypertension, renal disease, and chronic
1221	obstructive lung disease.
1222	(b)  The program shall include:
1223	1.  Countywide assessments of specific, causal, and
1224	behavioral risk factors that affect the health of residents;
1225	2.  The development of community-based programs for chronic
1226	disease prevention and health promotion which incorporate health
1227	promotion and preventive care practices that are supported in
1228	scientific and medical literature;
1229	3.  The development and implementation of statewide age-
1230	specific, disease-specific, and community-specific health
1231	promotion and preventive care strategies using primary,
1232	secondary, and tertiary prevention interventions;
1233	4.  The promotion of community, research-based health-
1234	promotion model programs that meet specific criteria, address
1235	major risk factors, and motivate individuals to permanently
1236	adopt healthy behaviors and increase social and personal
1237	responsibilities;
1238	5.  The development of policies that encourage the use of
1239	alternative community delivery sites for health promotion,
1240	disease prevention, and preventive care programs and promote the
1241	use of neighborhood delivery sites that are close to work, home,
1242	and school; and
1243	6.  An emphasis on the importance of healthy and physically
1244	active lifestyles to build self-esteem and reduce morbidity and
1245	mortality associated with chronic disease and being overweight
1246	or obese. Existing community resources, when available, shall be
1247	used to support the programs. The department shall seek funding
1248	for the programs from federal and state financial assistance
1249	programs which presently exist or which may be hereafter
1250	created. Additional services, as appropriate, may be
1251	incorporated into a program to the extent that resources are
1252	available. The department may accept gifts and grants in order
1253	to carry out a program.
1254	(c)  Volunteers shall be used to the maximum extent
1255	possible in carrying out the programs. The department shall
1256	contract for the necessary insurance coverage to protect
1257	volunteers from personal liability while acting within the scope
1258	of their volunteer assignments under a program.
1259	(d)  The department may contract for the provision of all
1260	or any portion of the services required by a program, and shall
1261	so contract whenever the services so provided are more cost-
1262	efficient than those provided by the department.
1263	(e)  If the department determines that it is necessary for
1264	clients to help pay for services provided by a program, the
1265	department may require clients to make contribution therefor in
1266	either money or personal services. The amount of money or value
1267	of the personal services shall be fixed according to a fee
1268	schedule established by the department or by the entity
1269	developing the program. In establishing the fee schedule, the
1270	department or the entity developing the program shall take into
1271	account the expenses and resources of a client and his or her
1272	overall ability to pay for the services.
1273	Section 22.  Section 385.105, Florida Statutes, is created
1274	to read:
1275	385.105  Physical activity, obesity prevention, nutrition,
1276	other health-promotion services, and wellness programs.--
1277	(1)  PHYSICAL ACTIVITY--.
1278	(a)  The department shall develop programs for people at
1279	every stage of their lives to increase physical fitness and
1280	promote behavior changes.
1281	(b)  The department shall work with school health advisory
1282	or wellness committees in each school district as established in
1283	s. 381.0056.
1284	(c)  The department shall develop public and private
1285	partnerships that allow the public to easily access recreational
1286	facilities and public land areas that are suitable for physical
1287	activity.
1288	(d)  The department shall work in collaboration with the
1289	Executive Office of the Governor and Volunteer Florida, Inc., to
1290	promote school initiatives, such as the Governor's Fitness
1291	Challenge.
1292	(e)  The department shall collaborate with the Department
1293	of Education in recognizing nationally accepted best practices
1294	for improving physical education in schools.
1295	(2)  OBESITY PREVENTION.--The department shall promote
1296	healthy lifestyles to reduce the prevalence of excess weight
1297	gain and being overweight or obese through programs that are
1298	directed towards all residents of this state by:
1299	(a)  Using all appropriate media to promote maximum public
1300	awareness of the latest research on healthy lifestyles and
1301	chronic diseases and disseminating relevant information through
1302	a statewide clearinghouse relating to wellness, physical
1303	activity, and nutrition and the effect of these factors on
1304	chronic diseases and disabling conditions.
1305	(b)  Providing technical assistance, training, and
1306	resources on healthy lifestyles and chronic diseases to the
1307	public, health care providers, school districts, and other
1308	persons or entities, including faith-based organizations that
1309	request such assistance to promote physical activity, nutrition,
1310	and healthy lifestyle programs.
1311	(c)  Developing, implementing, and using all available
1312	research methods to collect data, including, but not limited to,
1313	population-specific data, and tracking the incidence and effects
1314	of weight gain, obesity, and related chronic diseases. The
1315	department shall include an evaluation and data-collection
1316	component in all programs as appropriate. All research conducted
1317	under this paragraph is subject to review and approval as
1318	required by the department's institutional review board under s.
1319	381.86.
1320	(d)  Entering into partnerships with the Department of
1321	Education, local communities, school districts, and other
1322	entities to encourage schools in this state to promote
1323	activities during and after school to help students meet a
1324	minimum goal of 30 minutes of physical activity or physical
1325	fitness per day.
1326	(e)  Entering into partnerships with the Department of
1327	Education, school districts, and the Florida Sports Foundation
1328	to develop a programs recognizing the schools at which students
1329	demonstrate excellent physical fitness or fitness improvement.
1330	(f)  Collaborating with other state agencies to develop
1331	policies and strategies for preventing and treating obesity,
1332	which shall be incorporated into programs administered by each
1333	agency and shall include promoting healthy lifestyles of
1334	employees of each agency.
1335	(g)  Advising, in accordance with s. 456.081, health care
1336	practitioners about the morbidity, mortality, and costs
1337	associated with being overweight or obese, informing such
1338	practitioners of promising clinical practices for preventing and
1339	treating obesity, and encouraging practitioners to counsel their
1340	patients regarding the adoption of healthy lifestyles.
1341	(h)  Maximizing all local, state, and federal funding
1342	sources, including grants, public-private partnerships, and
1343	other mechanisms to strengthen the department's programs
1344	promoting physical activity and nutrition.
1345	(3)  NUTRITION.--The department shall promote optimal
1346	nutritional status in all stages of people's lives by developing
1347	strategies to:
1348	(a)  Promote and maintain optimal nutritional status in the
1349	population through activities, including, but not limited to:
1350	1.  Nutrition screening and assessment and nutrition
1351	counseling, including nutrition therapy, followup, case
1352	management, and referrals for persons who have medical
1353	conditions or nutrition-risk factors and who are provided health
1354	services through public health programs or through referrals
1355	from private health care providers or facilities;
1356	2.  Nutrition education to assist residents of the state in
1357	achieving optimal health and preventing chronic disease; and
1358	3.  Consultative nutrition services to group facilities
1359	which promote the provision of safe and nutritionally adequate
1360	diets.
1361	(b)  Monitor and conduct surveillance of the nutritional
1362	status of this state's population.
1363	(c)  Conduct or support research or evaluations related to
1364	public health nutrition. All research conducted under this
1365	paragraph is subject to review and approval as required by the
1366	department's institutional review board under s. 381.86.
1367	(d)  Establish policies and standards for public health
1368	nutrition practices.
1369	(e)  Promote interagency cooperation, professional
1370	education, and consultation.
1371	(f)  Provide technical assistance and advise state
1372	agencies, private institutions, and local organizations
1373	regarding public health nutrition standards.
1374	(g)  Work with the Department of Agriculture and Consumer
1375	Services, the Department of Education, and the Department of
1376	Management Services to further the use of fresh produce from
1377	this state in schools and encourage the development of community
1378	gardens. Nutritional services shall be available to eligible
1379	persons in accordance with eligibility criteria adopted by the
1380	department. The department shall provide by rule requirements
1381	for the service fees, when applicable, which may not exceed the
1382	department's actual costs.
1383
1384	The department may adopt rules to administer this subsection.
1385	(4)  OTHER HEALTH-PROMOTION SERVICES.--
1386	(a)  The department shall promote personal responsibility
1387	by encouraging residents of this state to be informed, follow
1388	health recommendations, seek medical consultations and health
1389	assessments, take healthy precautions, and comply with medical
1390	guidelines, including those that lead to earlier detection of
1391	chronic diseases in order to prevent chronic diseases or slow
1392	the progression of established chronic diseases.
1393	(b)  The department shall promote regular health visits
1394	during a person's lifetime, including annual physical
1395	examinations that include measuring body mass index and vital
1396	signs, blood work, immunizations, screenings, and dental
1397	examinations in order to reduce the financial, social, and
1398	personal burden of chronic disease.
1399	(5)  WELLNESS PROGRAMS.--
1400	(a)  Each state agency may conduct employee wellness
1401	programs in buildings and lands owned or leased by the state.
1402	The department shall serve as a model to develop and implement
1403	employee wellness programs that may include physical fitness,
1404	healthy nutrition, self-management of disease, education, and
1405	behavioral change. The department shall assist other state
1406	agencies to develop and implement employee wellness programs.
1407	These programs shall use existing resources, facilities, and
1408	programs or resources procured through grant funding and
1409	donations that are obtained in accordance with state ethics and
1410	procurement policies, and shall provide equal access to any such
1411	programs, resources, and facilities to all state employees.
1412	(b)  The department shall coordinate its efforts with the
1413	Department of Management Services and other state agencies.
1414	(c)  Each agency may establish an employee wellness work
1415	group to design the program. The department shall be available
1416	to provide policy guidance and assist in identifying effective
1417	wellness program strategies.
1418	(d)  The department shall provide by rule requirements for
1419	nominal participation fees, when applicable, which may not
1420	exceed the department's actual costs; collaborations with
1421	businesses; and the procurement of equipment and incentives.
1422	Section 23.  Section 385.202, Florida Statutes, is amended
1423	to read:
1424	385.202  Statewide cancer registry.--
1425	(1)  Each facility, laboratory, or practitioner licensed
1426	under chapter 395, chapter 458, chapter 459, chapter 464,
1427	chapter 483, and each freestanding radiation therapy center as
1428	defined in s. 408.07, shall report to the department of Health
1429	such information, specified by the department, by rule. The
1430	department may adopt rules regarding reporting requirements for
1431	the cancer registry, which shall include the data required, the
1432	timeframe for reporting, and those professionals who are
1433	responsible for ensuring compliance with reporting requirements,
1434	which indicates diagnosis, stage of disease, medical history,
1435	laboratory data, tissue diagnosis, and radiation, surgical, or
1436	other methods of diagnosis or treatment for each cancer
1437	diagnosed or treated by the facility or center. Failure to
1438	comply with this requirement may be cause for registration or
1439	licensure suspension or revocation.
1440	(2)  The department shall establish, or cause to have
1441	established, by contract with a recognized medical organization
1442	in this state and its affiliated institutions, a statewide
1443	cancer registry program to ensure that cancer reports required
1444	under this section shall be maintained and available for use in
1445	the course of public health surveillance and any study for the
1446	purpose of reducing morbidity or mortality; and no liability of
1447	any kind or character for damages or other relief shall arise or
1448	be enforced against any facility or practitioner hospital by
1449	reason of having provided such information or material to the
1450	department.
1451	(3)  The department may adopt rules regarding the
1452	establishment and operation of a statewide cancer registry
1453	program.
1454	(4)(3)  The department or a contractual designee operating
1455	the statewide cancer registry program required by this section
1456	shall use or publish said material only for the purpose of
1457	public health surveillance and advancing medical research or
1458	medical education in the interest of reducing morbidity or
1459	mortality, except that a summary of such studies may be released
1460	for general publication. Information which discloses or could
1461	lead to the disclosure of the identity of any person whose
1462	condition or treatment has been reported and studied shall be
1463	confidential and exempt from the provisions of s. 119.07(1),
1464	except that:
1465	(a)  Release may be made with the written consent of all
1466	persons to whom the information applies;
1467	(b)  The department or a contractual designee may contact
1468	individuals for the purpose of epidemiologic investigation and
1469	monitoring, provided information that is confidential under this
1470	section is not further disclosed; or
1471	(c)  The department may exchange personal data with any
1472	other governmental agency or a contractual designee for the
1473	purpose of public health surveillance and medical or scientific
1474	research, if provided such governmental agency or contractual
1475	designee does shall not further disclose information that is
1476	confidential under this section.
1477	(5)(4)  Funds appropriated for this section shall be used
1478	for establishing, administering, compiling, processing, and
1479	providing biometric and statistical analyses to the reporting
1480	facilities and practitioners. Funds may also be used to ensure
1481	the quality and accuracy of the information reported and to
1482	provide management information to the reporting facilities and
1483	practitioners.
1484	(6)(5)  The department may adopt rules regarding the
1485	classifications of, by rule, classify facilities that are
1486	responsible for making reports to the cancer registry, the
1487	content and frequency of the reports, and the penalty for
1488	failure to comply with these requirements for purposes of
1489	reports made to the cancer registry and specify the content and
1490	frequency of the reports. In classifying facilities, the
1491	department shall exempt certain facilities from reporting cancer
1492	information that was previously reported to the department or
1493	retrieved from existing state reports made to the department or
1494	the Agency for Health Care Administration. The provisions of
1495	This section does shall not apply to any facility whose primary
1496	function is to provide psychiatric care to its patients.
1497	(7)  Notwithstanding subsection (1), each facility and
1498	practitioner that reports cancer cases to the department shall
1499	make their records available for onsite review by the department
1500	or its authorized representative.
1501	Section 24.  Subsection (3) of section 385.203, Florida
1502	Statutes, is amended to read:
1503	385.203  Diabetes Advisory Council; creation; function;
1504	membership.--
1505	(3)  The council shall be composed of 26 25 citizens of the
1506	state who have knowledge of, or work in, the area of diabetes
1507	mellitus as follows:
1508	(a)  Five interested citizens, three of whom are affected
1509	by diabetes.
1510	(b)  Twenty-one Twenty members, who must include one
1511	representative from each of the following areas: nursing with
1512	diabetes-educator certification; dietary with diabetes educator
1513	certification; podiatry; ophthalmology or optometry; psychology;
1514	pharmacy; adult endocrinology; pediatric endocrinology; the
1515	American Diabetes Association (ADA); the Juvenile Diabetes
1516	Foundation (JDF); the Florida Academy of Family Physicians; a
1517	community health center; a county health department; an American
1518	Diabetes Association recognized community education program;
1519	each medical school in the state; an osteopathic medical school;
1520	the insurance industry; a Children's Medical Services diabetes
1521	regional program; and an employer.
1522	(c)  One or more representatives from the Department of
1523	Health, who shall serve on the council as ex officio members.
1524	Section 25.  Section 385.206, Florida Statutes, is amended
1525	to read:
1526	385.206  Pediatric Hematology-Oncology care Center
1527	Program.--
1528	(1)  DEFINITIONS.--As used in this section, the term:
1529	(a)  "Department" means the Department of Health.
1530	(b)  "Hematology" means the study, diagnosis, and treatment
1531	of blood and blood-forming tissues.
1532	(c)  "Oncology" means the study, diagnosis, and treatment
1533	of malignant neoplasms or cancer.
1534	(d)  "Hemophilia" or "other hemostatic disorder" means a
1535	bleeding disorder resulting from a genetic abnormality of
1536	mechanisms related to the control of bleeding.
1537	(e)  "Sickle-cell anemia or other hemoglobinopathy" means
1538	an hereditary, chronic disease caused by an abnormal type of
1539	hemoglobin.
1540	(f)  "Patient" means a person under the age of 21 who is in
1541	need of hematologic-oncologic services and who is enrolled in
1542	the Children's Medical Services Network declared medically and
1543	financially eligible by the department; or a person who received
1544	such services prior to age 21 and who requires long-term
1545	monitoring and evaluation to ascertain the sequelae and the
1546	effectiveness of treatment.
1547	(g)  "Center" means a facility designated by the department
1548	as having a program specifically designed to provide a full
1549	range of medical and specialty services to patients with
1550	hematologic and oncologic disorders.
1551	(2)  PEDIATRIC HEMATOLOGY-ONCOLOGY CARE CENTER PROGRAM;
1552	AUTHORITY.--The department may designate is authorized to make
1553	grants and reimbursements to designated centers and provide
1554	funding to establish and maintain programs for the care of
1555	patients with hematologic and oncologic disorders. Program
1556	administration costs shall be paid by the department from funds
1557	appropriated for this purpose.
1558	(3)  GRANT FUNDING CONTRACTS GRANT AGREEMENTS;
1559	CONDITIONS.--
1560	(a)  Funding provided A grant made under this section shall
1561	be pursuant to a contract contractual agreement made between a
1562	center and the department. Each contract agreement shall provide
1563	that patients will receive services specified types of treatment
1564	and care from the center without additional charge to the
1565	patients or their parents or guardians. Grants shall be
1566	disbursed in accordance with conditions set forth in the
1567	disbursement guidelines.
1568	(4)  GRANT DISBURSEMENTS AND SPECIAL DISBURSEMENTS FOR
1569	LOCAL PROGRAMS.--
1570	(b)(a)  Funding may be provided Grant disbursements may be
1571	made to centers that which meet the following criteria:
1572	1.  The personnel shall include at least one board-
1573	certified pediatric hematologist-oncologist, at least one board-
1574	certified pediatric surgeon, at least one board-certified
1575	radiotherapist, and at least one board-certified pathologist.
1576	2.  As approved by the department, The center shall
1577	actively participate in a national children's cancer study
1578	group, maintain a pediatric tumor registry, have a
1579	multidisciplinary pediatric tumor board, and meet other
1580	guidelines for development, including, but not limited to,
1581	guidelines from such organizations as the American Academy of
1582	Pediatrics and the American Pediatric Surgical Association.
1583	(b)  Programs shall also be established to provide care to
1584	hematology-oncology patients within each district of the
1585	department. The guidelines for local programs shall be
1586	formulated by the department. Special disbursements may be made
1587	by the program office to centers for educational programs
1588	designed for the districts of the department. These programs may
1589	include teaching total supportive care of the dying patient and
1590	his or her family, home therapy to hemophiliacs and patients
1591	with other hemostatic disorders, and screening and counseling
1592	for patients with sickle-cell anemia or other
1593	hemoglobinopathies.
1594	(4)(5)  PROGRAM AND PEER REVIEW.--The department shall
1595	evaluate at least annually during the grant period the services
1596	rendered by the centers and the districts of the department.
1597	Data from the centers and other sources relating to pediatric
1598	cancer shall be reviewed annually by the Florida Association of
1599	Pediatric Tumor Programs, Inc.; and a written report with
1600	recommendations shall be made to the department. This database
1601	will be available to the department for program planning and
1602	quality assurance initiatives formulation of its annual program
1603	and financial evaluation report. A portion of the funds
1604	appropriated for this section may be used to provide statewide
1605	consultation, supervision, and evaluation of the programs of the
1606	centers, as well as central program office support personnel.
1607	Section 26.  Paragraph (g) of subsection (2) and subsection
1608	(7) of section 385.207, Florida Statutes, are amended to read:
1609	385.207  Care and assistance of persons with epilepsy;
1610	establishment of programs in epilepsy control.--
1611	(2)  The Department of Health shall:
1612	(g)  Continue current programs and develop cooperative
1613	programs and services designed to enhance the vocational
1614	rehabilitation of epilepsy clients, including the current jobs
1615	programs. The department shall, as part of its contract with a
1616	provider of epilepsy services, collect information regarding the
1617	number of clients served, the outcomes reached, the expenses
1618	incurred, and the fees collected by such providers for the
1619	provision of services keep and make this information available
1620	to the Governor and the Legislature upon request information
1621	regarding the number of clients served, the outcome reached, and
1622	the expense incurred by such programs and services.
1623	(7)  The department shall limit total administrative
1624	expenditures from the Epilepsy Services Trust Fund to 5 percent
1625	of annual receipts.
1626	Section 27.  Paragraphs (b), (d), and (g) of subsection (2)
1627	and paragraph (b) of subsection (5) of section 385.210, Florida
1628	Statutes, are amended to read:
1629	385.210  Arthritis prevention and education.--
1630	(2)  LEGISLATIVE FINDINGS.--The Legislature finds the
1631	following:
1632	(b)  Arthritis is the leading cause of disability in the
1633	United States, limiting daily activities for more than 19 7
1634	million citizens.
1635	(d)  There are enormous economic and social costs
1636	associated with treating arthritis and its complications; the
1637	economic costs are estimated at over $128 billion (2003) $116
1638	billion (1997) annually in the United States.
1639	(g)  The National Arthritis Foundation, the CDC Centers for
1640	Disease Control and Prevention, and the Association of State and
1641	Territorial Health Officials have led the development of a
1642	public health strategy, the National Arthritis Action Plan, to
1643	respond to this challenge.
1644	(5)  FUNDING.--
1645	(b)  The State Surgeon General may shall seek any federal
1646	waiver or waivers that may be necessary to maximize funds from
1647	the Federal Government to implement this program.
1648	Section 28.  Section 385.301, Florida Statutes, is created
1649	to read:
1650	385.301  Rulemaking authority.--The department may adopt
1651	rules pursuant to chapter 120 to administer this chapter.
1652	Section 29.  Subsection (9) of section 409.904, Florida
1653	Statutes, is amended to read:
1654	409.904  Optional payments for eligible persons.--The
1655	agency may make payments for medical assistance and related
1656	services on behalf of the following persons who are determined
1657	to be eligible subject to the income, assets, and categorical
1658	eligibility tests set forth in federal and state law. Payment on
1659	behalf of these Medicaid eligible persons is subject to the
1660	availability of moneys and any limitations established by the
1661	General Appropriations Act or chapter 216.
1662	(9)  Eligible women with incomes at or below 200 percent of
1663	the federal poverty level and under age 65, for cancer treatment
1664	pursuant to the federal Breast and Cervical Cancer Prevention
1665	and Treatment Act of 2000, screened through the Mary Brogan
1666	Breast and Cervical Cancer Early Detection Program established
1667	under s. 385.2021 s. 381.93.
1668	Section 30.  The Pharmacy and Therapeutic Advisory
1669	Council.--
1670	(1)  The Pharmacy and Therapeutic Advisory Council is
1671	created within the Executive Office of the Governor to serve in
1672	an advisory capacity to the Department of Health and other
1673	governmental agencies. The council may not interfere with
1674	existing mandated Medicaid services and may not develop or
1675	implement new ones. Specifically, the council may not interfere
1676	with the work of the Agency for Health Care Administration as it
1677	complies with federal and state statutory obligations to develop
1678	a preferred drug list, to negotiate rebate agreements for
1679	medications included in the preferred drug list, and to protect
1680	the confidentiality of rebate agreements. The council may not
1681	interfere with the Medicaid Pharmacy and Therapeutics Committee
1682	or the Drug Utilization Review Board, which oversee clinical
1683	activities within the Bureau of Pharmacy Services if such
1684	interference would violate any federal or state statutory
1685	obligations.
1686	(2)  The Pharmacy and Therapeutic Advisory Council shall
1687	use Medicaid processes within the existing Medicaid structure of
1688	the Agency for Health Care Administration as a guide for
1689	assisting state agencies in:
1690	(a)  Developing an unbiased clinical perspective on drug
1691	evaluations and utilization protocols that are relevant to
1692	patient care provided through programs administered by state
1693	agencies.
1694	(b)  Developing drug-utilization-review processes that are
1695	relevant to the agencies and those receiving care through
1696	programs administered by the agencies.
1697	(c)  Building a formulary structure that enforces formulary
1698	compliance or adherence within each agency.
1699	(d)  Performing pharmacoeconomic analyses on formulary
1700	management so that the state maximizes the cost-effectiveness of
1701	its pharmaceutical purchasing.
1702	(e)  Reviewing new and existing therapies using criteria
1703	established for efficacy, safety, and quality in order to
1704	maximize cost-effective purchasing.
1705	(f)  Reviewing state agency proposals to maximize the cost-
1706	effectiveness of pharmaceutical purchasing in compliance with s.
1707	381.0203.
1708	(3) The council shall verify the cost-effectiveness and
1709	clinical efficacy of any state contracts under s. 381.0203(1),
1710	Florida Statutes, no less than once every 2 years.
1711	(4)  The members of the council and the chair shall be
1712	appointed by the Governor to 4-year staggered terms or until
1713	their successors are appointed. Members may be appointed to more
1714	than one term. The Governor shall fill any vacancies for the
1715	remainder of the unexpired term in the same manner as the
1716	original appointment.
1717	(5)  The council shall include voting and nonvoting
1718	members, and the chair, who is a voting member, must be a
1719	pharmacist employed by a state agency.
1720	(a)  The voting members shall represent:
1721	1.  The Agency for Health Care Administration.
1722	2.  The Agency for Persons with Disabilities.
1723	3.  The Department of Children and Family Services.
1724	4.  The Department of Corrections.
1725	5.  The Department of Elderly Affairs.
1726	6.  The Department of Health.
1727	7.  The Department of Juvenile Justice.
1728	8.  The Bureau of Pharmacy Services within the Agency for
1729	Health Care Administration, which shall be represented by the
1730	bureau chief.
1731	9.  The Bureau of Statewide Pharmaceutical Services within
1732	the Department of Health, which shall be represented by the
1733	bureau chief.
1734	(b)  The nonvoting members shall be:
1735	1.  A representative from the Agency for Health Care
1736	Administration's drug contracting program.
1737	2.  The contracting officer for the Department of Health's
1738	drug procurement program.
1739	3.  A clinical pharmacy program manager from the Agency for
1740	Health Care Administration.
1741	4.  The chair of the Department of Health's Pharmacy and
1742	Therapeutics Committee.
1743	5.  The general counsel for the Agency for Health Care
1744	Administration or his or her designee.
1745	6.  The general counsel for a state agency in the executive
1746	branch of state government, or his or her designee.
1747	7.  A representative from the Executive Office of the
1748	Governor.
1749	8.  The statewide pharmacy director of the Department of
1750	Corrections' Office of Health Services.
1751	(6)  Members of the council shall consist of at least one
1752	physician licensed under chapter 458 or chapter 459, Florida
1753	Statutes, at least one pharmacist licensed under chapter 465,
1754	Florida Statutes, and at least one registered nurse licensed
1755	under chapter 464, Florida Statutes. Each member designated in
1756	this subsection must have an active license in his or her
1757	profession and may not have been the subject of any agency
1758	disciplinary action.
1759	(7)  Members, who must be residents of this state, shall be
1760	selected on the basis of specialty, board certification, prior
1761	pharmacy and therapeutic experience, experience treating medical
1762	assistance recipients, ability to represent a broad base of
1763	constituents, and number of years of practice. Members must not
1764	have any conflicts of interest due to their service on the
1765	council.
1766	(8)  The council may request the participation of
1767	additional subject-matter experts to address specific drug,
1768	therapeutic, or drug-procurement issues under review by the
1769	council.
1770	(9)  A majority of the members of the council constitutes a
1771	quorum, and an affirmative vote of a majority of the voting
1772	members is necessary to take action.
1773	(10)  The council shall meet quarterly or at the call of
1774	the chair.
1775	(11)  The council shall be staffed by the chair's
1776	department or agency.
1777	(12)  The council members shall serve without compensation,
1778	but are entitled to reimbursement for travel and per diem
1779	expenses incurred in the performance of their duties in
1780	accordance with s. 112.061, Florida Statutes.
1781	Section 31.  Paragraph (g) is added to subsection (53) of
1782	section 499.003, Florida Statutes, to read:
1783	499.003  Definitions of terms used in this part.--As used
1784	in this part, the term:
1785	(53)  "Wholesale distribution" means distribution of
1786	prescription drugs to persons other than a consumer or patient,
1787	but does not include:
1788	(g)  The sale, purchase, trade, or transfer of a
1789	prescription drug among agencies and health care entities of the
1790	state to complete the dispensing of the prescription drug to a
1791	patient under the care of a state agency or health care entity,
1792	or to a patient for whom the state is responsible for providing
1793	or arranging health care services. The agency or health care
1794	entity that received the prescription drug on behalf of the
1795	patient is deemed the patient's agent under s. 465.003(6).
1796	Section 32.  This act shall take effect July 1, 2009.

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