CS for CS for SB 2614 First Engrossed
20092614e1
1 A bill to be entitled
2 An act relating to health care; amending s. 154.503,
3 F.S.; conforming a cross-reference; repealing s.
4 381.0053, F.S., relating to a comprehensive nutrition
5 program; repealing s. 381.0054, F.S., relating to
6 healthy lifestyles promotion; repealing ss. 381.732,
7 381.733, and 381.734, F.S., relating to the Healthy
8 Communities, Healthy People Act; amending s. 381.006,
9 F.S.; requiring the Department of Health, when
10 conducting an environmental health program inspection
11 of a certified domestic violence center and certain
12 residential child-caring agencies to limit the
13 inspection of the domestic violence center or
14 residential child-caring agency to the requirements
15 set forth in the department’s rules applicable to
16 community-based residential facilities with five or
17 fewer residents; requiring the Department of Health to
18 include in its environmental health program the
19 testing of the air in enclosed ice rinks; authorizing
20 the department to adopt rules relating to air quality
21 standards, monitoring, testing, record keeping, the
22 maintenance and operation of equipment that affects
23 air quality, and assessment of fees; authorizing the
24 department to enter and inspect an enclosed ice
25 skating rink at reasonable hours to determine
26 compliance with applicable air quality statutes or
27 rules; authorizing the department to assess a fee for
28 a specified purpose; requiring the air quality
29 standards be consistent with federal risk values or
30 exposure guidelines; amending s. 381.0061, F.S.;
31 providing that the department may impose a fine, which
32 may not exceed a specified amount for a violation of
33 the ice rink air quality standards; amending s.
34 381.0072, F.S.; requiring the Department of Health,
35 when conducting a food service inspection of a
36 certified domestic violence center to limit the
37 inspection of the domestic violence center to the
38 requirements set forth in the department’s rules
39 applicable to community-based residential facilities
40 with five or fewer residents; amending s. 381.0203,
41 F.S.; requiring certain state agencies to purchase
42 drugs through the statewide purchasing contract
43 administered by the Department of Health; providing an
44 exception; requiring the department to establish and
45 maintain certain pharmacy services program;
46 transferring, renumbering, and amending s. 381.84,
47 F.S., relating to the Comprehensive Statewide Tobacco
48 Education and Use Prevention Program; revising
49 definitions; revising program components; requiring
50 program components to include efforts to educate youth
51 and their parents about tobacco use; requiring a
52 youth-directed focus in each program component;
53 requiring the Tobacco Education and Use Prevention
54 Advisory Council to adhere to state ethics laws;
55 providing that meetings of the council are subject to
56 public-records and public-meetings requirements;
57 revising the duties of the council; deleting a
58 provision that prohibits a member of the council from
59 participating in a discussion or decision with respect
60 to a research proposal by a firm, entity, or agency
61 with which the member is associated as a member of the
62 governing body or as an employee or with which the
63 member has entered into a contractual arrangement;
64 revising the submission date of an annual report;
65 deleting an expired provision relating to rulemaking
66 authority of the department; transferring and
67 renumbering s. 381.91, F.S., relating to the Jessie
68 Trice Cancer Prevention Program; transferring,
69 renumbering, and amending s. 381.911, F.S., relating
70 to the Prostate Cancer Awareness Program; revising the
71 criteria for members of the prostate cancer advisory
72 committee; repealing s. 381.912, F.S., relating to the
73 Cervical Cancer Elimination Task Force; transferring
74 and renumbering s. 381.92, F.S., relating to the
75 Florida Cancer Council; transferring and renumbering
76 s. 381.921, F.S., relating to the mission and duties
77 of the Florida Cancer Council; amending s. 381.922,
78 F.S.; conforming cross-references; transferring and
79 renumbering s. 381.93, F.S., relating to a breast and
80 cervical cancer early detection program; transferring
81 and renumbering s. 381.931, F.S., relating to an
82 annual report on Medicaid expenditures; renaming ch.
83 385, F.S., as the “Healthy and Fit Florida Act”;
84 amending s. 385.101, F.S.; renaming the “Chronic
85 Diseases Act” as the “Healthy and Fit Florida Act”;
86 amending s. 385.102, F.S.; revising legislative
87 intent; creating s. 385.1021, F.S.; providing
88 definitions; creating s. 385.1022, F.S.; requiring the
89 Department of Health to support public health programs
90 to reduce the incidence of mortality and morbidity
91 from chronic diseases; creating s. 385.1023, F.S.;
92 requiring the department to create state-level
93 programs that address the risk factors of certain
94 chronic diseases; providing required activities of the
95 state-level programs; amending s. 385.103, F.S.;
96 providing for community-level programs for the
97 prevention of chronic diseases; revising definitions;
98 requiring the department to develop and implement a
99 community-based chronic disease prevention and health
100 promotion program; providing the purpose of the
101 program; providing requirements for the program;
102 creating s. 385.105, F.S.; requiring the department to
103 develop programs to increase physical fitness, to work
104 with school districts, to develop partnerships that
105 allow the public to access recreational facilities and
106 public land areas suitable for physical activity, to
107 work with the Executive Office of the Governor and
108 Volunteer Florida, Inc., to promote school
109 initiatives, and to collaborate with the Department of
110 Education in recognizing nationally accepted best
111 practices for improving physical education in schools;
112 requiring the Department of Health to promote healthy
113 lifestyles to reduce obesity; requiring the department
114 to promote optimal nutritional status in all stages of
115 people’s lives, personal responsibility to prevent
116 chronic disease or slow its progression, and regular
117 health visits during a person’s life span; authorizing
118 state agencies to conduct employee wellness programs;
119 requiring the department to serve as a model to
120 develop and implement employee wellness programs;
121 requiring the department to assist state agencies to
122 develop the employee wellness programs; providing
123 equal access to the programs by agency employees;
124 requiring the department to coordinate efforts with
125 the Department of Management Services and other state
126 agencies; authorizing each state agency to establish
127 an employee wellness work group to design the wellness
128 program; requiring the department to provide
129 requirements for participation fees, collaborations
130 with businesses, and procurement of equipment and
131 incentives; amending s. 385.202, F.S.; requiring
132 facilities, laboratories, and practitioners to report
133 information; authorizing the department to adopt rules
134 regarding reporting requirements for the cancer
135 registry; providing immunity from liability for
136 facilities and practitioners reporting certain
137 information; requiring the department to adopt rules
138 regarding the establishment and operation of a
139 statewide cancer registry program; requiring the
140 department or contractual designee operating the
141 statewide cancer registry program to use or publish
142 material only for the purpose of public health
143 surveillance and advancing medical research or medical
144 education in the interest of reducing morbidity or
145 mortality; authorizing the department to exchange
146 personal data with any agency or contractual designee
147 for the purpose of public health surveillance and
148 medical or scientific research under certain
149 circumstances; clarifying that the department may
150 adopt rules regarding the classifications of
151 facilities related to reports made to the cancer
152 registry; requiring each facility and practitioner
153 that reports cancer cases to the department to make
154 their records available for onsite review; amending s.
155 385.203, F.S.; increasing the size of the Diabetes
156 Advisory Council to include one representative of the
157 Florida Academy of Family Physicians; amending s.
158 385.206, F.S.; renaming the “hematology-oncology care
159 center program” as the “Pediatric Hematology-Oncology
160 Center Program”; revising definitions; authorizing the
161 department to designate centers and provide funding to
162 maintain programs for the care of patients with
163 hematologic and oncologic disorders; clarifying
164 provisions related to grant-funding agreements and
165 grant disbursements; revising the department’s
166 requirement to evaluate services rendered by the
167 centers; requiring data from the centers and other
168 sources relating to pediatric cancer to be available
169 to the department for program planning and quality
170 assurance initiatives; amending s. 385.207, F.S.;
171 clarifying provisions that require the department to
172 collect information regarding the number of clients
173 served, the outcomes reached, the expense incurred,
174 and fees collected by providers of epilepsy services;
175 deleting the provision that requires the department to
176 limit administrative expenses from the Epilepsy
177 Services Trust Fund to a certain percentage of annual
178 receipts; amending s. 385.210, F.S.; revising
179 legislative findings regarding the economic costs of
180 treating arthritis and its complications; authorizing
181 the State Surgeon General to seek any federal waivers
182 that may be necessary to maximize funds from the
183 Federal Government to implement the Arthritis
184 Prevention and Education Program; creating s. 385.301,
185 F.S.; authorizing the department to adopt rules to
186 administer the act; amending s. 409.904, F.S.;
187 conforming a cross-reference; creating the Pharmacy
188 and Therapeutic Advisory Council within the Executive
189 Office of the Governor; providing duties of the
190 council; providing for the appointment and
191 qualification of members; providing for the use of
192 subject-matter experts when necessary; providing
193 requirements for voting and a quorum; providing for
194 quarterly meetings of the council; providing for
195 staffing; providing for reimbursement of per diem and
196 travel expenses for members of the council; amending
197 s. 430.80, F.S.; redefining the term “teaching nursing
198 home” as it relates to the implementation of a
199 teaching nursing home pilot project; revising the
200 requirements to be designated as a teaching nursing
201 home; amending s. 499.003, F.S.; excluding from the
202 definition of “wholesale distribution” certain
203 activities of state agencies; providing an effective
204 date.
205
206 Be It Enacted by the Legislature of the State of Florida:
207
208 Section 1. Paragraph (e) of subsection (2) of section
209 154.503, Florida Statutes, is amended to read:
210 154.503 Primary Care for Children and Families Challenge
211 Grant Program; creation; administration.—
212 (2) The department shall:
213 (e) Coordinate with the primary care program developed
214 pursuant to s. 154.011, the Florida Healthy Kids Corporation
215 program created in s. 624.91, the school health services program
216 created in ss. 381.0056 and 381.0057, the Healthy Communities,
217 Healthy People Program created in s. 381.734, and the volunteer
218 health care provider program developed pursuant to s. 766.1115.
219 Section 2. Sections 381.0053, 381.0054, 381.732, 381.733,
220 and 381.734, Florida Statutes, are repealed.
221 Section 3. Subsection (16) of section 381.006, Florida
222 Statutes, is amended, and subsection (18) is added to that
223 section, to read:
224 381.006 Environmental health.—The department shall conduct
225 an environmental health program as part of fulfilling the
226 state’s public health mission. The purpose of this program is to
227 detect and prevent disease caused by natural and manmade factors
228 in the environment. The environmental health program shall
229 include, but not be limited to:
230 (16) A group-care-facilities function, where a group care
231 facility means any public or private school, housing, building
232 or buildings, section of a building, or distinct part of a
233 building or other place, whether operated for profit or not,
234 which undertakes, through its ownership or management, to
235 provide one or more personal services, care, protection, and
236 supervision to persons who require such services and who are not
237 related to the owner or administrator. The department may adopt
238 rules necessary to protect the health and safety of residents,
239 staff, and patrons of group care facilities, such as child care
240 facilities, family day care homes, assisted living facilities,
241 adult day care centers, adult family care homes, hospices,
242 residential treatment facilities, crisis stabilization units,
243 pediatric extended care centers, intermediate care facilities
244 for the developmentally disabled, group care homes, and, jointly
245 with the Department of Education, private and public schools.
246 These rules may include definitions of terms; provisions
247 relating to operation and maintenance of facilities, buildings,
248 grounds, equipment, furnishings, and occupant-space
249 requirements; lighting; heating, cooling, and ventilation; food
250 service; water supply and plumbing; sewage; sanitary facilities;
251 insect and rodent control; garbage; safety; personnel health,
252 hygiene, and work practices; and other matters the department
253 finds are appropriate or necessary to protect the safety and
254 health of the residents, staff, or patrons. The department may
255 not adopt rules that conflict with rules adopted by the
256 licensing or certifying agency. The department may enter and
257 inspect at reasonable hours to determine compliance with
258 applicable statutes or rules. An environmental health program
259 inspection of a certified domestic violence center or
260 residential child-caring agency licensed by the Department of
261 Children and Family Services pursuant to chapter 409 shall be
262 limited to the requirements set forth in the department’s rules
263 applicable to community-based residential facilities with five
264 or fewer residents. In addition to any sanctions that the
265 department may impose for violations of rules adopted under this
266 section, the department shall also report such violations to any
267 agency responsible for licensing or certifying the group care
268 facility. The licensing or certifying agency may also impose any
269 sanction based solely on the findings of the department.
270
271 The department may adopt rules to carry out the provisions of
272 this section.
273 (18) A function related to air quality inside an enclosed
274 ice rink to protect the health and safety of visitors and
275 employees of an enclosed ice skating rink from dangers
276 associated with oxides of nitrogen (NOX), hydrocarbons (CXHX),
277 carbon monoxide (CO), carbon dioxide (CO2) and other harmful
278 gasses, vapors, or particles as identified by the department
279 that change the air quality due to the operation of the ice
280 rink. The department may adopt rules including definitions; air
281 quality standards, monitoring, testing, and record keeping;
282 maintenance and operation requirements for equipment that
283 affects air quality; ventilation of the facility; operators’
284 required response activities to the exceedance of an air quality
285 standard; and assessment of fees. The department may enter and
286 inspect an enclosed ice skating rink at reasonable hours to
287 determine compliance with applicable statutes or rules. The
288 department may assess a fee no greater than $300 to cover the
289 actual costs of the annual inspection and review of the air
290 quality of enclosed ice skating rinks. The air quality standards
291 adopted by the department must be consistent with risk values or
292 exposure guidelines recommended by the United States
293 Environmental Protection Agency or the United States Centers for
294 Disease Control and Prevention.
295 Section 4. Subsection (1) of section 381.0061, Florida
296 Statutes, is amended to read:
297 381.0061 Administrative fines.—
298 (1) In addition to any administrative action authorized by
299 chapter 120 or by other law, the department may impose a fine,
300 which shall not exceed $500 for each violation, for a violation
301 of s. 381.006(16), s. 381.006(18), s. 381.0065, s. 381.0066, s.
302 381.0072, or part III of chapter 489, for a violation of any
303 rule adopted under this chapter, or for a violation of any of
304 the provisions of chapter 386. Notice of intent to impose such
305 fine shall be given by the department to the alleged violator.
306 Each day that a violation continues may constitute a separate
307 violation.
308 Section 5. Paragraph (a) of subsection (2) of section
309 381.0072, Florida Statutes, is amended to read:
310 381.0072 Food service protection.—It shall be the duty of
311 the Department of Health to adopt and enforce sanitation rules
312 consistent with law to ensure the protection of the public from
313 food-borne illness. These rules shall provide the standards and
314 requirements for the storage, preparation, serving, or display
315 of food in food service establishments as defined in this
316 section and which are not permitted or licensed under chapter
317 500 or chapter 509.
318 (2) DUTIES.—
319 (a) The department shall adopt rules, including definitions
320 of terms which are consistent with law prescribing minimum
321 sanitation standards and manager certification requirements as
322 prescribed in s. 509.039, and which shall be enforced in food
323 service establishments as defined in this section. The
324 sanitation standards must address the construction, operation,
325 and maintenance of the establishment; lighting, ventilation,
326 laundry rooms, lockers, use and storage of toxic materials and
327 cleaning compounds, and first-aid supplies; plan review; design,
328 construction, installation, location, maintenance, sanitation,
329 and storage of food equipment and utensils; employee training,
330 health, hygiene, and work practices; food supplies, preparation,
331 storage, transportation, and service, including access to the
332 areas where food is stored or prepared; and sanitary facilities
333 and controls, including water supply and sewage disposal;
334 plumbing and toilet facilities; garbage and refuse collection,
335 storage, and disposal; and vermin control. Public and private
336 schools, if the food service is operated by school employees;
337 hospitals licensed under chapter 395; nursing homes licensed
338 under part II of chapter 400; child care facilities as defined
339 in s. 402.301; residential facilities colocated with a nursing
340 home or hospital, if all food is prepared in a central kitchen
341 that complies with nursing or hospital regulations; and bars and
342 lounges, as defined by department rule, are exempt from the
343 rules developed for manager certification. The department shall
344 administer a comprehensive inspection, monitoring, and sampling
345 program to ensure such standards are maintained. With respect to
346 food service establishments permitted or licensed under chapter
347 500 or chapter 509, the department shall assist the Division of
348 Hotels and Restaurants of the Department of Business and
349 Professional Regulation and the Department of Agriculture and
350 Consumer Services with rulemaking by providing technical
351 information. Food service inspections of a certified domestic
352 violence center shall be limited to the requirements set forth
353 in the department’s rules applicable to community-based
354 residential facilities with five or fewer residents.
355 Section 6. Subsection (1) and paragraph (a) of subsection
356 (2) of section 381.0203, Florida Statutes, are amended to read:
357 381.0203 Pharmacy services.—
358 (1) The department must may contract on a statewide basis
359 for the purchase of drugs, as defined in s. 499.003, to be used
360 by state agencies and political subdivisions, and may adopt
361 rules to administer this section. Effective January 1, 2010, all
362 state agencies, except the Agency for Health Care
363 Administration, the Department of Veterans’ Affairs, and the
364 Department of Management Services, must purchase drugs through
365 the statewide contract unless:
366 (a) The Pharmacy and Therapeutic Advisory Council approves
367 a more cost-effective purchasing plan; or
368 (b) The drugs required are not available through the
369 statewide purchasing contract.
370 (2) The department must may establish and maintain a
371 pharmacy services program that includes, including, but is not
372 limited to:
373 (a) A central pharmacy to support pharmaceutical services
374 provided by the county health departments, including
375 pharmaceutical repackaging, dispensing, and the purchase and
376 distribution of immunizations and other pharmaceuticals. Such
377 services shall be provided to other state agencies and political
378 subdivisions of the state upon written agreement. State agencies
379 purchasing pharmaceutical services shall purchase pharmaceutical
380 services, including pharmaceutical repackaging and dispensing
381 services in the most cost-effective manner consistent with the
382 delivery of quality medical care. Nothing in this subsection
383 prohibits state agencies from contracting with vendors to
384 provide these pharmaceutical services. Cost savings realized by
385 the state through utilization of the central pharmacy may be
386 used by the department to offset additional costs.
387 Section 7. Section 381.84, Florida Statutes, is
388 transferred, renumbered as section 385.106, Florida Statutes,
389 and amended to read:
390 385.106 381.84 Comprehensive Statewide Tobacco Education
391 and Use Prevention Program.—
392 (1) DEFINITIONS.—As used in this section and for purposes
393 of the provisions of s. 27, Art. X of the State Constitution,
394 the term:
395 (a) “AHEC network” means an area health education center
396 network established under s. 381.0402.
397 (b) “Best practices” means the Best Practices for
398 Comprehensive Tobacco Control Programs as established by the
399 CDC, as amended.
400 (c)(b) “CDC” means the United States Centers for Disease
401 Control and Prevention.
402 (d)(c) “Council” means the Tobacco Education and Use
403 Prevention Advisory Council.
404 (d) “Department” means the Department of Health.
405 (e) “Tobacco” means, without limitation, tobacco itself and
406 tobacco products that include tobacco and are intended or
407 expected for human use or consumption, including, but not
408 limited to, cigarettes, cigars, pipe tobacco, and smokeless
409 tobacco.
410 (f) “Youth” means minors and young adults.
411 (2) PURPOSE, FINDINGS, AND INTENT.—It is the purpose of
412 this section to implement s. 27, Art. X of the State
413 Constitution. The Legislature finds that s. 27, Art. X of the
414 State Constitution requires the funding of a statewide tobacco
415 education and use prevention program that focuses on tobacco use
416 by youth. The Legislature further finds that the primary goals
417 of the program are to reduce the prevalence of tobacco use among
418 youth, adults, and pregnant women; reduce per capita tobacco
419 consumption; and reduce exposure to environmental tobacco smoke.
420 Further, it is the intent of the Legislature to base increases
421 in funding for individual components of the program on the
422 results of assessments and evaluations. Recognizing that some
423 components will need to grow faster than inflation, it is the
424 intent of the Legislature to fund portions of the program on a
425 nonrecurring basis in the early years so that those components
426 that are most effective can be supported as the program matures.
427 (3) PROGRAM COMPONENTS AND REQUIREMENTS.—The department
428 shall conduct a comprehensive, statewide tobacco education and
429 use prevention program consistent with the recommendations for
430 effective program components contained in the 1999 Best
431 Practices for Comprehensive Tobacco Control Programs of the CDC,
432 as amended by the CDC. The program shall include the following
433 components, each of which shall focus on educating people,
434 particularly youth and their parents, about the health hazards
435 of tobacco and discouraging the use of tobacco. All program
436 components shall include efforts to educate youth and their
437 parents about tobacco use, and a youth-directed focus shall
438 exist in all components outlined in this subsection.:
439 (a) State and community interventions.—These interventions
440 shall include, but not be limited to, a statewide tobacco
441 control program that combines and coordinates community-based
442 interventions that focus on preventing initiation of tobacco use
443 among youth and young adults; promoting quitting among adults,
444 youth, and pregnant women; eliminating exposure to secondhand
445 smoke; identifying and eliminating tobacco-related disparities
446 among population groups; and promoting a range of collaborations
447 to prevent and alleviate the effects of chronic diseases.
448 Counter-marketing and advertising; cyberspace resource center.
449 The counter-marketing and advertising campaign shall include, at
450 a minimum, Internet, print, radio, and television advertising
451 and shall be funded with a minimum of one-third of the total
452 annual appropriation required by s. 27, Art. X of the State
453 Constitution. A cyberspace resource center for copyrighted
454 materials and information concerning tobacco education and use
455 prevention, including cessation, shall be maintained by the
456 program. Such resource center must be accessible to the public,
457 including parents, teachers, and students, at each level of
458 public and private schools, universities, and colleges in the
459 state and shall provide links to other relevant resources. The
460 Internet address for the resource center must be incorporated in
461 all advertising. The information maintained in the resource
462 center shall be used by the other components of the program.
463 (b) Health communication interventions.—Effective media and
464 health communication intervention efforts include, but are not
465 limited to, audience research to define themes and execute
466 messages for influential, high impact, and specifically targeted
467 campaigns; market research to identify the target market and the
468 behavioral theory motivating change; counter-marketing
469 surveillance; community tie-ins to support and reinforce the
470 statewide campaign; technologies such as viral marketing, social
471 networks, personal web pages, and web logs; traditional media;
472 process and outcome evaluation of the communication efforts; and
473 promotion of available services, including the state telephone
474 cessation quitline. Cessation programs, counseling, and
475 treatment.—This program component shall include two
476 subcomponents:
477 1. A statewide toll-free cessation service, which may
478 include counseling, referrals to other local resources and
479 support services, and treatment to the extent funds are
480 available for treatment services; and
481 2. A local community-based program to disseminate
482 information about smoking cessation, how smoking cessation
483 relates to prenatal care and obesity prevention, and other
484 chronic tobacco-related diseases.
485 (c) Cessation interventions.—Cessation interventions
486 include, but are not limited to, sustaining, expanding, and
487 promoting the service through population-based counseling and
488 treatment programs; encouraging public and private insurance
489 coverage for counseling and FDA-approved medication treatments
490 for tobacco-use cessation; eliminating cost and other barriers
491 to treatment for underserved populations; and making health care
492 system changes. Youth interventions to prevent tobacco-use
493 initiation and encourage cessation among young people are needed
494 in order to reshape the environment so that it supports tobacco
495 free norms. Because most people who start smoking are younger
496 than 18 years of age, intervening during adolescence is
497 critical. Community programs and school-based policies and
498 interventions should be a part of a comprehensive effort that is
499 implemented in coordination with community and school
500 environments and in conjunction with increasing the unit price
501 of tobacco products, sustaining anti-tobacco media campaigns,
502 making environments tobacco free, and engaging in other efforts
503 to create tobacco-free social norms. Surveillance and
504 evaluation.—The program shall conduct ongoing epidemiological
505 surveillance and shall contract for annual independent
506 evaluations of the effectiveness of the various components of
507 the program in meeting the goals as set forth in subsection (2).
508 (d) Surveillance and evaluation.—The surveillance and
509 evaluation of all program components shall monitor and document
510 short-term, intermediate, and long-term intervention outcomes to
511 inform program and policy direction and ensure accountability.
512 The surveillance and evaluation must be conducted objectively
513 through scientifically sound methodology. Youth school
514 programs.—School and after-school programs shall use current
515 evidence-based curricula and programs that involve youth to
516 educate youth about the health hazards of tobacco, help youth
517 develop skills to refuse tobacco, and demonstrate to youth how
518 to stop using tobacco.
519 (e) Administration and management.—Administration and
520 management activities include, but are not limited to, strategic
521 planning to guide program efforts and resources in order to
522 accomplish goals; recruiting and developing qualified and
523 diverse technical, program, and administrative staff; awarding
524 and monitoring program contracts and grants to coordinate
525 implementation across program areas; developing and maintaining
526 a fiscal-management system to track allocations and the
527 expenditure of funds; increasing capacity at the community level
528 through ongoing training and technical assistance; creating
529 effective communications internally among chronic disease
530 prevention programs and local coalitions and partners; and
531 educating the public and decisionmakers on the health effects of
532 tobacco and evidence-based effective program and policy
533 interventions. Community programs and chronic disease
534 prevention.—The department shall promote and support local
535 community-based partnerships that emphasize programs involving
536 youth, including programs for the prevention, detection, and
537 early intervention of smoking-related chronic diseases.
538 (f) Training.—The program shall include the training of
539 health care practitioners, smoking-cessation counselors, and
540 teachers by health professional students and other tobacco-use
541 prevention specialists who are trained in preventing tobacco use
542 and health education. Smoking-cessation counselors shall be
543 trained by specialists who are certified in tobacco-use
544 cessation.
545 (g) County health departments Administration, statewide
546 programs, and county health departments.—Each county health
547 department is eligible to receive a portion of the annual
548 appropriation, on a per capita basis, for coordinating tobacco
549 education and use prevention programs within that county.
550 Appropriated funds may be used to improve the infrastructure of
551 the county health department to implement the comprehensive,
552 statewide tobacco education and use prevention program. Each
553 county health department shall prominently display in all
554 treatment rooms and waiting rooms, counter-marketing and
555 advertisement materials in the form of wall posters, brochures,
556 television advertising if televisions are used in the lobby or
557 waiting room, and screensavers and Internet advertising if
558 computer kiosks are available for use or viewing by people at
559 the county health department.
560 (h) Enforcement and awareness of related laws.—In
561 coordination with the Department of Business and Professional
562 Regulation, the program shall monitor the enforcement of laws,
563 rules, and policies prohibiting the sale or other provision of
564 tobacco to minors, as well as the continued enforcement of the
565 Clean Indoor Air Act prescribed in chapter 386. The
566 advertisements produced in accordance with paragraph (b)
567 paragraph (a) may also include information designed to make the
568 public aware of these related laws and rules. The departments
569 may enter into interagency agreements to carry out this program
570 component.
571 (i) AHEC smoking-cessation initiative.—For the 2007-2008
572 and 2008-2009 fiscal years only, The AHEC network shall expand
573 the AHEC smoking-cessation initiative to each county within the
574 state and perform other activities as determined by the
575 department.
576 (4) ADVISORY COUNCIL; MEMBERS, APPOINTMENTS, AND MEETINGS.
577 The Tobacco Education and Use Prevention Advisory Council is
578 created within the department.
579 (a) The council shall consist of 23 members, including:
580 1. The State Surgeon General, who shall serve as the
581 chairperson.
582 2. One county health department director, appointed by the
583 State Surgeon General.
584 3. Two members appointed by the Commissioner of Education,
585 of whom one must be a school district superintendent.
586 4. The chief executive officer of the Florida Division of
587 the American Cancer Society, or his or her designee.
588 5. The chief executive officer of the Greater Southeast
589 Affiliate of the American Heart Association, or his or her
590 designee.
591 6. The chief executive officer of the American Lung
592 Association of Florida, or his or her designee.
593 7. The dean of the University of Miami School of Medicine,
594 or his or her designee.
595 8. The dean of the University of Florida College of
596 Medicine, or his or her designee.
597 9. The dean of the University of South Florida College of
598 Medicine, or his or her designee.
599 10. The dean of the Florida State University College of
600 Medicine, or his or her designee.
601 11. The dean of Nova Southeastern College of Osteopathic
602 Medicine, or his or her designee.
603 12. The dean of the Lake Erie College of Osteopathic
604 Medicine in Bradenton, Florida, or his or her designee.
605 13. The chief executive officer of the Campaign for Tobacco
606 Free Kids, or his or her designee.
607 14. The chief executive officer of the Legacy Foundation,
608 or his or her designee.
609 15. Four members appointed by the Governor, of whom two
610 must have expertise in the field of tobacco-use prevention and
611 education or smoking cessation and one individual who shall be
612 between the ages of 16 and 21 at the time of his or her
613 appointment.
614 16. Two members appointed by the President of the Senate,
615 of whom one must have expertise in the field of tobacco-use
616 prevention and education or smoking cessation.
617 17. Two members appointed by the Speaker of the House of
618 Representatives, of whom one must have expertise in the field of
619 tobacco-use prevention and education or smoking cessation.
620 (b) The appointments shall be for 3-year terms and shall
621 reflect the diversity of the state’s population. A vacancy shall
622 be filled by appointment by the original appointing authority
623 for the unexpired portion of the term.
624 (c) An appointed member may not serve more than two
625 consecutive terms.
626 (d) The council shall meet at least quarterly and upon the
627 call of the chairperson. Meetings may be held via teleconference
628 or other electronic means.
629 (e) Members of the council shall serve without
630 compensation, but are entitled to reimbursement for per diem and
631 travel expenses pursuant to s. 112.061. Members who are state
632 officers or employees or who are appointed by state officers or
633 employees shall be reimbursed for per diem and travel expenses
634 pursuant to s. 112.061 from the state agency through which they
635 serve.
636 (f) The council shall adhere to all state ethics laws.
637 Meetings of the council and the review panels are subject to
638 chapter 119, s. 286.011, and s. 24, Art. I of the State
639 Constitution. The department shall provide council members with
640 information and other assistance as is reasonably necessary to
641 assist the council in carrying out its responsibilities.
642 (5) COUNCIL DUTIES AND RESPONSIBILITIES.—The council shall
643 advise the State Surgeon General as to the direction and scope
644 of the Comprehensive Statewide Tobacco Education and Use
645 Prevention Program. The responsibilities of the council may
646 include, but are not limited to:
647 (a) Providing advice on program priorities and emphases.
648 (b) Providing advice on the overall program budget.
649 (c) Providing advice on copyrighted material, trademark,
650 and future transactions as they pertain to the tobacco education
651 and use prevention program.
652 (d) Reviewing, as requested by the department, broadcast
653 material prepared for the Internet, portable media players,
654 radio, and television advertisement as it relates to the
655 advertising component of the tobacco education and use
656 prevention program.
657 (e) Participating in periodic program evaluation, as
658 requested by the department.
659 (f) Assisting the department in developing the development
660 of guidelines to ensure fairness, neutrality, and adherence to
661 the principles of merit and quality in the conduct of the
662 program.
663 (g) Assisting the department in developing the development
664 of administrative procedures relating to solicitation, review,
665 and award of contracts and grants in order to ensure an
666 impartial, high-quality peer review system.
667 (h) Assisting the department in developing panels to review
668 and evaluate potential fund recipients the development and
669 supervision of peer review panels.
670 (i) Assisting the department in reviewing reports of peer
671 review panels and making recommendations for funding allocations
672 contracts and grants.
673 (j) Assisting the department in reviewing the activities
674 and evaluating the performance of the AHEC network to avoid
675 duplicative efforts using state funds.
676 (k) Recommending specific measureable outcomes meaningful
677 outcome measures through a regular review of evidence-based and
678 promising tobacco-use prevention and education strategies and
679 programs of other states and the Federal Government.
680 (l) Recommending policies to encourage a coordinated
681 response to tobacco use in this state, focusing specifically on
682 creating partnerships within and between the public and private
683 sectors.
684 (6) CONTRACT REQUIREMENTS.—Contracts or grants for the
685 program components or subcomponents described in paragraphs
686 (3)(a)-(f) shall be awarded by the State Surgeon General, after
687 consultation with the council, on the basis of merit, as
688 determined by an open, competitive, peer-reviewed process that
689 ensures objectivity, consistency, and high quality. The
690 department shall award such grants or contracts no later than
691 October 1 for each fiscal year. A recipient of a contract or
692 grant for the program component described in paragraph (3)(d)
693 (3)(c) is not eligible for a contract or grant award for any
694 other program component described in subsection (3) in the same
695 state fiscal year. A school or college of medicine that is
696 represented on the council is not eligible to receive a contract
697 or grant under this section. For the 2007-2008 and 2008-2009
698 fiscal years only, The department shall award a contract or
699 grant in the amount of $11 $10 million to the AHEC network for
700 the purpose of developing the components described in paragraph
701 (3)(i). The AHEC network may apply for a competitive contract or
702 grant after the 2008-2009 fiscal year.
703 (a) In order to ensure that all proposals for funding are
704 appropriate and are evaluated fairly on the basis of merit, the
705 State Surgeon General, in consultation with the council, shall
706 appoint a peer review panel of independent, qualified experts in
707 the field of tobacco control to review the content of each
708 proposal and establish its priority score. The priority scores
709 shall be forwarded to the council and must be considered in
710 determining which proposals will be recommended for funding.
711 (b) The council and the peer review panel shall establish
712 and follow rigorous guidelines for ethical conduct and adhere to
713 a strict policy with regard to conflicts of interest. Council
714 members are subject to the applicable provisions of chapter 112.
715 A member of the council or panel may not participate in any
716 discussion or decision with respect to a research proposal by
717 any firm, entity, or agency with which the member is associated
718 as a member of the governing body or as an employee or with
719 which the member has entered into a contractual arrangement.
720 Meetings of the council and the peer review panels are subject
721 to chapter 119, s. 286.011, and s. 24, Art. I of the State
722 Constitution.
723 (c) In each contract or grant agreement, the department
724 shall limit the use of food and promotional items to no more
725 than 2.5 percent of the total amount of the contract or grant
726 and limit overhead or indirect costs to no more than 7.5 percent
727 of the total amount of the contract or grant. The department, in
728 consultation with the Department of Financial Services, shall
729 publish guidelines for appropriate food and promotional items.
730 (d) In each advertising contract, the department shall
731 limit the total of production fees, buyer commissions, and
732 related costs to no more than 10 percent of the total contract
733 amount.
734 (e) Notwithstanding the competitive process for contracts
735 prescribed in this subsection, each county health department is
736 eligible for core funding, on a per capita basis, to implement
737 tobacco education and use prevention activities within that
738 county.
739 (7) ANNUAL REPORT REQUIRED.—By February 28 January 31 of
740 each year, the department shall provide to the Governor, the
741 President of the Senate, and the Speaker of the House of
742 Representatives a report that evaluates the program’s
743 effectiveness in reducing and preventing tobacco use and that
744 recommends improvements to enhance the program’s effectiveness.
745 The report must contain, at a minimum, an annual survey of youth
746 attitudes and behavior toward tobacco, as well as a description
747 of the progress in reducing the prevalence of tobacco use among
748 youth, adults, and pregnant women; reducing per capita tobacco
749 consumption; and reducing exposure to environmental tobacco
750 smoke.
751 (8) LIMITATION ON ADMINISTRATIVE EXPENSES.—From the total
752 funds appropriated for the Comprehensive Statewide Tobacco
753 Education and Use Prevention Program in the General
754 Appropriations Act, an amount of up to 5 percent may be used by
755 the department for administrative expenses.
756 (9) RULEMAKING AUTHORIZED.—By January 1, 2008, the
757 department shall adopt rules pursuant to ss. 120.536(1) and
758 120.54 to administer this section.
759 Section 8. Section 381.91, Florida Statutes, is transferred
760 and renumbered as section 385.2024, Florida Statutes, to read:
761 385.2024 381.91 Jessie Trice Cancer Prevention Program.—
762 (1) It is the intent of the Legislature to:
763 (a) Reduce the rates of illness and death from lung cancer
764 and other cancers and improve the quality of life among low
765 income African-American and Hispanic populations through
766 increased access to early, effective screening and diagnosis,
767 education, and treatment programs.
768 (b) Create a community faith-based disease-prevention
769 program in conjunction with the Health Choice Network and other
770 community health centers to build upon the natural referral and
771 education networks in place within minority communities and to
772 increase access to health service delivery in Florida.
773 (c) Establish a funding source to build upon local private
774 participation to sustain the operation of the program.
775 (2)(a) There is created the Jessie Trice Cancer Prevention
776 Program, to be located, for administrative purposes, within the
777 Department of Health, and operated from the community health
778 centers within the Health Choice Network in Florida.
779 (b) Funding may be provided to develop contracts with
780 community health centers and local community faith-based
781 education programs to provide cancer screening, diagnosis,
782 education, and treatment services to low-income populations
783 throughout the state.
784 Section 9. Section 381.911, Florida Statutes, is
785 transferred, renumbered as section 385.2023, Florida Statutes,
786 and amended to read:
787 385.2023 381.911 Prostate Cancer Awareness Program.—
788 (1) To the extent that funds are specifically made
789 available for this purpose, the Prostate Cancer Awareness
790 Program is established within the Department of Health. The
791 purpose of this program is to implement the recommendations of
792 January 2000 of the Florida Prostate Cancer Task Force to
793 provide for statewide outreach and health education activities
794 to ensure that men are aware of and appropriately seek medical
795 counseling for prostate cancer as an early-detection health care
796 measure.
797 (2) For purposes of implementing the program, the
798 Department of Health and the Florida Public Health Foundation,
799 Inc., may:
800 (a) Conduct activities directly or enter into a contract
801 with a qualified nonprofit community education entity.
802 (b) Seek any available gifts, grants, or funds from the
803 state, the Federal Government, philanthropic foundations, and
804 industry or business groups.
805 (3) A prostate cancer advisory committee is created to
806 advise and assist the Department of Health and the Florida
807 Public Health Foundation, Inc., in implementing the program.
808 (a) The State Surgeon General shall appoint the advisory
809 committee members, who shall consist of:
810 1. Three persons from prostate cancer survivor groups or
811 cancer-related advocacy groups.
812 2. Three persons who are scientists or clinicians from
813 public or nonpublic universities or research organizations.
814 3. Three persons who are engaged in the practice of a
815 cancer-related medical specialty from health organizations
816 committed to cancer research and control.
817 (b) Members shall serve without compensation but are
818 entitled to reimbursement, pursuant to s. 112.061, for per diem
819 and travel expenses incurred in the performance of their
820 official duties.
821 (4) The program shall coordinate its efforts with those of
822 the Florida Public Health Foundation, Inc.
823 Section 10. Section 381.912, Florida Statutes, is repealed.
824 Section 11. Section 381.92, Florida Statutes, is
825 transferred and renumbered as section 385.2025, Florida
826 Statutes, to read:
827 385.2025 381.92 Florida Cancer Council.—
828 (1) Effective July 1, 2004, the Florida Cancer Council
829 within the Department of Health is established for the purpose
830 of making the state a center of excellence for cancer research.
831 (2)(a) The council shall be representative of the state’s
832 cancer centers, hospitals, and patient groups and shall be
833 organized and shall operate in accordance with this act.
834 (b) The Florida Cancer Council may create not-for-profit
835 corporate subsidiaries to fulfill its mission. The council and
836 its subsidiaries are authorized to receive, hold, invest, and
837 administer property and any moneys acquired from private, local,
838 state, and federal sources, as well as technical and
839 professional income generated or derived from the mission
840 related activities of the council.
841 (c) The members of the council shall consist of:
842 1. The chair of the Florida Dialogue on Cancer, who shall
843 serve as the chair of the council;
844 2. The State Surgeon General or his or her designee;
845 3. The chief executive officer of the H. Lee Moffitt Cancer
846 Center or his or her designee;
847 4. The director of the University of Florida Shands Cancer
848 Center or his or her designee;
849 5. The chief executive officer of the University of Miami
850 Sylvester Comprehensive Cancer Center or his or her designee;
851 6. The chief executive officer of the Mayo Clinic,
852 Jacksonville, or his or her designee;
853 7. The chief executive officer of the American Cancer
854 Society, Florida Division, Inc., or his or her designee;
855 8. The president of the American Cancer Society, Florida
856 Division, Inc., Board of Directors or his or her designee;
857 9. The president of the Florida Society of Clinical
858 Oncology or his or her designee;
859 10. The president of the American College of Surgeons,
860 Florida Chapter, or his or her designee;
861 11. The chief executive officer of Enterprise Florida,
862 Inc., or his or her designee;
863 12. Five representatives from cancer programs approved by
864 the American College of Surgeons. Three shall be appointed by
865 the Governor, one shall be appointed by the Speaker of the House
866 of Representatives, and one shall be appointed by the President
867 of the Senate;
868 13. One member of the House of Representatives, to be
869 appointed by the Speaker of the House of Representatives; and
870 14. One member of the Senate, to be appointed by the
871 President of the Senate.
872 (d) Appointments made by the Speaker of the House of
873 Representatives and the President of the Senate pursuant to
874 paragraph (c) shall be for 2-year terms, concurrent with the
875 bienniums in which they serve as presiding officers.
876 (e) Appointments made by the Governor pursuant to paragraph
877 (c) shall be for 2-year terms, although the Governor may
878 reappoint members.
879 (f) Members of the council or any subsidiaries shall serve
880 without compensation, and each organization represented on the
881 council shall cover the expenses of its representatives.
882 (3) The council shall issue an annual report to the Center
883 for Universal Research to Eradicate Disease, the Governor, the
884 Speaker of the House of Representatives, and the President of
885 the Senate by December 15 of each year, with policy and funding
886 recommendations regarding cancer research capacity in Florida
887 and related issues.
888 Section 12. Section 381.921, Florida Statutes, is
889 transferred and renumbered as section 385.20251, Florida
890 Statutes, to read:
891 385.20251 381.921 Florida Cancer Council mission and
892 duties.—The council, which shall work in concert with the
893 Florida Center for Universal Research to Eradicate Disease to
894 ensure that the goals of the center are advanced, shall endeavor
895 to dramatically improve cancer research and treatment in this
896 state through:
897 (1) Efforts to significantly expand cancer research
898 capacity in the state by:
899 (a) Identifying ways to attract new research talent and
900 attendant national grant-producing researchers to cancer
901 research facilities in this state;
902 (b) Implementing a peer-reviewed, competitive process to
903 identify and fund the best proposals to expand cancer research
904 institutes in this state;
905 (c) Funding through available resources for those proposals
906 that demonstrate the greatest opportunity to attract federal
907 research grants and private financial support;
908 (d) Encouraging the employment of bioinformatics in order
909 to create a cancer informatics infrastructure that enhances
910 information and resource exchange and integration through
911 researchers working in diverse disciplines, to facilitate the
912 full spectrum of cancer investigations;
913 (e) Facilitating the technical coordination, business
914 development, and support of intellectual property as it relates
915 to the advancement of cancer research; and
916 (f) Aiding in other multidisciplinary research-support
917 activities as they inure to the advancement of cancer research.
918 (2) Efforts to improve both research and treatment through
919 greater participation in clinical trials networks by:
920 (a) Identifying ways to increase adult enrollment in cancer
921 clinical trials;
922 (b) Supporting public and private professional education
923 programs designed to increase the awareness and knowledge about
924 cancer clinical trials;
925 (c) Providing tools to cancer patients and community-based
926 oncologists to aid in the identification of cancer clinical
927 trials available in the state; and
928 (d) Creating opportunities for the state’s academic cancer
929 centers to collaborate with community-based oncologists in
930 cancer clinical trials networks.
931 (3) Efforts to reduce the impact of cancer on disparate
932 groups by:
933 (a) Identifying those cancers that disproportionately
934 impact certain demographic groups; and
935 (b) Building collaborations designed to reduce health
936 disparities as they relate to cancer.
937 Section 13. Paragraph (a) of subsection (2) and subsection
938 (5) of section 381.922, Florida Statutes, as amended by section
939 2 of chapter 2009-5, Laws of Florida, is amended to read:
940 381.922 William G. “Bill” Bankhead, Jr., and David Coley
941 Cancer Research Program.—
942 (2) The program shall provide grants for cancer research to
943 further the search for cures for cancer.
944 (a) Emphasis shall be given to the goals enumerated in s.
945 385.20251 s. 381.921, as those goals support the advancement of
946 such cures.
947 (5) For the 2008-2009 fiscal year and each fiscal year
948 thereafter, the sum of $6.75 million is appropriated annually
949 from recurring funds in the General Revenue Fund to the
950 Biomedical Research Trust Fund within the Department of Health
951 for purposes of the William G. “Bill” Bankhead, Jr., and David
952 Coley Cancer Research Program and shall be distributed pursuant
953 to this section to provide grants to researchers seeking cures
954 for cancer, with emphasis given to the goals enumerated in s.
955 385.20251 s. 381.921. From the total funds appropriated, an
956 amount of up to 10 percent may be used for administrative
957 expenses.
958 Section 14. Section 381.93, Florida Statutes, is
959 transferred and renumbered as section 385.2021, Florida
960 Statutes, to read:
961 385.2021 381.93 Breast and cervical cancer early detection
962 program.—This section may be cited as the “Mary Brogan Breast
963 and Cervical Cancer Early Detection Program Act.”
964 (1) It is the intent of the Legislature to reduce the rates
965 of death due to breast and cervical cancer through early
966 diagnosis and increased access to early screening, diagnosis,
967 and treatment programs.
968 (2) The Department of Health, using available federal funds
969 and state funds appropriated for that purpose, is authorized to
970 establish the Mary Brogan Breast and Cervical Cancer Screening
971 and Early Detection Program to provide screening, diagnosis,
972 evaluation, treatment, case management, and followup and
973 referral to the Agency for Health Care Administration for
974 coverage of treatment services.
975 (3) The Mary Brogan Breast and Cervical Cancer Early
976 Detection Program shall be funded through grants for such
977 screening and early detection purposes from the federal Centers
978 for Disease Control and Prevention under Title XV of the Public
979 Health Service Act, 42 U.S.C. ss. 300k et seq.
980 (4) The department shall limit enrollment in the program to
981 persons with incomes up to and including 200 percent of the
982 federal poverty level. The department shall establish an
983 eligibility process that includes an income-verification process
984 to ensure that persons served under the program meet income
985 guidelines.
986 (5) The department may provide other breast and cervical
987 cancer screening and diagnostic services; however, such services
988 shall be funded separately through other sources than this act.
989 Section 15. Section 381.931, Florida Statutes, is
990 transferred and renumbered as section 385.20211, Florida
991 Statutes, to read:
992 385.20211 381.931 Annual report on Medicaid expenditures.
993 The Department of Health and the Agency for Health Care
994 Administration shall monitor the total Medicaid expenditures for
995 services made under this act. If Medicaid expenditures are
996 projected to exceed the amount appropriated by the Legislature,
997 the Department of Health shall limit the number of screenings to
998 ensure Medicaid expenditures do not exceed the amount
999 appropriated. The Department of Health, in cooperation with the
1000 Agency for Health Care Administration, shall prepare an annual
1001 report that must include the number of women screened; the
1002 percentage of positive and negative outcomes; the number of
1003 referrals to Medicaid and other providers for treatment
1004 services; the estimated number of women who are not screened or
1005 not served by Medicaid due to funding limitations, if any; the
1006 cost of Medicaid treatment services; and the estimated cost of
1007 treatment services for women who were not screened or referred
1008 for treatment due to funding limitations. The report shall be
1009 submitted to the President of the Senate, the Speaker of the
1010 House of Representatives, and the Executive Office of the
1011 Governor by March 1 of each year.
1012 Section 16. Chapter 385, Florida Statutes, entitled
1013 “Chronic Diseases,” is renamed the “Healthy and Fit Florida
1014 Act.”
1015 Section 17. Section 385.101, Florida Statutes, is amended
1016 to read:
1017 385.101 Short title.—This chapter Sections 385.101-385.103
1018 may be cited as the “Healthy and Fit Florida Chronic Diseases
1019 Act.”
1020 Section 18. Section 385.102, Florida Statutes, is amended
1021 to read:
1022 385.102 Legislative intent.—It is the finding of the
1023 Legislature that:
1024 (1) Chronic diseases continue to be the leading cause of
1025 death and disability in this state and the country exist in high
1026 proportions among the people of this state. These Chronic
1027 diseases include, but are not limited to, arthritis,
1028 cardiovascular disease heart disease, hypertension, diabetes,
1029 renal disease, cancer, and chronic obstructive lung disease,
1030 including chronic obstructive pulmonary disease. These diseases
1031 are often have the same preventable risk factors interrelated,
1032 and they directly and indirectly account for a high rate of
1033 death, disability, and underlying costs to the state’s health
1034 care system illness.
1035 (2) Chronic diseases have a significant impact on quality
1036 of life, not only for the individuals who experience their
1037 painful symptoms and resulting disabilities, but also for family
1038 members and caregivers.
1039 (3) Racial and ethnic minorities and other underserved
1040 populations are disproportionately affected by chronic diseases.
1041 (4) There are enormous medical costs and lost wages
1042 associated with chronic diseases and their complications.
1043 (5)(2) Advances in medical knowledge and technology assist
1044 have assisted in the prevention, detection, and management of
1045 chronic diseases. Comprehensive approaches that stress the
1046 stressing application of current medical treatment, continuing
1047 research, professional training, and patient education, and
1048 community-level policy and environmental changes should be
1049 implemented encouraged.
1050 (6)(3) A comprehensive program dealing with the early
1051 detection and prevention of chronic diseases is required to make
1052 knowledge and therapy available to all people of this state. The
1053 mobilization of scientific, medical, and educational resources,
1054 along with the implementation of community-based policy under
1055 one comprehensive chronic disease law, act will facilitate the
1056 prevention, early intervention, and management treatment of
1057 chronic these diseases and their symptoms. This integration of
1058 resources and policy will and result in a decline in death and
1059 disability illness among the people of this state.
1060 (7) Chronic diseases account for 70 percent of all deaths
1061 in the United States. The following chronic diseases are the
1062 leading causes of death and disability:
1063 (a) Heart disease and stroke, which have remained the first
1064 and third leading causes of death for both men and women in the
1065 United States for over seven decades and account for
1066 approximately one-third of total deaths each year in this state.
1067 (b) Cancer, which is the second leading cause of death and
1068 is responsible for one in four deaths in this state.
1069 (c) Lung disease, which is the third leading cause of death
1070 and accounts for one in every six deaths in this state.
1071 (d) Diabetes, which is the sixth leading cause of death in
1072 this state.
1073 (e) Arthritis, which is the leading cause of disability in
1074 the United States, limiting daily activities for more than 19
1075 million citizens. In this state, arthritis limits daily
1076 activities for an estimated 1.3 million people.
1077 (8) The department shall establish, promote, and maintain
1078 state-level and local-level programs for chronic disease
1079 prevention and health promotion to the extent that funds are
1080 specifically made available for this purpose.
1081 Section 19. Section 385.1021, Florida Statutes, is created
1082 to read:
1083 385.1021 Definitions.—As used in this chapter, the term:
1084 (1) “CDC” means the United States Centers for Disease
1085 Control and Prevention.
1086 (2) “Chronic disease” means an illness that is prolonged,
1087 does not resolve spontaneously, and is rarely cured completely.
1088 (3) “Department” means the Department of Health.
1089 (4) “Environmental changes” means changes to the economic,
1090 social, or physical natural or built environments which
1091 encourage or enable behaviors.
1092 (5) “Policy change” means altering an informal or formal
1093 agreement between public or private sectors which sets forth
1094 values, behaviors, or resource allocation in order to improve
1095 health.
1096 (6) “Primary prevention” means an intervention that is
1097 directed toward healthy populations and focuses on avoiding
1098 disease before it occurs.
1099 (7) “Risk factor” means a characteristic or condition
1100 identified during the course of an epidemiological study of a
1101 disease that appears to be statistically associated with a high
1102 incidence of that disease.
1103 (8) “Secondary prevention” means an intervention that is
1104 designed to promote the early detection and management of
1105 diseases and reduce the risks experienced by at-risk
1106 populations.
1107 (9) “System changes” means altering standard activities,
1108 protocols, policies, processes, and structures carried out in
1109 population-based settings, such as schools, worksites, health
1110 care facilities, faith-based organizations, and the overall
1111 community, which promote and support new behaviors.
1112 (10) “Tertiary prevention” means an intervention that is
1113 directed at rehabilitating and minimizing the effects of disease
1114 in a chronically ill population.
1115 (11) “Tobacco” means, without limitation, tobacco itself
1116 and tobacco products that include tobacco and are intended or
1117 expected for human use or consumption, including, but not
1118 limited to, cigarettes, cigars, pipe tobacco, and smokeless
1119 tobacco.
1120 (12) “Wellness program” means a structured program that is
1121 designed or approved by the department to offer intervention
1122 activities on or off the worksite which help state employees
1123 change certain behaviors or adopt healthy lifestyles.
1124 (13) “Youth” means children and young adults, up through 24
1125 years of age, inclusive.
1126 Section 20. Section 385.1022, Florida Statutes, is created
1127 to read:
1128 385.1022 Chronic disease prevention program.—The department
1129 shall support public health programs to reduce the incidence of
1130 mortality and morbidity from diseases for which risk factors can
1131 be identified. Such risk factors include, but are not limited
1132 to, being overweight or obese, physical inactivity, poor
1133 nutrition and diet, tobacco use, sun exposure, and other
1134 practices that are detrimental to health. The programs shall
1135 educate and screen the general public as well as groups at
1136 particularly high risk of chronic diseases.
1137 Section 21. Section 385.1023, Florida Statutes, is created
1138 to read:
1139 385.1023 State-level prevention programs for chronic
1140 disease.—
1141 (1) The department shall create state-level programs that
1142 address the leading, preventable chronic disease risk factors of
1143 poor nutrition and obesity, tobacco use, sun exposure, and
1144 physical inactivity in order to decrease the incidence of
1145 arthritis, cancer, diabetes, heart disease, lung disease,
1146 stroke, and other chronic diseases.
1147 (2) State-level programs shall address, but need not be
1148 limited to, the following activities:
1149 (a) Monitoring specific causal and behavioral risk factors
1150 that affect the health of residents in the state.
1151 (b) Analyzing data regarding chronic disease mortality and
1152 morbidity to track changes over time.
1153 (c) Promoting public awareness and increasing knowledge
1154 concerning the causes of chronic diseases, the importance of
1155 early detection, diagnosis, and appropriate evidence-based
1156 prevention, management, and treatment strategies.
1157 (d) Disseminating educational materials and information
1158 concerning evidence-based results, available services, and
1159 pertinent new research findings and prevention strategies to
1160 patients, health insurers, health professionals, and the public.
1161 (e) Using education and training resources and services
1162 developed by organizations having appropriate expertise and
1163 knowledge of chronic diseases for technical assistance.
1164 (f) Evaluating the quality and accessibility of existing
1165 community-based services for chronic disease.
1166 (g) Increasing awareness among state and local officials
1167 involved in health and human services, health professionals and
1168 providers, and policymakers about evidence-based chronic-disease
1169 prevention, tobacco cessation, and treatment strategies and
1170 their benefits for people who have chronic diseases.
1171 (h) Developing a partnership with state and local
1172 governments, voluntary health organizations, hospitals, health
1173 insurers, universities, medical centers, employer groups,
1174 private companies, and health care providers to address the
1175 burden of chronic disease in this state.
1176 (i) Implementing and coordinating state-level policies in
1177 order to reduce the burden of chronic disease.
1178 (j) Providing lasting improvements in the delivery of
1179 health care for individuals who have chronic disease and their
1180 families, thus improving their quality of life while also
1181 containing health care costs.
1182 Section 22. Section 385.103, Florida Statutes, is amended
1183 to read:
1184 385.103 Community-level Community intervention programs for
1185 chronic disease prevention and health promotion.—
1186 (1) DEFINITIONS.—As used in this section, the term:
1187 (a) “Chronic disease prevention and health promotion
1188 control program” means a program that may include, but is not
1189 limited to, including a combination of the following elements:
1190 1. Staff who are sufficiently trained and skilled in public
1191 health, community health, or school health education to
1192 facilitate the operation of the program Health screening;
1193 2. Community input into the planning, implementation, and
1194 evaluation processes Risk factor detection;
1195 3. Use of public health data to make decisions and to
1196 develop and prioritize community-based interventions focusing on
1197 chronic diseases and their risk factors; Appropriate
1198 intervention to enable and encourage changes in behaviors that
1199 create health risks; and
1200 4. Adherence to a population-based approach by using a
1201 socioecological model that addresses the influence on individual
1202 behavior, interpersonal behavior, organizational behavior, the
1203 community, and public policy; Counseling in nutrition, physical
1204 activity, the effects of tobacco use, hypertension, blood
1205 pressure control, and diabetes control and the provision of
1206 other clinical prevention services.
1207 5. Focus on at least the common preventable risk factors
1208 for chronic disease, such as physical inactivity, obesity, poor
1209 nutrition, and tobacco use;
1210 6. Focus on developing and implementing interventions and
1211 activities through communities, schools, worksites, faith-based
1212 organizations, and health-care settings;
1213 7. Use of evidence-based interventions as well as best and
1214 promising practices to guide specific activities and effect
1215 change, which may include guidelines developed by organizations,
1216 volunteer scientists, and health care professionals who write
1217 published medical, scientific statements on various chronic
1218 disease topics. The statements shall be supported by scientific
1219 studies published in recognized journals that have a rigorous
1220 review and approval process. Scientific statements generally
1221 include a review of data available on a specific subject and an
1222 evaluation of its relationship to overall chronic disease
1223 science;
1224 8. Use of policy, system, and environmental changes that
1225 support healthy behaviors so as to affect large segments of the
1226 population and encourage healthy choices;
1227 9. Development of extensive and comprehensive evaluation
1228 that is linked to program planning at the state level and the
1229 community level in order to determine the program’s
1230 effectiveness or necessary program modifications; and
1231 10. Reduction of duplication of efforts through
1232 coordination among appropriate entities for the efficient use of
1233 resources.
1234 (b) “Community Health education program” means a program
1235 that follows involving the planned and coordinated use of the
1236 educational standards and teaching methods resources available
1237 in a community in an effort to provide:
1238 1. Appropriate medical, research-based interventions to
1239 enable and encourage changes in behaviors which reduce or
1240 eliminate health risks;
1241 2. Counseling in nutrition, weight management, physical
1242 inactivity, and tobacco-use prevention and cessation strategies;
1243 hypertension, blood pressure, high cholesterol, and diabetes
1244 control; and other clinical prevention services;
1245 3.1. Motivation and assistance to individuals or groups in
1246 adopting and maintaining Motivate and assist citizens to adopt
1247 and maintain healthful practices and lifestyles; and
1248 4.2. Make available Learning opportunities that which will
1249 increase the ability of people to make informed decisions
1250 affecting their personal, family, and community well-being and
1251 that which are designed to facilitate voluntary adoption of
1252 behavior that which will improve or maintain health.;
1253 3. Reduce, through coordination among appropriate agencies,
1254 duplication of health education efforts; and
1255 4. Facilitate collaboration among appropriate agencies for
1256 efficient use of scarce resources.
1257 (c) “Community intervention program” means a program
1258 combining the required elements of a chronic disease prevention
1259 and health promotion control program and the principles of a
1260 community health education program that addresses system,
1261 policy, and environmental changes that ensure that communities
1262 provide support for healthy lifestyles into a unified program
1263 over which a single administrative entity has authority and
1264 responsibility.
1265 (d) “Department” means the Department of Health.
1266 (e) “Risk factor” means a factor identified during the
1267 course of an epidemiological study of a disease, which factor
1268 appears to be statistically associated with a high incidence of
1269 that disease.
1270 (2) OPERATION OF COMMUNITY-LEVEL COMMUNITY INTERVENTION
1271 PROGRAMS FOR CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION.—
1272 (a) The department shall develop and implement a
1273 comprehensive, community-based program for chronic disease
1274 prevention and health promotion. The program shall be designed
1275 to reduce major behavioral risk factors that are associated with
1276 chronic diseases by enhancing the knowledge, skills, motivation,
1277 and opportunities for individuals, organizations, health care
1278 providers, small businesses, health insurers, and communities to
1279 develop and maintain healthy lifestyles. The department shall
1280 assist the county health departments in developing and operating
1281 community intervention programs throughout the state. At a
1282 minimum, the community intervention programs shall address one
1283 to three of the following chronic diseases: cancer, diabetes,
1284 heart disease, stroke, hypertension, renal disease, and chronic
1285 obstructive lung disease.
1286 (b) The program shall include:
1287 1. Countywide assessments of specific, causal, and
1288 behavioral risk factors that affect the health of residents;
1289 2. The development of community-based programs for chronic
1290 disease prevention and health promotion which incorporate health
1291 promotion and preventive care practices that are supported in
1292 scientific and medical literature;
1293 3. The development and implementation of statewide age
1294 specific, disease-specific, and community-specific health
1295 promotion and preventive care strategies using primary,
1296 secondary, and tertiary prevention interventions;
1297 4. The promotion of community, research-based health
1298 promotion model programs that meet specific criteria, address
1299 major risk factors, and motivate individuals to permanently
1300 adopt healthy behaviors and increase social and personal
1301 responsibilities;
1302 5. The development of policies that encourage the use of
1303 alternative community delivery sites for health promotion,
1304 disease prevention, and preventive care programs and promote the
1305 use of neighborhood delivery sites that are close to work, home,
1306 and school; and
1307 6. An emphasis on the importance of healthy and physically
1308 active lifestyles to build self-esteem and reduce morbidity and
1309 mortality associated with chronic disease and being overweight
1310 or obese. Existing community resources, when available, shall be
1311 used to support the programs. The department shall seek funding
1312 for the programs from federal and state financial assistance
1313 programs which presently exist or which may be hereafter
1314 created. Additional services, as appropriate, may be
1315 incorporated into a program to the extent that resources are
1316 available. The department may accept gifts and grants in order
1317 to carry out a program.
1318 (c) Volunteers shall be used to the maximum extent possible
1319 in carrying out the programs. The department shall contract for
1320 the necessary insurance coverage to protect volunteers from
1321 personal liability while acting within the scope of their
1322 volunteer assignments under a program.
1323 (d) The department may contract for the provision of all or
1324 any portion of the services required by a program, and shall so
1325 contract whenever the services so provided are more cost
1326 efficient than those provided by the department.
1327 (e) If the department determines that it is necessary for
1328 clients to help pay for services provided by a program, the
1329 department may require clients to make contribution therefor in
1330 either money or personal services. The amount of money or value
1331 of the personal services shall be fixed according to a fee
1332 schedule established by the department or by the entity
1333 developing the program. In establishing the fee schedule, the
1334 department or the entity developing the program shall take into
1335 account the expenses and resources of a client and his or her
1336 overall ability to pay for the services.
1337 Section 23. Section 385.105, Florida Statutes, is created
1338 to read:
1339 385.105 Physical activity, obesity prevention, nutrition,
1340 other health-promotion services, and wellness programs.—
1341 (1) PHYSICAL ACTIVITY—.
1342 (a) The department shall develop programs for people at
1343 every stage of their lives to increase physical fitness and
1344 promote behavior changes.
1345 (b) The department shall work with school health advisory
1346 or wellness committees in each school district as established in
1347 s. 381.0056.
1348 (c) The department shall develop public and private
1349 partnerships that allow the public to easily access recreational
1350 facilities and public land areas that are suitable for physical
1351 activity.
1352 (d) The department shall work in collaboration with the
1353 Executive Office of the Governor and Volunteer Florida, Inc., to
1354 promote school initiatives, such as the Governor’s Fitness
1355 Challenge.
1356 (e) The department shall collaborate with the Department of
1357 Education in recognizing nationally accepted best practices for
1358 improving physical education in schools.
1359 (2) OBESITY PREVENTION.—The department shall promote
1360 healthy lifestyles to reduce the prevalence of excess weight
1361 gain and being overweight or obese through programs that are
1362 directed towards all residents of this state by:
1363 (a) Using all appropriate media to promote maximum public
1364 awareness of the latest research on healthy lifestyles and
1365 chronic diseases and disseminating relevant information through
1366 a statewide clearinghouse relating to wellness, physical
1367 activity, and nutrition and the effect of these factors on
1368 chronic diseases and disabling conditions.
1369 (b) Providing technical assistance, training, and resources
1370 on healthy lifestyles and chronic diseases to the public, health
1371 care providers, school districts, and other persons or entities,
1372 including faith-based organizations that request such assistance
1373 to promote physical activity, nutrition, and healthy lifestyle
1374 programs.
1375 (c) Developing, implementing, and using all available
1376 research methods to collect data, including, but not limited to,
1377 population-specific data, and tracking the incidence and effects
1378 of weight gain, obesity, and related chronic diseases. The
1379 department shall include an evaluation and data-collection
1380 component in all programs as appropriate. All research conducted
1381 under this paragraph is subject to review and approval as
1382 required by the department’s institutional review board under s.
1383 381.86.
1384 (d) Entering into partnerships with the Department of
1385 Education, local communities, school districts, and other
1386 entities to encourage schools in this state to promote
1387 activities during and after school to help students meet a
1388 minimum goal of 30 minutes of physical activity or physical
1389 fitness per day.
1390 (e) Entering into partnerships with the Department of
1391 Education, school districts, and the Florida Sports Foundation
1392 to develop a programs recognizing the schools at which students
1393 demonstrate excellent physical fitness or fitness improvement.
1394 (f) Collaborating with other state agencies to develop
1395 policies and strategies for preventing and treating obesity,
1396 which shall be incorporated into programs administered by each
1397 agency and shall include promoting healthy lifestyles of
1398 employees of each agency.
1399 (g) Advising, in accordance with s. 456.081, health care
1400 practitioners about the morbidity, mortality, and costs
1401 associated with being overweight or obese, informing such
1402 practitioners of promising clinical practices for preventing and
1403 treating obesity, and encouraging practitioners to counsel their
1404 patients regarding the adoption of healthy lifestyles.
1405 (h) Maximizing all local, state, and federal funding
1406 sources, including grants, public-private partnerships, and
1407 other mechanisms to strengthen the department’s programs
1408 promoting physical activity and nutrition.
1409 (3) NUTRITION.—The department shall promote optimal
1410 nutritional status in all stages of people’s lives by developing
1411 strategies to:
1412 (a) Promote and maintain optimal nutritional status in the
1413 population through activities, including, but not limited to:
1414 1. Nutrition screening and assessment and nutrition
1415 counseling, including nutrition therapy, followup, case
1416 management, and referrals for persons who have medical
1417 conditions or nutrition-risk factors and who are provided health
1418 services through public health programs or through referrals
1419 from private health care providers or facilities;
1420 2. Nutrition education to assist residents of the state in
1421 achieving optimal health and preventing chronic disease; and
1422 3. Consultative nutrition services to group facilities
1423 which promote the provision of safe and nutritionally adequate
1424 diets.
1425 (b) Monitor and conduct surveillance of the nutritional
1426 status of this state’s population.
1427 (c) Conduct or support research or evaluations related to
1428 public health nutrition. All research conducted under this
1429 paragraph is subject to review and approval as required by the
1430 department’s institutional review board under s. 381.86.
1431 (d) Establish policies and standards for public health
1432 nutrition practices.
1433 (e) Promote interagency cooperation, professional
1434 education, and consultation.
1435 (f) Provide technical assistance and advise state agencies,
1436 private institutions, and local organizations regarding public
1437 health nutrition standards.
1438 (g) Work with the Department of Agriculture and Consumer
1439 Services, the Department of Education, and the Department of
1440 Management Services to further the use of fresh produce from
1441 this state in schools and encourage the development of community
1442 gardens. Nutritional services shall be available to eligible
1443 persons in accordance with eligibility criteria adopted by the
1444 department. The department shall provide by rule requirements
1445 for the service fees, when applicable, which may not exceed the
1446 department’s actual costs.
1447
1448 The department may adopt rules to administer this subsection.
1449 (4) OTHER HEALTH-PROMOTION SERVICES.—
1450 (a) The department shall promote personal responsibility by
1451 encouraging residents of this state to be informed, follow
1452 health recommendations, seek medical consultations and health
1453 assessments, take healthy precautions, and comply with medical
1454 guidelines, including those that lead to earlier detection of
1455 chronic diseases in order to prevent chronic diseases or slow
1456 the progression of established chronic diseases.
1457 (b) The department shall promote regular health visits
1458 during a person’s lifetime, including annual physical
1459 examinations that include measuring body mass index and vital
1460 signs, blood work, immunizations, screenings, and dental
1461 examinations in order to reduce the financial, social, and
1462 personal burden of chronic disease.
1463 (5) WELLNESS PROGRAMS.—
1464 (a) Each state agency may conduct employee wellness
1465 programs in buildings and lands owned or leased by the state.
1466 The department shall serve as a model to develop and implement
1467 employee wellness programs that may include physical fitness,
1468 healthy nutrition, self-management of disease, education, and
1469 behavioral change. The department shall assist other state
1470 agencies to develop and implement employee wellness programs.
1471 These programs shall use existing resources, facilities, and
1472 programs or resources procured through grant funding and
1473 donations that are obtained in accordance with state ethics and
1474 procurement policies, and shall provide equal access to any such
1475 programs, resources, and facilities to all state employees.
1476 (b) The department shall coordinate its efforts with the
1477 Department of Management Services and other state agencies.
1478 (c) Each agency may establish an employee wellness work
1479 group to design the program. The department shall be available
1480 to provide policy guidance and assist in identifying effective
1481 wellness program strategies.
1482 (d) The department shall provide by rule requirements for
1483 nominal participation fees, when applicable, which may not
1484 exceed the department’s actual costs; collaborations with
1485 businesses; and the procurement of equipment and incentives.
1486 Section 24. Section 385.202, Florida Statutes, is amended
1487 to read:
1488 385.202 Statewide cancer registry.—
1489 (1) Each facility, laboratory, or practitioner licensed
1490 under chapter 395, chapter 458, chapter 459, chapter 464,
1491 chapter 483, and each freestanding radiation therapy center as
1492 defined in s. 408.07, shall report to the department of Health
1493 such information, specified by the department, by rule. The
1494 department may adopt rules regarding reporting requirements for
1495 the cancer registry, which shall include the data required, the
1496 timeframe for reporting, and those professionals who are
1497 responsible for ensuring compliance with reporting requirements,
1498 which indicates diagnosis, stage of disease, medical history,
1499 laboratory data, tissue diagnosis, and radiation, surgical, or
1500 other methods of diagnosis or treatment for each cancer
1501 diagnosed or treated by the facility or center. Failure to
1502 comply with this requirement may be cause for registration or
1503 licensure suspension or revocation.
1504 (2) The department shall establish, or cause to have
1505 established, by contract with a recognized medical organization
1506 in this state and its affiliated institutions, a statewide
1507 cancer registry program to ensure that cancer reports required
1508 under this section shall be maintained and available for use in
1509 the course of public health surveillance and any study for the
1510 purpose of reducing morbidity or mortality; and no liability of
1511 any kind or character for damages or other relief shall arise or
1512 be enforced against any facility or practitioner hospital by
1513 reason of having provided such information or material to the
1514 department.
1515 (3) The department may adopt rules regarding the
1516 establishment and operation of a statewide cancer registry
1517 program.
1518 (4)(3) The department or a contractual designee operating
1519 the statewide cancer registry program required by this section
1520 shall use or publish said material only for the purpose of
1521 public health surveillance and advancing medical research or
1522 medical education in the interest of reducing morbidity or
1523 mortality, except that a summary of such studies may be released
1524 for general publication. Information which discloses or could
1525 lead to the disclosure of the identity of any person whose
1526 condition or treatment has been reported and studied shall be
1527 confidential and exempt from the provisions of s. 119.07(1),
1528 except that:
1529 (a) Release may be made with the written consent of all
1530 persons to whom the information applies;
1531 (b) The department or a contractual designee may contact
1532 individuals for the purpose of epidemiologic investigation and
1533 monitoring, provided information that is confidential under this
1534 section is not further disclosed; or
1535 (c) The department may exchange personal data with any
1536 other governmental agency or a contractual designee for the
1537 purpose of public health surveillance and medical or scientific
1538 research, if provided such governmental agency or contractual
1539 designee does shall not further disclose information that is
1540 confidential under this section.
1541 (5)(4) Funds appropriated for this section shall be used
1542 for establishing, administering, compiling, processing, and
1543 providing biometric and statistical analyses to the reporting
1544 facilities and practitioners. Funds may also be used to ensure
1545 the quality and accuracy of the information reported and to
1546 provide management information to the reporting facilities and
1547 practitioners.
1548 (6)(5) The department may adopt rules regarding the
1549 classifications of, by rule, classify facilities that are
1550 responsible for making reports to the cancer registry, the
1551 content and frequency of the reports, and the penalty for
1552 failure to comply with these requirements for purposes of
1553 reports made to the cancer registry and specify the content and
1554 frequency of the reports. In classifying facilities, the
1555 department shall exempt certain facilities from reporting cancer
1556 information that was previously reported to the department or
1557 retrieved from existing state reports made to the department or
1558 the Agency for Health Care Administration. The provisions of
1559 This section does shall not apply to any facility whose primary
1560 function is to provide psychiatric care to its patients.
1561 (7) Notwithstanding subsection (1), each facility and
1562 practitioner that reports cancer cases to the department shall
1563 make their records available for onsite review by the department
1564 or its authorized representative.
1565 Section 25. Subsection (3) of section 385.203, Florida
1566 Statutes, is amended to read:
1567 385.203 Diabetes Advisory Council; creation; function;
1568 membership.—
1569 (3) The council shall be composed of 26 25 citizens of the
1570 state who have knowledge of, or work in, the area of diabetes
1571 mellitus as follows:
1572 (a) Five interested citizens, three of whom are affected by
1573 diabetes.
1574 (b) Twenty-one Twenty members, who must include one
1575 representative from each of the following areas: nursing with
1576 diabetes-educator certification; dietary with diabetes educator
1577 certification; podiatry; ophthalmology or optometry; psychology;
1578 pharmacy; adult endocrinology; pediatric endocrinology; the
1579 American Diabetes Association (ADA); the Juvenile Diabetes
1580 Foundation (JDF); the Florida Academy of Family Physicians; a
1581 community health center; a county health department; an American
1582 Diabetes Association recognized community education program;
1583 each medical school in the state; an osteopathic medical school;
1584 the insurance industry; a Children’s Medical Services diabetes
1585 regional program; and an employer.
1586 (c) One or more representatives from the Department of
1587 Health, who shall serve on the council as ex officio members.
1588 Section 26. Section 385.206, Florida Statutes, is amended
1589 to read:
1590 385.206 Pediatric Hematology-Oncology care Center Program.—
1591 (1) DEFINITIONS.—As used in this section, the term:
1592 (a) “Department” means the Department of Health.
1593 (b) “Hematology” means the study, diagnosis, and treatment
1594 of blood and blood-forming tissues.
1595 (c) “Oncology” means the study, diagnosis, and treatment of
1596 malignant neoplasms or cancer.
1597 (d) “Hemophilia” or “other hemostatic disorder” means a
1598 bleeding disorder resulting from a genetic abnormality of
1599 mechanisms related to the control of bleeding.
1600 (e) “Sickle-cell anemia or other hemoglobinopathy” means an
1601 hereditary, chronic disease caused by an abnormal type of
1602 hemoglobin.
1603 (f) “Patient” means a person under the age of 21 who is in
1604 need of hematologic-oncologic services and who is enrolled in
1605 the Children’s Medical Services Network declared medically and
1606 financially eligible by the department; or a person who received
1607 such services prior to age 21 and who requires long-term
1608 monitoring and evaluation to ascertain the sequelae and the
1609 effectiveness of treatment.
1610 (g) “Center” means a facility designated by the department
1611 as having a program specifically designed to provide a full
1612 range of medical and specialty services to patients with
1613 hematologic and oncologic disorders.
1614 (2) PEDIATRIC HEMATOLOGY-ONCOLOGY CARE CENTER PROGRAM;
1615 AUTHORITY.—The department may designate is authorized to make
1616 grants and reimbursements to designated centers and provide
1617 funding to establish and maintain programs for the care of
1618 patients with hematologic and oncologic disorders. Program
1619 administration costs shall be paid by the department from funds
1620 appropriated for this purpose.
1621 (3) GRANT FUNDING CONTRACTS GRANT AGREEMENTS; CONDITIONS.—
1622 (a) Funding provided A grant made under this section shall
1623 be pursuant to a contract contractual agreement made between a
1624 center and the department. Each contract agreement shall provide
1625 that patients will receive services specified types of treatment
1626 and care from the center without additional charge to the
1627 patients or their parents or guardians. Grants shall be
1628 disbursed in accordance with conditions set forth in the
1629 disbursement guidelines.
1630 (4) GRANT DISBURSEMENTS AND SPECIAL DISBURSEMENTS FOR LOCAL
1631 PROGRAMS.—
1632 (b)(a) Funding may be provided Grant disbursements may be
1633 made to centers that which meet the following criteria:
1634 1. The personnel shall include at least one board-certified
1635 pediatric hematologist-oncologist, at least one board-certified
1636 pediatric surgeon, at least one board-certified radiotherapist,
1637 and at least one board-certified pathologist.
1638 2. As approved by the department, The center shall actively
1639 participate in a national children’s cancer study group,
1640 maintain a pediatric tumor registry, have a multidisciplinary
1641 pediatric tumor board, and meet other guidelines for
1642 development, including, but not limited to, guidelines from such
1643 organizations as the American Academy of Pediatrics and the
1644 American Pediatric Surgical Association.
1645 (b) Programs shall also be established to provide care to
1646 hematology-oncology patients within each district of the
1647 department. The guidelines for local programs shall be
1648 formulated by the department. Special disbursements may be made
1649 by the program office to centers for educational programs
1650 designed for the districts of the department. These programs may
1651 include teaching total supportive care of the dying patient and
1652 his or her family, home therapy to hemophiliacs and patients
1653 with other hemostatic disorders, and screening and counseling
1654 for patients with sickle-cell anemia or other
1655 hemoglobinopathies.
1656 (4)(5) PROGRAM AND PEER REVIEW.—The department shall
1657 evaluate at least annually during the grant period the services
1658 rendered by the centers and the districts of the department.
1659 Data from the centers and other sources relating to pediatric
1660 cancer shall be reviewed annually by the Florida Association of
1661 Pediatric Tumor Programs, Inc.; and a written report with
1662 recommendations shall be made to the department. This database
1663 will be available to the department for program planning and
1664 quality assurance initiatives formulation of its annual program
1665 and financial evaluation report. A portion of the funds
1666 appropriated for this section may be used to provide statewide
1667 consultation, supervision, and evaluation of the programs of the
1668 centers, as well as central program office support personnel.
1669 Section 27. Paragraph (g) of subsection (2) and subsection
1670 (7) of section 385.207, Florida Statutes, are amended to read:
1671 385.207 Care and assistance of persons with epilepsy;
1672 establishment of programs in epilepsy control.—
1673 (2) The Department of Health shall:
1674 (g) Continue current programs and develop cooperative
1675 programs and services designed to enhance the vocational
1676 rehabilitation of epilepsy clients, including the current jobs
1677 programs. The department shall, as part of its contract with a
1678 provider of epilepsy services, collect information regarding the
1679 number of clients served, the outcomes reached, the expenses
1680 incurred, and the fees collected by such providers for the
1681 provision of services keep and make this information available
1682 to the Governor and the Legislature upon request information
1683 regarding the number of clients served, the outcome reached, and
1684 the expense incurred by such programs and services.
1685 (7) The department shall limit total administrative
1686 expenditures from the Epilepsy Services Trust Fund to 5 percent
1687 of annual receipts.
1688 Section 28. Paragraphs (b), (d), and (g) of subsection (2)
1689 and paragraph (b) of subsection (5) of section 385.210, Florida
1690 Statutes, are amended to read:
1691 385.210 Arthritis prevention and education.—
1692 (2) LEGISLATIVE FINDINGS.—The Legislature finds the
1693 following:
1694 (b) Arthritis is the leading cause of disability in the
1695 United States, limiting daily activities for more than 19 7
1696 million citizens.
1697 (d) There are enormous economic and social costs associated
1698 with treating arthritis and its complications; the economic
1699 costs are estimated at over $128 billion (2003) $116 billion
1700 (1997) annually in the United States.
1701 (g) The National Arthritis Foundation, the CDC Centers for
1702 Disease Control and Prevention, and the Association of State and
1703 Territorial Health Officials have led the development of a
1704 public health strategy, the National Arthritis Action Plan, to
1705 respond to this challenge.
1706 (5) FUNDING.—
1707 (b) The State Surgeon General may shall seek any federal
1708 waiver or waivers that may be necessary to maximize funds from
1709 the Federal Government to implement this program.
1710 Section 29. Section 385.301, Florida Statutes, is created
1711 to read:
1712 385.301 Rulemaking authority.—The department may adopt
1713 rules pursuant to chapter 120 to administer this chapter.
1714 Section 30. Subsection (9) of section 409.904, Florida
1715 Statutes, is amended to read:
1716 409.904 Optional payments for eligible persons.—The agency
1717 may make payments for medical assistance and related services on
1718 behalf of the following persons who are determined to be
1719 eligible subject to the income, assets, and categorical
1720 eligibility tests set forth in federal and state law. Payment on
1721 behalf of these Medicaid eligible persons is subject to the
1722 availability of moneys and any limitations established by the
1723 General Appropriations Act or chapter 216.
1724 (9) Eligible women with incomes at or below 200 percent of
1725 the federal poverty level and under age 65, for cancer treatment
1726 pursuant to the federal Breast and Cervical Cancer Prevention
1727 and Treatment Act of 2000, screened through the Mary Brogan
1728 Breast and Cervical Cancer Early Detection Program established
1729 under s. 385.2021 s. 381.93.
1730 Section 31. The Pharmacy and Therapeutic Advisory Council.—
1731 (1) The Pharmacy and Therapeutic Advisory Council is
1732 created within the Executive Office of the Governor to serve in
1733 an advisory capacity to the Department of Health and other
1734 governmental agencies. The council may not interfere with
1735 existing mandated Medicaid services and may not develop or
1736 implement new ones. Specifically, the council may not interfere
1737 with the work of the Agency for Health Care Administration as it
1738 complies with federal and state statutory obligations to develop
1739 a preferred drug list, to negotiate rebate agreements for
1740 medications included in the preferred drug list, and to protect
1741 the confidentiality of rebate agreements. The council may not
1742 interfere with the Medicaid Pharmacy and Therapeutics Committee
1743 or the Drug Utilization Review Board, which oversee clinical
1744 activities within the Bureau of Pharmacy Services if such
1745 interference would violate any federal or state statutory
1746 obligations.
1747 (2) The Pharmacy and Therapeutic Advisory Council shall use
1748 Medicaid processes within the existing Medicaid structure of the
1749 Agency for Health Care Administration as a guide for assisting
1750 state agencies in:
1751 (a) Developing an unbiased clinical perspective on drug
1752 evaluations and utilization protocols that are relevant to
1753 patient care provided through programs administered by state
1754 agencies.
1755 (b) Developing drug-utilization-review processes that are
1756 relevant to the agencies and those receiving care through
1757 programs administered by the agencies.
1758 (c) Building a formulary structure that enforces formulary
1759 compliance or adherence within each agency.
1760 (d) Performing pharmacoeconomic analyses on formulary
1761 management so that the state maximizes the cost-effectiveness of
1762 its pharmaceutical purchasing.
1763 (e) Reviewing new and existing therapies using criteria
1764 established for efficacy, safety, and quality in order to
1765 maximize cost-effective purchasing.
1766 (f) Reviewing state agency proposals to maximize the cost
1767 effectiveness of pharmaceutical purchasing in compliance with s.
1768 381.0203.
1769 (3) The council shall verify the cost-effectiveness and
1770 clinical efficacy of any state contracts under s. 381.0203(1),
1771 Florida Statutes, no less than once every 2 years.
1772 (4) The members of the council and the chair shall be
1773 appointed by the Governor to 4-year staggered terms or until
1774 their successors are appointed. Members may be appointed to more
1775 than one term. The Governor shall fill any vacancies for the
1776 remainder of the unexpired term in the same manner as the
1777 original appointment.
1778 (5) The council shall include voting and nonvoting members,
1779 and the chair, who is a voting member, must be a pharmacist
1780 employed by a state agency.
1781 (a) The voting members shall represent:
1782 1. The Agency for Health Care Administration.
1783 2. The Agency for Persons with Disabilities.
1784 3. The Department of Children and Family Services.
1785 4. The Department of Corrections.
1786 5. The Department of Elderly Affairs.
1787 6. The Department of Health.
1788 7. The Department of Juvenile Justice.
1789 8. The Bureau of Pharmacy Services within the Agency for
1790 Health Care Administration, which shall be represented by the
1791 bureau chief.
1792 9. The Bureau of Statewide Pharmaceutical Services within
1793 the Department of Health, which shall be represented by the
1794 bureau chief.
1795 (b) The nonvoting members shall be:
1796 1. A representative from the Agency for Health Care
1797 Administration’s drug contracting program.
1798 2. The contracting officer for the Department of Health’s
1799 drug procurement program.
1800 3. A clinical pharmacy program manager from the Agency for
1801 Health Care Administration.
1802 4. The chair of the Department of Health’s Pharmacy and
1803 Therapeutics Committee.
1804 5. The general counsel for the Agency for Health Care
1805 Administration or his or her designee.
1806 6. The general counsel for a state agency in the executive
1807 branch of state government, or his or her designee.
1808 7. A representative from the Executive Office of the
1809 Governor.
1810 8. The statewide pharmacy director of the Department of
1811 Corrections’ Office of Health Services.
1812 (6) Members of the council shall consist of at least one
1813 physician licensed under chapter 458 or chapter 459, Florida
1814 Statutes, at least one pharmacist licensed under chapter 465,
1815 Florida Statutes, and at least one registered nurse licensed
1816 under chapter 464, Florida Statutes. Each member designated in
1817 this subsection must have an active license in his or her
1818 profession and may not have been the subject of any agency
1819 disciplinary action.
1820 (7) Members, who must be residents of this state, shall be
1821 selected on the basis of specialty, board certification, prior
1822 pharmacy and therapeutic experience, experience treating medical
1823 assistance recipients, ability to represent a broad base of
1824 constituents, and number of years of practice. Members must not
1825 have any conflicts of interest due to their service on the
1826 council.
1827 (8) The council may request the participation of additional
1828 subject-matter experts to address specific drug, therapeutic, or
1829 drug-procurement issues under review by the council.
1830 (9) A majority of the members of the council constitutes a
1831 quorum, and an affirmative vote of a majority of the voting
1832 members is necessary to take action.
1833 (10) The council shall meet quarterly or at the call of the
1834 chair.
1835 (11) The council shall be staffed by the chair’s department
1836 or agency.
1837 (12) The council members shall serve without compensation,
1838 but are entitled to reimbursement for travel and per diem
1839 expenses incurred in the performance of their duties in
1840 accordance with s. 112.061, Florida Statutes.
1841 Section 32. Subsections (1) and (3) of section 430.80,
1842 Florida Statutes, are amended to read:
1843 430.80 Implementation of a teaching nursing home pilot
1844 project.—
1845 (1) As used in this section, the term “teaching nursing
1846 home” means a nursing home facility licensed under chapter 400
1847 which contains a minimum of 275 400 licensed nursing home beds;
1848 has access to a resident senior population of sufficient size to
1849 support education, training, and research relating to geriatric
1850 care; and has a contractual relationship with a federally funded
1851 accredited geriatric research center in this state or operates
1852 in its own right a geriatric research center.
1853 (3) To be designated as a teaching nursing home, a nursing
1854 home licensee must, at a minimum:
1855 (a) Provide a comprehensive program of integrated senior
1856 services that include institutional services and community-based
1857 services;
1858 (b) Participate in a nationally recognized accreditation
1859 program and hold a valid accreditation, such as the
1860 accreditation awarded by the Joint Commission on Accreditation
1861 of Healthcare Organizations, or possess a Gold Seal Award as
1862 conferred by the Agency for Health Care Administration on its
1863 licensed nursing home;
1864 (c) Have been in business in this state for a minimum of 10
1865 consecutive years;
1866 (d) Demonstrate an active program in multidisciplinary
1867 education and research that relates to gerontology;
1868 (e) Have a formalized contractual relationship with at
1869 least one accredited health profession education program located
1870 in this state;
1871 (f) Have a formalized contractual relationship with an
1872 accredited hospital that is designated by law as a teaching
1873 hospital; and
1874 (f)(g) Have senior staff members who hold formal faculty
1875 appointments at universities, which must include at least one
1876 accredited health profession education program; and.
1877 (g)(h) Maintain insurance coverage pursuant to s.
1878 400.141(20) or proof of financial responsibility in a minimum
1879 amount of $750,000. Such proof of financial responsibility may
1880 include:
1881 1. Maintaining an escrow account consisting of cash or
1882 assets eligible for deposit in accordance with s. 625.52; or
1883 2. Obtaining and maintaining pursuant to chapter 675 an
1884 unexpired, irrevocable, nontransferable and nonassignable letter
1885 of credit issued by any bank or savings association organized
1886 and existing under the laws of this state or any bank or savings
1887 association organized under the laws of the United States that
1888 has its principal place of business in this state or has a
1889 branch office which is authorized to receive deposits in this
1890 state. The letter of credit shall be used to satisfy the
1891 obligation of the facility to the claimant upon presentment of a
1892 final judgment indicating liability and awarding damages to be
1893 paid by the facility or upon presentment of a settlement
1894 agreement signed by all parties to the agreement when such final
1895 judgment or settlement is a result of a liability claim against
1896 the facility.
1897 Section 33. Paragraph (g) is added to subsection (53) of
1898 section 499.003, Florida Statutes, to read:
1899 499.003 Definitions of terms used in this part.—As used in
1900 this part, the term:
1901 (53) “Wholesale distribution” means distribution of
1902 prescription drugs to persons other than a consumer or patient,
1903 but does not include:
1904 (g) The sale, purchase, trade, or transfer of a
1905 prescription drug among agencies and health care entities of the
1906 state to complete the dispensing of the prescription drug to a
1907 patient under the care of a state agency or health care entity,
1908 or to a patient for whom the state is responsible for providing
1909 or arranging health care services. The agency or health care
1910 entity that received the prescription drug on behalf of the
1911 patient is deemed the patient’s agent under s. 465.003(6).
1912 Section 34. This act shall take effect July 1, 2009.