Florida Senate - 2009                                    SB 1840
       
       
       
       By Senator Deutch
       
       
       
       
       30-00019D-09                                          20091840__
    1                        A bill to be entitled                      
    2         An act relating to health care; providing legislative
    3         findings and intent; amending s. 210.01, F.S.;
    4         defining the terms “council,” “total collections,” and
    5         “net collections”; amending s. 210.02, F.S.;
    6         increasing the amount of the cigarette tax by the
    7         equivalent of $1 per standard pack; amending s.
    8         210.18, F.S.; conforming a cross-reference; amending
    9         s. 210.20, F.S.; requiring that the Division of
   10         Alcoholic Beverages and Tobacco certify to the Chief
   11         Financial Officer monthly the amount of net
   12         collections derived from the cigarette tax; requiring
   13         that the division credit a specified percent of the
   14         total base allocation to certain trust funds, research
   15         centers, and medical residency and fellowship
   16         programs; providing that certain funds are subject to
   17         a funding match and may be used for bonding purposes
   18         if certain conditions are met; requiring that any
   19         funds that cannot be matched revert to the Biomedical
   20         Research Trust Fund; amending s. 210.201, F.S.;
   21         requiring that the Board of Directors of the H. Lee
   22         Moffitt Cancer Center and Research Institute use funds
   23         to secure bonds or financial products for cancer
   24         facilities; amending s. 215.5601, F.S.; revising
   25         provisions relating to the Lawton Chiles Endowment
   26         Fund; providing that moneys derived from the cigarette
   27         tax be allocated to the endowment during a specified
   28         fiscal year; increasing the number of members of the
   29         Lawton Chiles Endowment Fund Advisory Council;
   30         requiring that the council include a representative of
   31         a public health organization having a major interest
   32         in tobacco control and a consumer who is eligible for
   33         Medicaid benefits; amending s. 215.5602, F.S.;
   34         revising provisions relating to the James and Esther
   35         King Biomedical Research Program's long-term goals to
   36         include the expansion of research capacity and
   37         infrastructure needed to address tobacco-related
   38         illnesses; providing funding for the program's
   39         operating costs; extending certain expiration dates;
   40         amending s. 318.0302, F.S.; revising provisions
   41         relating to the Florida Health Services Corps;
   42         requiring that the Department of Health give priority
   43         to students who indicate a desire to practice certain
   44         medical specialties when selecting students for public
   45         health program scholarships; authorizing the
   46         department to increase stipends if the funds are
   47         sufficient; creating s. 381.04035, F.S.; creating the
   48         Graduate Medical Education Workforce Act; providing
   49         legislative findings and intent; establishing a
   50         program for funding graduate medical education
   51         positions within the Department of Health; providing
   52         funding for hospitals for costs associated with
   53         internship, residency, and fellowship positions;
   54         requiring that participating hospitals submit an
   55         annual report to the department and the Graduate
   56         Medical Education Council; establishing a program for
   57         funding graduate medical education programs and
   58         academic centers of excellence within the department;
   59         providing funding for hospitals, universities, and
   60         other sponsoring entities that apply to participate in
   61         the program; requiring participants to submit an
   62         annual report; creating the Graduate Medical Education
   63         Council; providing for membership and terms; requiring
   64         that the Governor make initial appointments by a
   65         specified date; requiring that the State Surgeon
   66         General designate an administrator to serve as the
   67         council's staff director; requiring that the
   68         department perform certain oversight functions;
   69         providing criteria for the department to consider when
   70         evaluating requests for funding; requiring that the
   71         department establish reporting requirements; requiring
   72         that the funds for the program be used to match funds
   73         from a local or state governmental, hospital, or
   74         sponsoring entity source; providing for staffing;
   75         amending s. 381.4018, F.S.; revising provisions
   76         relating to assessing and developing the physician
   77         workforce to include the burden of cancer, heart, and
   78         lung diseases based on the state's demographics;
   79         requiring that the department consider physicians who
   80         practice certain medical specialties when developing
   81         the state strategic plan; amending s. 381.84, F.S.;
   82         revising the components of the Comprehensive Statewide
   83         Tobacco Education and Use Prevention Program relating
   84         to cessation programs, counseling, and treatment;
   85         requiring that a statewide toll-free cessation service
   86         include referrals to the Cover Florida Health Care
   87         Access Program; amending s. 381.855, F.S.; providing
   88         funding for the Florida Center for Universal Research
   89         to Eradicate Disease; revising provisions relating to
   90         the center's advisory council; amending s. 381.91,
   91         F.S.; revising provisions relating to the Jessie Trice
   92         Cancer Prevention Program; repealing ss. 381.92 and
   93         381.921, F.S., relating to the Florida Cancer Council;
   94         amending s. 381.922, F.S.; revising the purpose of the
   95         William G. “Bill” Bankhead, Jr., and David Coley
   96         Cancer Research Program to expand cancer research and
   97         treatment; requiring that a specified percentage of
   98         the program's annual allocation apply toward
   99         recruiting cancer researchers and institutions;
  100         providing goals for advancing cures for cancer;
  101         extending certain expiration dates; amending s.
  102         381.93, F.S.; revising provisions relating to the Mary
  103         Brogan Breast and Cervical Cancer Early Detection
  104         Program; providing that funds derived from the
  105         cigarette tax be used by the program; expanding
  106         enrollment in the program; amending s. 395.6061, F.S.;
  107         revising provisions relating to the rural hospital
  108         capital improvement grant program; authorizing rural
  109         hospitals to apply for funds derived from the
  110         cigarette tax; amending s. 408.9091, F.S.; revising
  111         provisions relating to the Cover Florida Health Care
  112         Access Program to conform to changes made by the act;
  113         providing that certain individuals who are
  114         participating in a smoking cessation program are
  115         eligible for a temporary premium subsidy; creating s.
  116         1009.675, F.S.; establishing the Nursing Education
  117         Enhancement Program to provide supplemental funding
  118         for public nursing education; providing for funding
  119         and the distribution of such funding; requiring that
  120         the Chancellor of the State University System and the
  121         Chancellor of the Community College System submit a
  122         report to the Governor and the Legislature by a
  123         specified date; authorizing the State University
  124         System and the State College System to adopt rules;
  125         amending s. 1009.68, F.S.; revising provisions
  126         relating to the Florida Minority Medical Education
  127         Program; requiring that the program provide
  128         scholarships to enable minority students to pursue a
  129         medical education at Florida Atlantic University, the
  130         University of Central Florida, or Florida
  131         International University; providing for the
  132         distribution of the scholarships; creating s. 1013.83,
  133         F.S.; establishing the Florida Medical School
  134         Facilities Program; requiring that the Board of
  135         Governors administer the program; requiring that the
  136         funds for the program be used to construct and equip
  137         state medical schools and other related facilities in
  138         the state; requiring that the Board of Governors
  139         solicit competitive proposals for the use of such
  140         funds; providing that preference be given to proposals
  141         demonstrating the greatest need in fulfilling the
  142         institution's core medical education mission and
  143         proposals representing collaborative or shared-use
  144         facilities; providing that the program be funded with
  145         proceeds derived from s. 210.20, F.S.; providing for
  146         expiration of the program; authorizing the Board of
  147         Governors to adopt rules; providing that the
  148         additional tax on cigarettes applies to existing
  149         inventory on the effective date of the act; requiring
  150         that each manufacturer, distributor, wholesaler, and
  151         vendor take an inventory of the cigarettes in its
  152         possession on the effective date of this act;
  153         requiring that the amount of such inventory be
  154         certified to the Division of Alcoholic Beverages and
  155         Tobacco of the Department of Business and Professional
  156         Regulation by a specified date; providing for
  157         penalties and interest for delinquent payments;
  158         requiring that the proceeds from the additional tax be
  159         deposited into the Cigarette Tax Collection Trust Fund
  160         and distributed as required in s. 210.20, F.S.;
  161         requiring that the Department of Health submit a
  162         report to the Governor and the Legislature by a
  163         specified date which contains an estimate of the
  164         financial impact of tobacco use and related illnesses
  165         on the economy and taxpayers; providing an effective
  166         date.
  167         
  168  Be It Enacted by the Legislature of the State of Florida:
  169         
  170         Section 1. (1)The Legislature finds that tobacco
  171  consumption, which is the cause of nearly one-third of all
  172  cancer deaths, contributes substantially to the state having the
  173  second-highest relative cancer burden in the nation. The
  174  Legislature further finds that tobacco consumption dramatically
  175  affects the state's Medicaid budget and creates a substantial
  176  deficit between the amount consumers pay in related excise taxes
  177  or privilege fees and the actual health care costs incurred by
  178  the state. Therefore, the Legislature intends to increase the
  179  amount of the tax on cigarettes, which must be at least
  180  commensurate with the projected governmental costs associated
  181  with the consumption of cigarettes. The Legislature also intends
  182  to apply the revenue derived from the tax to health care,
  183  specifically to:
  184         (a)Measures for which there is a connection between
  185  cigarette consumption and the revenue generated from such
  186  consumption; and
  187         (b)Measures aimed at making Florida the nation's leader in
  188  cancer and biomedical research.
  189         (2)The Legislature finds that the state’s medical service
  190  delivery infrastructure is falling woefully behind the capacity
  191  needed to address the inordinately high burden related to cancer
  192  and other diseases. In order to significantly improve the
  193  state's ability to serve the health care needs of its citizens,
  194  the Legislature intends to dramatically enhance the state’s core
  195  medical capacity, especially in rural and underserved areas,
  196  which ranges from nurses to medical practitioners in family
  197  practice and to key medical primary specialties such as
  198  oncology.
  199         (3)The Legislature finds that it is in the public interest
  200  to stimulate the state's economic activity in the fields of
  201  health care, biomedical research, and education by providing
  202  financial support to increase the amount and prominence of such
  203  programs and by providing financial inducements for medical,
  204  biomedical, and other healthcare-related businesses and research
  205  and educational facilities to expand in Florida. The Legislature
  206  further finds that the state’s previous investment in the
  207  expansion of biomedical research has already yielded substantial
  208  positive results for the state's economy and public welfare, and
  209  that it is crucial to build upon such success through immediate
  210  and strategic investment in capital projects and infrastructure
  211  necessary to support growth in the biomedical industry. The
  212  Legislature also finds that it is of critical importance to
  213  develop funding sources for such health care programs and
  214  infrastructure without burdening the general public with
  215  additional, unnecessary health care costs, and that such funding
  216  sources, to the extent possible, must be balanced against the
  217  demands placed upon the state’s overall cost of health care
  218  services, including, without limitation, the state’s budget for
  219  Medicaid and other indigent health care services.
  220         Section 2. Section 210.01, Florida Statutes, is amended to
  221  read:
  222         210.01 Definitions.—When used in this part, the term the
  223  following words shall have the meaning herein indicated:
  224         (1) “Cigarette” means any roll for smoking, except one of
  225  which the tobacco is fully naturally fermented, without regard
  226  to the kind of tobacco or other substances used in the inner
  227  roll or the nature or composition of the material in which the
  228  roll is wrapped, which is made wholly or in part of tobacco
  229  irrespective of size or shape and whether such tobacco is
  230  flavored, adulterated, or mixed with any other ingredient.
  231         (2) “Persons” means any individual, copartnership, society,
  232  club, association, corporation, joint stock company, and any
  233  combination of individuals and also an executor, administrator,
  234  receiver, trustee, or other fiduciary.
  235         (3) “Sale” means any transfer, exchange, or barter in any
  236  manner, or by any means whatever.
  237         (4) “Retail sale” or “sale at retail” means a sale to a
  238  consumer or to any person for any purpose other than resale.
  239         (5)“Dealer” means any wholesale dealer as hereinafter
  240  defined.
  241         (5)(6) “Wholesale dealer” or “dealer” means any person
  242  located inside or outside this state who sells cigarettes to
  243  retail dealers or other persons for purposes of resale only.
  244  Such term does shall not include any cigarette manufacturer,
  245  export warehouse proprietor, or importer with a valid permit
  246  under 26 U.S.C. s. 5712 if such person sells or distributes
  247  cigarettes in this state only to dealers who are agents and who
  248  hold valid and current permits under s. 210.15 or to any
  249  cigarette manufacturer, export warehouse proprietor, or importer
  250  who holds a valid and current permit under 26 U.S.C. s. 5712.
  251         (6)(7) “Retail dealer” means any person located inside or
  252  outside this state other than a wholesale dealer engaged in the
  253  business of selling cigarettes, including persons issued a
  254  permit pursuant to s. 569.003.
  255         (7)(8) “Package” means the individual package, box, or
  256  other container in or from which retail sales of cigarettes are
  257  normally made or intended to be made.
  258         (8)(9) “Agent” means any person authorized by the Division
  259  of Alcoholic Beverages and Tobacco to purchase and affix
  260  adhesive or meter stamps under this part.
  261         (9)(10) “Division” means the Division of Alcoholic
  262  Beverages and Tobacco of the Department of Business and
  263  Professional Regulation.
  264         (10)“Council” means the Biomedical Research Advisory
  265  Council within the Department of Health established in s.
  266  215.5602.
  267         (11) “Use” means the consuming, giving away, or disposing,
  268  in any manner, of cigarettes.
  269         (12) “First sale” means the first use or consumption of
  270  cigarettes within this state.
  271         (13) “Operating ad valorem millage” means all millages
  272  other than those fixed for debt service.
  273         (14)“Total collections” means the total amount derived
  274  from the cigarette tax during a specified period.
  275         (15)“Net collections” means 99.5 percent of total
  276  collections less the service charge prescribed in s. 215.20.
  277         (16)(14) “Distributing agent” means every person, firm, or
  278  corporation in this state who acts as an agent for any person,
  279  firm, or corporation outside or inside the state by receiving
  280  cigarettes in interstate or intrastate commerce and storing such
  281  cigarettes subject to distribution or delivery upon order from
  282  said principal to wholesale dealers and other distributing
  283  agents inside or outside this state.
  284         (17)(15) “Place of business” means any place where
  285  cigarettes are sold or where cigarettes are stored or kept for
  286  the purpose of sale or consumption; or, if cigarettes are sold
  287  from a vending machine, the place in which the vending machine
  288  is located.
  289         (18)(16) “Manufacturer's representative” means a person who
  290  represents a manufacturer of cigarettes but who has no place of
  291  business in this state where cigarettes are stored. A
  292  manufacturer's representative shall is required to obtain any
  293  cigarettes required by her or him through a wholesale dealer in
  294  this state and to make such reports as may be required by the
  295  Division of Alcoholic Beverages and Tobacco of the Department of
  296  Business and Professional Regulation.
  297         (19)(17) “Exporter” means a person who transports tax
  298  exempt cigarettes into this state under bond for delivery beyond
  299  the borders of this state. Each permit entitles shall entitle
  300  the permittee to store such cigarettes under bond at one
  301  location in this state pending shipment beyond the borders of
  302  this state.
  303         (20)(18) “Unstamped package” or “unstamped cigarettes”
  304  means a package on which the tax required by this part has not
  305  been paid, regardless of whether or not such package is stamped
  306  or marked with the indicia of any other taxing authority, or a
  307  package on which there has been affixed a counterfeit or
  308  fraudulent indicium or stamp.
  309         (21)(19) “Stamp” or “stamps” means the indicia required to
  310  be placed on cigarette packages which that evidence payment of
  311  the tax on cigarettes under s. 210.02.
  312         (22)(20) “Importer” means any person with a valid permit
  313  under 26 U.S.C. s. 5712 who imports into the United States,
  314  directly or indirectly, a finished cigarette for sale or
  315  distribution.
  316         (23)(21) “Manufacturer” means any domestic person or entity
  317  with a valid permit under 26 U.S.C. s. 5712 that manufactures,
  318  fabricates, assembles, processes, or labels a finished
  319  cigarette.
  320         (24)(22) “Counterfeit cigarettes” means cigarettes that
  321  have false manufacturing labels, tobacco product packs with
  322  counterfeit tax stamps, or any combination thereof.
  323         Section 3. Section 210.02, Florida Statutes, is amended to
  324  read:
  325         210.02 Cigarette tax imposed; collection.—
  326         (1) An excise or privilege tax, in addition to all other
  327  taxes of every kind imposed by law, is imposed upon the sale,
  328  receipt, purchase, possession, consumption, handling,
  329  distribution, and use of cigarettes in this state, in the
  330  following amounts, except as hereinafter otherwise provided, for
  331  cigarettes of standard dimensions:
  332         (a) Upon all cigarettes weighing not more than 3 pounds per
  333  thousand, 66.95 16.95 mills on each cigarette.
  334         (b) Upon all cigarettes weighing more than 3 pounds per
  335  thousand and not more than 6 inches long, 133.9 33.9 mills on
  336  each cigarette.
  337         (c) Upon all cigarettes weighing more than 3 pounds per
  338  thousand and more than 6 inches long, 267.8 67.8 mills on each
  339  cigarette.
  340         (2) The description of cigarettes contained in paragraphs
  341  (1)(a), (b), and (c) of subsection (1) are hereby declared to be
  342  standard as to dimensions for taxing purposes as provided in
  343  this section, law and if should any cigarette is be received,
  344  purchased, possessed, sold, offered for sale, given away, or
  345  used of a size other than of standard dimensions, the same shall
  346  be taxed at the rate of 5.69 1.41 cents on each such cigarette.
  347         (3) When cigarettes as described in paragraph (1)(a) are
  348  packed in varying quantities of 20 cigarettes or fewer less,
  349  except manufacturer's free samples authorized under s.
  350  210.04(9), the following rate shall govern:
  351         (a) Packages containing 10 cigarettes or fewer less require
  352  a 66.9-cent 16.95-cent tax.
  353         (b) Packages containing more than 10 but not more than 20
  354  cigarettes require a 133.9-cent 33.9-cent tax.
  355         (4) When cigarettes as described in paragraph (1)(b) are
  356  packed in varying quantities of 20 cigarettes or fewer less,
  357  except manufacturer's free samples authorized under s.
  358  210.04(9), the following rates shall govern:
  359         (a) Packages containing 10 cigarettes or fewer less require
  360  a 133.9-cent 33.9-cent tax.
  361         (b) Packages containing more than 10 but not more than 20
  362  cigarettes require a 267.8-cent 67.8-cent tax.
  363         (5) When cigarettes as described in paragraph (1)(c) are
  364  packed in varying quantities of 20 cigarettes or fewer less,
  365  except manufacturer's free samples authorized under s.
  366  210.04(9), the following rates shall govern:
  367         (a) Packages containing 10 cigarettes or fewer less require
  368  a 267.8-cent 67.8-cent tax.
  369         (b) Packages containing more than 10 but not more than 20
  370  cigarettes require a 535.6-cent 135.6-cent tax.
  371         (6) This tax shall be paid by the dealer to the division
  372  for deposit and distribution as hereinafter provided upon the
  373  first sale or transaction within the state, whether or not such
  374  sale or transfer is be to the ultimate purchaser or consumer.
  375  The seller or dealer shall collect the tax from the purchaser or
  376  consumer, and the purchaser or consumer shall pay the tax to the
  377  seller. The seller or dealer is shall be responsible for the
  378  collection of the tax and the payment of the same to the
  379  division. All taxes are due not later than the 10th day of the
  380  month following the calendar month in which they were incurred,
  381  and thereafter must shall bear interest at the rate of 1 percent
  382  per month. If the amount of tax due for a given period is
  383  assessed without allocating it to any particular month, the
  384  interest begins shall begin with the date of the assessment.
  385  Whenever cigarettes are shipped from outside the state to anyone
  386  other than a distributing agent or wholesale dealer, the person
  387  receiving the cigarettes is shall be responsible for the tax on
  388  said cigarettes and the payment of same to the division.
  389         (7) It is the legislative intent that the tax on cigarettes
  390  shall be uniform throughout the state.
  391         Section 4. Subsection (10) of section 210.18, Florida
  392  Statutes, is amended to read:
  393         210.18 Penalties for tax evasion; reports by sheriffs.—
  394         (10) It is unlawful to sell or possess with the intent to
  395  sell counterfeit cigarettes, as defined in s. 210.01(24) s.
  396  210.01(22).
  397         (a) A person who does not hold a permit or holds a retail
  398  permit under the provisions of this chapter and who violates
  399  this subsection commits a felony of the third degree, punishable
  400  as provided in s. 775.082, s. 775.083, or s. 775.084, and is
  401  subject to the imposition of fines and additional penalties as
  402  follows:
  403         1. If the quantity of counterfeit cigarettes sold or
  404  possessed with the intent to sell is less than two cartons or
  405  the equivalent, the fine for a first violation shall not exceed
  406  $1,000 or five times the retail value of the counterfeit
  407  cigarettes, whichever is greater. A subsequent violation may
  408  result in the imposition of a fine not to exceed $5,000 or five
  409  times the retail value of the counterfeit cigarettes, whichever
  410  is greater, and shall result in revocation of the retail permit
  411  by the division.
  412         2. If the quantity of counterfeit cigarettes sold or
  413  possessed with the intent to sell is two cartons or more or the
  414  equivalent, the fine for a first violation shall not exceed
  415  $2,000 or five times the retail value of the counterfeit
  416  cigarettes, whichever is greater. A subsequent violation may
  417  result in the imposition of a fine not to exceed $50,000 or five
  418  times the retail value of the counterfeit cigarettes, whichever
  419  is greater, and shall result in revocation of the retail permit
  420  by the division.
  421         (b) A person who holds a permit, other than a retail
  422  permit, under the provisions of this chapter and who violates
  423  this subsection commits a felony of the third degree, punishable
  424  as provided in s. 775.082, s. 775.083, or s. 775.084, and is
  425  subject to the imposition of fines and additional penalties as
  426  follows:
  427         1. If the quantity of counterfeit cigarettes sold or
  428  possessed with the intent to sell is less than 10 cartons or the
  429  equivalent, the fine for a first violation shall not exceed
  430  $1,000 or five times the retail value of the counterfeit
  431  cigarettes, whichever is greater. A subsequent violation may
  432  result in the imposition of a fine not to exceed $5,000 or five
  433  times the retail value of the counterfeit cigarettes, whichever
  434  is greater, and shall result in revocation of the permit by the
  435  division.
  436         2. If the quantity of counterfeit cigarettes sold or
  437  possessed with the intent to sell is 10 cartons or more or the
  438  equivalent, the fine for a first violation shall not exceed
  439  $2,000 or five times the retail value of the counterfeit
  440  cigarettes, whichever is greater. A subsequent violation may
  441  result in the imposition of a fine not to exceed $50,000 or five
  442  times the retail value of the counterfeit cigarettes, whichever
  443  is greater, and shall result in revocation of the permit by the
  444  division.
  445  For purposes of this subsection, any counterfeit cigarettes
  446  seized by the division shall be destroyed.
  447         Section 5. Subsection (2) of section 210.20, Florida
  448  Statutes, is amended to read:
  449         210.20 Employees and assistants; distribution of funds.—
  450         (2)(a) As collections are received by the division from the
  451  tax on cigarettes such cigarette taxes, it shall pay the same
  452  into a trust fund in the State Treasury designated “Cigarette
  453  Tax Collection Trust Fund.which shall be paid and distributed
  454  as follows:
  455         (b)(a) The division shall from month to month certify to
  456  the Chief Financial Officer the amount of net collections
  457  derived from the cigarette tax imposed by s. 210.02, less the
  458  service charges provided for in s. 215.20 and less 0.9 percent
  459  of the amount derived from the cigarette tax imposed by s.
  460  210.02, which shall be deposited into the Alcoholic Beverage and
  461  Tobacco Trust Fund, specifying the amounts to be transferred
  462  from the Cigarette Tax Collection Trust Fund and credited on the
  463  following bases:
  464         1.The sum of 1.1322 basis of 2.9 percent of the total base
  465  allocation net collections to the Revenue Sharing Trust Fund for
  466  Counties for distribution pursuant to the Florida Revenue
  467  Sharing Act.
  468         2.The sum of 11.3337 and 29.3 percent of the total base
  469  allocation to the Public Medical Assistance Trust Fund net
  470  collections for the funding of indigent health care pursuant to
  471  s. 409.918 to the Public Medical Assistance Trust Fund.
  472         3.The sum of 5.0597 percent of the total base allocation
  473  to the H. Lee Moffitt Cancer Center and Research Institute,
  474  established in s. 1004.43, which shall be paid monthly to the
  475  center's board of directors by warrant drawn by the Chief
  476  Financial Officer upon the State Treasury. The revenues derived
  477  from this allocation are separate and distinct from any funds
  478  allocated to the H. Lee Moffitt Cancer Center through the James
  479  and Esther King Biomedical Research Program or the William G.
  480  “Bill” Bankhead, Jr., and David Coley Cancer Research Program.
  481  Funds derived pursuant to this subparagraph shall be used for
  482  the purpose of constructing, furnishing, and equipping cancer
  483  research, treatment, and related facilities. The appropriation
  484  of funds may not be less than the amount that would have been
  485  paid to the H. Lee Moffitt and Cancer Research Institute for the
  486  2007-2008 fiscal year if this subparagraph had been in effect.
  487         4.The sum of 1.5179 percent of the total base allocation
  488  to the Shands at the University of Florida Cancer Hospital. The
  489  revenues derived from this allocation are separate and distinct
  490  from any funds allocated to the Shands at the University of
  491  Florida Cancer Hospital through the James and Esther King
  492  Biomedical Research Program or the William G. “Bill” Bankhead
  493  Coley Cancer Research Program. Funds derived pursuant to this
  494  subparagraph shall be used for the purposes of constructing,
  495  furnishing, and equipping cancer research, treatment, and
  496  related facilities, and may include the recruitment and
  497  retention of faculty or other personnel related to such research
  498  programs.
  499         5.The sum of 1.5179 percent of the total base allocation
  500  to the Sylvester Comprehensive Cancer Center at the University
  501  of Miami Miller School of Medicine. The revenues derived from
  502  this allocation are separate and distinct from any funds
  503  allocated to the Sylvester Comprehensive Cancer Center at the
  504  University of Miami Miller School of Medicine through the James
  505  and Esther King Biomedical Research Program or the William G.
  506  “Bill” Bankhead-Coley Cancer Research Program. Funds derived
  507  pursuant to this subparagraph shall be used for the purposes of
  508  constructing, furnishing, and equipping cancer research,
  509  treatment, and related facilities, and may include the
  510  recruitment and retention of faculty or other personnel related
  511  to research programs.
  512         6.The sum of 0.506 percent of the total base allocation to
  513  the M.D. Anderson Cancer Center in Orlando. The revenues derived
  514  from this allocation are separate and distinct from any funds
  515  allocated to the M.D. Anderson Cancer Center in Orlando through
  516  the James and Esther King Biomedical Research Program or the
  517  William G. “Bill” Bankhead-Coley Cancer Research Program. Funds
  518  derived pursuant to this subparagraph shall be used for the
  519  purposes of constructing, furnishing, and equipping research,
  520  treatment, and related facilities, and may include the
  521  recruitment and retention of faculty or other personnel related
  522  to research programs. Funds derived from this subparagraph shall
  523  only be expended within the state. When awarding the funds
  524  pursuant to this subparagraph, preference shall be given to
  525  proposals for specific projects that demonstrate a collaboration
  526  between institutions.
  527         7.The sum of 0.506 percent of the total base allocation to
  528  the Mayo Clinic, Jacksonville. The revenues derived from this
  529  allocation are separate and distinct from any funds allocated to
  530  the Mayo Clinic, Jacksonville through the James and Esther King
  531  Biomedical Research Program or the William G. “Bill” Bankhead
  532  Coley Cancer Research Program. Funds derived pursuant this
  533  subparagraph shall be used for the purposes of constructing,
  534  furnishing, and equipping research, treatment, and related
  535  facilities, and may include the recruitment and retention of
  536  faculty or other personnel related to research programs. Funds
  537  derived from this subparagraph shall only be expended within the
  538  state.
  539         8.The sum of 15.1791 percent of the total base allocation
  540  to the Medical Care Trust Fund for the funding of the Medically
  541  Needy Program established in 42 U.S.C. ss. 1396(a) and (d) and
  542  s. 409.904(2).
  543         9.The sum of 15.1791 percent of the total base allocation
  544  to the Medical Care Trust Fund for the funding of the MEDS-AD
  545  Waiver Program.
  546         10.The sum of 5.0597 percent of the total base allocation
  547  to the Public Medical Assistance Trust Fund to contribute to the
  548  state share of funding for the low-income pool.
  549         11.The sum of 6.0716 percent of the total base allocation
  550  to the Biomedical Research Trust Fund for distribution by the
  551  Biomedical Research Advisory Council to the grantees of the
  552  James and Esther King Biomedical Research Program and the
  553  William G. “Bill” Bankhead, Jr., and David Coley Cancer Research
  554  Program. The programs shall equally divide the allocation,
  555  subject to the methods provided in ss. 215.5602 and 381.922,
  556  respectively.
  557         12.The sum of 1.0119 percent of the total base allocation
  558  to the Division of Children’s Medical Services Prevention and
  559  Intervention within the Department of Health established in s.
  560  20.43(3)(h). The funds that are generated pursuant to this
  561  section in excess of the division’s appropriation for the 2008
  562  2009 fiscal year shall be used for any approved Children’s
  563  Medical Services hematology center or oncology center.
  564         13.The sum of 3.0358 percent of the total base allocation
  565  to the Lawton Chiles Endowment Trust Fund.
  566         14.The sum of 0.1012 percent of the total base allocation
  567  to the Florida Health Services Corps established in s. 381.302.
  568         15.The sum of 3.0358 percent of the total base allocation
  569  to fund the direct costs associated with medical internship,
  570  residency, and fellowship positions, pursuant to s. 381.04035,
  571  the Graduate Medical Education Physician Workforce Act.
  572         16.The sum of 0.2024 percent of the total base allocation
  573  to fund the purposes provided in s. 381.91, the Jesse Trice
  574  Cancer Prevention Program.
  575         17.The sum of 0.2024 percent of the total base allocation
  576  to fund the purposes provided in s. 381.93, the Mary Brogan
  577  Breast and Cervical Cancer Early Detection and Treatment
  578  Program.
  579         18.The sum of 0.3036 percent of the total base allocation
  580  for the enhancement of rural hospital facilities pursuant to s.
  581  395.6061.
  582         19.The sum of 0.6072 percent of the total base allocation
  583  to fund temporary Cover Florida Health Care Plan premium
  584  subsidies for individuals who are eligible for the plan and who
  585  are referred by the statewide comprehensive tobacco use
  586  prevention and education program pursuant to s. 408.9091.
  587         20.The sum of 0.2024 percent of the total base allocation
  588  to fund the enhancement of pharmacotherapeutic tools for use by
  589  enrollees in the state smoking cessation program in s. 381.84.
  590  The funds may not be used to supplant funds appropriated for
  591  this purpose as of January 1, 2009.
  592         21.The sum of 1.2649 percent of the total base allocation
  593  to fund the Nursing Education Enhancement Program, established
  594  in s. 1009.675, which shall be equally divided between the State
  595  University System and the State College System.
  596         22.The sum of 0.2024 percent of the total base allocation
  597  to fund the Minority Medical Education Program as provided in s.
  598  1009.68.
  599         23.The sum of 3.0358 percent of the total base allocation
  600  to fund the Florida Medical Education Program, as prescribed in
  601  s. 1013.83.
  602         24.The sum of 0.253 percent of the total base allocation
  603  to the Diabetes Research Institute for the purposes of
  604  conducting research.
  605         25.The sum of 0.1518 percent of the total base allocation
  606  to the Miami Project to Cure Paralysis for the purposes of
  607  conducting research.
  608  The funds designated in subparagraphs (b)4.-7. are subject to a
  609  funding match of 50 percent of the funds designated in each
  610  subparagraph. Such funds may also be used for bonding purposes
  611  only if the named institution can demonstrate that the match
  612  requirement can be met for the length of the term during which
  613  the earmarked proceeds would be used to service the debt on the
  614  bonds. Any funds designated pursuant to this paragraph which
  615  cannot be matched by the named institutions in any given fiscal
  616  year shall revert to the Biomedical Research Trust Fund to be
  617  used for the purposes provided in subparagraph (b)11.
  618         (c)Before transferring and crediting moneys from the
  619  Cigarette Tax Collection Trust Fund pursuant to paragraph (b),
  620  the division shall first deposit monthly into the Alcoholic
  621  Beverage and Tobacco Trust Fund an amount equal to the sum of
  622  0.5 percent of total collections and the service charge on total
  623  collections provided for in s. 215.20.
  624         (b)1.Beginning January 1, 1999, and continuing for 10
  625  years thereafter, the division shall from month to month certify
  626  to the Chief Financial Officer the amount derived from the
  627  cigarette tax imposed by s. 210.02, less the service charges
  628  provided for in s. 215.20 and less 0.9 percent of the amount
  629  derived from the cigarette tax imposed by s. 210.02, which shall
  630  be deposited into the Alcoholic Beverage and Tobacco Trust Fund,
  631  specifying an amount equal to 2.59 percent of the net
  632  collections, and that amount shall be paid to the Board of
  633  Directors of the H. Lee Moffitt Cancer Center and Research
  634  Institute, established under s. 1004.43, by warrant drawn by the
  635  Chief Financial Officer upon the State Treasury. These funds are
  636  hereby appropriated monthly out of the Cigarette Tax Collection
  637  Trust Fund, to be used for the purpose of constructing,
  638  furnishing, and equipping a cancer research facility at the
  639  University of South Florida adjacent to the H. Lee Moffitt
  640  Cancer Center and Research Institute. In fiscal years 1999-2000
  641  and thereafter with the exception of fiscal year 2008-2009, the
  642  appropriation to the H. Lee Moffitt Cancer Center and Research
  643  Institute authorized by this subparagraph shall not be less than
  644  the amount that would have been paid to the H. Lee Moffitt
  645  Cancer Center and Research Institute for fiscal year 1998-1999
  646  had payments been made for the entire fiscal year rather than
  647  for a 6-month period thereof.
  648         2.Beginning July 1, 2002, and continuing through June 30,
  649  2004, the division shall, in addition to the distribution
  650  authorized in subparagraph 1., from month to month certify to
  651  the Chief Financial Officer the amount derived from the
  652  cigarette tax imposed by s. 210.02, less the service charges
  653  provided for in s. 215.20 and less 0.9 percent of the amount
  654  derived from the cigarette tax imposed by s. 210.02, which shall
  655  be deposited into the Alcoholic Beverage and Tobacco Trust Fund,
  656  specifying an amount equal to 0.2632 percent of the net
  657  collections, and that amount shall be paid to the Board of
  658  Directors of the H. Lee Moffitt Cancer Center and Research
  659  Institute, established under s. 1004.43, by warrant drawn by the
  660  Chief Financial Officer. Beginning July 1, 2004, and continuing
  661  through June 30, 2016, the division shall, in addition to the
  662  distribution authorized in subparagraph 1., from month to month
  663  certify to the Chief Financial Officer the amount derived from
  664  the cigarette tax imposed by s. 210.02, less the service charges
  665  provided for in s. 215.20 and less 0.9 percent of the amount
  666  derived from the cigarette tax imposed by s. 210.02, which shall
  667  be deposited into the Alcoholic Beverage and Tobacco Trust Fund,
  668  specifying an amount equal to 1.47 percent of the net
  669  collections, and that amount shall be paid to the Board of
  670  Directors of the H. Lee Moffitt Cancer Center and Research
  671  Institute, established under s. 1004.43, by warrant drawn by the
  672  Chief Financial Officer. These funds are appropriated monthly
  673  out of the Cigarette Tax Collection Trust Fund, to be used for
  674  the purpose of constructing, furnishing, and equipping a cancer
  675  research facility at the University of South Florida adjacent to
  676  the H. Lee Moffitt Cancer Center and Research Institute. In
  677  fiscal years 2004-2005 and thereafter, the appropriation to the
  678  H. Lee Moffitt Cancer Center and Research Institute authorized
  679  by this subparagraph shall not be less than the amount that
  680  would have been paid to the H. Lee Moffitt Cancer Center and
  681  Research Institute in fiscal year 2001-2002, had this
  682  subparagraph been in effect.
  683         Section 6. Section 210.201, Florida Statutes, is amended to
  684  read:
  685         210.201 Cancer facilities research facility at the
  686  University of South Florida; establishment; funding.—The Board
  687  of Directors of the H. Lee Moffitt Cancer Center and Research
  688  Institute shall construct, furnish, and equip, and shall
  689  covenant to complete, the cancer research facility at the
  690  University of South Florida adjacent to the H. Lee Moffitt
  691  Cancer Center and Research Institute. Moneys transferred to the
  692  Board of Directors of the H. Lee Moffitt Cancer Center and
  693  Research Institute pursuant to s. 210.20 shall be used to secure
  694  financing to pay or secure bonds or financial products issued or
  695  incurred in connection with the costs related to constructing,
  696  furnishing, and equipping the cancer research, treatment, and
  697  related facilities facility. Such financing may include the
  698  issuance of tax-exempt bonds or other forms of indebtedness by a
  699  local authority, municipality, or county pursuant to parts II
  700  and III of chapter 159. Such bonds shall not constitute state
  701  bonds for purposes of s. 11, Art. VII of the State Constitution,
  702  but shall constitute bonds of a “local agency,” as defined in s.
  703  159.27(4). The cigarette tax dollars pledged to the facilities
  704  this facility pursuant to s. 210.20 may be replaced annually by
  705  the Legislature from tobacco litigation settlement proceeds.
  706         Section 7. Paragraph (d) of subsection (1), paragraphs (b),
  707  (c), and (d) of subsection (3), and paragraph (a) of subsection
  708  (6) of section 215.5601, Florida Statutes, are amended to read:
  709         215.5601 Lawton Chiles Endowment Fund.—
  710         (1) LEGISLATIVE INTENT.—It is the intent of the Legislature
  711  to:
  712         (d) Provide funds to help support public-health and
  713  biomedical research for the prevention, diagnosis, treatment,
  714  and cure of diseases related to tobacco use by creating an
  715  annual and perpetual source of funding for biomedical research
  716  in the state in order to expand the foundation of biomedical
  717  knowledge relating to the prevention, diagnosis, treatment, and
  718  cure of diseases related to tobacco use, including cancer,
  719  cardiovascular disease, stroke, and pulmonary disease; improve
  720  the quality of the state's academic health centers by bringing
  721  the advances of biomedical research into the training of
  722  physicians and other health care providers; and increase the
  723  state's per capita funding for biomedical research by
  724  undertaking new initiatives in biomedical research which will
  725  attract additional researchers and funding from sources other
  726  than outside the state while also stimulating economic activity
  727  in the state in areas related to biomedical research, such as
  728  the research and production of pharmaceuticals, biotechnology,
  729  and medical devices.
  730         (3) LAWTON CHILES ENDOWMENT FUND; CREATION; PRINCIPAL.—
  731         (b) The endowment shall receive moneys from the sale of the
  732  state's right, title, and interest in and to the tobacco
  733  settlement agreement as defined in s. 215.56005, including the
  734  right to receive payments under such agreement, and from
  735  accounts transferred from the Department of Financial Services
  736  Tobacco Settlement Clearing Trust Fund established under s.
  737  17.41. Amounts to be transferred from the Department of
  738  Financial Services Tobacco Settlement Clearing Trust Fund to the
  739  endowment shall be in the following amounts for the following
  740  fiscal years:
  741         1. For fiscal year 1999-2000, $1.1 billion;
  742         2. For fiscal year 2000-2001, $200 million;
  743         3. For fiscal year 2001-2002, $200 million; and
  744         4. For fiscal year 2002-2003, $200 million.; and
  745         (c) For fiscal year 2009-2010, and each fiscal year
  746  thereafter, moneys designated pursuant to s. 210.20 shall be
  747  allocated to the endowment Amounts to be transferred under
  748  subparagraphs (b)2., 3., and 4. may be reduced by an amount
  749  equal to the lesser of $200 million or the amount the endowment
  750  receives in that fiscal year from the sale of the state's right,
  751  title, and interest in and to the tobacco settlement agreement.
  752         (d) One hundred and fifty million dollars For fiscal year
  753  2001-2002, $150 million of the existing principal in the
  754  endowment shall be reserved and accounted for within the
  755  endowment, the income from which shall be used solely for the
  756  funding for biomedical research activities as provided in s.
  757  215.5602. The income from the remaining principal shall be used
  758  solely as the source of funding for health and human services
  759  programs for children and elders as provided in subsection (5).
  760  The separate account for biomedical research shall be dissolved
  761  and the entire principal in the endowment shall be used
  762  exclusively for health and human services programs when cures
  763  have been found for tobacco-related cancer, heart, and lung
  764  disease.
  765         (6) ADVISORY COUNCIL.—The Lawton Chiles Endowment Fund
  766  Advisory Council is established for the purpose of reviewing the
  767  funding priorities of the state agencies, evaluating their
  768  requests against the mission and goals of the agencies and
  769  legislative intent for the use of endowment funds, and allowing
  770  for public input and advocacy.
  771         (a) The advisory council shall consist of 17 15 members,
  772  including:
  773         1. The director of the United Way of Florida, Inc., or his
  774  or her designee;
  775         2. The director of the Foster Parents Association, or his
  776  or her designee;
  777         3. The chair of the Department of Elderly Affairs Advisory
  778  Council, or his or her designee;
  779         4. The president of the Florida Association of Area
  780  Agencies on Aging, or his or her designee;
  781         5. The State Long-Term Care Ombudsman, or his or her
  782  designee;
  783         6. The state director of the Florida AARP, or his or her
  784  designee;
  785         7. The director of the Florida Pediatric Society, or his or
  786  her designee;
  787         8. A representative of the Guardian Ad Litem Program,
  788  appointed by the Governor;
  789         9. A representative of a child welfare lead agency for
  790  community-based care, appointed by the Governor;
  791         10. A representative of an elder care lead agency for
  792  community-based care, appointed by the Governor;
  793         11. A representative of a statewide child advocacy
  794  organization, appointed by the Governor;
  795         12. One consumer caregiver for children, appointed by the
  796  Governor;
  797         13. One person older than over the age of 60 years of age
  798  to represent the interests of elders, appointed by the Governor;
  799         14. One person younger than under the age of 18 years of
  800  age to represent the interests of children, appointed by the
  801  Governor; and
  802         15. One consumer caregiver for a functionally impaired
  803  elderly person, appointed by the Governor;.
  804         16.One representative of a public health organization
  805  having a major interest in tobacco control, appointed by the
  806  Governor; and
  807         17.One consumer who is currently eligible for benefits
  808  under Title XIX of the Medicaid program.
  809         Section 8. Subsections (1), (2), (12), (13), (14), and (15)
  810  of section 215.5602, Florida Statutes, as amended by section 1
  811  of chapter 2009-5, Laws of Florida, are amended to read:
  812         215.5602 James and Esther King Biomedical Research
  813  Program.—
  814         (1) There is established within the Department of Health
  815  the James and Esther King Biomedical Research Program funded by
  816  the proceeds designated pursuant to s. 210.20 and any portion of
  817  the Lawton Chiles Endowment Fund pursuant to s. 215.5601. The
  818  purpose of the James and Esther King Biomedical Research Program
  819  is to provide an annual and perpetual source of funding in order
  820  to support research initiatives that address the health care
  821  problems of Floridians in the areas of tobacco-related cancer,
  822  cardiovascular disease, stroke, and pulmonary disease. The long
  823  term goals of the program are to:
  824         (a) Improve the health of Floridians by researching better
  825  prevention, diagnoses, treatments, and cures for cancer,
  826  cardiovascular disease, stroke, and pulmonary disease.
  827         (b) Expand the foundation of biomedical knowledge relating
  828  to the prevention, diagnosis, treatment, and cure of diseases
  829  related to tobacco use, including cancer, cardiovascular
  830  disease, stroke, and pulmonary disease.
  831         (c) Improve the quality of the state's academic health
  832  centers by bringing the advances of biomedical research into the
  833  training of physicians and other health care providers.
  834         (d) Increase the state's per capita funding for research by
  835  undertaking new initiatives in public health and biomedical
  836  research that will attract additional funding from outside the
  837  state.
  838         (e) Stimulate economic activity in the state in areas
  839  related to biomedical research, such as the research and
  840  production of pharmaceuticals, biotechnology, and medical
  841  devices.
  842         (f)Expand the research capacity and infrastructure needed
  843  to conduct research on tobacco-related illnesses using funding
  844  for fixed capital outlay projects, as determined by the
  845  Biomedical Research Advisory Council, within the program's
  846  annual appropriation and up to 50 percent of the program's
  847  annual funding allocated for such purpose; however, grant
  848  recipients receiving funds for fixed capital outlay projects
  849  must use matching funds of at least 200 percent of the moneys
  850  awarded by the council.
  851         (2) Funds appropriated for the James and Esther King
  852  Biomedical Research Program shall be used exclusively for the
  853  award of grants and fellowships as established in this section;
  854  for research relating to the prevention, diagnosis, treatment,
  855  and cure of diseases related to tobacco use, including cancer,
  856  cardiovascular disease, stroke, and pulmonary disease; for
  857  expenditures related to the expansion of tobacco-related
  858  research capacity and infrastructure within the state, including
  859  capital outlay costs to achieve such purpose, consistent with
  860  the match requirements in paragraph (1)(f); and for expenses
  861  incurred in the administration of this section. Priority shall
  862  be granted to research designed to prevent or cure disease. The
  863  state shall have, commensurate with its level of investment, a
  864  commercialization interest in any research supported by the
  865  funds appropriated for the program.
  866         (12) For the 2008-2009 fiscal year and each fiscal year
  867  thereafter, the sum of $4.5 million is appropriated annually
  868  from recurring funds in the General Revenue Fund to the
  869  Biomedical Research Trust Fund within the Department of Health
  870  for purposes of the James and Esther King Biomedical Research
  871  Program pursuant to this section. From these funds up to $1
  872  million $250,000 shall be available for the operating costs of
  873  the Florida Center for Universal Research to Eradicate Disease.
  874  Beginning in the 2010-2011 fiscal year, up to $1 million of the
  875  funds allocated to the program shall be available for the
  876  program's operating costs incurred pursuant to. s. 210.20.
  877         (13) By June 1, 2017 June 1, 2009, the Division of
  878  Statutory Revision of the Office of Legislative Services shall
  879  certify to the President of the Senate and the Speaker of the
  880  House of Representatives the language and statutory citation of
  881  this section, which is scheduled to expire January 1, 2018
  882  January 1, 2011.
  883         (14) The Legislature shall review the performance, the
  884  outcomes, and the financial management of the James and Esther
  885  King Biomedical Research Program during the 2017 2010 Regular
  886  Session of the Legislature and shall determine the most
  887  appropriate funding source and means of funding the program
  888  based on its review.
  889         (15) This section expires January 1, 2018 January 1, 2011,
  890  unless reviewed and reenacted by the Legislature before that
  891  date.
  892         Section 9. Paragraphs (c) and (d) of subsection (5) and
  893  subsection (12) of section 381.0302, Florida Statutes, are
  894  amended to read:
  895         381.0302 Florida Health Services Corps.—
  896         (5) The department may award scholarships to students
  897  studying medicine, osteopathic medicine, chiropractic medicine,
  898  podiatric, nursing, or dentistry.
  899         (c) In selecting students to participate in the scholarship
  900  program, priority shall be given to students who indicate a
  901  desire to practice a primary care specialty in a medically
  902  underserved area after their obligation is completed and who
  903  indicate an intent to practice medical specialties for which the
  904  department has a need. Additional priority shall be given to
  905  students who indicate a desire to practice the medical
  906  specialties of oncology, cardiology, or pulmonology.
  907         (d) Scholarship assistance shall consist of reimbursement
  908  for tuition and other educational costs such as books, supplies,
  909  equipment, transportation, and monthly living expense stipends.
  910  The department shall pay at least the same amount for living
  911  expense stipends as is paid by the National Health Services
  912  Corps. If the funds allocated to the program pursuant to s.
  913  210.20 are sufficient, the department may increase the stipends
  914  annually by an amount equal to the Consumer Price Index. Each
  915  monthly living expense stipend shall be for a 12-month period
  916  beginning with the first month of each school year in which the
  917  student is a participant. The department may reimburse a
  918  participant for books, supplies, and equipment based on average
  919  costs incurred by participants for these items. The department
  920  shall prescribe, by rule, eligible expenses for reimbursement
  921  and allowable amounts.
  922         (12) Funds appropriated under this section shall be
  923  deposited in the Florida Health Services Corps Trust Fund, which
  924  shall be administered by the department. The department may use
  925  funds appropriated for the Florida Health Services Corps,
  926  including any moneys allocated pursuant to s. 210.20, as
  927  matching funds for federal service-obligation scholarship
  928  programs for health care practitioners, such as the
  929  Demonstration Grants to States for Community Scholarship Grants
  930  program. If funds appropriated under this section are used as
  931  matching funds, federal criteria shall be followed whenever
  932  there is a conflict between provisions in this section and
  933  federal requirements.
  934         Section 10. Section 381.04035, Florida Statutes, is created
  935  to read:
  936         381.04035Graduate Medical Education Workforce Act.—
  937         (1)LEGISLATIVE FINDINGS AND INTENT.—
  938         (a)It is the intent of the Legislature to improve access
  939  to health care services for all residents of the state and to
  940  foster and maintain accredited graduate medical education
  941  programs and positions to address the unique issues relating
  942  such access by the state's growing and aging population.
  943         (b)The Legislature also finds that the inordinately high
  944  burden of diseases caused by tobacco use requires an increase in
  945  the number of positions in the medical specialties of oncology,
  946  cardiology, and pulmonology. The Legislature finds that the
  947  shortage of physicians, including primary care residents,
  948  available to care for persons who have certain emergent
  949  conditions and traumatic injuries requires an increase in the
  950  number of positions for subspecialists, including, but not
  951  limited to, plastic surgery, hand surgery, orthopedics,
  952  neurosurgery, and pediatric surgery.
  953         (c)In order to meet the state's present and future medical
  954  needs, the Legislature intends to expand and maintain accredited
  955  graduate medical education intern, resident, and fellowship
  956  positions and programs. The Legislature intends to provide
  957  funding for newly created, accredited graduate medical education
  958  positions at an average of, accounting for differences in
  959  specialties, $90,000 per position per year to fund the direct
  960  costs associated with the positions. The funding for positions
  961  initiated after the enactment of the 1997 Balanced Budget Act by
  962  the Congress of the United States through July 1, 2009, shall be
  963  90 percent of the average cost.
  964         (d)The Legislature also encourages entities sponsoring and
  965  funding graduate medical education positions and programs to
  966  apply to the Department of Health for nonrecurring start-up
  967  funds and recurring grants for recruiting and retaining faculty
  968  physicians and developing and maintaining academic centers of
  969  excellence.
  970         (2)PROGRAM FOR FUNDING GRADUATE MEDICAL EDUCATION
  971  POSITIONS.—
  972         (a)A program for funding accredited graduate medical
  973  education positions is established within the Department of
  974  Health. The program shall provide financial support to hospitals
  975  for the direct costs associated with new internships,
  976  residencies, and fellowships initiated on or after July 1, 2009.
  977  The program shall also provide financial support to hospitals,
  978  which do not otherwise receive funding under the Medicare
  979  program, for 90 percent of the direct costs associated with
  980  internships, residencies, and fellowships initiated before July
  981  1, 2009, and after the enactment of the 1997 Balanced Budget Act
  982  by Congress. If feasible, and subject to the General
  983  Appropriations Act, state funds shall be used to generate
  984  federal matching funds under the Medicaid program or other
  985  federal programs. The combined state and federal funds shall be
  986  allocated to hospitals participating in the program.
  987         (b)The department, based on recommendations made by the
  988  Graduate Medical Education Council, shall determine the levels
  989  of funding for new internships, residencies, and fellowships in
  990  accredited programs. A hospital having full-time equivalent
  991  interns, residents, and fellows may apply to the department for
  992  grants-in-aid for such positions.
  993         (c)The funding for internships, residencies, and
  994  fellowships in accredited programs which are added after the
  995  adoption of the 1997 Balanced Budget Act by Congress and before
  996  July 1, 2009, and for which the hospital does not receive
  997  federal funding shall be limited to 90 percent of the amount
  998  determined under paragraph (b). A hospital having full-time
  999  equivalent interns, residents, and fellows may apply to the
 1000  department for grants-in-aid for qualifying positions.
 1001         (d)A hospital receiving funding through the program shall
 1002  submit an annual report to the department and the Graduate
 1003  Medical Education Council which identifies the graduate medical
 1004  education activities supported by the program.
 1005         (3)PROGRAM FOR FUNDING GRADUATE MEDICAL EDUCATION PROGRAMS
 1006  AND ACADEMIC CENTERS OF EXCELLENCE.—
 1007         (a)A program for funding graduate medical education
 1008  programs and academic centers of excellence is established
 1009  within the Department of Health. It is the intent of the
 1010  Legislature to fund the development and maintenance of graduate
 1011  medical education programs, including start-up costs and the
 1012  costs associated with recruiting and retaining qualified faculty
 1013  physicians, and the establishment and support of academic
 1014  centers of excellence. Hospitals, universities, and other
 1015  sponsoring entities may apply to the department for nonrecurring
 1016  grants-in-aid for such costs. If feasible, and subject to the
 1017  General Appropriations Act, state funds shall be used to
 1018  generate federal matching funds under the Medicaid program or
 1019  other federal programs. The combined state and federal funds
 1020  shall be allocated to eligible participants.
 1021         (b)Start-up costs may include, but need not be limited to,
 1022  items such as capital expenditures, equipment, and technology.
 1023         (c)The department, in consultation with the Graduate
 1024  Medical Education Council, shall determine the criteria for and
 1025  identification of the levels of funding for recruiting and
 1026  retaining faculty physicians, and the criteria for supporting
 1027  and developing academic centers of excellence, except for the
 1028  state's designated burn units established in s. 408.0361.
 1029         (d)Participating entities that receive funds under the
 1030  program shall submit an annual report to the department and the
 1031  Graduate Medical Education Council which identifies the graduate
 1032  medical education activities supported by the program.
 1033         (4)GRADUATE MEDICAL EDUCATION COUNCIL; MEMBERSHIP;
 1034  STAFFING.—
 1035         (a)The Graduate Medical Education Council is created and
 1036  shall consist of nine members as follows:
 1037         1.Four members shall be recommended by the Council of
 1038  Medical School Deans;
 1039         2.Two members shall be recommended by the Statutory
 1040  Teaching Hospital Council of Florida;
 1041         3.One member shall be a representative of a family
 1042  practice teaching hospital as defined in s. 395.805;
 1043         4.One member shall be a representative of a community
 1044  hospital education program hospital as provided in s.381.0403;
 1045  and
 1046         5.One member shall be a consumer representative.
 1047  Each member shall be appointed by the Governor for a 4-year
 1048  term. Initial appointments shall be made by September 1, 2009.
 1049         (b)A member's term shall end when his or her
 1050  representative status no longer exists. A member who has a
 1051  similar representative status shall be appointed to replace the
 1052  retiring or resigning member.
 1053         (c)The State Surgeon General shall designate an
 1054  administrator to serve as staff director of the council. The
 1055  council shall elect a chairperson from among its membership.
 1056         (d)The council shall develop a formal process to implement
 1057  this section by December 1, 2009.
 1058         (5)DEPARTMENT OF HEALTH; REPORTING REQUIREMENTS.—
 1059         (a)The department, based on recommendations made by the
 1060  Graduate Medical Education Council, shall analyze the cost
 1061  reports submitted by hospitals that have graduate medical
 1062  education programs and positions; determine the direct costs
 1063  associated with internship, residency, and fellowship positions;
 1064  and set the amount per position, based on the specialty, which
 1065  shall be an average of $90,000 per position. The department
 1066  shall require the hospitals receiving funds appropriated
 1067  pursuant to subsection (2) to submit, at a minimum:
 1068         1.Evidence that the graduate medical education positions
 1069  are accredited by the Accreditation Council for Graduate Medical
 1070  Education or the American Osteopathic Association.
 1071         2.Quarterly reports indicating the number of positions for
 1072  which the hospital is receiving funding.
 1073         3.An annual report identifying the graduate medical
 1074  education positions supported by the program.
 1075         (b)When evaluating requests for funding under subsection
 1076  (3), the department, based on recommendations made by the
 1077  council, shall consult with the Agency for Health Care
 1078  Administration and review, at a minimum:
 1079         1.Reports from the physician workforce assessment and
 1080  development activities and materials created pursuant to s.
 1081  381.4018;
 1082         2.Reports and materials created pursuant to s. 381.0403;
 1083         3.Reports, materials, and work groups formed by the
 1084  department's Office of Trauma under part I of chapter 395;
 1085         4.Inventory of hospital emergency room services created
 1086  pursuant to the Access to Emergency Care Act, s. 395.1041; and
 1087         5.Burn units established pursuant to s. 408.0361 and rule
 1088  59C-1.043, Florida Administrative Code.
 1089         (c)The department shall establish reporting requirements
 1090  for hospitals, universities, and other qualified entities
 1091  receiving funding under subsection (3), which shall include, but
 1092  not be limited to:
 1093         1.Evidence that the graduate medical education programs
 1094  are seeking accreditation from or have been accredited by the
 1095  Accreditation Council for Graduate Medical Education or the
 1096  American Osteopathic Association.
 1097         2.Quarterly receipts of any nonrecurring start-up
 1098  expenditures.
 1099         3.Evidence that the funding for establishing and
 1100  maintaining academic centers of excellence has improved
 1101  patients' access to health care.
 1102         (6)MATCHING FUNDS.—Funds appropriated pursuant to s.
 1103  210.20 shall be used to match funds from any local or state
 1104  governmental, hospital, or sponsoring entity source. The
 1105  matching funds must provide up to 70 percent of the funds
 1106  necessary to support and maintain the graduate medical education
 1107  programs. In addition to the reporting requirements in
 1108  subsection (5), hospitals, universities, and sponsoring entities
 1109  shall provide the department with evidence of nonstate support
 1110  for the graduate medical education programs and positions.
 1111         (7)STAFFING.—The department may employ other personnel as
 1112  necessary to implement and administer this section. The funds
 1113  appropriated pursuant to s. 210.20 shall support the
 1114  department's staff.
 1115         Section 11. Subsection (1) and paragraphs (a), (b), (e),
 1116  (f), and (h) of subsection (3) of section 381.4018, Florida
 1117  Statutes, are amended to read:
 1118         381.4018 Physician workforce assessment and development.—
 1119         (1) LEGISLATIVE INTENT.—The Legislature recognizes that
 1120  physician workforce planning is an essential component of
 1121  ensuring that there is an adequate and appropriate supply of
 1122  well-trained physicians to meet the this state's future health
 1123  care service needs as the general population and elderly
 1124  population of the state increase. The Legislature finds that
 1125  items to consider relative to assessing the physician workforce
 1126  may include physician practice status; specialty mix; geographic
 1127  distribution; demographic information, including, but not
 1128  limited to, age, gender, race, and cultural considerations; and
 1129  needs of current or projected medically underserved areas in the
 1130  state; and the relative burden of cancer, heart, and lung
 1131  diseases which is exacerbated by the state's demographics. Long
 1132  term strategic planning is essential as the period from the time
 1133  a medical student enters medical school to completion of
 1134  graduate medical education may range from 7 to 10 years or
 1135  longer. The Legislature recognizes that strategies to provide
 1136  for a well-trained supply of physicians must include ensuring
 1137  the availability and capacity of quality graduate medical
 1138  schools in the this state, as well as using new or existing
 1139  state and federal programs providing incentives for physicians
 1140  to practice in needed specialties and in underserved areas in a
 1141  manner that addresses projected needs for physician manpower.
 1142         (3) GENERAL FUNCTIONS.—The department shall maximize the
 1143  use of existing programs under the jurisdiction of the
 1144  department and other state agencies and coordinate governmental
 1145  and nongovernmental stakeholders and resources in order to
 1146  develop a state strategic plan and assess the implementation of
 1147  such strategic plan. In developing the state strategic plan, the
 1148  department shall:
 1149         (a) Monitor, evaluate, and report on the supply and
 1150  distribution of physicians, including physicians who practice
 1151  medical specialties, licensed under chapter 458 or chapter 459.
 1152  The department shall maintain a database to serve as a statewide
 1153  source of data concerning the physician workforce.
 1154         (b) Develop a model and quantify, on an ongoing basis, the
 1155  adequacy of the state's current and future physician workforce,
 1156  including physicians who practice medical specialties, as
 1157  reliable data becomes available. The Such model must take into
 1158  account demographics, physician practice status, place of
 1159  education and training, generational changes, population growth,
 1160  economic indicators, and issues concerning the “pipeline” into
 1161  medical education.
 1162         (e) Pursue strategies and policies to create, expand, and
 1163  maintain graduate medical education positions in the state based
 1164  on the analysis of the physician workforce data, and provide for
 1165  innovations in medical specialties, including oncology,
 1166  cardiology, and pulmonology, based upon the state's demographics
 1167  and its present and future burdens related to such diseases. The
 1168  Such strategies and policies must take into account the effect
 1169  of federal funding limitations on the expansion and creation of
 1170  positions in graduate medical education. The department shall
 1171  develop options to address such federal funding limitations. The
 1172  department shall consider options to provide direct state
 1173  funding for graduate medical education positions in a manner
 1174  that addresses requirements and needs relative to accreditation
 1175  of graduate medical education programs using moneys designated
 1176  for such purpose pursuant to s. 210.20. The department shall
 1177  consider funding residency positions as a means of addressing
 1178  needed physician specialty areas, including oncology,
 1179  cardiology, pulmonology, and other specialty areas adversely
 1180  affected by the state's demographics, rural areas having a
 1181  shortage of physicians, and areas of ongoing critical need, and
 1182  as a means of addressing the state's physician workforce needs
 1183  based on an ongoing analysis of physician workforce data.
 1184         (f) Develop strategies to maximize federal and state
 1185  programs that provide for the use of incentives to attract
 1186  physicians to the this state or retain physicians within the
 1187  state. The Such strategies shall should explore and maximize
 1188  federal-state partnerships that provide incentives for
 1189  physicians to practice in federally designated shortage areas.
 1190  The strategies shall also consider the use of state programs,
 1191  such as the Florida Health Service Corps established pursuant to
 1192  s. 381.0302 and the Medical Education Reimbursement and Loan
 1193  Repayment Program pursuant to s. 1009.65, which provide for
 1194  education loan repayment or loan forgiveness and provide
 1195  monetary incentives for physicians to relocate to underserved
 1196  areas of the state. A portion of the funds allocated pursuant to
 1197  s. 210.20 may be used for the purposes provided in this
 1198  paragraph.
 1199         (h) Work in conjunction with and act as a coordinating body
 1200  for governmental and nongovernmental stakeholders to address
 1201  matters relating to the state's physician workforce assessment
 1202  and development for the purpose of ensuring an adequate supply
 1203  of well-trained physicians to meet the state's future needs.
 1204         1. Such governmental stakeholders shall include, but need
 1205  not be limited to:,
 1206         a. The State Surgeon General or his or her designee;,
 1207         b. The Commissioner of Education or his or her designee;,
 1208         c. The Secretary of Health Care Administration or his or
 1209  her designee;, and
 1210         d. The Chancellor of the State University System or his or
 1211  her designee from the Board of Governors of the State University
 1212  System;, and,
 1213         e. At the discretion of the department, other
 1214  representatives of state and local agencies that are involved in
 1215  assessing, educating, or training the state's current or future
 1216  physicians.
 1217         2. Other stakeholders shall include, but need not be
 1218  limited to:,
 1219         a. Organizations representing the state's public and
 1220  private allopathic and osteopathic medical schools;
 1221         b. Organizations representing hospitals and other
 1222  institutions providing health care, particularly those that have
 1223  an interest in providing accredited medical education and
 1224  graduate medical education to medical students and medical
 1225  residents;
 1226         c. Organizations representing allopathic and osteopathic
 1227  practicing physicians; and,
 1228         d. At the discretion of the department, representatives of
 1229  other organizations or entities involved in assessing,
 1230  educating, or training the state's current or future physicians,
 1231  including public health groups and organizations having an
 1232  expertise in the trends of diseases, which are relevant to the
 1233  state, and in the need to anticipate and adequately address
 1234  issues concerning medical capacity.
 1235         Section 12. Paragraphs (b) and (h) of subsection (3) of
 1236  section 381.84, Florida Statutes, are amended to read:
 1237         381.84 Comprehensive Statewide Tobacco Education and Use
 1238  Prevention Program.—
 1239         (3) PROGRAM COMPONENTS AND REQUIREMENTS.—The department
 1240  shall conduct a comprehensive, statewide tobacco education and
 1241  use prevention program consistent with the recommendations for
 1242  effective program components contained in the 1999 Best
 1243  Practices for Comprehensive Tobacco Control Programs of the CDC,
 1244  as amended by the CDC. The program shall include the following
 1245  components, each of which shall focus on educating people,
 1246  particularly youth and their parents, about the health hazards
 1247  of tobacco and discouraging the use of tobacco:
 1248         (b) Cessation programs, counseling, and treatment.—This
 1249  program component shall include two subcomponents:
 1250         1. A statewide toll-free cessation service that shall,
 1251  which may include counseling, referrals to other local and state
 1252  resources and support services, including the Cover Florida
 1253  Health Care Access Program for persons who meet the eligibility
 1254  requirements in s. 408.9091(7), and treatment to the extent
 1255  funds are available for treatment services; and
 1256         2. A local community-based program to disseminate
 1257  information about smoking cessation, how smoking cessation
 1258  relates to prenatal care and obesity prevention, and other
 1259  chronic tobacco-related diseases.
 1260         (h) Enforcement and awareness of related laws.—In
 1261  coordination with the Department of Business and Professional
 1262  Regulation, the program shall monitor the enforcement of laws,
 1263  rules, and policies prohibiting the sale or other provision of
 1264  tobacco to minors, as well as the continued enforcement of the
 1265  Clean Indoor Air Act prescribed in chapter 386. The
 1266  advertisements produced in accordance with paragraph (a) may
 1267  also include information designed to make the public aware of
 1268  these related laws and rules. The departments may enter into
 1269  interagency agreements to carry out this program component.
 1270  Funds designated pursuant to s. 210.20 shall be used to
 1271  administer this paragraph.
 1272         Section 13. Subsection (5) of section 381.855, Florida
 1273  Statutes, is amended, present subsections (5) through (7) of
 1274  that section are redesignated as subsections (6) through (8),
 1275  respectively, and a new subsection (5) is added to that section
 1276  to read:
 1277         381.855 Florida Center for Universal Research to Eradicate
 1278  Disease.—
 1279         (5)Beginning in the 2009-2010 fiscal year, an annual sum
 1280  of no more than $1 million shall be allocated to the center for
 1281  its operations pursuant to s. 210.20 for the James and Esther
 1282  King Biomedical Research Program.
 1283         (6)(5) There is established within the center an advisory
 1284  council that shall meet at least annually.
 1285         (a) The council shall consist of one representative from a
 1286  Florida not-for-profit institution engaged in basic and clinical
 1287  biomedical research and education which receives more than $10
 1288  million in annual grant funding from the National Institutes of
 1289  Health, to be appointed by the State Surgeon General from a
 1290  different institution each term, and one representative from and
 1291  appointed by each of the following entities:
 1292         1. Enterprise Florida, Inc.
 1293         2. BioFlorida.
 1294         3. The Biomedical Research Advisory Council.
 1295         4. The Florida Medical Foundation.
 1296         5. Pharmaceutical Research and Manufacturers of America.
 1297         6.The Florida Cancer Council.
 1298         6.7. The American Cancer Society, Florida Division, Inc.
 1299         7.8. The American Heart Association, Greater Southeast
 1300  Affiliate.
 1301         8.9. The American Lung Association of Florida.
 1302         9.10. The American Diabetes Association, South Coastal
 1303  Region.
 1304         10.11. The Alzheimer's Association.
 1305         11.12. The Epilepsy Foundation.
 1306         12.13. The National Parkinson Foundation.
 1307         14.The Florida Public Health Foundation, Inc.
 1308         13.15. The Florida Research Consortium.
 1309         14.A Florida-based research facility that is designated by
 1310  the National Cancer Institute as a comprehensive cancer center.
 1311         (b) Members of the council shall serve without
 1312  compensation, and each organization represented shall cover all
 1313  expenses of its representative.
 1314         Section 14. Paragraph (c) of subsection (1) of section
 1315  381.91, Florida Statutes, is amended to read:
 1316         381.91 Jessie Trice Cancer Prevention Program.—
 1317         (1) It is the intent of the Legislature to:
 1318         (c) Establish a funding source, from which moneys shall be
 1319  designated pursuant to s. 210.20, to build upon local private
 1320  participation to sustain the operation of the program.
 1321         Section 15. Section 381.92, Florida Statutes, is repealed.
 1322         Section 16. Section 381.921, Florida Statutes, is repealed.
 1323         Section 17. Subsections (1), (2), (5), (6), (7), and (8) of
 1324  section 381.922, Florida Statutes, as amended by section 2 of
 1325  chapter 2009-5, Laws of Florida, are amended, present
 1326  subsections (6) through (8) are redesignated as subsections (7)
 1327  through (10), respectively, and new subsections (6) and (7) are
 1328  added to that section, to read:
 1329         381.922 William G. “Bill” Bankhead, Jr., and David Coley
 1330  Cancer Research Program.—
 1331         (1) The William G. “Bill” Bankhead, Jr., and David Coley
 1332  Cancer Research Program, which may be otherwise cited as the
 1333  “Bankhead-Coley Program,” is created within the Department of
 1334  Health. The purpose of the program is shall be to advance
 1335  progress towards cures for cancer using through grants awarded
 1336  through a peer-reviewed, competitive process, and to expand
 1337  cancer research and treatment capacity in the state.
 1338         (2) The program shall provide grants for cancer research to
 1339  further the search for cures for cancer, for recruiting cancer
 1340  researchers and research teams to institutions in the state, for
 1341  operational start-up grants for newly recruited cancer
 1342  researchers and research teams, and for fixed capital outlay
 1343  expenditures related to the expansion of cancer research and
 1344  treatment capacity in the state. Fifty percent of the program's
 1345  annual allocation shall apply to the purposes provided in this
 1346  subsection. Grantees receiving moneys for purposes other than
 1347  research shall use matching funds of at least 200 percent of the
 1348  amount awarded by the Biomedical Research Advisory Council.
 1349         (a) In order to support the advancement of cures for cancer
 1350  in the state, emphasis shall be given to the following goals:
 1351  enumerated in s. 381.921, as those goals support the advancement
 1352  of such cures.
 1353         1.Significantly expand cancer research capacity by
 1354  identifying ways to attract new research talent and attendant
 1355  national grant-producing researchers to cancer research
 1356  facilities by:
 1357         a.Implementing a peer-reviewed, competitive process to
 1358  identify and fund the best proposals to expand cancer research
 1359  institutes;
 1360         b.Providing funding by using available resources for
 1361  proposals that demonstrate the greatest opportunity to attract
 1362  federal research grants and private financial support;
 1363         c.Encouraging the employment of bioinformatics in order to
 1364  create a cancer informatics infrastructure that enhances
 1365  information and resource exchange and integration through
 1366  researchers working in diverse disciplines and to facilitate the
 1367  full spectrum of cancer investigations;
 1368         d.Facilitating the technical coordination, business
 1369  development, and support of intellectual property as it relates
 1370  to the advancement of cancer research; and
 1371         e.Aiding in other multidisciplinary research-support
 1372  activities that benefit the advancement of cancer research.
 1373         2.Improve both research and treatment through greater
 1374  participation in clinical trials networks by:
 1375         a.Identifying ways to increase adult enrollment in cancer
 1376  clinical trials;
 1377         b.Supporting public and private professional education
 1378  programs designed to increase the awareness and knowledge of
 1379  cancer clinical trials;
 1380         c.Providing tools for cancer patients and community-based
 1381  oncologists to aid in the identification of cancer clinical
 1382  trials; and
 1383         d.Creating opportunities for academic cancer centers to
 1384  collaborate with community-based oncologists in cancer clinical
 1385  trials networks.
 1386         3.Reduce the impact of cancer on disparate groups by:
 1387         a.Identifying those cancers that disproportionately affect
 1388  certain demographic groups; and
 1389         b.Building collaborations designed to reduce health
 1390  disparities relating to cancer.
 1391         (b) Preference may be given to grant proposals that foster
 1392  collaborations among institutions, researchers, and community
 1393  practitioners, as such proposals support the advancement of
 1394  cures through basic or applied research, including clinical
 1395  trials involving cancer patients and related networks.
 1396         (5) For the 2008-2009 fiscal year and each fiscal year
 1397  thereafter, the sum of $6.75 million is appropriated annually
 1398  from recurring funds in the General Revenue Fund to the
 1399  Biomedical Research Trust Fund within the Department of Health
 1400  for purposes of the William G. “Bill” Bankhead, Jr., and David
 1401  Coley Cancer Research Program and shall be distributed pursuant
 1402  to this section to provide grants to researchers seeking cures
 1403  for cancer, with emphasis given to the goals enumerated in
 1404  subsection (2) of this section s. 381.921. From the total funds
 1405  appropriated, an amount of up to 10 percent may be used for
 1406  administrative expenses.
 1407         (6)Beginning in the 2009-2010 fiscal year, and every year
 1408  thereafter, funds generated pursuant to s. 210.20 shall be used
 1409  to support the purposes provided in this section. The annual
 1410  appropriation of such funds shall allow for reasonable
 1411  administrative costs associated with implementing the program.
 1412         (7)The state shall have, commensurate with its level of
 1413  investment, a commercialization interest in any research
 1414  supported by the funds appropriated from the program.
 1415         (8)(6) By June 1, 2016 June 1, 2009, the Division of
 1416  Statutory Revision of the Office of Legislative Services shall
 1417  certify to the President of the Senate and the Speaker of the
 1418  House of Representatives the language and statutory citation of
 1419  this section, which is scheduled to expire January 1, 2018
 1420  January 1, 2011.
 1421         (9)(7) The Legislature shall review the performance, the
 1422  outcomes, and the financial management of the William G. “Bill”
 1423  Bankhead, Jr., and David Coley Cancer Research Program during
 1424  the 2010 Regular Session of the Legislature and shall determine
 1425  the most appropriate funding source and means of funding the
 1426  program based on its review.
 1427         (10)(8) This section expires January 1, 2018 January 1,
 1428  2011, unless reviewed and reenacted by the Legislature before
 1429  that date.
 1430         Section 18. Subsections (3) and (4) of section 381.93,
 1431  Florida Statutes, are amended to read:
 1432         381.93 Breast and cervical cancer early detection program.
 1433  This section may be cited as the “Mary Brogan Breast and
 1434  Cervical Cancer Early Detection Program Act.”
 1435         (3) The Mary Brogan Breast and Cervical Cancer Early
 1436  Detection Program shall be funded through grants for such
 1437  screening and early detection purposes from the federal Centers
 1438  for Disease Control and Prevention under Title XV of the Public
 1439  Health Service Act, 42 U.S.C. ss. 300k et seq. and moneys
 1440  designated for such purposes pursuant to s. 210.20.
 1441         (4) The department shall limit enrollment in the program to
 1442  persons with incomes up to and including 250 200 percent of the
 1443  federal poverty level. The department shall establish an
 1444  eligibility process that includes an income-verification process
 1445  to ensure that persons served under the program meet income
 1446  guidelines.
 1447         Section 19. Subsections (2) and (3) of section 395.6061,
 1448  Florida Statutes, are amended to read:
 1449         395.6061 Rural hospital capital improvement.—There is
 1450  established a rural hospital capital improvement grant program.
 1451         (2) Each rural hospital as defined in s. 395.602 shall
 1452  receive a minimum of $100,000 annually, subject to legislative
 1453  appropriation, upon application to the Department of Health, for
 1454  projects to acquire, repair, improve, or upgrade systems,
 1455  facilities, or equipment. Each rural hospital may apply for
 1456  funds designated pursuant to s. 210.20 for the purposes provided
 1457  in this section.
 1458         (3) Funds for the acquisition, repair, improvement, or
 1459  upgrade of systems, facilities, or equipment at rural hospitals
 1460  Any remaining funds shall annually be annually disbursed to
 1461  rural hospitals in accordance with this section. The Department
 1462  of Health shall establish, by rule, criteria for awarding grants
 1463  for any remaining funds, which must be used exclusively for the
 1464  support and assistance of rural hospitals as defined in s.
 1465  395.602, including criteria relating to the level of
 1466  uncompensated care rendered by the hospital, the participation
 1467  in a rural health network as defined in s. 381.0406, and the
 1468  proposed use of the grant by the rural hospital to resolve a
 1469  specific problem. The department must consider any information
 1470  submitted in an application for the grants in accordance with
 1471  subsection (1) in determining eligibility for and the amount of
 1472  the grant, and none of the individual items of information by
 1473  itself may be used to deny grant eligibility.
 1474         Section 20. Subsection (2), paragraph (a) of subsection
 1475  (4), and present subsection (9) of section 408.9091, Florida
 1476  Statutes, are amended, present subsections (8) through (11) of
 1477  that section are redesignated as subsections (9) through (12),
 1478  respectively, and a new subsection (8) is added to that section,
 1479  to read:
 1480         408.9091 Cover Florida Health Care Access Program.—
 1481         (2) LEGISLATIVE INTENT.—The Legislature finds that a
 1482  significant number of state residents are unable to obtain
 1483  affordable health insurance coverage. The Legislature also finds
 1484  that existing health flex plan coverage has had limited
 1485  participation due in part to narrow eligibility restrictions as
 1486  well as minimal benefit options for catastrophic and emergency
 1487  care coverage. Therefore, it is the intent of the Legislature to
 1488  expand the availability of health care options for uninsured
 1489  residents by developing an affordable health care product that
 1490  emphasizes coverage for basic and preventive health care
 1491  services and smoking cessation; provides inpatient hospital,
 1492  urgent, and emergency care services; and is offered statewide by
 1493  approved health insurers, health maintenance organizations,
 1494  health-care-provider-sponsored organizations, or health care
 1495  districts.
 1496         (4) PROGRAM.—The agency and the office shall jointly
 1497  establish and administer the Cover Florida Health Care Access
 1498  Program.
 1499         (a) General Cover Florida plan components must require
 1500  that:
 1501         1. Plans are offered on a guaranteed-issue basis to
 1502  enrollees, subject to exclusions for preexisting conditions
 1503  approved by the office and the agency.
 1504         2. Plans are portable such that the enrollee remains
 1505  covered regardless of employment status or the cost-sharing of
 1506  premiums.
 1507         3. Plans provide for cost containment through limits on the
 1508  number of services, caps on benefit payments, and copayments for
 1509  services.
 1510         4. A Cover Florida plan entity makes all benefit plan and
 1511  marketing materials available in English and Spanish.
 1512         5. In order to provide for consumer choice, Cover Florida
 1513  plan entities develop two alternative benefit option plans
 1514  having different cost and benefit levels, including at least one
 1515  plan that provides catastrophic coverage.
 1516         6. Plans without catastrophic coverage provide coverage
 1517  options for services including, but not limited to:
 1518         a. Preventive health services, including immunizations,
 1519  annual health assessments, well-woman and well-care services,
 1520  and preventive screenings such as mammograms, cervical cancer
 1521  screenings, and noninvasive colorectal or prostate screenings.
 1522         b. Incentives for routine preventive care.
 1523         c. Office visits for the diagnosis and treatment of illness
 1524  or injury.
 1525         d. Office surgery, including anesthesia.
 1526         e. Behavioral health services.
 1527         f. Durable medical equipment and prosthetics.
 1528         g. Diabetic supplies.
 1529         h.Nicotine-replacement therapy supplies and other
 1530  pharmacotherapeutic tools relating to smoking cessation.
 1531         7. Plans providing catastrophic coverage, at a minimum,
 1532  provide coverage options for all of the services listed under
 1533  subparagraph 6.; however, such plans may include, but are not
 1534  limited to, coverage options for:
 1535         a. Inpatient hospital stays.
 1536         b. Hospital emergency care services.
 1537         c. Urgent care services.
 1538         d. Outpatient facility services, outpatient surgery, and
 1539  outpatient diagnostic services.
 1540         8. All plans offer prescription drug benefit coverage, use
 1541  a prescription drug manager, or offer a discount drug card.
 1542         9. Plan enrollment materials provide information in plain
 1543  language on policy benefit coverage, benefit limits, cost
 1544  sharing requirements, and exclusions and a clear representation
 1545  of what is not covered in the plan. Such enrollment materials
 1546  must include a standard disclosure form adopted by rule by the
 1547  Financial Services Commission, to be reviewed and executed by
 1548  all consumers purchasing Cover Florida plan coverage.
 1549         10. Plans offered through a qualified employer meet the
 1550  requirements of s. 125 of the Internal Revenue Code.
 1551         (8)TEMPORARY PREMIUM SUBSIDY FOR CERTAIN PERSONS.—An
 1552  individual who meets the eligibility requirements in subsection
 1553  (7) and who is enrolled and actively participating in a smoking
 1554  cessation program as provided in s. 381.84 is eligible to have
 1555  his or her insurance premium subsidized by the state for a
 1556  period of up to 12 months, at an amount of up to $75 per month,
 1557  to the extent that the funds designated pursuant to s. 210.20
 1558  for this purpose are available.
 1559         (10)(9) NONENTITLEMENT.—Notwithstanding subsection (8),
 1560  coverage under a Cover Florida plan is not an entitlement, and a
 1561  cause of action does not arise against the state, a local
 1562  government entity, any other political subdivision of the state,
 1563  or the agency or the office for failure to make coverage
 1564  available to eligible persons under this section.
 1565         Section 21. Section 1009.675, Florida Statutes, is created
 1566  to read:
 1567         1009.675Nursing Education Enhancement Program.—
 1568         (1)The Nursing Education Enhancement Program is
 1569  established to provide supplemental funding for public nursing
 1570  education in the state for the purpose of expanding the
 1571  affordability and accessibility of college credit for a nursing
 1572  education.
 1573         (2)The program shall be funded by moneys designated
 1574  pursuant to s. 210.20 and for the purposes provide in this
 1575  section, which shall be divided equally between the State
 1576  University System and the Community College System.
 1577         (3)The funds awarded by the Chancellor of the State
 1578  University System or the Chancellor of the Community College
 1579  System shall be distributed to support, as appropriate:
 1580         (a)Nursing faculty salary enhancements or bonuses;
 1581         (b)Patient simulators that may be used for clinical
 1582  experience;
 1583         (c)Scholarships that may be used by the nursing faculty to
 1584  obtain advanced degrees in the nursing field; and
 1585         (d)Other nursing-related instructional activities.
 1586         (4)The Chancellor of the State University System and the
 1587  Chancellor of the Community College System shall submit a
 1588  report, which details the initial use of the funds and the
 1589  anticipated impact of the program on the state’s nursing
 1590  shortage, to the Governor, the President of the Senate, and the
 1591  Speaker of the House of Representatives by January 15, 2010.
 1592         (5)The State University System and the Community College
 1593  System may adopt rules to administer this section.
 1594         Section 22. Subsections (1), (4), and (5) of section
 1595  1009.68, Florida Statutes, are amended to read:
 1596         1009.68 Florida Minority Medical Education Program.—
 1597         (1) There is created a Florida Minority Medical Education
 1598  Program to be administered by the Department of Education in
 1599  accordance with rules established by the State Board of
 1600  Education. The program shall provide scholarships to enable
 1601  minority students to pursue a medical education at the
 1602  University of Florida, the University of South Florida, Florida
 1603  State University, the University of Miami, including Florida
 1604  Atlantic University, or Southeastern University of the Health
 1605  Sciences, the University of Central Florida, or Florida
 1606  International University for the purpose of addressing the
 1607  primary health care needs of underserved groups.
 1608         (4) The number of scholarships annually awarded shall be
 1609  equally distributed to the institutions listed in subsection (1)
 1610  from moneys allocated pursuant to s. 210.20; however, any unused
 1611  scholarships may be redistributed by the department to
 1612  institutions having qualified applicants three per school.
 1613  Priority in the distribution of scholarships shall be given to
 1614  students with the lowest total family resources.
 1615         (5) Funds appropriated by the Legislature for the program,
 1616  which shall be substantially funded pursuant to s. 210.20, shall
 1617  be deposited in the State Student Financial Assistance Trust
 1618  Fund. Interest income accruing to the program from funds of the
 1619  program in the trust fund not allocated shall increase the funds
 1620  available for scholarships. Any balance in the trust fund at the
 1621  end of any fiscal year which that has been allocated to the
 1622  program shall remain in the trust fund and shall be available
 1623  for carrying out the purposes in of this section.
 1624         Section 23. Section 1013.83, Florida Statutes, is created
 1625  to read:
 1626         1013.83Florida Medical School Facilities Program.—
 1627         (1)The Florida Medical School Facilities Program is
 1628  established and shall be administered by the Board of Governors.
 1629         (2)Funds appropriated for the program shall be used to
 1630  construct and equip state medical schools and other related
 1631  facilities in the state. The Board of Governors shall solicit
 1632  competitive proposals for the use of such funds. Preference
 1633  shall be given to proposals from institutions which demonstrate
 1634  the greatest need in fulfilling their core medical education
 1635  mission, as well as proposals involving collaborative or shared
 1636  use facilities.
 1637         (3)The program shall be funded with proceeds designated
 1638  pursuant to s. 210.20.
 1639         (4)This section shall expire June 30, 2017.
 1640         (5)The Board of Governors may adopt rules to administer
 1641  and implement this section.
 1642         Section 24. The additional tax imposed by s. 210.20,
 1643  Florida Statutes, applies to existing inventory on the effective
 1644  date of this act. On July 1, 2009, each manufacturer,
 1645  distributor, wholesaler, and vendor in the state shall take an
 1646  inventory of the cigarettes in its possession before opening for
 1647  business. The amount of inventory shall be certified to the
 1648  Division of Alcoholic Beverages and Tobacco of the Department of
 1649  Business and Professional Regulation on or before July 21, 2009,
 1650  and shall include documentation accompanied by certified check,
 1651  money order, or an electronic funds transfer for the amount of
 1652  the additional tax due on the inventory. Chapter 210, Florida
 1653  Statutes, relating to penalties and interest for delinquent
 1654  payments applies to this section. The proceeds of the additional
 1655  tax on the existing inventory shall be deposited into the
 1656  Cigarette Tax Collection Trust Fund and shall be distributed in
 1657  accordance with the manner prescribed in s. 210.20, Florida
 1658  Statutes.
 1659         Section 25. By December 1, 2009, and before December 1 of
 1660  each year thereafter, the Department of Health shall submit to
 1661  the Governor, the President of the Senate, and the Speaker of
 1662  the House of Representatives a report containing an estimate of
 1663  the financial impact that tobacco use and tobacco-related
 1664  illnesses have on the state's economy and its taxpayers for each
 1665  of the prior 10 years, as well as an estimate of the value of
 1666  cost savings associated with the expenditure of revenues
 1667  generated by the cigarette tax imposed pursuant to s. 210.02,
 1668  Florida Statutes, during the same period.
 1669         Section 26. This act shall take effect July 1, 2009.