Florida Senate - 2010                                    SB 1954
       
       
       
       By Senator Aronberg
       
       
       
       
       27-01521-10                                           20101954__
    1                        A bill to be entitled                      
    2         An act relating to health care; amending s. 20.43,
    3         F.S.; establishing the Office of Public Health
    4         Nutrition within the Department of Health; amending
    5         ss. 20.435, 154.503, and 215.5602, F.S.; conforming
    6         cross-references; repealing s. 381.0053, F.S.,
    7         relating to the comprehensive nutrition program;
    8         repealing s. 381.0054, F.S., relating to the promotion
    9         of healthy lifestyles; repealing ss. 381.732 and
   10         381.733, F.S., relating to the Healthy Communities,
   11         Healthy People Act; repealing s. 381.734, F.S.,
   12         relating to the Healthy Communities, Healthy People
   13         Program; repealing s. 381.912, F.S., relating to the
   14         Cervical Cancer Elimination Task Force; repealing s.
   15         385.103, F.S., relating to community intervention
   16         programs; renumbering s. 381.91, F.S., relating to the
   17         Jessie Trice Cancer Prevention Program; renumbering
   18         and amending s. 381.911, F.S., relating to the
   19         Prostate Cancer Awareness Program; revising the
   20         criteria for members of the prostate cancer advisory
   21         committee; renumbering s. 381.92, F.S., relating to
   22         the Florida Cancer Council; renumbering s. 381.921,
   23         F.S., relating to the mission and duties of the
   24         Florida Cancer Council; renumbering and amending s.
   25         381.922, F.S., relating to the William G. “Bill”
   26         Bankhead, Jr., and David Coley Cancer Research
   27         Program; conforming cross-references; renumbering s.
   28         381.93, F.S., relating to a breast and cervical cancer
   29         early detection program; renumbering and amending s.
   30         381.931, F.S., relating to an annual report on
   31         Medicaid expenditures; removing a provision limiting
   32         the number of breast and cervical cancer screenings
   33         based on projected Medicaid expenditures; renumbering
   34         s. 381.932, F.S., relating to the breast cancer early
   35         detection and treatment referral program; renaming ch.
   36         385, F.S., as the “Healthy and Fit Florida Act”;
   37         amending s. 385.101, F.S.; revising the short title;
   38         amending s. 385.102, F.S.; revising legislative intent
   39         with regard to chronic diseases and health promotion;
   40         creating s. 385.1021, F.S.; providing definitions;
   41         creating s. 385.1022, F.S.; requiring the Department
   42         of Health to support the creation of public health
   43         programs at the state and community levels to reduce
   44         the incidence of mortality and morbidity from chronic
   45         diseases; authorizing the department to advance funds
   46         for program startup and contracted services under
   47         certain conditions; creating s. 385.1023, F.S.;
   48         requiring the department to create state-level
   49         programs to address the preventable risk factors
   50         associated with chronic diseases; requiring the
   51         program to perform certain activities; requiring a
   52         biennial report to the Governor and Legislature;
   53         creating s. 385.1035, F.S.; providing for community
   54         level programs for the prevention of chronic diseases
   55         and the promotion of health; requiring the department
   56         to develop and implement a community-level chronic
   57         disease prevention and health promotion program;
   58         providing the purpose of the program; providing
   59         requirements for the program; creating s. 385.104,
   60         F.S.; creating the State Employee Wellness Interagency
   61         Council; providing for purpose, membership, and duties
   62         of the council; creating s. 385.105, F.S.; requiring
   63         the department to develop programs to promote physical
   64         fitness, healthy lifestyles, and weight control;
   65         requiring the Office of Public Health Nutrition to
   66         promote optimal nutritional status in the state’s
   67         population; requiring the department to promote
   68         personal responsibility and regular health visits;
   69         authorizing state agencies to conduct employee
   70         wellness programs; requiring the department to serve
   71         as a model for the development and implementation of
   72         wellness programs; requiring the department to assist
   73         state agencies in developing and implementing wellness
   74         programs; providing equal access to the programs by
   75         agency employees; requiring the department to
   76         coordinate efforts with the Department of Management
   77         Services and other state agencies; authorizing each
   78         state agency to establish an employee wellness
   79         workgroup to design the agency’s wellness program;
   80         requiring the department to adopt rules to provide
   81         requirements for participation fees, collaboration
   82         with businesses, and procurement of equipment and
   83         incentives; amending s. 385.202, F.S.; requiring
   84         licensed laboratories and practitioners to report
   85         certain information to the department; authorizing the
   86         department to adopt rules regarding reporting
   87         requirements for the statewide cancer registry;
   88         removing a provision that provides for registration or
   89         licensure suspension or revocation for failure to
   90         comply with such requirements; providing immunity from
   91         liability for facilities, laboratories, and
   92         practitioners reporting certain information;
   93         authorizing the department to adopt rules regarding
   94         the establishment and operation of a statewide cancer
   95         registry program; permitting the department or
   96         contractual designee operating the statewide cancer
   97         registry program to use or publish information
   98         contained in the registry for the purpose of public
   99         health surveillance under certain circumstances;
  100         authorizing the department to exchange personal data
  101         with an agency or contractual designee for the purpose
  102         of public health surveillance under certain
  103         circumstances; authorizing additional uses for funds
  104         appropriated for the program; clarifying that the
  105         department may adopt rules regarding the
  106         classifications of facilities, laboratories, and
  107         practitioners related to reports made to the statewide
  108         cancer registry; removing an exemption from reporting
  109         requirements for certain facilities; requiring each
  110         facility, laboratory, and practitioner that reports
  111         cancer cases to the department to make their records
  112         available for onsite review; amending s. 385.203,
  113         F.S.; increasing the membership of the Diabetes
  114         Advisory Council; amending s. 385.206, F.S.; renaming
  115         the “Hematology-oncology care center program” as the
  116         “Pediatric Hematology-oncology Center Program”;
  117         revising the definition of the term “patient”;
  118         authorizing the department to designate centers and
  119         provide funding to maintain programs for the care of
  120         patients with hematologic and oncologic disorders;
  121         providing requirements for contracts that provide
  122         funding for the program; deleting a requirement for
  123         the establishment of district programs and annual
  124         review thereof; revising procedure for evaluation of
  125         services provided by the centers; requiring data from
  126         the centers and other sources relating to pediatric
  127         cancer to be available to the department for program
  128         planning and quality assurance initiatives; amending
  129         s. 385.207, F.S.; revising provisions that require the
  130         department to collect information regarding the number
  131         of clients served, outcomes reached, expenses
  132         incurred, and fees collected by providers of epilepsy
  133         services; deleting a provision that requires the
  134         department to limit administrative expenses from the
  135         Epilepsy Services Trust Fund to a certain percentage
  136         of annual receipts; amending s. 385.210, F.S.;
  137         revising legislative findings regarding the economic
  138         costs of treating arthritis and its complications;
  139         authorizing the State Surgeon General to seek any
  140         federal waivers necessary to maximize funds from the
  141         Federal Government to implement an arthritis
  142         prevention and education program; creating s. 385.301,
  143         F.S.; authorizing the department to adopt rules to
  144         administer ch. 385, F.S.; creating s. 385.401, F.S.;
  145         authorizing the department, with the approval of the
  146         State Surgeon General, to establish a direct-support
  147         organization; specifying duties; providing for
  148         appointment and terms of members of the board of
  149         directors; providing for the use of department and
  150         county health department property and facilities by
  151         the direct-support organization under certain
  152         conditions; requiring the direct-support organization
  153         to comply with directives and requirements established
  154         by funding sources; requiring the direct-support
  155         organization to submit certain forms to the department
  156         and reports to the Governor and Legislature; requiring
  157         an annual audit; amending s. 409.904, F.S.; conforming
  158         a cross-reference; providing an effective date.
  159  
  160         WHEREAS, chronic diseases account for 70 percent of all
  161  deaths in the United States, and
  162         WHEREAS, heart disease and stroke have remained the first
  163  and third leading causes of death in the United States for over
  164  seven decades and are responsible for approximately one-third of
  165  total deaths each year in this state, and
  166         WHEREAS, cancer is the second leading cause of death and is
  167  responsible for one in every four deaths in this state, and
  168         WHEREAS, lung disease is the fourth leading cause of death
  169  and is responsible for one in every six deaths in this state,
  170  and
  171         WHEREAS, diabetes is the sixth leading cause of death in
  172  this state, and
  173         WHEREAS, oral disease, specifically dental caries, commonly
  174  known as tooth decay, is the single most common chronic disease
  175  in children. Dental caries is the most prevalent chronic disease
  176  experienced by children that is not self-limiting or amenable to
  177  a short-term course of antibiotics, despite the fact that dental
  178  caries is usually preventable, and
  179         WHEREAS, arthritis is the leading cause of disability in
  180  the United States, limiting the daily activities of more than 19
  181  million people across the country and more than 1 million people
  182  in this state alone, NOW, THEREFORE,
  183  
  184  Be It Enacted by the Legislature of the State of Florida:
  185  
  186         Section 1. Subsection (10) is added to section 20.43,
  187  Florida Statutes, to read:
  188         20.43 Department of Health.—There is created a Department
  189  of Health.
  190         (10) There is established within the Department of Health
  191  the Office of Public Health Nutrition.
  192         Section 2. Paragraph (a) of subsection (8) of section
  193  20.435, Florida Statutes, is amended to read:
  194         20.435 Department of Health; trust funds.—The following
  195  trust funds shall be administered by the Department of Health:
  196         (8) Biomedical Research Trust Fund.
  197         (a) Funds to be credited to the trust fund shall consist of
  198  funds deposited pursuant to s. 215.5601 and any other funds
  199  appropriated by the Legislature. Funds shall be used for the
  200  purposes of the James and Esther King Biomedical Research
  201  Program and the William G. “Bill” Bankhead, Jr., and David Coley
  202  Cancer Research Program as specified in ss. 215.5602, 288.955,
  203  and 385.20252 381.922. The trust fund is exempt from the service
  204  charges imposed by s. 215.20.
  205         Section 3. Paragraph (e) of subsection (2) of section
  206  154.503, Florida Statutes, is amended to read:
  207         154.503 Primary Care for Children and Families Challenge
  208  Grant Program; creation; administration.—
  209         (2) The department shall:
  210         (e) Coordinate with the primary care program developed
  211  pursuant to s. 154.011, the Florida Healthy Kids Corporation
  212  program created in s. 624.91, the school health services program
  213  created in ss. 381.0056 and 381.0057, the Healthy Communities,
  214  Healthy People Program created in s. 381.734, and the volunteer
  215  health care provider program developed pursuant to s. 766.1115.
  216         Section 4. Subsection (11) of section 215.5602, Florida
  217  Statutes, is amended to read:
  218         215.5602 James and Esther King Biomedical Research
  219  Program.—
  220         (11) The council shall award grants for cancer research
  221  through the William G. “Bill” Bankhead, Jr., and David Coley
  222  Cancer Research Program created in s. 385.20252 s. 381.922.
  223         Section 5. Sections 381.0053, 381.0054, 381.732, 381.733,
  224  381.734, 381.912, and 385.103, Florida Statutes, are repealed.
  225         Section 6. Section 381.91, Florida Statutes, is renumbered
  226  as section 385.2023, Florida Statutes, to read:
  227         385.2023 381.91 Jessie Trice Cancer Prevention Program.—
  228         (1) It is the intent of the Legislature to:
  229         (a) Reduce the rates of illness and death from lung cancer
  230  and other cancers and improve the quality of life among low
  231  income African-American and Hispanic populations through
  232  increased access to early, effective screening and diagnosis,
  233  education, and treatment programs.
  234         (b) Create a community faith-based disease-prevention
  235  program in conjunction with the Health Choice Network and other
  236  community health centers to build upon the natural referral and
  237  education networks in place within minority communities and to
  238  increase access to health service delivery in Florida.
  239         (c) Establish a funding source to build upon local private
  240  participation to sustain the operation of the program.
  241         (2)(a) There is created the Jessie Trice Cancer Prevention
  242  Program, to be located, for administrative purposes, within the
  243  Department of Health, and operated from the community health
  244  centers within the Health Choice Network in Florida.
  245         (b) Funding may be provided to develop contracts with
  246  community health centers and local community faith-based
  247  education programs to provide cancer screening, diagnosis,
  248  education, and treatment services to low-income populations
  249  throughout the state.
  250         Section 7. Section 381.911, Florida Statutes, is renumbered
  251  as section 385.2024, Florida Statutes, and amended to read:
  252         385.2024 381.911 Prostate Cancer Awareness Program.—
  253         (1) To the extent that funds are specifically made
  254  available for this purpose, the Prostate Cancer Awareness
  255  Program is established within the Department of Health. The
  256  purpose of this program is to implement the recommendations of
  257  January 2000 of the Florida Prostate Cancer Task Force to
  258  provide for statewide outreach and health education activities
  259  to ensure that men are aware of and appropriately seek medical
  260  counseling for prostate cancer as an early-detection health care
  261  measure.
  262         (2) For purposes of implementing the program, the
  263  Department of Health and the Florida Public Health Institute,
  264  Inc., may:
  265         (a) Conduct activities directly or enter into a contract
  266  with a qualified nonprofit community education entity.
  267         (b) Seek any available gifts, grants, or funds from the
  268  state, the Federal Government, philanthropic foundations, and
  269  industry or business groups.
  270         (3) A prostate cancer advisory committee is created to
  271  advise and assist the Department of Health and the Florida
  272  Public Health Institute, Inc., in implementing the program.
  273         (a) The State Surgeon General shall appoint the advisory
  274  committee members, who shall consist of:
  275         1. Three persons from prostate cancer survivor groups or
  276  cancer-related advocacy groups.
  277         2. Three persons who are scientists or clinicians from
  278  public or nonpublic universities or research organizations.
  279         3. Three persons who are engaged in the practice of a
  280  cancer-related medical specialty from health organizations
  281  committed to cancer research and control.
  282         (b) Members shall serve without compensation but are
  283  entitled to reimbursement, pursuant to s. 112.061, for per diem
  284  and travel expenses incurred in the performance of their
  285  official duties.
  286         (4) The program shall coordinate its efforts with those of
  287  the Florida Public Health Institute, Inc.
  288         Section 8. Section 381.92, Florida Statutes, is renumbered
  289  as section 385.2025, Florida Statutes, to read:
  290         385.2025 381.92 Florida Cancer Council.—
  291         (1) Effective July 1, 2004, the Florida Cancer Council
  292  within the Department of Health is established for the purpose
  293  of making the state a center of excellence for cancer research.
  294         (2)(a) The council shall be representative of the state’s
  295  cancer centers, hospitals, and patient groups and shall be
  296  organized and shall operate in accordance with this act.
  297         (b) The Florida Cancer Council may create not-for-profit
  298  corporate subsidiaries to fulfill its mission. The council and
  299  its subsidiaries are authorized to receive, hold, invest, and
  300  administer property and any moneys acquired from private, local,
  301  state, and federal sources, as well as technical and
  302  professional income generated or derived from the mission
  303  related activities of the council.
  304         (c) The members of the council shall consist of:
  305         1. The chair of the Florida Dialogue on Cancer, who shall
  306  serve as the chair of the council;
  307         2. The State Surgeon General or his or her designee;
  308         3. The chief executive officer of the H. Lee Moffitt Cancer
  309  Center or his or her designee;
  310         4. The director of the University of Florida Shands Cancer
  311  Center or his or her designee;
  312         5. The chief executive officer of the University of Miami
  313  Sylvester Comprehensive Cancer Center or his or her designee;
  314         6. The chief executive officer of the Mayo Clinic,
  315  Jacksonville, or his or her designee;
  316         7. The chief executive officer of the American Cancer
  317  Society, Florida Division, Inc., or his or her designee;
  318         8. The president of the American Cancer Society, Florida
  319  Division, Inc., Board of Directors or his or her designee;
  320         9. The president of the Florida Society of Clinical
  321  Oncology or his or her designee;
  322         10. The president of the American College of Surgeons,
  323  Florida Chapter, or his or her designee;
  324         11. The chief executive officer of Enterprise Florida,
  325  Inc., or his or her designee;
  326         12. Five representatives from cancer programs approved by
  327  the American College of Surgeons. Three shall be appointed by
  328  the Governor, one shall be appointed by the Speaker of the House
  329  of Representatives, and one shall be appointed by the President
  330  of the Senate;
  331         13. One member of the House of Representatives, to be
  332  appointed by the Speaker of the House of Representatives; and
  333         14. One member of the Senate, to be appointed by the
  334  President of the Senate.
  335         (d) Appointments made by the Speaker of the House of
  336  Representatives and the President of the Senate pursuant to
  337  paragraph (c) shall be for 2-year terms, concurrent with the
  338  bienniums in which they serve as presiding officers.
  339         (e) Appointments made by the Governor pursuant to paragraph
  340  (c) shall be for 2-year terms, although the Governor may
  341  reappoint members.
  342         (f) Members of the council or any subsidiaries shall serve
  343  without compensation, and each organization represented on the
  344  council shall cover the expenses of its representatives.
  345         (3) The council shall issue an annual report to the Center
  346  for Universal Research to Eradicate Disease, the Governor, the
  347  Speaker of the House of Representatives, and the President of
  348  the Senate by December 15 of each year, with policy and funding
  349  recommendations regarding cancer research capacity in Florida
  350  and related issues.
  351         Section 9. Section 381.921, Florida Statutes, is renumbered
  352  as section 385.20251, Florida Statutes, to read:
  353         385.20251 381.921 Florida Cancer Council mission and
  354  duties.—The council, which shall work in concert with the
  355  Florida Center for Universal Research to Eradicate Disease to
  356  ensure that the goals of the center are advanced, shall endeavor
  357  to dramatically improve cancer research and treatment in this
  358  state through:
  359         (1) Efforts to significantly expand cancer research
  360  capacity in the state by:
  361         (a) Identifying ways to attract new research talent and
  362  attendant national grant-producing researchers to cancer
  363  research facilities in this state;
  364         (b) Implementing a peer-reviewed, competitive process to
  365  identify and fund the best proposals to expand cancer research
  366  institutes in this state;
  367         (c) Funding through available resources for those proposals
  368  that demonstrate the greatest opportunity to attract federal
  369  research grants and private financial support;
  370         (d) Encouraging the employment of bioinformatics in order
  371  to create a cancer informatics infrastructure that enhances
  372  information and resource exchange and integration through
  373  researchers working in diverse disciplines, to facilitate the
  374  full spectrum of cancer investigations;
  375         (e) Facilitating the technical coordination, business
  376  development, and support of intellectual property as it relates
  377  to the advancement of cancer research; and
  378         (f) Aiding in other multidisciplinary research-support
  379  activities as they inure to the advancement of cancer research.
  380         (2) Efforts to improve both research and treatment through
  381  greater participation in clinical trials networks by:
  382         (a) Identifying ways to increase adult enrollment in cancer
  383  clinical trials;
  384         (b) Supporting public and private professional education
  385  programs designed to increase the awareness and knowledge about
  386  cancer clinical trials;
  387         (c) Providing tools to cancer patients and community-based
  388  oncologists to aid in the identification of cancer clinical
  389  trials available in the state; and
  390         (d) Creating opportunities for the state’s academic cancer
  391  centers to collaborate with community-based oncologists in
  392  cancer clinical trials networks.
  393         (3) Efforts to reduce the impact of cancer on disparate
  394  groups by:
  395         (a) Identifying those cancers that disproportionately
  396  impact certain demographic groups; and
  397         (b) Building collaborations designed to reduce health
  398  disparities as they relate to cancer.
  399         Section 10. Section 381.922, Florida Statutes, is
  400  renumbered as section 385.20252, Florida Statutes, and amended,
  401  to read:
  402         385.20252 381.922 William G. “Bill” Bankhead, Jr., and
  403  David Coley Cancer Research Program.—
  404         (1) The William G. “Bill” Bankhead, Jr., and David Coley
  405  Cancer Research Program, which may be otherwise cited as the
  406  “Bankhead-Coley Program,” is created within the Department of
  407  Health. The purpose of the program shall be to advance progress
  408  towards cures for cancer through grants awarded through a peer
  409  reviewed, competitive process.
  410         (2) The program shall provide grants for cancer research to
  411  further the search for cures for cancer.
  412         (a) Emphasis shall be given to the goals enumerated in s.
  413  385.20251 s. 381.921, as those goals support the advancement of
  414  such cures.
  415         (b) Preference may be given to grant proposals that foster
  416  collaborations among institutions, researchers, and community
  417  practitioners, as such proposals support the advancement of
  418  cures through basic or applied research, including clinical
  419  trials involving cancer patients and related networks.
  420         (3)(a) Applications for funding for cancer research may be
  421  submitted by any university or established research institute in
  422  the state. All qualified investigators in the state, regardless
  423  of institutional affiliation, shall have equal access and
  424  opportunity to compete for the research funding. Collaborative
  425  proposals, including those that advance the program’s goals
  426  enumerated in subsection (2), may be given preference. Grants
  427  shall be awarded by the State Surgeon General, after
  428  consultation with the Biomedical Research Advisory Council, on
  429  the basis of scientific merit, as determined by an open,
  430  competitive peer review process that ensures objectivity,
  431  consistency, and high quality. The following types of
  432  applications shall be considered for funding:
  433         1. Investigator-initiated research grants.
  434         2. Institutional research grants.
  435         3. Collaborative research grants, including those that
  436  advance the finding of cures through basic or applied research.
  437         (b) In order to ensure that all proposals for research
  438  funding are appropriate and are evaluated fairly on the basis of
  439  scientific merit, the State Surgeon General, in consultation
  440  with the council, shall appoint a peer review panel of
  441  independent, scientifically qualified individuals to review the
  442  scientific content of each proposal and establish its priority
  443  score. The priority scores shall be forwarded to the council and
  444  must be considered in determining which proposals shall be
  445  recommended for funding.
  446         (c) The council and the peer review panel shall establish
  447  and follow rigorous guidelines for ethical conduct and adhere to
  448  a strict policy with regard to conflicts of interest. A member
  449  of the council or panel may not participate in any discussion or
  450  decision with respect to a research proposal by any firm,
  451  entity, or agency with which the member is associated as a
  452  member of the governing body or as an employee or with which the
  453  member has entered into a contractual arrangement. Meetings of
  454  the council and the peer review panels are subject to chapter
  455  119, s. 286.011, and s. 24, Art. I of the State Constitution.
  456         (4) By December 15 of each year, the Department of Health
  457  shall submit to the Governor, the President of the Senate, and
  458  the Speaker of the House of Representatives a report indicating
  459  progress towards the program’s mission and making
  460  recommendations that further its purpose.
  461         (5) Funds appropriated for the William G. “Bill” Bankhead,
  462  Jr., and David Coley Cancer Research Program shall be
  463  distributed pursuant to this section to provide grants to
  464  researchers seeking cures for cancer and cancer-related
  465  illnesses, with emphasis given to the goals enumerated in s.
  466  385.20251 s. 381.921. From the total funds appropriated, an
  467  amount of up to 10 percent may be used for administrative
  468  expenses. In the 2009-2010 fiscal year, 2.5 percent, not to
  469  exceed $25 million, of the revenue deposited into the Health
  470  Care Trust Fund pursuant to s. 215.5602(12)(a) shall be
  471  transferred to the Biomedical Research Trust Fund within the
  472  Department of Health for the William G. “Bill” Bankhead, Jr.,
  473  and David Coley Cancer Research Program.
  474         (6) By June 1, 2009, the Division of Statutory Revision of
  475  the Office of Legislative Services shall certify to the
  476  President of the Senate and the Speaker of the House of
  477  Representatives the language and statutory citation of this
  478  section, which is scheduled to expire January 1, 2011.
  479         (7) The Legislature shall review the performance, the
  480  outcomes, and the financial management of the William G. “Bill”
  481  Bankhead, Jr., and David Coley Cancer Research Program during
  482  the 2010 Regular Session of the Legislature and shall determine
  483  the most appropriate funding source and means of funding the
  484  program based on its review.
  485         (8) This section expires January 1, 2011, unless reviewed
  486  and reenacted by the Legislature before that date.
  487         Section 11. Section 381.93, Florida Statutes, is renumbered
  488  as section 385.20253, Florida Statutes, to read:
  489         385.20253 381.93 Breast and cervical cancer early detection
  490  program.—This section may be cited as the “Mary Brogan Breast
  491  and Cervical Cancer Early Detection Program Act.”
  492         (1) It is the intent of the Legislature to reduce the rates
  493  of death due to breast and cervical cancer through early
  494  diagnosis and increased access to early screening, diagnosis,
  495  and treatment programs.
  496         (2) The Department of Health, using available federal funds
  497  and state funds appropriated for that purpose, is authorized to
  498  establish the Mary Brogan Breast and Cervical Cancer Screening
  499  and Early Detection Program to provide screening, diagnosis,
  500  evaluation, treatment, case management, and followup and
  501  referral to the Agency for Health Care Administration for
  502  coverage of treatment services.
  503         (3) The Mary Brogan Breast and Cervical Cancer Early
  504  Detection Program shall be funded through grants for such
  505  screening and early detection purposes from the federal Centers
  506  for Disease Control and Prevention under Title XV of the Public
  507  Health Service Act, 42 U.S.C. ss. 300k et seq.
  508         (4) The department shall limit enrollment in the program to
  509  persons with incomes up to and including 200 percent of the
  510  federal poverty level. The department shall establish an
  511  eligibility process that includes an income-verification process
  512  to ensure that persons served under the program meet income
  513  guidelines.
  514         (5) The department may provide other breast and cervical
  515  cancer screening and diagnostic services; however, such services
  516  shall be funded separately through other sources than this act.
  517         Section 12. Section 381.931, Florida Statutes, is
  518  renumbered as section 385.20254, Florida Statutes, and amended
  519  to read:
  520         385.20254 381.931 Annual report on Medicaid expenditures.
  521  The Department of Health and the Agency for Health Care
  522  Administration shall monitor the total Medicaid expenditures for
  523  services made under this act. If Medicaid expenditures are
  524  projected to exceed the amount appropriated by the Legislature,
  525  the Department of Health shall limit the number of screenings to
  526  ensure Medicaid expenditures do not exceed the amount
  527  appropriated. The Department of Health, in cooperation with the
  528  Agency for Health Care Administration, shall prepare an annual
  529  report that must include the number of women screened; the
  530  percentage of positive and negative outcomes; the number of
  531  referrals to Medicaid and other providers for treatment
  532  services; the estimated number of women who are not screened or
  533  not served by Medicaid due to funding limitations, if any; the
  534  cost of Medicaid treatment services; and the estimated cost of
  535  treatment services for women who were not screened or referred
  536  for treatment due to funding limitations. The report shall be
  537  submitted to the President of the Senate, the Speaker of the
  538  House of Representatives, and the Executive Office of the
  539  Governor by March 1 of each year.
  540         Section 13. Section 381.932, Florida Statutes, is
  541  renumbered as section 385.20255, Florida Statutes, to read:
  542         385.20255 381.932 Breast cancer early detection and
  543  treatment referral program.—
  544         (1) For purposes of this section, the term:
  545         (a) “Breast cancer screening and referral services” means
  546  necessary breast cancer screening and referral services for a
  547  procedure intended to treat cancer of the human breast,
  548  including, but not limited to, surgery, radiation therapy,
  549  chemotherapy, hormonal therapy, and related medical followup
  550  services.
  551         (b) “Unserved or underserved populations” means women who
  552  are:
  553         1. At or below 200 percent of the federal poverty level for
  554  individuals;
  555         2. Without health insurance that covers breast cancer
  556  screenings; and
  557         3. Nineteen to 64 years of age, inclusive.
  558         (2) There is established, within existing or specific
  559  appropriations, a breast cancer early detection and treatment
  560  referral program within the Department of Health. The purposes
  561  of the program are to:
  562         (a) Promote referrals for the screening, detection, and
  563  treatment of breast cancer among unserved or underserved
  564  populations.
  565         (b) Educate the public regarding breast cancer and the
  566  benefits of early detection.
  567         (c) Provide referral services for persons seeking
  568  treatment.
  569         (3) The program shall include, but is not be limited to,
  570  the:
  571         (a) Establishment of a public education and outreach
  572  initiative to publicize breast cancer early detection services,
  573  the benefits of early detection of breast cancer, and the
  574  recommended frequency for receiving screening services,
  575  including clinical breast examinations and mammography
  576  guidelines established by the United States Preventive Services
  577  Task Force.
  578         (b) Development of professional education programs that
  579  include information regarding the benefits of the early
  580  detection of breast cancer and the recommended frequency for
  581  receiving a mammogram, as recommended in the most current breast
  582  cancer screening guidelines established by the United States
  583  Preventive Services Task Force.
  584         (c) Establishment of a system to track and monitor all
  585  women screened for breast cancer in the program. The system
  586  shall include, but is not be limited to, monitoring abnormal
  587  screening tests, referring women for treatment when needed, and
  588  tracking women to be screened at recommended screening
  589  intervals.
  590         (4) The State Surgeon General shall submit an annual report
  591  to the appropriate substantive committees of the Legislature.
  592  The report shall include, but is not be limited to, a
  593  description of the rate of breast cancer morbidity and mortality
  594  in the state and the extent to which women are participating in
  595  breast cancer screening as reported by the Behavioral Risk
  596  Factor Surveillance System.
  597         Section 14. Chapter 385, Florida Statutes, entitled
  598  “Chronic Diseases,” is renamed the “Healthy and Fit Florida
  599  Act.”
  600         Section 15. Section 385.101, Florida Statutes, is amended
  601  to read:
  602         385.101 Short title.—This chapter Sections 385.101-385.103
  603  may be cited as the “Healthy and Fit Florida Chronic Diseases
  604  Act.”
  605         Section 16. Section 385.102, Florida Statutes, is amended
  606  to read:
  607         385.102 Legislative intent.—It is the finding of the
  608  Legislature that:
  609         (1) Chronic diseases continue to be the leading cause of
  610  death and disability in the state and the nation exist in high
  611  proportions among the people of this state. These Chronic
  612  diseases include, but are not limited to, arthritis,
  613  cardiovascular disease heart disease, hypertension, diabetes,
  614  renal disease, oral diseases, cancer, and chronic obstructive
  615  lung disease, including chronic obstructive pulmonary disease
  616  and asthma. These diseases are often have the same preventable
  617  risk factors and interrelated, and they directly and indirectly
  618  account for a high rate of death and disability, which results
  619  in higher costs to the state’s health care system illness.
  620         (2) Chronic diseases have a significant impact on quality
  621  of life, not only for the individuals who experience the painful
  622  symptoms and resulting disabilities, but also for family members
  623  and caregivers.
  624         (3) Racial and ethnic minorities and other underserved
  625  populations are disproportionately affected by chronic diseases.
  626         (4) Chronic diseases and the complications associated with
  627  these diseases result in increased medical costs and lost wages.
  628         (5)(2) Advances in medical knowledge and technology assist
  629  have assisted in the prevention, detection, and management of
  630  chronic diseases. Comprehensive approaches that stress the
  631  stressing application of current medical treatment, continuing
  632  research, professional training, and patient education, and
  633  state and local policy and environmental changes should be
  634  implemented encouraged.
  635         (6)(3) A comprehensive program dealing with the early
  636  detection and prevention of chronic diseases is required to make
  637  knowledge and therapy available to all people of this state. The
  638  mobilization of scientific, medical, and educational resources
  639  and the implementation of state and local policies relating to
  640  chronic diseases under one comprehensive law chronic disease act
  641  will facilitate the prevention, early intervention, and
  642  management of chronic and treatment of these diseases and their
  643  symptoms. This integration of resources and policy will and
  644  result in a decline in death and disability illness among the
  645  people of this state.
  646         (7) The department shall establish, promote, and maintain
  647  programs at the state and community levels for chronic disease
  648  prevention and health promotion as described in this chapter to
  649  the extent that funds are specifically made available for this
  650  purpose.
  651         Section 17. Section 385.1021, Florida Statutes, is created
  652  to read:
  653         385.1021 Definitions.—As used in this chapter, the term:
  654         (1) “Best and promising practices” means specific
  655  activities used to effect change, which may include guidelines
  656  developed by organizations, volunteer scientists, and health
  657  care professionals who have published medical or scientific
  658  articles on topics relating to chronic diseases in a generally
  659  available scientific journal that has a rigorous review and
  660  approval process.
  661         (2) “CDC” means the United States Centers for Disease
  662  Control and Prevention.
  663         (3) “Chronic disease” means an illness that is prolonged,
  664  does not resolve spontaneously, and is rarely cured completely.
  665         (4) “Department” means the Department of Health.
  666         (5) “Environmental changes” means changes to the economic,
  667  social, or physical natural or built environment that encourage
  668  or enable healthy behavior.
  669         (6) “Policy change” means altering an informal or formal
  670  agreement between the public or private sector to identify
  671  values, behaviors, or resource allocation in order to improve
  672  health.
  673         (7) “Primary prevention” means an intervention that is
  674  directed toward healthy populations and focuses on preventing a
  675  disease before it occurs.
  676         (8) “Risk factor” means a characteristic or condition
  677  identified during the course of an epidemiological study of a
  678  disease that appears to be statistically associated with a high
  679  incidence of that disease.
  680         (9) “Secondary prevention” means an intervention that is
  681  designed to promote the early detection and management of
  682  diseases and reduce the risks experienced by at-risk
  683  populations.
  684         (10) “System changes” means altering standard activities,
  685  protocols, policies, processes, and structures carried out in
  686  population-based settings, such as schools, worksites, health
  687  care facilities, faith-based organizations, and the overall
  688  community, which promote and support new behaviors.
  689         (11) “Tertiary prevention” means an intervention that is
  690  directed at rehabilitating and minimizing the effects of disease
  691  in a chronically ill population.
  692         (12) “Wellness program” means a structured program that is
  693  designed or approved by the department to offer intervention
  694  activities on or off the worksite which help state and local
  695  government employees change certain behaviors or adopt healthy
  696  lifestyles.
  697         Section 18. Section 385.1022, Florida Statutes, is created
  698  to read:
  699         385.1022 Chronic disease prevention and health promotion
  700  program.—
  701         (1) The department shall support the creation of public
  702  health programs at the state and community levels to reduce the
  703  incidence of mortality and morbidity from chronic diseases for
  704  which risk factors can be identified. Such risk factors include,
  705  but are not limited to, being overweight or obese, physical
  706  inactivity, poor diet and nutrition habits, sun exposure, poor
  707  oral hygiene, and other practices that are detrimental to
  708  health.
  709         (2) For any contracts or grants awarded pursuant to this
  710  chapter, the department may make advances in total or
  711  periodically for program startup or contracted services to other
  712  governmental entities and not-for-profit corporations. The
  713  amount advanced may not exceed the expected financial needs of
  714  the contractor or recipient during the initial 3 months of the
  715  contract. Any agreement that provides for advancements may
  716  contain a clause that permits the contractor or recipient to
  717  temporarily invest the proceeds, provided that any interest
  718  income shall be returned to the agency or applied against the
  719  agency’s obligation to pay the contract amount.
  720         Section 19. Section 385.1023, Florida Statutes, is created
  721  to read:
  722         385.1023 State-level programs for chronic disease
  723  prevention.—
  724         (1) The department shall create state-level programs that
  725  address preventable chronic disease risk factors, such as being
  726  overweight or obese, physical inactivity, poor diet and
  727  nutrition habits, sun exposure, poor oral hygiene, and other
  728  practices that are detrimental to health, in order to decrease
  729  the incidence of arthritis, cancer, diabetes, heart disease,
  730  lung disease, including chronic obstructive pulmonary disease
  731  and asthma, stroke, and other chronic diseases.
  732         (2) State-level programs shall include, but not be limited
  733  to:
  734         (a) Monitoring specific causal and behavioral risk factors
  735  that affect the health of residents of this state.
  736         (b) Analyzing data regarding chronic disease mortality and
  737  morbidity to track changes.
  738         (c) Promoting public awareness and increasing knowledge
  739  concerning the causes of chronic diseases, including the
  740  importance of early detection, diagnosis, and appropriate
  741  evidence-based prevention, management, and treatment strategies.
  742         (d) Disseminating educational materials and information
  743  concerning evidence-based results, available services, and
  744  pertinent new research findings and prevention strategies to
  745  patients, health insurers, health professionals, and the public.
  746         (e) Providing technical assistance using educational and
  747  training resources and services developed by organizations with
  748  the appropriate expertise and knowledge of chronic diseases.
  749         (f) Evaluating the quality and accessibility of existing
  750  community-based services for persons with chronic diseases.
  751         (g) Increasing awareness among state and local officials
  752  involved in health and human services, health professionals and
  753  providers, and policymakers regarding evidence-based chronic
  754  disease prevention, treatment strategies, and benefits for
  755  persons with chronic diseases.
  756         (h) Developing a partnership with state and local
  757  governments, voluntary health organizations, hospitals, health
  758  insurers, universities, medical centers, faith-based
  759  organizations, employer groups, private companies, and health
  760  care providers to address the issue of chronic diseases in this
  761  state.
  762         (i) Implementing and coordinating state-level policies in
  763  order to reduce the impact of chronic diseases.
  764         (j) Providing lasting improvements in the delivery of
  765  health care for individuals who have chronic diseases and their
  766  families, thus improving their quality of life while also
  767  containing health care costs.
  768         (3) The department shall prepare a biennial report on the
  769  status of chronic diseases, including current data regarding
  770  incidences of chronic disease in the state. The report shall be
  771  submitted to the Governor, the President of the Senate, and the
  772  Speaker of the House of Representatives by March 1 and shall
  773  include:
  774         (a) An analysis reviewing and forecasting the correlation
  775  of chronic diseases and emerging related issues, as determined
  776  by the state chronic disease report, to the direct and indirect
  777  financial costs to the state, which may include costs relating
  778  to health care, lost productivity, and a reduced quality of
  779  life.
  780         (b) The reporting of health disparities regarding
  781  incidences of chronic diseases among different segments of the
  782  population.
  783         (c) Recommendations supported by the data provided in the
  784  state chronic disease report.
  785         Section 20. Section 385.1035, Florida Statutes, is created
  786  to read:
  787         385.1035 Community-level programs for chronic disease
  788  prevention and health promotion.—The department shall develop
  789  and implement a comprehensive, community-level program for
  790  chronic disease prevention and health promotion. The program
  791  shall be designed to reduce major behavioral risk factors
  792  associated with chronic diseases by enhancing knowledge, skills,
  793  motivation, and opportunities to enable individuals,
  794  organizations, health care providers, small businesses, health
  795  insurers, and communities to develop and maintain healthy
  796  lifestyles. A community-level chronic disease prevention and
  797  health promotion program shall include, but not be limited to:
  798         (1) The employment of skilled staff who are trained in
  799  public health, community health, or school health education to
  800  facilitate the operation of the program.
  801         (2) A process for soliciting community input into the
  802  planning, implementation, and evaluation processes.
  803         (3) The use of local and statewide data as a basis for
  804  decisionmaking and the development and prioritization of
  805  community-based interventions focused on the risk factors
  806  associated with chronic diseases.
  807         (4) The development and implementation of interventions and
  808  activities through community organizations, schools, worksites,
  809  faith-based organizations, and health-care settings.
  810         (5) The use of evidence-based interventions as well as best
  811  and promising practices.
  812         (6) The use of policies, systems, and environmental changes
  813  that support healthy behaviors in order to affect large segments
  814  of the population and encourage healthy choices.
  815         (7) The provision of counseling in nutrition, physical
  816  activity, the effects of tobacco use, hypertension, blood
  817  pressure control, and diabetes control, and other clinical
  818  prevention services.
  819         Section 21. Section 385.104, Florida Statutes, is created
  820  to read:
  821         385.104 State Employee Wellness Interagency Council.—
  822         (1) The State Employee Wellness Interagency Council is
  823  created within the Department of Health for the purpose of
  824  developing policies to enhance the full implementation of
  825  employee wellness in state agencies. The council shall operate
  826  as a workgroup under the State Surgeon General.
  827         (2) The council shall be composed of representatives of no
  828  fewer than six agencies, including, but not limited to, the
  829  Department of Health, the Department of Revenue, the Department
  830  of Education, and the Department of Management Services. The
  831  council shall include state agency representatives in leadership
  832  positions in the areas of human resources, risk assessment, or
  833  existing employee wellness programs. Council members shall be
  834  appointed in such a manner as to equitably represent the state
  835  agencies on the council. Not more than two members of the
  836  council may be from any one state agency.
  837         (3) Council members shall be nominated by the agency head
  838  and appointed by the State Surgeon General to 4-year terms,
  839  except that the initial terms shall be staggered, with three
  840  members appointed to 3-year terms and three members appointed to
  841  4-year terms.
  842         (4) A member’s absence from three consecutive meetings
  843  shall result in his or her automatic removal from the council. A
  844  vacancy on the council shall be filled for the remainder of the
  845  unexpired term.
  846         (5) The council shall annually elect from its membership
  847  one member to serve as chair of the council and one member to
  848  serve as vice chair. The State Surgeon General shall serve as
  849  chair until an election is held.
  850         (6) The first meeting of the council shall be called by the
  851  chair not more than 60 days after the council members are
  852  appointed by the State Surgeon General. The council shall
  853  thereafter meet at least once quarterly and may meet more often
  854  as necessary. The department shall provide staff assistance to
  855  the council which shall include, but is not limited to, keeping
  856  records of the proceedings of the council and serving as
  857  custodian of all books, documents, and papers filed with the
  858  council.
  859         (7) A majority of the members of the council constitutes a
  860  quorum.
  861         (8) Service on the council shall be considered a part of a
  862  member’s job duties and responsibilities.
  863         (9) The council shall:
  864         (a) Work to develop and implement policies that offer
  865  evidence-based wellness programs to employees of state agencies.
  866         (b) Work to encourage state employees to participate in
  867  wellness programs. The council may prepare informational
  868  programs and brochures for state agencies and employees.
  869         (c) In consultation with the department, develop standards
  870  and criteria for age-based and gender-based wellness programs.
  871         (d) Define employee wellness and establish the minimum
  872  elements of any employee wellness program and specify those
  873  activities that are prohibited.
  874         Section 22. Section 385.105, Florida Statutes, is created
  875  to read:
  876         385.105 Physical activity, obesity prevention, nutrition,
  877  and other health-promotion services and wellness programs.—
  878         (1) PHYSICAL ACTIVITY.—The department shall:
  879         (a) Promote programs for people at every stage of their
  880  lives to increase physical fitness and encourage healthy
  881  behavior changes.
  882         (b) Work with school health advisory committees in each
  883  school district as established in s. 381.0056 to encourage the
  884  physical activity of students, staff, and teachers.
  885         (c) Develop public and private partnerships that allow the
  886  public to easily access recreational facilities and public land
  887  areas that are suitable for physical activity.
  888         (d) Work in collaboration with the Executive Office of the
  889  Governor and Volunteer Florida, Inc., to promote school
  890  initiatives, such as the Governor’s Fitness Challenge.
  891         (e) Collaborate with the Department of Education in
  892  recognizing nationally accepted best practices for improving
  893  physical education in schools.
  894         (2) OBESITY PREVENTION.—The department shall promote
  895  healthy lifestyles to reduce the rate of obesity and encourage
  896  weight control and weight reduction through programs that are
  897  directed towards all residents of this state by:
  898         (a) Using all appropriate media to promote maximum public
  899  awareness of the latest research on healthy lifestyles and
  900  chronic diseases and disseminating relevant information relating
  901  to wellness, physical activity, and nutrition and the effect of
  902  these factors on chronic diseases and disabling conditions
  903  through a statewide clearinghouse.
  904         (b) Providing technical assistance, training, and resources
  905  on healthy lifestyles and chronic diseases to the public, health
  906  care providers, school districts, and other persons or entities,
  907  including faith-based organizations, that request such
  908  assistance to promote physical activity, nutrition, and healthy
  909  lifestyle programs.
  910         (c) Developing, implementing, and using all available
  911  research methods to collect data, including, but not limited to,
  912  population-specific data, and tracking the incidence and effects
  913  of weight gain, obesity, and related chronic diseases. All
  914  research conducted under this paragraph is subject to review and
  915  approval as required by the department’s Institutional Review
  916  Board under s. 381.86.
  917         (d) Entering into partnerships with the Department of
  918  Education, local communities, school districts, and other
  919  entities to encourage schools in the state to promote activities
  920  during and after school to help students meet a minimum goal of
  921  30 minutes of physical fitness activities per day.
  922         (e) Entering into partnerships with the Department of
  923  Education, school districts, and the Florida Sports Foundation
  924  to develop programs recognizing the schools at which students
  925  demonstrate excellent physical fitness or fitness improvement.
  926         (f) Collaborating with other state agencies to develop
  927  policies and strategies for preventing and treating obesity,
  928  which shall be incorporated into programs administered by each
  929  agency and shall include promoting healthy lifestyles among the
  930  employees of each agency.
  931         (g) Advising, in accordance with s. 456.081, health care
  932  practitioners about the morbidity, mortality, and costs
  933  associated with being overweight or obese; informing
  934  practitioners of promising clinical practices for preventing and
  935  treating obesity; and encouraging practitioners to counsel their
  936  patients regarding the adoption of healthy lifestyles.
  937         (h) Maximizing all local, state, and federal funding
  938  sources, including seeking grants, public-private partnerships,
  939  and other mechanisms, to strengthen the department’s programs
  940  that promote physical activity and nutrition.
  941         (3) NUTRITION.—The Office of Public Health Nutrition shall:
  942         (a) Promote the maintenance of optimal nutritional status
  943  in the state’s population through activities, including, but not
  944  limited to:
  945         1. Nutrition screening and assessment and nutrition
  946  counseling, including nutrition therapy, followup, case
  947  management, and referrals, for persons who have medical
  948  conditions or nutrition risk factors and who receive health
  949  services through public health programs or through referrals
  950  from private health care providers or facilities.
  951         2. Nutrition education to assist residents of the state in
  952  achieving optimal health and preventing chronic disease.
  953         3. Consultative nutrition services to group facilities
  954  which promote the provision of safe and nutritionally adequate
  955  diets.
  956         (b) Monitor and conduct surveillance of the nutritional
  957  status of the state’s population.
  958         (c) Conduct or support research or evaluations related to
  959  public health nutrition. All research conducted under this
  960  paragraph is subject to review and approval as required by the
  961  department’s Institutional Review Board under s. 381.86.
  962         (d) Establish policies and standards for public health
  963  nutrition practices.
  964         (e) Promote interagency cooperation, professional
  965  education, and consultation.
  966         (f) Provide technical assistance and advise state agencies,
  967  private institutions, and local organizations regarding public
  968  health nutrition standards.
  969         (g) Work with the Department of Agriculture and Consumer
  970  Services, the Department of Education, and the Department of
  971  Management Services to further the use of the state’s fresh
  972  produce in schools and encourage the development of community
  973  gardens. Nutritional services shall be available to eligible
  974  persons in accordance with eligibility criteria adopted by the
  975  department. The department shall provide by rule requirements
  976  for the service fees, when applicable, which may not exceed the
  977  department’s actual costs.
  978  
  979  The department may adopt rules to administer this subsection.
  980         (4) OTHER HEALTH PROMOTION SERVICES.—The department shall:
  981         (a) Promote personal responsibility by encouraging
  982  residents of this state to be informed, follow health
  983  recommendations, seek medical consultations and health
  984  assessments, and comply with medical guidelines, including those
  985  that lead to earlier detection of chronic diseases, in order to
  986  prevent chronic diseases or slow the progression of established
  987  chronic diseases.
  988         (b) Promote regular health visits during a person’s
  989  lifetime, including annual physical examinations that include
  990  measuring body mass index and vital signs, blood work,
  991  immunizations, screenings, and dental examinations, in order to
  992  reduce the financial, social, and personal burden of chronic
  993  disease.
  994         (5) WELLNESS PROGRAMS.—
  995         (a) Each state agency may conduct employee wellness
  996  programs in buildings and on lands owned or leased by the state.
  997  The department shall serve as a model for the development and
  998  implementation of employee wellness programs that may include
  999  physical fitness, healthy nutrition, self-management of disease,
 1000  wellness and fitness education, and behavioral change elements.
 1001  The department shall assist other state agencies in developing
 1002  and implementing employee wellness programs. These programs
 1003  shall use existing resources, facilities, and programs or
 1004  resources procured through grant funding and donations that are
 1005  obtained in accordance with state ethics and procurement
 1006  policies, and shall provide equal access to any such programs,
 1007  resources, and facilities to all state employees.
 1008         (b) The department shall coordinate its efforts with the
 1009  Department of Management Services and other state agencies.
 1010         (c) Each state agency may establish an employee wellness
 1011  workgroup to design the agency’s wellness program. The
 1012  department shall provide policy guidance and assist in
 1013  identifying effective wellness program strategies.
 1014         (d) The department shall provide by rule requirements for
 1015  nominal participation fees, when applicable, which may not
 1016  exceed the department’s actual costs, collaboration with
 1017  businesses, and the procurement of equipment and incentives.
 1018         Section 23. Section 385.202, Florida Statutes, is amended
 1019  to read:
 1020         385.202 Statewide cancer registry.—
 1021         (1) Each facility, laboratory, or practitioner licensed
 1022  under chapter 395, chapter 458, chapter 459, chapter 464,
 1023  chapter 483, or chapter 485, and each freestanding radiation
 1024  therapy center as defined in s. 408.07, shall report to the
 1025  department of Health such information, specified by the
 1026  department, by rule. The department may adopt rules regarding
 1027  reporting requirements for the statewide cancer registry, which
 1028  shall include the data required, the timeframe for reporting,
 1029  and those professionals who are responsible for ensuring
 1030  compliance with reporting requirements, which indicates
 1031  diagnosis, stage of disease, medical history, laboratory data,
 1032  tissue diagnosis, and radiation, surgical, or other methods of
 1033  diagnosis or treatment for each cancer diagnosed or treated by
 1034  the facility or center. Failure to comply with this requirement
 1035  may be cause for registration or licensure suspension or
 1036  revocation.
 1037         (2) The department shall establish, or cause to have
 1038  established, by contract with a recognized medical organization
 1039  in this state and its affiliated institutions, a statewide
 1040  cancer registry program to ensure that cancer reports required
 1041  under this section shall be maintained and available for use in
 1042  the course of public health surveillance and any study for the
 1043  purpose of reducing morbidity or mortality; and no liability of
 1044  any kind or character for damages or other relief shall arise or
 1045  be enforced against any facility, laboratory, or practitioner
 1046  hospital by reason of having provided such information or
 1047  material to the department.
 1048         (3) The department may adopt rules regarding the
 1049  establishment and operation of a statewide cancer registry
 1050  program.
 1051         (4)(3) The department or a contractual designee operating
 1052  the statewide cancer registry program required by this section
 1053  shall use or publish such said material only for the purpose of
 1054  public health surveillance and advancing medical research or
 1055  medical education in the interest of reducing morbidity or
 1056  mortality, except that a summary of such studies may be released
 1057  for general publication. Information which discloses or could
 1058  lead to the disclosure of the identity of any person whose
 1059  condition or treatment has been reported and studied shall be
 1060  confidential and exempt from the provisions of s. 119.07(1),
 1061  except that:
 1062         (a) Release may be made with the written consent of all
 1063  persons to whom the information applies;
 1064         (b) The department or a contractual designee may contact
 1065  individuals for the purpose of epidemiologic investigation and
 1066  monitoring, provided information that is confidential under this
 1067  section is not further disclosed; or
 1068         (c) The department may exchange personal data with any
 1069  other governmental agency or a contractual designee for the
 1070  purpose of public health surveillance and medical or scientific
 1071  research, if provided such governmental agency or contractual
 1072  designee does shall not further disclose information that is
 1073  confidential under this section.
 1074         (5)(4) Funds appropriated for this section shall be used
 1075  for establishing, administering, compiling, processing, and
 1076  providing biometric and statistical analyses to the reporting
 1077  facilities, laboratories, and practitioners. Funds may also be
 1078  used to ensure the quality and accuracy of the information
 1079  reported and to provide management information to the reporting
 1080  facilities, laboratories, and practitioners.
 1081         (6)(5) The department may adopt rules regarding the
 1082  classifications of, by rule, classify facilities, laboratories,
 1083  and practitioners that are responsible for making reports to the
 1084  statewide cancer registry, the content and frequency of the
 1085  reports, and the penalty for failure to comply with these
 1086  requirements for purposes of reports made to the cancer registry
 1087  and specify the content and frequency of the reports. In
 1088  classifying facilities, the department shall exempt certain
 1089  facilities from reporting cancer information that was previously
 1090  reported to the department or retrieved from existing state
 1091  reports made to the department or the Agency for Health Care
 1092  Administration. The provisions of this section shall not apply
 1093  to any facility whose primary function is to provide psychiatric
 1094  care to its patients.
 1095         (7) Notwithstanding subsection (1), each facility,
 1096  laboratory, and practitioner that reports cancer cases to the
 1097  department shall make their records available for onsite review
 1098  by the department or its authorized representative.
 1099         Section 24. Subsection (3) of section 385.203, Florida
 1100  Statutes, is amended to read:
 1101         385.203 Diabetes Advisory Council; creation; function;
 1102  membership.—
 1103         (3) The council shall be composed of 26 25 citizens of the
 1104  state who have knowledge of, or work in, the area of diabetes
 1105  mellitus as follows:
 1106         (a) Five interested citizens, three of whom are affected by
 1107  diabetes.
 1108         (b) Twenty-one Twenty members, who must include one
 1109  representative from each of the following areas: nursing with
 1110  diabetes-educator certification; dietary with diabetes educator
 1111  certification; podiatry; ophthalmology or optometry; psychology;
 1112  pharmacy; adult endocrinology; pediatric endocrinology; the
 1113  American Diabetes Association (ADA); the Juvenile Diabetes
 1114  Foundation (JDF); the Florida Academy of Family Physicians; a
 1115  community health center; a county health department; an American
 1116  Diabetes Association recognized community education program;
 1117  each medical school in the state; an osteopathic medical school;
 1118  the insurance industry; a Children’s Medical Services diabetes
 1119  regional program; and an employer.
 1120         (c) One or more representatives from the Department of
 1121  Health, who shall serve on the council as ex officio members.
 1122         Section 25. Section 385.206, Florida Statutes, is amended
 1123  to read:
 1124         385.206 Pediatric Hematology-oncology care Center Program.—
 1125         (1) DEFINITIONS.—As used in this section, the term:
 1126         (a) “Department” means the Department of Health.
 1127         (b) “Hematology” means the study, diagnosis, and treatment
 1128  of blood and blood-forming tissues.
 1129         (c) “Oncology” means the study, diagnosis, and treatment of
 1130  malignant neoplasms or cancer.
 1131         (d) “Hemophilia” or “other hemostatic disorder” means a
 1132  bleeding disorder resulting from a genetic abnormality of
 1133  mechanisms related to the control of bleeding.
 1134         (e) “Sickle-cell anemia or other hemoglobinopathy” means an
 1135  hereditary, chronic disease caused by an abnormal type of
 1136  hemoglobin.
 1137         (f) “Patient” means a person under the age of 21 who is in
 1138  need of hematologic-oncologic services and who is enrolled in
 1139  the Children’s Medical Services Network declared medically and
 1140  financially eligible by the department; or a person who received
 1141  such services prior to age 21 and who requires long-term
 1142  monitoring and evaluation to ascertain the sequelae and the
 1143  effectiveness of treatment.
 1144         (g) “Center” means a facility designated by the department
 1145  as having a program specifically designed to provide a full
 1146  range of medical and specialty services to patients with
 1147  hematologic and oncologic disorders.
 1148         (2) PEDIATRIC HEMATOLOGY-ONCOLOGY CARE CENTER PROGRAM;
 1149  AUTHORITY.—The department may designate is authorized to make
 1150  grants and reimbursements to designated centers and provide
 1151  funding to establish and maintain programs for the care of
 1152  patients with hematologic and oncologic disorders. Program
 1153  administration costs shall be paid by the department from funds
 1154  appropriated for this purpose.
 1155         (3) FUNDING; CONTRACT REQUIREMENTS GRANT AGREEMENTS;
 1156  CONDITIONS.—
 1157         (a) Funding provided A grant made under this section shall
 1158  be pursuant to a contract contractual agreement made between a
 1159  center and the department. Each contract agreement shall provide
 1160  that patients will receive services specified types of treatment
 1161  and care from the center without additional charge to the
 1162  patients or their parents or guardians. Grants shall be
 1163  disbursed in accordance with conditions set forth in the
 1164  disbursement guidelines.
 1165         (4) GRANT DISBURSEMENTS AND SPECIAL DISBURSEMENTS FOR LOCAL
 1166  PROGRAMS.—
 1167         (b)(a)Funding may be provided Grant disbursements may be
 1168  made to centers that which meet the following criteria:
 1169         1. The personnel shall include at least one board-certified
 1170  pediatric hematologist-oncologist, at least one board-certified
 1171  pediatric surgeon, at least one board-certified radiotherapist,
 1172  and at least one board-certified pathologist.
 1173         2. As approved by the department, The center shall actively
 1174  participate in a national children’s cancer study group,
 1175  maintain a pediatric tumor registry, have a multidisciplinary
 1176  pediatric tumor board, and meet other guidelines for
 1177  development, including, but not limited to, guidelines from such
 1178  organizations as the American Academy of Pediatrics and the
 1179  American Pediatric Surgical Association.
 1180         (b) Programs shall also be established to provide care to
 1181  hematology-oncology patients within each district of the
 1182  department. The guidelines for local programs shall be
 1183  formulated by the department. Special disbursements may be made
 1184  by the program office to centers for educational programs
 1185  designed for the districts of the department. These programs may
 1186  include teaching total supportive care of the dying patient and
 1187  his or her family, home therapy to hemophiliacs and patients
 1188  with other hemostatic disorders, and screening and counseling
 1189  for patients with sickle-cell anemia or other
 1190  hemoglobinopathies.
 1191         (4)(5) PROGRAM AND PEER REVIEW.—The department shall
 1192  evaluate at least annually during the grant period the services
 1193  rendered by the centers and the districts of the department.
 1194  Data from the centers and other sources relating to pediatric
 1195  cancer shall be reviewed annually by the Florida Association of
 1196  Pediatric Tumor Programs, Inc.; and a written report with
 1197  recommendations shall be made to the department. This database
 1198  will be available to the department for program planning and
 1199  quality assurance initiatives formulation of its annual program
 1200  and financial evaluation report. A portion of the funds
 1201  appropriated for this section may be used to provide statewide
 1202  consultation, supervision, and evaluation of the programs of the
 1203  centers, as well as central program office support personnel.
 1204         Section 26. Paragraph (g) of subsection (2) and subsection
 1205  (7) of section 385.207, Florida Statutes, are amended to read:
 1206         385.207 Care and assistance of persons with epilepsy;
 1207  establishment of programs in epilepsy control.—
 1208         (2) The Department of Health shall:
 1209         (g) Continue current programs and develop cooperative
 1210  programs and services designed to enhance the vocational
 1211  rehabilitation of epilepsy clients, including the current jobs
 1212  programs. The department shall, as part of its contract with a
 1213  provider of epilepsy services, collect information regarding the
 1214  number of clients served, the outcomes reached, the expenses
 1215  incurred, and the fees collected by such providers for the
 1216  provision of services keep and make this information available
 1217  to the Governor and the Legislature upon request information
 1218  regarding the number of clients served, the outcome reached, and
 1219  the expense incurred by such programs and services.
 1220         (7) The department shall limit total administrative
 1221  expenditures from the Epilepsy Services Trust Fund to 5 percent
 1222  of annual receipts.
 1223         Section 27. Paragraphs (b), (d), and (g) of subsection (2)
 1224  and paragraph (b) of subsection (5) of section 385.210, Florida
 1225  Statutes, are amended to read:
 1226         385.210 Arthritis prevention and education.—
 1227         (2) LEGISLATIVE FINDINGS.—The Legislature finds the
 1228  following:
 1229         (b) Arthritis is the leading cause of disability in the
 1230  United States, limiting daily activities for more than 7 million
 1231  citizens.
 1232         (d) There are enormous economic and social costs associated
 1233  with treating arthritis and its complications; the economic
 1234  costs are estimated at over $116 billion (1997) annually in the
 1235  United States.
 1236         (g) The National Arthritis Foundation, the CDC Centers for
 1237  Disease Control and Prevention, and the Association of State and
 1238  Territorial Health Officials have led the development of a
 1239  public health strategy, the National Arthritis Action Plan, to
 1240  respond to this challenge.
 1241         (5) FUNDING.—
 1242         (b) The State Surgeon General may shall seek any federal
 1243  waiver or waivers that may be necessary to maximize funds from
 1244  the Federal Government to implement this program.
 1245         Section 28. Section 385.301, Florida Statutes, is created
 1246  to read:
 1247         385.301 Rulemaking authority.—The department may adopt
 1248  rules pursuant to ss. 120.536(1) and 120.54 to implement the
 1249  provisions of this chapter.
 1250         Section 29. Section 385.401, Florida Statutes, is created
 1251  to read:
 1252         385.401 Direct-support organization.—
 1253         (1) DIRECT-SUPPORT ORGANIZATION ESTABLISHED.—The Department
 1254  of Health may establish a direct-support organization to provide
 1255  assistance, funding, and support for the department in carrying
 1256  out the specific mission of promoting a range of collaborations
 1257  to prevent and alleviate the effects of chronic disease upon
 1258  written approval by the State Surgeon General. This section
 1259  governs the creation, use, powers, and duties of the direct
 1260  support organization. Such direct-support organization is an
 1261  organization that is:
 1262         (a) A Florida corporation, not for profit, incorporated
 1263  under chapter 617, exempted from filing fees, and approved by
 1264  the Department of State.
 1265         (b) Organized and operated to conduct programs and
 1266  activities; to initiate developmental projects; to raise funds;
 1267  to request and receive grants, gifts, and bequests of moneys; to
 1268  acquire, receive, hold, invest, and administer in its own name
 1269  securities, funds, or property; and to make expenditures to or
 1270  for the direct or indirect benefit of the state public health
 1271  system for promoting a range of collaborations to prevent and
 1272  alleviate the effects of chronic disease through the department
 1273  or its individual county health departments and the health care
 1274  system.
 1275         (c) Determined by the department to be operating in a
 1276  manner consistent with the priority issues and objectives of the
 1277  department and in the best interest of the state.
 1278         (d) Approved in writing by the State Surgeon General to
 1279  operate for the direct or indirect benefit of the department or
 1280  its individual county health departments. This approval shall be
 1281  in a form determined by the department.
 1282         (2) BOARD OF DIRECTORS.—The direct-support organization
 1283  shall be governed by a board of directors.
 1284         (a) The board of directors shall consist of at least seven
 1285  members, five of whom shall be appointed by the State Surgeon
 1286  General, one of whom shall be appointed by the President of the
 1287  Senate, and one of whom shall be appointed by the Speaker of the
 1288  House of Representatives. Networks and partnerships in the state
 1289  that are involved in issues related to chronic disease may
 1290  recommend nominees to the State Surgeon General.
 1291         (b) The term of office of the board members shall be 3
 1292  years, except that the terms of the initial appointees shall be
 1293  for 1 year, 2 years, or 3 years in order to achieve staggered
 1294  terms. A member may be reappointed when his or her term expires.
 1295  The State Surgeon General or his or her designee shall serve as
 1296  an ex officio member of the board.
 1297         (c) Members must be current residents of this state. A
 1298  majority of the board members must be highly knowledgeable about
 1299  the department, its service personnel, and its missions. The
 1300  board shall include representatives of county government, the
 1301  health care industry, the medical community, and other
 1302  components of the public health system. The State Surgeon
 1303  General may remove any member of the board for cause and with
 1304  the approval of a majority of the members. The State Surgeon
 1305  General shall appoint a replacement for any vacancy that occurs.
 1306         (3) USE OF PROPERTY.—
 1307         (a) The department and each county health department may
 1308  allow, without charge, the use of the department’s fixed
 1309  property and facilities within the state public health system by
 1310  the direct-support organization, subject to this section. Use of
 1311  the fixed property and facilities by the direct-support
 1312  organization may not interfere with use of the fixed property
 1313  and facilities by the department’s clients or staff.
 1314         (b) The department may not allow the use of its fixed
 1315  property and facilities by a direct-support organization that is
 1316  organized under this section and does not provide equal
 1317  employment opportunities to all persons regardless of race,
 1318  color, national origin, gender, age, or religion.
 1319         (4) DIRECTIVES.—The direct-support organization must comply
 1320  with directives and requirements established by the sources of
 1321  its funding.
 1322         (5) ANNUAL BUDGETS AND REPORTS.—
 1323         (a) The fiscal year of the direct-support organization
 1324  shall begin on July 1 of each year and end on June 30 of the
 1325  following year.
 1326         (b) The direct-support organization shall submit to the
 1327  department its federal Internal Revenue Service Application for
 1328  Recognition of Exemption form and its federal Internal Revenue
 1329  Service Return of Organization Exempt from Income Tax form.
 1330         (c) By January 15th of each year, the direct-support
 1331  organization shall submit to the Governor, the President of the
 1332  Senate, and the Speaker of the House of Representative a report
 1333  describing the progress of the organization in meeting the goals
 1334  of its mission, making recommendations that further its purpose,
 1335  and providing an audit of its expenditures.
 1336         (6) ANNUAL AUDIT.—The direct-support organization shall
 1337  provide for an annual financial audit in accordance with s.
 1338  215.981.
 1339         Section 30. Subsection (9) of section 409.904, Florida
 1340  Statutes, is amended to read:
 1341         409.904 Optional payments for eligible persons.—The agency
 1342  may make payments for medical assistance and related services on
 1343  behalf of the following persons who are determined to be
 1344  eligible subject to the income, assets, and categorical
 1345  eligibility tests set forth in federal and state law. Payment on
 1346  behalf of these Medicaid eligible persons is subject to the
 1347  availability of moneys and any limitations established by the
 1348  General Appropriations Act or chapter 216.
 1349         (9) Eligible women with incomes at or below 200 percent of
 1350  the federal poverty level and under age 65, for cancer treatment
 1351  pursuant to the federal Breast and Cervical Cancer Prevention
 1352  and Treatment Act of 2000, screened through the Mary Brogan
 1353  Breast and Cervical Cancer Early Detection Program established
 1354  under s. 385.20253 s. 381.93.
 1355         Section 31. This act shall take effect July 1, 2010.