HB 5311

1	A bill to be entitled
2	An act relating to the Department of Health; amending s.
3	20.435, F.S.; revising provisions for administration and
4	use of funds in the Administrative Trust Fund and the
5	Emergency Medical Services Trust Fund; providing for such
6	administration and use under specified provisions;
7	amending ss. 318.14, 318.18, and 318.21, F.S.; providing
8	that funds collected from disposition of certain motor
9	vehicle infractions shall be deposited into the Emergency
10	Medical Services Trust Fund; removing provisions for
11	deposit of such funds into the Administrative Trust Fund;
12	providing for use of the funds; correcting a reference;
13	amending ss. 320.131, 327.35, 381.765, and 938.07, F.S.;
14	correcting references to the Brain and Spinal Cord Injury
15	Program Trust Fund; amending ss. 381.78 and 381.79, F.S.;
16	correcting references; amending s. 395.403, F.S., relating
17	to reimbursement of trauma centers; revising eligibility
18	provisions to remove provisional trauma centers and
19	certain hospitals; providing for payments to be made from
20	the Emergency Medical Services Trust Fund; removing
21	provisions for one-time payments from the Administrative
22	Trust Fund; amending s. 395.4036, F.S.; providing for use
23	of funds in the Emergency Medical Services Trust Fund for
24	verified trauma centers; removing provisions for such use
25	of funds in the Administrative Trust Fund; reenacting and
26	amending s. 215.5602, F.S., relating to James and Esther
27	King Biomedical Research Program; specifying that a
28	certain amount of the revenue deposited into the Health
29	Care Trust Fund be reserved for tobacco-related and
30	cancer-related research; providing for specified amounts
31	of revenue to be appropriated to the James and Esther King
32	Biomedical Research Program, the William G. "Bill"
33	Bankhead, Jr., and David Coley Cancer Research Program,
34	and the H. Lee Moffitt Cancer Center and Research
35	Institute; deleting obsolete language; reenacting and
36	amending s. 381.922, F.S., relating to William G. "Bill"
37	Bankhead, Jr., and David Coley Cancer Research Program;
38	providing that the program give emphasis to certain goals;
39	specifying sources of funding for the program; providing
40	for a portion of the funds to be made available to the
41	Florida Center for Universal Research to Eradicate
42	Disease; deleting obsolete language; amending s. 20.43,
43	F.S.; removing a provision authorizing division directors
44	in the Department of Health to appoint certain committees;
45	prohibiting the department from establishing new programs
46	or modifying current programs without legislative
47	approval; requiring the department to notify the Governor
48	and the Legislature before applying for continuation of or
49	new federal or private grants over a specified amount;
50	providing for content of the notification; amending s.
51	381.0011, F.S.; requiring the department to manage
52	emergency preparedness and disaster response functions;
53	amending s. 381.006, F.S.; revising the definition of the
54	term "group care facility"; revising rulemaking authority;
55	amending s. 381.0072, F.S.; revising the definition of the
56	term "food service establishment"; authorizing the
57	department to advise and consult with other agencies
58	concerning the provision of food services; revising
59	entities that are exempt from rules developed for manager
60	certification; repealing ss. 411.23, 411.231, and 411.232,
61	F.S., relating to the Children's Early Investment Program;
62	amending ss. 411.01 and 411.224, F.S.; conforming
63	provisions to changes made by the act; amending s.
64	499.003, F.S.; defining the term "medical convenience kit"
65	for purposes of the Florida Drug and Cosmetic Act;
66	correcting cross-references; amending s. 499.01, F.S.;
67	providing exceptions from requirements for a device
68	manufacturer permit; amending s. 499.01212, F.S.;
69	exempting wholesale distribution of prescription drugs
70	within a medical convenience kit from requirements for the
71	wholesaler to provide a pedigree paper if certain
72	conditions are met; providing that the exemption does not
73	apply to a kit containing certain controlled substances;
74	amending s. 509.013, F.S.; revising exclusions to the
75	definition of the terms "public lodging establishment" and
76	"public food service establishment" to provide for certain
77	facilities certified or licensed by the Agency for Health
78	Care Administration or the Department of Children and
79	Family Services; requiring the department to develop a
80	plan to provide tuberculosis services; requiring the
81	department to submit the plan to the Governor and
82	Legislature by a specified date; providing plan elements;
83	transferring and reassigning certain functions and
84	responsibilities, including records, personnel, property,
85	and unexpended balances of appropriations and other
86	resources, from the Department of Health to the Department
87	of Business and Professional Regulation by a type two
88	transfer; providing for the continued validity of pending
89	judicial or administrative actions to which the Department
90	of Health is a party; providing for the continued validity
91	of lawful orders issued by the Department of Health;
92	transferring rules created by the Department of Health to
93	the Department of Business and Professional Regulation;
94	providing for the continued validity of permits and
95	certifications issued by the Department of Health;
96	amending s. 381.0403, F.S., deleting provisions relating
97	to the program for graduate medical education innovations
98	and the graduate medical education committee and report;
99	conforming a cross-reference; amending s. 381.4018, F.S.;
100	revising provisions for physician workforce assessment and
101	development; providing definitions; creating the Physician
102	Workforce Advisory Council; providing for membership and
103	organization; providing duties of the council; amending
104	ss. 458.3192 and 459.0082, F.S.; revising provisions for
105	analysis by the department of physician surveys under
106	specified provisions; amending s. 458.315; revising
107	provisions for issuance by the Board of Medicine of a
108	temporary certificate to practice medicine in certain
109	areas; creating s. 459.0076, F.S.; providing for issuance
110	by the Board of Osteopathic Medicine of a temporary
111	certificate to practice osteopathic medicine in certain
112	areas; directing the department to conduct an evaluation
113	and justification review of its divisions; providing
114	review requirements; requiring the department to submit a
115	report to the Governor, the Legislature, and the State
116	Surgeon General by a specified date; amending s.
117	381.00315, F.S.; directing the Department of Health to
118	accept funds from counties, municipalities, and certain
119	other entities for the purchase of certain products made
120	available under a contract with the United States
121	Department of Health and Human Services for the
122	manufacture and delivery of such products in response to a
123	public health emergency; authorizing the department to
124	submit a budget amendment requesting additional budget
125	authority for the Florida Center for Nursing to make
126	certain expenditures; amending ss. 409.9201, 465.0265,
127	499.01, 499.01211, 499.01212, 499.03, 499.05, and 794.075,
128	F.S.; correcting cross-references; providing effective
129	dates.
130
131	Be It Enacted by the Legislature of the State of Florida:
132
133	Section 1.  Paragraph (a) of subsection (1) and paragraph
134	(a) of subsection (14) of section 20.435, Florida Statutes, are
135	amended to read:
136	20.435  Department of Health; trust funds.-The following
137	trust funds shall be administered by the Department of Health:
138	(1)  Administrative Trust Fund.
139	(a)  Funds to be credited to and uses of the trust fund
140	shall be administered in accordance with s. 215.32 consist of
141	regulatory fees such as those pertaining to the
142	permitting, and inspection of septic tanks, food
143	sewage, Superfund compliance, solid waste
144	facilities, mobile home and recreational vehicle park
145	inspection, other departmental regulatory and health care
146	programs, and indirect earnings from grants. Funds shall be used
147	for the purpose of supporting the regulatory activities of the
148	department and for other such purposes as may be appropriate and
149	shall be expended only pursuant to legislative appropriation or
150	an approved amendment to the department's operating budget
151	pursuant to the provisions of chapter 216.
152	(14)  Emergency Medical Services Trust Fund.
153	(a)  Funds to be credited to and uses of the trust fund
154	shall be administered in accordance with ss. 318.14, 318.18,
155	318.21, 395.403, and 395.4036 and the provisions of parts I and
156	II of chapter 401.
157	Section 2.  Subsection (5) of section 318.14, Florida
158	Statutes, is amended to read:
159	318.14  Noncriminal traffic infractions; exception;
160	procedures.-
161	(5)  Any person electing to appear before the designated
162	official or who is required so to appear shall be deemed to have
163	waived his or her right to the civil penalty provisions of s.
164	318.18. The official, after a hearing, shall make a
165	determination as to whether an infraction has been committed. If
166	the commission of an infraction has been proven, the official
167	may impose a civil penalty not to exceed $500, except that in
168	cases involving unlawful speed in a school zone or involving
169	unlawful speed in a construction zone, the civil penalty may not
170	exceed $1,000; or require attendance at a driver improvement
171	school, or both. If the person is required to appear before the
172	designated official pursuant to s. 318.19(1) and is found to
173	have committed the infraction, the designated official shall
174	impose a civil penalty of $1,000 in addition to any other
175	penalties and the person's driver's license shall be suspended
176	for 6 months. If the person is required to appear before the
177	designated official pursuant to s. 318.19(2) and is found to
178	have committed the infraction, the designated official shall
179	impose a civil penalty of $500 in addition to any other
180	penalties and the person's driver's license shall be suspended
181	for 3 months. If the official determines that no infraction has
182	been committed, no costs or penalties shall be imposed and any
183	costs or penalties that have been paid shall be returned. Moneys
184	received from the mandatory civil penalties imposed pursuant to
185	this subsection upon persons required to appear before a
186	designated official pursuant to s. 318.19(1) or (2) shall be
187	remitted to the Department of Revenue and deposited into the
188	Department of Health Emergency Medical Services Administrative
189	Trust Fund to provide financial support to certified trauma
190	centers to assure the availability and accessibility of trauma
191	services throughout the state. Funds deposited into the
192	Emergency Medical Services Administrative Trust Fund under this
193	section shall be allocated as follows:
194	(a)  Fifty percent shall be allocated equally among all
195	Level I, Level II, and pediatric trauma centers in recognition
196	of readiness costs for maintaining trauma services.
197	(b)  Fifty percent shall be allocated among Level I, Level
198	II, and pediatric trauma centers based on each center's relative
199	volume of trauma cases as reported in the Department of Health
200	Trauma Registry.
201	Section 3.  Paragraph (h) of subsection (3), paragraph (c)
202	of subsection (5), and subsection (20) of section 318.18,
203	Florida Statutes, are amended to read:
204	318.18  Amount of penalties.-The penalties required for a
205	noncriminal disposition pursuant to s. 318.14 or a criminal
206	offense listed in s. 318.17 are as follows:
207	(3)
208	(h)  A person cited for a second or subsequent conviction
209	of speed exceeding the limit by 30 miles per hour and above
210	within a 12-month period shall pay a fine that is double the
211	amount listed in paragraph (b). For purposes of this paragraph,
212	the term "conviction" means a finding of guilt as a result of a
213	jury verdict, nonjury trial, or entry of a plea of guilty.
214	Moneys received from the increased fine imposed by this
215	paragraph shall be remitted to the Department of Revenue and
216	deposited into the Department of Health Emergency Medical
217	Services Administrative Trust Fund to provide financial support
218	to certified trauma centers to assure the availability and
219	accessibility of trauma services throughout the state. Funds
220	deposited into the Emergency Medical Services Administrative
221	Trust Fund under this section shall be allocated as follows:
222	1.  Fifty percent shall be allocated equally among all
223	Level I, Level II, and pediatric trauma centers in recognition
224	of readiness costs for maintaining trauma services.
225	2.  Fifty percent shall be allocated among Level I, Level
226	II, and pediatric trauma centers based on each center's relative
227	volume of trauma cases as reported in the Department of Health
228	Trauma Registry.
229	(5)
230	(c)  In addition to the penalty under paragraph (a) or
231	paragraph (b), $65 for a violation of s. 316.172(1)(a) or (b).
232	If the alleged offender is found to have committed the offense,
233	the court shall impose the civil penalty under paragraph (a) or
234	paragraph (b) plus an additional $65. The additional $65
235	collected under this paragraph shall be remitted to the
236	Department of Revenue for deposit into the Emergency Medical
237	Services Administrative Trust Fund of the Department of Health
238	to be used as provided in s. 395.4036.
239	(20)  In addition to any other penalty, $65 for a violation
240	of s. 316.191, prohibiting racing on highways, or s. 316.192,
241	prohibiting reckless driving. The additional $65 collected under
242	this subsection shall be remitted to the Department of Revenue
243	for deposit into the Emergency Medical Services Administrative
244	Trust Fund of the Department of Health to be used as provided in
245	s. 395.4036.
246	Section 4.  Paragraph (d) of subsection (2) and subsection
247	(15) of section 318.21, Florida Statutes, are amended to read:
248	318.21  Disposition of civil penalties by county courts.-
249	All civil penalties received by a county court pursuant to the
250	provisions of this chapter shall be distributed and paid monthly
251	as follows:
252	(2)  Of the remainder:
253	(d)  Eight and two-tenths percent shall be remitted to the
254	Department of Revenue for deposit in the Brain and Spinal Cord
255	Injury Program Rehabilitation Trust Fund for the purposes set
256	forth in s. 381.79.
257	(15)  Of the additional fine assessed under s. 318.18(3)(e)
258	for a violation of s. 316.1893, 50 percent of the moneys
259	received from the fines shall be appropriated to the Agency for
260	Health Care Administration as general revenue to provide an
261	enhanced Medicaid payment to nursing homes that serve Medicaid
262	recipients with brain and spinal cord injuries. The remaining 50
263	percent of the moneys received from the enhanced fine imposed
264	under s. 318.18(3)(e) shall be remitted to the Department of
265	Revenue and deposited into the Department of Health Emergency
266	Medical Services Administrative Trust Fund to provide financial
267	support to certified trauma centers in the counties where
268	enhanced penalty zones are established to ensure the
269	availability and accessibility of trauma services. Funds
270	deposited into the Emergency Medical Services Administrative
271	Trust Fund under this subsection shall be allocated as follows:
272	(a)  Fifty percent shall be allocated equally among all
273	Level I, Level II, and pediatric trauma centers in recognition
274	of readiness costs for maintaining trauma services.
275	(b)  Fifty percent shall be allocated among Level I, Level
276	II, and pediatric trauma centers based on each center's relative
277	volume of trauma cases as reported in the Department of Health
278	Trauma Registry.
279	Section 5.  Subsection (2) of section 320.131, Florida
280	Statutes, is amended to read:
281	320.131  Temporary tags.-
282	(2)  The department is authorized to sell temporary tags,
283	in addition to those listed above, to their agents and where
284	need is demonstrated by a consumer complainant. The fee shall be
285	$2 each. One dollar from each tag sold shall be deposited into
286	the Brain and Spinal Cord Injury Program Rehabilitation Trust
287	Fund, with the remaining proceeds being deposited into the
288	Highway Safety Operating Trust Fund. Agents of the department
289	shall sell temporary tags for $2 each and shall charge the
290	service charge authorized by s. 320.04 per transaction,
291	regardless of the quantity sold. Requests for purchase of
292	temporary tags to the department or its agents shall be made,
293	where applicable, on letterhead stationery and notarized. Except
294	as specifically provided otherwise, a temporary tag shall be
295	valid for 30 days, and no more than two shall be issued to the
296	same person for the same vehicle.
297	Section 6.  Subsection (9) of section 327.35, Florida
298	Statutes, is amended to read:
299	327.35  Boating under the influence; penalties; "designated
300	drivers".-
301	(9)  Notwithstanding any other provision of this section,
302	for any person convicted of a violation of subsection (1), in
303	addition to the fines set forth in subsections (2) and (4), an
304	additional fine of $60 shall be assessed and collected in the
305	same manner as the fines set forth in subsections (2) and (4).
306	All fines collected under this subsection shall be remitted by
307	the clerk of the court to the Department of Revenue for deposit
308	into the Brain and Spinal Cord Injury Program Rehabilitation
309	Trust Fund and used for the purposes set forth in
310	after 5 percent is deducted therefrom by the clerk of
311	for administrative costs.
312	Section 7.  Subsection (2) of section 381.765, Florida
313	Statutes, is amended to read:
314	381.765  Retention of title to and disposal of equipment.-
315	(2)  The department may offer for sale any surplus items
316	acquired in operating the brain and spinal cord injury program
317	when they are no longer necessary or exchange them for necessary
318	items that may be used to greater advantage. When any such
319	surplus equipment is sold or exchanged, a receipt for the
320	equipment shall be taken from the purchaser showing the
321	consideration given for such equipment and forwarded to the
322	Chief Financial Officer, and any funds received by the brain and
323	spinal cord injury program pursuant to any such transaction
324	shall be deposited in the Brain and Spinal Cord Injury Program
325	Rehabilitation Trust Fund and shall be available for expenditure
326	for any purpose consistent with ss. 381.739-381.79 this part.
327	Section 8.  Subsection (7) of section 381.78, Florida
328	Statutes, is amended to read:
329	381.78  Advisory council on brain and spinal cord
330	injuries.-
331	(7)  A member of the advisory council may be removed from
332	office by the State Surgeon General for malfeasance,
333	misfeasance, neglect of duty, incompetence, or permanent
334	inability to perform official duties or for pleading nolo
335	contendere to, or being found guilty of, a crime. Malfeasance
336	includes, but is not limited to, a violation of any specific
337	prohibition within ss. 381.739-381.79 this part.
338	Section 9.  Subsection (6) of section 381.79, Florida
339	Statutes, is amended to read:
340	381.79  Brain and Spinal Cord Injury Program Trust Fund.-
341	(6)  The department may accept, deposit into the trust
342	fund, and use for carrying out the purposes of ss. 381.739-
343	381.79 this part gifts made unconditionally by will or
344	otherwise. Any gift made under conditions that, in the judgment
345	of the department, are proper and consistent with this section,
346	the laws of the United States, and the laws of this state may be
347	accepted and shall be held, invested, reinvested, and used in
348	accordance with the conditions of the gift.
349	Section 10.  Subsections (1) and (2) of section 395.403,
350	Florida Statutes, are amended to read:
351	395.403  Reimbursement of trauma centers.-
352	(1)  All provisional trauma centers and trauma centers
353	shall be considered eligible to receive state funding when state
354	funds are specifically appropriated for state-sponsored trauma
355	centers in the General Appropriations Act. Effective July 1,
356	2010 2004, the department shall make one-time payments from the
357	Emergency Medical Services Administrative Trust Fund under s.
358	20.435 to the trauma centers and a hospital with a pending
359	application for a Level I trauma center in recognition of the
360	capital investment made by the hospital to establish the trauma
361	service. Payments shall be in equal amounts for the trauma
362	centers approved by the department as of July 1 of the fiscal
363	year in which funding is appropriated, with lesser amounts for
364	the hospital with an application pending for a Level I trauma
365	center at the department as of April 1, 2004. In the event a
366	trauma center does not maintain its status as a trauma center
367	for any state fiscal year in which such funding is appropriated,
368	the provisional trauma center or trauma center shall repay the
369	state for the portion of the year during which it was not a
370	trauma center.
371	(2)  Provisional trauma centers and Trauma centers eligible
372	to receive distributions from the Emergency Medical Services
373	Administrative Trust Fund under s. 20.435 in accordance with
374	subsection (1) may request that such funds be used as
375	intergovernmental transfer funds in the Medicaid program.
376	Section 11.  Subsections (1) and (2) of section 395.4036,
377	Florida Statutes, are amended to read:
378	395.4036  Trauma payments.-
379	(1)  Recognizing the Legislature's stated intent to provide
380	financial support to the current verified trauma centers and to
381	provide incentives for the establishment of additional trauma
382	centers as part of a system of state-sponsored trauma centers,
383	the department shall utilize funds collected under s. 318.18 and
384	deposited into the Emergency Medical Services Administrative
385	Trust Fund of the department to ensure the availability and
386	accessibility of trauma services throughout the state as
387	provided in this subsection.
388	(a)  Funds collected under s. 318.18(15) shall be
389	distributed as follows:
390	1.  Twenty percent of the total funds collected during the
391	state fiscal year shall be distributed to verified trauma
392	centers that have a local funding contribution as of December
393	31. Distribution of funds under this subparagraph shall be based
394	on trauma caseload volume for the most recent calendar year
395	available.
396	2.  Forty percent of the total funds collected shall be
397	distributed to verified trauma centers based on trauma caseload
398	volume for the most recent calendar year available. The
399	determination of caseload volume for distribution of funds under
400	this subparagraph shall be based on the department's Trauma
401	Registry data.
402	3.  Forty percent of the total funds collected shall be
403	distributed to verified trauma centers based on severity of
404	trauma patients for the most recent calendar year available. The
405	determination of severity for distribution of funds under this
406	subparagraph shall be based on the department's International
407	Classification Injury Severity Scores or another statistically
408	valid and scientifically accepted method of stratifying a trauma
409	patient's severity of injury, risk of mortality, and resource
410	consumption as adopted by the department by rule, weighted based
411	on the costs associated with and incurred by the trauma center
412	in treating trauma patients. The weighting of scores shall be
413	established by the department by rule.
414	(b)  Funds collected under s. 318.18(5)(c) and (19) shall
415	be distributed as follows:
416	1.  Thirty percent of the total funds collected shall be
417	distributed to Level II trauma centers operated by a public
418	hospital governed by an elected board of directors as of
419	December 31, 2008.
420	2.  Thirty-five percent of the total funds collected shall
421	be distributed to verified trauma centers based on trauma
422	caseload volume for the most recent calendar year available. The
423	determination of caseload volume for distribution of funds under
424	this subparagraph shall be based on the department's Trauma
425	Registry data.
426	3.  Thirty-five percent of the total funds collected shall
427	be distributed to verified trauma centers based on severity of
428	trauma patients for the most recent calendar year available. The
429	determination of severity for distribution of funds under this
430	subparagraph shall be based on the department's International
431	Classification Injury Severity Scores or another statistically
432	valid and scientifically accepted method of stratifying a trauma
433	patient's severity of injury, risk of mortality, and resource
434	consumption as adopted by the department by rule, weighted based
435	on the costs associated with and incurred by the trauma center
436	in treating trauma patients. The weighting of scores shall be
437	established by the department by rule.
438	(2)  Funds deposited in the department's Emergency Medical
439	Services Administrative Trust Fund for verified trauma centers
440	may be used to maximize the receipt of federal funds that may be
441	available for such trauma centers. Notwithstanding this section
442	and s. 318.14, distributions to trauma centers may be adjusted
443	in a manner to ensure that total payments to trauma centers
444	represent the same proportional allocation as set forth in this
445	section and s. 318.14. For purposes of this section and s.
446	318.14, total funds distributed to trauma centers may include
447	revenue from the Emergency Medical Services Administrative Trust
448	Fund and federal funds for which revenue from the Administrative
449	Trust Fund is used to meet state or local matching requirements.
450	Funds collected under ss. 318.14 and 318.18 and deposited in the
451	Emergency Medical Services Administrative Trust Fund of the
452	department shall be distributed to trauma centers on a quarterly
453	basis using the most recent calendar year data available. Such
454	data shall not be used for more than four quarterly
455	distributions unless there are extenuating circumstances as
456	determined by the department, in which case the most recent
457	calendar year data available shall continue to be used and
458	appropriate adjustments shall be made as soon as the more recent
459	data becomes available.
460	Section 12. Section 938.07, Florida Statutes, is amended to
461	read:
462	938.07  Driving or boating under the influence.-
463	Notwithstanding any other provision of s. 316.193 or s. 327.35,
464	a court cost of $135 shall be added to any fine imposed pursuant
465	to s. 316.193 or s. 327.35. The clerks shall remit the funds to
466	the Department of Revenue, $25 of which shall be deposited in
467	the Emergency Medical Services Trust Fund, $50 shall be
468	deposited in the Operating Trust Fund of the Department of Law
469	Enforcement to be used for operational expenses in conducting
470	the statewide criminal analysis laboratory system established in
471	s. 943.32, and $60 shall be deposited in the Brain and Spinal
472	Cord Injury Program Rehabilitation Trust Fund created in s.
473	381.79.
474	Section 13.  Section 215.5602, Florida Statutes, is
475	reenacted and amended to read:
476	215.5602  James and Esther King Biomedical Research
477	Program.-
478	(1)  There is established within the Department of Health
479	the James and Esther King Biomedical Research Program funded by
480	the proceeds of the Lawton Chiles Endowment Fund pursuant to s.
481	215.5601. The purpose of the James and Esther King Biomedical
482	Research Program is to provide an annual and perpetual source of
483	funding in order to support research initiatives that address
484	the health care problems of Floridians in the areas of tobacco-
485	related cancer, cardiovascular disease, stroke, and pulmonary
486	disease. The long-term goals of the program are to:
487	(a)  Improve the health of Floridians by researching better
488	prevention, diagnoses, treatments, and cures for cancer,
489	cardiovascular disease, stroke, and pulmonary disease.
490	(b)  Expand the foundation of biomedical knowledge relating
491	to the prevention, diagnosis, treatment, and cure of diseases
492	related to tobacco use, including cancer, cardiovascular
493	disease, stroke, and pulmonary disease.
494	(c)  Improve the quality of the state's academic health
495	centers by bringing the advances of biomedical research into the
496	training of physicians and other health care providers.
497	(d)  Increase the state's per capita funding for research
498	by undertaking new initiatives in public health and biomedical
499	research that will attract additional funding from outside the
500	state.
501	(e)  Stimulate economic activity in the state in areas
502	related to biomedical research, such as the research and
503	production of pharmaceuticals, biotechnology, and medical
504	devices.
505	(2)  Funds appropriated for the James and Esther King
506	Biomedical Research Program shall be used exclusively for the
507	award of grants and fellowships as established in this section;
508	for research relating to the prevention, diagnosis, treatment,
509	and cure of diseases related to tobacco use, including cancer,
510	cardiovascular disease, stroke, and pulmonary disease; and for
511	expenses incurred in the administration of this section.
512	Priority shall be granted to research designed to prevent or
513	cure disease.
514	(3)  There is created within the Department of Health the
515	Biomedical Research Advisory Council.
516	(a)  The council shall consist of 11 members, including:
517	the chief executive officer of the Florida Division of the
518	American Cancer Society, or a designee; the chief executive
519	officer of the Florida/Puerto Rico Affiliate of the American
520	Heart Association, or a designee; and the chief executive
521	officer of the American Lung Association of Florida, or a
522	designee. The remaining 8 members of the council shall be
523	appointed as follows:
524	1.  The Governor shall appoint four members, two members
525	with expertise in the field of biomedical research, one member
526	from a research university in the state, and one member
527	representing the general population of the state.
528	2.  The President of the Senate shall appoint two members,
529	one member with expertise in the field of behavioral or social
530	research and one representative from a cancer program approved
531	by the American College of Surgeons.
532	3.  The Speaker of the House of Representatives shall
533	appoint two members, one member from a professional medical
534	organization and one representative from a cancer program
535	approved by the American College of Surgeons.
536
537	In making these appointments, the Governor, the President of the
538	Senate, and the Speaker of the House of Representatives shall
539	select primarily, but not exclusively, Floridians with
540	biomedical and lay expertise in the general areas of cancer,
541	cardiovascular disease, stroke, and pulmonary disease. The
542	appointments shall be for a 3-year term and shall reflect the
543	diversity of the state's population. An appointed member may not
544	serve more than two consecutive terms.
545	(b)  The council shall adopt internal organizational
546	procedures as necessary for its efficient organization.
547	(c)  The department shall provide such staff, information,
548	and other assistance as is reasonably necessary to assist the
549	council in carrying out its responsibilities.
550	(d)  Members of the council shall serve without
551	compensation, but may receive reimbursement as provided in s.
552	112.061 for travel and other necessary expenses incurred in the
553	performance of their official duties.
554	(4)  The council shall advise the State Surgeon General as
555	to the direction and scope of the biomedical research program.
556	The responsibilities of the council may include, but are not
557	limited to:
558	(a)  Providing advice on program priorities and emphases.
559	(b)  Providing advice on the overall program budget.
560	(c)  Participating in periodic program evaluation.
561	(d)  Assisting in the development of guidelines to ensure
562	fairness, neutrality, and adherence to the principles of merit
563	and quality in the conduct of the program.
564	(e)  Assisting in the development of appropriate linkages
565	to nonacademic entities, such as voluntary organizations, health
566	care delivery institutions, industry, government agencies, and
567	public officials.
568	(f)  Developing criteria and standards for the award of
569	research grants.
570	(g)  Developing administrative procedures relating to
571	solicitation, review, and award of research grants and
572	fellowships, to ensure an impartial, high-quality peer review
573	system.
574	(h)  Developing and supervising research peer review
575	panels.
576	(i)  Reviewing reports of peer review panels and making
577	recommendations for research grants and fellowships.
578	(j)  Developing and providing oversight regarding
579	mechanisms for the dissemination of research results.
580	(5)(a)  Applications for biomedical research funding under
581	the program may be submitted from any university or established
582	research institute in the state. All qualified investigators in
583	the state, regardless of institution affiliation, shall have
584	equal access and opportunity to compete for the research
585	funding.
586	(b)  Grants and fellowships shall be awarded by the State
587	Surgeon General, after consultation with the council, on the
588	basis of scientific merit, as determined by an open competitive
589	peer review process that ensures objectivity, consistency, and
590	high quality. The following types of applications shall be
591	considered for funding:
592	1.  Investigator-initiated research grants.
593	2.  Institutional research grants.
594	3.  Predoctoral and postdoctoral research fellowships.
595	(6)  To ensure that all proposals for research funding are
596	appropriate and are evaluated fairly on the basis of scientific
597	merit, the State Surgeon General, in consultation with the
598	council, shall appoint a peer review panel of independent,
599	scientifically qualified individuals to review the scientific
600	content of each proposal and establish its scientific priority
601	score. The priority scores shall be forwarded to the council and
602	must be considered in determining which proposals shall be
603	recommended for funding.
604	(7)  The council and the peer review panel shall establish
605	and follow rigorous guidelines for ethical conduct and adhere to
606	a strict policy with regard to conflict of interest. A member of
607	the council or panel may not participate in any discussion or
608	decision with respect to a research proposal by any firm,
609	entity, or agency with which the member is associated as a
610	member of the governing body or as an employee, or with which
611	the member has entered into a contractual arrangement. Meetings
612	of the council and the peer review panels shall be subject to
613	the provisions of chapter 119, s. 286.011, and s. 24, Art. I of
614	the State Constitution.
615	(8)  The department may contract on a competitive-bid basis
616	with an appropriate entity to administer the program.
617	Administrative expenses may not exceed 15 percent of the total
618	funds available to the program in any given year.
619	(9)  The department, after consultation with the council,
620	may adopt rules as necessary to implement this section.
621	(10)  The council shall submit an annual progress report on
622	the state of biomedical research in this state to the Florida
623	Center for Universal Research to Eradicate Disease and to the
624	Governor, the State Surgeon General, the President of the
625	Senate, and the Speaker of the House of Representatives by
626	February 1. The report must include:
627	(a)  A list of research projects supported by grants or
628	fellowships awarded under the program.
629	(b)  A list of recipients of program grants or fellowships.
630	(c)  A list of publications in peer reviewed journals
631	involving research supported by grants or fellowships awarded
632	under the program.
633	(d)  The total amount of biomedical research funding
634	currently flowing into the state.
635	(e)  New grants for biomedical research which were funded
636	based on research supported by grants or fellowships awarded
637	under the program.
638	(f)  Progress in the prevention, diagnosis, treatment, and
639	cure of diseases related to tobacco use, including cancer,
640	cardiovascular disease, stroke, and pulmonary disease.
641	(11)  The council shall award grants for cancer research
642	through the William G. "Bill" Bankhead, Jr., and David Coley
643	Cancer Research Program created in s. 381.922.
644	(12)  From funds appropriated to accomplish the goals of
645	this section, up to $250,000 shall be available for the
646	operating costs of the Florida Center for Universal Research to
647	Eradicate Disease.
648	(a)  Beginning in the 2010-2011 2009-2010 fiscal year and
649	thereafter, $50 million from 5 percent of the revenue deposited
650	into the Health Care Trust Fund pursuant to ss. 210.011(9) and
651	210.276(7) shall be reserved for research of tobacco-related or
652	cancer-related illnesses; however, the sum of the revenue
653	reserved pursuant to ss. 210.011(9) and 210.276(7) may not
654	exceed $50 million in any fiscal year. Of the revenue deposited
655	in the Health Care Trust Fund pursuant to this section, $50
656	million shall be transferred to the Biomedical Research Trust
657	Fund within the Department of Health. Subject to annual
658	appropriations in the General Appropriations Act, $20 million
659	shall be appropriated to the James and Esther King Biomedical
660	Research Program, $20 million shall be appropriated to the
661	William G. "Bill" Bankhead, Jr., and David Coley Cancer Research
662	Program created under s. 381.922, and $10 million shall be
663	appropriated to the H. Lee Moffitt Cancer Center and Research
664	Institute established under s. 1004.43.
665	(b)  In the 2009-2010 fiscal year, 2.5 percent, not to
666	exceed $25 million, of the revenue deposited into the Health
667	Care Trust Fund pursuant to this subsection shall be transferred
668	to the Biomedical Research Trust Fund within the Department of
669	Health for the James and Esther King Biomedical Research
670	Program.
671	(13)  By June 1, 2009, the Division of Statutory Revision
672	of the Office of Legislative Services shall certify to the
673	President of the Senate and the Speaker of the House of
674	Representatives the language and statutory citation of this
675	section, which is scheduled to expire January 1, 2011.
676	(14)  The Legislature shall review the performance, the
677	outcomes, and the financial management of the James and Esther
678	King Biomedical Research Program during the 2010 Regular Session
679	of the Legislature and shall determine the most appropriate
680	funding source and means of funding the program based on its
681	review.
682	(15)  This section expires January 1, 2011, unless reviewed
683	and reenacted by the Legislature before that date.
684	Section 14.  Section 381.922, Florida Statutes, is
685	reenacted and amended to read:
686	381.922  William G. "Bill" Bankhead, Jr., and David Coley
687	Cancer Research Program.-
688	(1)  The William G. "Bill" Bankhead, Jr., and David Coley
689	Cancer Research Program, which may be otherwise cited as the
690	"Bankhead-Coley Program," is created within the Department of
691	Health. The purpose of the program shall be to advance progress
692	towards cures for cancer through grants awarded through a peer-
693	reviewed, competitive process.
694	(2)  The program shall provide grants for cancer research
695	to further the search for cures for cancer.
696	(a)  Emphasis shall be given to the following goals
697	enumerated in s. 381.921, as those goals support the advancement
698	of such cures:
699	1.  Efforts to significantly expand cancer research
700	capacity in the state by:
701	a.  Identifying ways to attract new research talent and
702	attendant national grant-producing researchers to cancer
703	research facilities in this state;
704	b.  Implementing a peer-reviewed, competitive process to
705	identify and fund the best proposals to expand cancer research
706	institutes in this state;
707	c.  Funding through available resources for those proposals
708	that demonstrate the greatest opportunity to attract federal
709	research grants and private financial support;
710	d.  Encouraging the employment of bioinformatics in order
711	to create a cancer informatics infrastructure that enhances
712	information and resource exchange and integration through
713	researchers working in diverse disciplines, to facilitate the
714	full spectrum of cancer investigations;
715	e.  Facilitating the technical coordination, business
716	development, and support of intellectual property as it relates
717	to the advancement of cancer research; and
718	f.  Aiding in other multidisciplinary research-support
719	activities as they inure to the advancement of cancer research.
720	2.  Efforts to improve both research and treatment through
721	greater participation in clinical trials networks by:
722	a.  Identifying ways to increase adult enrollment in cancer
723	clinical trials;
724	b.  Supporting public and private professional education
725	programs designed to increase the awareness and knowledge about
726	cancer clinical trials;
727	c.  Providing tools to cancer patients and community-based
728	oncologists to aid in the identification of cancer clinical
729	trials available in the state; and
730	d.  Creating opportunities for the state's academic cancer
731	centers to collaborate with community-based oncologists in
732	cancer clinical trials networks.
733	3.  Efforts to reduce the impact of cancer on disparate
734	groups by:
735	a.  Identifying those cancers that disproportionately
736	impact certain demographic groups; and
737	b.  Building collaborations designed to reduce health
738	disparities as they relate to cancer.
739	(b)  Preference may be given to grant proposals that foster
740	collaborations among institutions, researchers, and community
741	practitioners, as such proposals support the advancement of
742	cures through basic or applied research, including clinical
743	trials involving cancer patients and related networks.
744	(3)(a)  Applications for funding for cancer research may be
745	submitted by any university or established research institute in
746	the state. All qualified investigators in the state, regardless
747	of institutional affiliation, shall have equal access and
748	opportunity to compete for the research funding. Collaborative
749	proposals, including those that advance the program's goals
750	enumerated in subsection (2), may be given preference. Grants
751	shall be awarded by the State Surgeon General, after
752	consultation with the Biomedical Research Advisory Council, on
753	the basis of scientific merit, as determined by an open,
754	competitive peer review process that ensures objectivity,
755	consistency, and high quality. The following types of
756	applications shall be considered for funding:
757	1.  Investigator-initiated research grants.
758	2.  Institutional research grants.
759	3.  Collaborative research grants, including those that
760	advance the finding of cures through basic or applied research.
761	(b)  In order to ensure that all proposals for research
762	funding are appropriate and are evaluated fairly on the basis of
763	scientific merit, the State Surgeon General, in consultation
764	with the council, shall appoint a peer review panel of
765	independent, scientifically qualified individuals to review the
766	scientific content of each proposal and establish its priority
767	score. The priority scores shall be forwarded to the council and
768	must be considered in determining which proposals shall be
769	recommended for funding.
770	(c)  The council and the peer review panel shall establish
771	and follow rigorous guidelines for ethical conduct and adhere to
772	a strict policy with regard to conflicts of interest. A member
773	of the council or panel may not participate in any discussion or
774	decision with respect to a research proposal by any firm,
775	entity, or agency with which the member is associated as a
776	member of the governing body or as an employee or with which the
777	member has entered into a contractual arrangement. Meetings of
778	the council and the peer review panels are subject to chapter
779	119, s. 286.011, and s. 24, Art. I of the State Constitution.
780	(4)  By December 15 of each year, the Department of Health
781	shall submit to the Governor, the President of the Senate, and
782	the Speaker of the House of Representatives a report indicating
783	progress towards the program's mission and making
784	recommendations that further its purpose.
785	(5)  The William G. "Bill" Bankhead, Jr., and David Coley
786	Cancer Research Program is funded pursuant to s. 215.5602(12).
787	Funds appropriated for the William G. "Bill" Bankhead, Jr., and
788	David Coley Cancer Research Program shall be distributed
789	pursuant to this section to provide grants to researchers
790	seeking cures for cancer and cancer-related illnesses, with
791	emphasis given to the goals enumerated in this section s.
792	381.921. From the total funds appropriated, an amount of up to
793	10 percent may be used for administrative expenses. From funds
794	appropriated to accomplish the goals of this section, up to
795	$250,000 shall be available for the operating costs of the
796	Florida Center for Universal Research to Eradicate Disease. In
797	the 2009-2010 fiscal year, 2.5 percent, not to exceed $25
798	million, of the revenue deposited into the Health Care Trust
799	Fund pursuant to s. 215.5602(12)(a) shall be transferred to the
800	Biomedical Research Trust Fund within the Department of Health
801	for the William G. "Bill" Bankhead, Jr., and David Coley Cancer
802	Research Program.
803	(6)  By June 1, 2009, the Division of Statutory Revision of
804	the Office of Legislative Services shall certify to the
805	President of the Senate and the Speaker of the House of
806	Representatives the language and statutory citation of this
807	section, which is scheduled to expire January 1, 2011.
808	(7)  The Legislature shall review the performance, the
809	outcomes, and the financial management of the William G. "Bill"
810	Bankhead, Jr., and David Coley Cancer Research Program during
811	the 2010 Regular Session of the Legislature and shall determine
812	the most appropriate funding source and means of funding the
813	program based on its review.
814	(8)  This section expires January 1, 2011, unless reviewed
815	and reenacted by the Legislature before that date.
816	Section 15.  Subsection (6) of section 20.43, Florida
817	Statutes, is amended, and subsection (10) is added to that
818	section, to read:
819	20.43  Department of Health.-There is created a Department
820	of Health.
821	(6)  The State Surgeon General is and division directors
822	are authorized to appoint ad hoc advisory committees as
823	necessary. The issue or problem that the ad hoc committee shall
824	address, and the timeframe within which the committee is to
825	complete its work, shall be specified at the time the committee
826	is appointed. Ad hoc advisory committees shall include
827	representatives of groups or entities affected by the issue or
828	problem that the committee is asked to examine. Members of ad
829	hoc advisory committees shall receive no compensation, but may,
830	within existing departmental resources, receive reimbursement
831	for travel expenses as provided in s. 112.061.
832	(10)(a)  Beginning in fiscal year 2010-2011, the department
833	shall initiate or commence new programs only when the
834	Legislative Budget Commission or the Legislature expressly
835	authorizes the department to do so.
836	(b)  Beginning in fiscal year 2010-2011, before applying
837	for any continuation of or new federal or private grants that
838	are for an amount of $50,000 or greater, the department shall
839	provide written notification to the Governor, the President of
840	the Senate, and the Speaker of the House of Representatives. The
841	notification must include detailed information about the purpose
842	of the grant, the intended use of the funds, and the number of
843	full-time permanent or temporary employees needed to administer
844	the program funded by the grant.
845	Section 16.  Subsection (14) of section 381.0011, Florida
846	Statutes, is renumbered as subsection (15), and a new subsection
847	(14) is added to that section, to read:
848	381.0011  Duties and powers of the Department of Health.-It
849	is the duty of the Department of Health to:
850	(14)  Manage and coordinate emergency preparedness and
851	disaster response functions to: investigate and control the
852	spread of disease; coordinate the availability and staffing of
853	special needs shelters; support patient evacuation; ensure the
854	safety of food and drugs; provide critical incident stress
855	debriefing; and provide surveillance and control of
856	radiological, chemical, biological, and other environmental
857	hazards.
858	Section 17.  Subsection (16) of section 381.006, Florida
859	Statutes, is amended to read:
860	381.006  Environmental health.-The department shall conduct
861	an environmental health program as part of fulfilling the
862	state's public health mission. The purpose of this program is to
863	detect and prevent disease caused by natural and manmade factors
864	in the environment. The environmental health program shall
865	include, but not be limited to:
866	(16)  A group-care-facilities function. As used in this
867	subsection, the term, where a "group care facility" means any
868	public or private school, assisted living facility, adult
869	family-care home, adult day care center, short-term residential
870	treatment center, residential treatment facility, home for
871	special services, transitional living facility, crisis
872	stabilization unit, hospice, prescribed pediatric extended care
873	center, intermediate care facility for persons with
874	developmental disabilities, or boarding school housing, building
875	or buildings, section of a building, or distinct part of a
876	building or other place, whether operated for profit or not,
877	which undertakes, through its ownership or management, to
878	provide one or more personal services, care, protection, and
879	supervision to persons who require such services and who are not
880	related to the owner or administrator. The department may adopt
881	rules necessary to protect the health and safety of residents,
882	staff, and patrons of group care facilities. Rules related to
883	public and private schools shall be developed by, such as child
884	care facilities, family day care homes, assisted living
885	facilities, adult day care centers, adult family care homes,
886	hospices, residential treatment facilities, crisis stabilization
887	units, pediatric extended care centers, intermediate care
888	facilities for the developmentally disabled, group care homes,
889	and, jointly with the Department of Education in consultation
890	with the department, private and public schools. These Rules
891	adopted under this subsection may include definitions of terms;
892	provisions relating to operation and maintenance of facilities,
893	buildings, grounds, equipment, furnishings, and occupant-space
894	requirements; lighting; heating, cooling, and ventilation; food
895	service; water supply and plumbing; sewage; sanitary facilities;
896	insect and rodent control; garbage; safety; personnel health,
897	hygiene, and work practices; and other matters the department
898	finds are appropriate or necessary to protect the safety and
899	health of the residents, staff, students, faculty, or patrons.
900	The department may not adopt rules that conflict with rules
901	adopted by the licensing or certifying agency. The department
902	may enter and inspect at reasonable hours to determine
903	compliance with applicable statutes or rules. In addition to any
904	sanctions that the department may impose for violations of rules
905	adopted under this section, the department shall also report
906	such violations to any agency responsible for licensing or
907	certifying the group care facility. The licensing or certifying
908	agency may also impose any sanction based solely on the findings
909	of the department.
910
911	The department may adopt rules to carry out the provisions of
912	this section.
913	Section 18.  Subsections (1), (2), (3), and (6) of section
914	381.0072, Florida Statutes, are amended to read:
915	381.0072  Food service protection.-It shall be the duty of
916	the Department of Health to adopt and enforce sanitation rules
917	consistent with law to ensure the protection of the public from
918	food-borne illness. These rules shall provide the standards and
919	requirements for the storage, preparation, serving, or display
920	of food in food service establishments as defined in this
921	section and which are not permitted or licensed under chapter
922	500 or chapter 509.
923	(1)  DEFINITIONS.-As used in this section, the term:
924	(a)  "Department" means the Department of Health or its
925	representative county health department.
926	(b)  "Food service establishment" means detention
927	facilities, public or private schools, migrant labor camps,
928	assisted living facilities, adult family-care homes, adult day
929	care centers, short-term residential treatment centers,
930	residential treatment facilities, homes for special services,
931	transitional living facilities, crisis stabilization units,
932	hospices, prescribed pediatric extended care centers,
933	intermediate care facilities for persons with developmental
934	disabilities, boarding schools, civic or fraternal
935	organizations, bars and lounges, vending machines that dispense
936	potentially hazardous foods at facilities expressly named in
937	this paragraph, and facilities used as temporary food events or
938	mobile food units at any facility expressly named any facility,
939	as described in this paragraph, where food is prepared and
940	intended for individual portion service, including and includes
941	the site at which individual portions are provided,. The term
942	includes any such facility regardless of whether consumption is
943	on or off the premises and regardless of whether there is a
944	charge for the food. The term includes detention facilities,
945	child care facilities, schools, institutions, civic or fraternal
946	organizations, bars and lounges and facilities used at temporary
947	food events, mobile food units, and vending machines at any
948	facility regulated under this section. The term does not include
949	any entity not expressly named in this paragraph private homes
950	where food is prepared or served for individual family
951	consumption; nor does the term include churches, synagogues, or
952	other not-for-profit religious organizations as long as these
953	organizations serve only their members and guests and do not
954	advertise food or drink for public consumption, or any facility
955	or establishment permitted or licensed under chapter 500 or
956	chapter 509; nor does the term include any theater, if the
957	primary use is as a theater and if patron service is limited to
958	food items customarily served to the admittees of theaters; nor
959	does the term include a research and development test kitchen
960	limited to the use of employees and which is not open to the
961	general public.
962	(c)  "Operator" means the owner, operator, keeper,
963	proprietor, lessee, manager, assistant manager, agent, or
964	employee of a food service establishment.
965	(2)  DUTIES.-
966	(a)  The department may advise and consult with the Agency
967	for Health Care Administration, the Department of Business and
968	Professional Regulation, the Department of Agriculture and
969	Consumer Services, and the Department of Children and Family
970	Services concerning procedures related to the storage,
971	preparation, serving, or display of food at any building,
972	structure, or facility not expressly included in this section
973	that is inspected, licensed, or regulated by those agencies.
974	(b)(a)  The department shall adopt rules, including
975	definitions of terms which are consistent with law prescribing
976	minimum sanitation standards and manager certification
977	requirements as prescribed in s. 509.039, and which shall be
978	enforced in food service establishments as defined in this
979	section. The sanitation standards must address the construction,
980	operation, and maintenance of the establishment; lighting,
981	ventilation, laundry rooms, lockers, use and storage of toxic
982	materials and cleaning compounds, and first-aid supplies; plan
983	review; design, construction, installation, location,
984	maintenance, sanitation, and storage of food equipment and
985	utensils; employee training, health, hygiene, and work
986	practices; food supplies, preparation, storage, transportation,
987	and service, including access to the areas where food is stored
988	or prepared; and sanitary facilities and controls, including
989	water supply and sewage disposal; plumbing and toilet
990	facilities; garbage and refuse collection, storage, and
991	disposal; and vermin control. Public and private schools, if the
992	food service is operated by school employees,; hospitals
993	licensed under chapter 395; nursing homes licensed under part II
994	of chapter 400; child care facilities as defined in s. 402.301;
995	residential facilities colocated with a nursing home or
996	hospital, if all food is prepared in a central kitchen that
997	complies with nursing or hospital regulations; and bars and
998	lounges, civic organizations, and any other facility that is not
999	regulated under this section as defined by department rule, are
1000	exempt from the rules developed for manager certification. The
1001	department shall administer a comprehensive inspection,
1002	monitoring, and sampling program to ensure such standards are
1003	maintained. With respect to food service establishments
1004	permitted or licensed under chapter 500 or chapter 509, the
1005	department shall assist the Division of Hotels and Restaurants
1006	of the Department of Business and Professional Regulation and
1007	the Department of Agriculture and Consumer Services with
1008	rulemaking by providing technical information.
1009	(c)(b)  The department shall carry out all provisions of
1010	this chapter and all other applicable laws and rules relating to
1011	the inspection or regulation of food service establishments as
1012	defined in this section, for the purpose of safeguarding the
1013	public's health, safety, and welfare.
1014	(d)(c)  The department shall inspect each food service
1015	establishment as often as necessary to ensure compliance with
1016	applicable laws and rules. The department shall have the right
1017	of entry and access to these food service establishments at any
1018	reasonable time. In inspecting food service establishments as
1019	provided under this section, the department shall provide each
1020	inspected establishment with the food recovery brochure
1021	developed under s. 570.0725.
1022	(e)(d)  The department or other appropriate regulatory
1023	entity may inspect theaters exempted in subsection (1) to ensure
1024	compliance with applicable laws and rules pertaining to minimum
1025	sanitation standards. A fee for inspection shall be prescribed
1026	by rule, but the aggregate amount charged per year per theater
1027	establishment shall not exceed $300, regardless of the entity
1028	providing the inspection.
1029	(3)  LICENSES REQUIRED.-
1030	(a)  Licenses; annual renewals.-Each food service
1031	establishment regulated under this section shall obtain a
1032	license from the department annually. Food service establishment
1033	licenses shall expire annually and are not transferable from one
1034	place or individual to another. However, those facilities
1035	licensed by the department's Office of Licensure and
1036	Certification, the Child Care Services Program Office, or the
1037	Agency for Persons with Disabilities are exempt from this
1038	subsection. It shall be a misdemeanor of the second degree,
1039	punishable as provided in s. 381.0061, s. 775.082, or s.
1040	775.083, for such an establishment to operate without this
1041	license. The department may refuse a license, or a renewal
1042	thereof, to any establishment that is not constructed or
1043	maintained in accordance with law and with the rules of the
1044	department. Annual application for renewal is not required.
1045	(b)  Application for license.-Each person who plans to open
1046	a food service establishment regulated under this section and
1047	not regulated under chapter 500 or chapter 509 shall apply for
1048	and receive a license prior to the commencement of operation.
1049	(6)  IMMINENT DANGERS; STOP-SALE ORDERS.-
1050	(a)  In the course of epidemiological investigations or for
1051	those establishments regulated by the department under this
1052	chapter, the department, to protect the public from food that is
1053	unwholesome or otherwise unfit for human consumption, may
1054	examine, sample, seize, and stop the sale or use of food to
1055	determine its condition. The department may stop the sale and
1056	supervise the proper destruction of food when the State Health
1057	Officer or his or her designee determines that such food
1058	represents a threat to the public health.
1059	(b)  The department may determine that a food service
1060	establishment regulated under this section is an imminent danger
1061	to the public health and require its immediate closure when such
1062	establishment fails to comply with applicable sanitary and
1063	safety standards and, because of such failure, presents an
1064	imminent threat to the public's health, safety, and welfare. The
1065	department may accept inspection results from state and local
1066	building and firesafety officials and other regulatory agencies
1067	as justification for such actions. Any facility so deemed and
1068	closed shall remain closed until allowed by the department or by
1069	judicial order to reopen.
1070	Section 19.  Sections 411.23, 411.231, and 411.232, Florida
1071	Statutes, are repealed.
1072	Section 20.  Paragraph (d) of subsection (5) of section
1073	411.01, Florida Statutes, is amended to read:
1074	411.01  School readiness programs; early learning
1075	coalitions.-
1076	(5)  CREATION OF EARLY LEARNING COALITIONS.-
1077	(d)  Implementation.-
1078	1.  An early learning coalition may not implement the
1079	school readiness program until the coalition is authorized
1080	through approval of the coalition's school readiness plan by the
1081	Agency for Workforce Innovation.
1082	2.  Each early learning coalition shall develop a plan for
1083	implementing the school readiness program to meet the
1084	requirements of this section and the performance standards and
1085	outcome measures adopted by the Agency for Workforce Innovation.
1086	The plan must demonstrate how the program will ensure that each
1087	3-year-old and 4-year-old child in a publicly funded school
1088	readiness program receives scheduled activities and instruction
1089	designed to enhance the age-appropriate progress of the children
1090	in attaining the performance standards adopted by the Agency for
1091	Workforce Innovation under subparagraph (4)(d)8. Before
1092	implementing the school readiness program, the early learning
1093	coalition must submit the plan to the Agency for Workforce
1094	Innovation for approval. The Agency for Workforce Innovation may
1095	approve the plan, reject the plan, or approve the plan with
1096	conditions. The Agency for Workforce Innovation shall review
1097	school readiness plans at least annually.
1098	3.  If the Agency for Workforce Innovation determines
1099	during the annual review of school readiness plans, or through
1100	monitoring and performance evaluations conducted under paragraph
1101	(4)(l), that an early learning coalition has not substantially
1102	implemented its plan, has not substantially met the performance
1103	standards and outcome measures adopted by the agency, or has not
1104	effectively administered the school readiness program or
1105	Voluntary Prekindergarten Education Program, the Agency for
1106	Workforce Innovation may dissolve the coalition and temporarily
1107	contract with a qualified entity to continue school readiness
1108	and prekindergarten services in the coalition's county or
1109	multicounty region until the coalition is reestablished through
1110	resubmission of a school readiness plan and approval by the
1111	agency.
1112	4.  The Agency for Workforce Innovation shall adopt
1113	criteria for the approval of school readiness plans. The
1114	criteria must be consistent with the performance standards and
1115	outcome measures adopted by the agency and must require each
1116	approved plan to include the following minimum standards and
1117	provisions:
1118	a.  A sliding fee scale establishing a copayment for
1119	parents based upon their ability to pay, which is the same for
1120	all program providers, to be implemented and reflected in each
1121	program's budget.
1122	b.  A choice of settings and locations in licensed,
1123	registered, religious-exempt, or school-based programs to be
1124	provided to parents.
1125	c.  Instructional staff who have completed the training
1126	course as required in s. 402.305(2)(d)1., as well as staff who
1127	have additional training or credentials as required by the
1128	Agency for Workforce Innovation. The plan must provide a method
1129	for assuring the qualifications of all personnel in all program
1130	settings.
1131	d.  Specific eligibility priorities for children within the
1132	early learning coalition's county or multicounty region in
1133	accordance with subsection (6).
1134	e.  Performance standards and outcome measures adopted by
1135	the Agency for Workforce Innovation.
1136	f.  Payment rates adopted by the early learning coalition
1137	and approved by the Agency for Workforce Innovation. Payment
1138	rates may not have the effect of limiting parental choice or
1139	creating standards or levels of services that have not been
1140	authorized by the Legislature.
1141	g.  Systems support services, including a central agency,
1142	child care resource and referral, eligibility determinations,
1143	training of providers, and parent support and involvement.
1144	h.  Direct enhancement services to families and children.
1145	System support and direct enhancement services shall be in
1146	addition to payments for the placement of children in school
1147	readiness programs.
1148	i.  The business organization of the early learning
1149	coalition, which must include the coalition's articles of
1150	incorporation and bylaws if the coalition is organized as a
1151	corporation. If the coalition is not organized as a corporation
1152	or other business entity, the plan must include the contract
1153	with a fiscal agent. An early learning coalition may contract
1154	with other coalitions to achieve efficiency in multicounty
1155	services, and these contracts may be part of the coalition's
1156	school readiness plan.
1157	j.  Strategies to meet the needs of unique populations,
1158	such as migrant workers.
1159
1160	As part of the school readiness plan, the early learning
1161	coalition may request the Governor to apply for a waiver to
1162	allow the coalition to administer the Head Start Program to
1163	accomplish the purposes of the school readiness program. If a
1164	school readiness plan demonstrates that specific statutory goals
1165	can be achieved more effectively by using procedures that
1166	require modification of existing rules, policies, or procedures,
1167	a request for a waiver to the Agency for Workforce Innovation
1168	may be submitted as part of the plan. Upon review, the Agency
1169	for Workforce Innovation may grant the proposed modification.
1170	5.  Persons with an early childhood teaching certificate
1171	may provide support and supervision to other staff in the school
1172	readiness program.
1173	6.  An early learning coalition may not implement its
1174	school readiness plan until it submits the plan to and receives
1175	approval from the Agency for Workforce Innovation. Once the plan
1176	is approved, the plan and the services provided under the plan
1177	shall be controlled by the early learning coalition. The plan
1178	shall be reviewed and revised as necessary, but at least
1179	biennially. An early learning coalition may not implement the
1180	revisions until the coalition submits the revised plan to and
1181	receives approval from the Agency for Workforce Innovation. If
1182	the Agency for Workforce Innovation rejects a revised plan, the
1183	coalition must continue to operate under its prior approved
1184	plan.
1185	7.  Sections 125.901(2)(a)3. and, 411.221, and 411.232 do
1186	not apply to an early learning coalition with an approved school
1187	readiness plan. To facilitate innovative practices and to allow
1188	the regional establishment of school readiness programs, an
1189	early learning coalition may apply to the Governor and Cabinet
1190	for a waiver of, and the Governor and Cabinet may waive, any of
1191	the provisions of ss. 411.223, 411.232, and 1003.54, if the
1192	waiver is necessary for implementation of the coalition's school
1193	readiness plan.
1194	8.  Two or more counties may join for purposes of planning
1195	and implementing a school readiness program.
1196	9.  An early learning coalition may, subject to approval by
1197	the Agency for Workforce Innovation as part of the coalition's
1198	school readiness plan, receive subsidized child care funds for
1199	all children eligible for any federal subsidized child care
1200	program.
1201	10.  An early learning coalition may enter into multiparty
1202	contracts with multicounty service providers in order to meet
1203	the needs of unique populations such as migrant workers.
1204	Section 21.  Subsection (2) of section 411.224, Florida
1205	Statutes, is amended to read:
1206	411.224  Family support planning process.-The Legislature
1207	establishes a family support planning process to be used by the
1208	Department of Children and Family Services as the service
1209	planning process for targeted individuals, children, and
1210	families under its purview.
1211	(2)  To the extent possible within existing resources, the
1212	following populations must be included in the family support
1213	planning process:
1214	(a)  Children from birth to age 5 who are served by the
1215	clinic and programs of the Division of Children's Medical
1216	Services of the Department of Health.
1217	(b)  Children participating in the developmental evaluation
1218	and intervention program of the Division of Children's Medical
1219	Services of the Department of Health.
1220	(c)  Children from age 3 through age 5 who are served by
1221	the Agency for Persons with Disabilities.
1222	(d)  Children from birth through age 5 who are served by
1223	the Mental Health Program Office of the Department of Children
1224	and Family Services.
1225	(e)  Participants who are served by the Children's Early
1226	Investment Program established in s. 411.232.
1227	(e)(f)  Healthy Start participants in need of ongoing
1228	service coordination.
1229	(f)(g)  Children from birth through age 5 who are served by
1230	the voluntary family services, protective supervision, foster
1231	care, or adoption and related services programs of the Child
1232	Care Services Program Office of the Department of Children and
1233	Family Services, and who are eligible for ongoing services from
1234	one or more other programs or agencies that participate in
1235	family support planning; however, children served by the
1236	voluntary family services program, where the planned length of
1237	intervention is 30 days or less, are excluded from this
1238	population.
1239	Section 22.  Subsections (32) through (54) of section
1240	499.003, Florida Statutes, are renumbered as subsections (33)
1241	through (55), respectively, present subsection (42) is amended,
1242	and a new subsection (32) is added to that section, to read:
1243	499.003  Definitions of terms used in this part.-As used in
1244	this part, the term:
1245	(32)  "Medical convenience kit" means packages or units
1246	that contain combination products as defined in 21 C.F.R. s.
1247	3.2(e)(2).
1248	(43)(42)  "Prescription drug" means a prescription,
1249	medicinal, or legend drug, including, but not limited to,
1250	finished dosage forms or active ingredients subject to, defined
1251	by, or described by s. 503(b) of the Federal Food, Drug, and
1252	Cosmetic Act or s. 465.003(8), s. 499.007(13), or subsection
1253	(11), subsection (46) (45), or subsection (53) (52).
1254	Section 23.  Paragraph (q) of subsection (2) of section
1255	499.01, Florida Statutes, is amended to read:
1256	499.01  Permits.-
1257	(2)  The following permits are established:
1258	(q)  Device manufacturer permit.-
1259	1.  A device manufacturer permit is required for any person
1260	that engages in the manufacture, repackaging, or assembly of
1261	medical devices for human use in this state, except that a
1262	permit is not required if:
1263	a.  The person is engaged only in manufacturing,
1264	repackaging, or assembling a medical device pursuant to a
1265	practitioner's order for a specific patient; or
1266	b.  The person does not manufacture, repackage, or assemble
1267	any medical devices or components for such devices, except those
1268	devices or components which are exempt from registration
1269	pursuant to s. 499.015(8).
1270	2.1.  A manufacturer or repackager of medical devices in
1271	this state must comply with all appropriate state and federal
1272	good manufacturing practices and quality system rules.
1273	3.2.  The department shall adopt rules related to storage,
1274	handling, and recordkeeping requirements for manufacturers of
1275	medical devices for human use.
1276	Section 24.  Paragraph (i) is added to subsection (3) of
1277	section 499.01212, Florida Statutes, to read:
1278	499.01212  Pedigree paper.-
1279	(3)  EXCEPTIONS.-A pedigree paper is not required for:
1280	(i)  The wholesale distribution of prescription drugs
1281	within a medical convenience kit if:
1282	1.  The medical convenience kit is assembled in an
1283	establishment that is registered with the United States Food and
1284	Drug Administration as a medical device manufacturer;
1285	2.  The medical convenience kit manufacturer purchased the
1286	prescription drug directly from the manufacturer or from a
1287	wholesaler that purchased the prescription drug directly from
1288	the manufacturer;
1289	3.  The medical convenience kit manufacturer complies with
1290	federal law for the distribution of the prescription drugs
1291	within the kit; and
1292	4.  The drugs contained in the medical kit are:
1293	a.  Intravenous solutions intended for the replenishment of
1294	fluids and electrolytes;
1295	b.  Products intended to maintain the equilibrium of water
1296	and minerals in the body;
1297	c.  Products intended for irrigation or reconstitution;
1298	d.  Anesthetics; or
1299	e.  Anticoagulants.
1300
1301	This exemption does not apply to a convenience kit containing
1302	any controlled substance that appears in a schedule contained in
1303	or subject to chapter 893 or the federal Comprehensive Drug
1304	Abuse Prevention and Control Act of 1970.
1305	Section 25.  Subsections (4) and (5) of section 509.013,
1306	Florida Statutes, are amended to read:
1307	509.013  Definitions.-As used in this chapter, the term:
1308	(4)(a)  "Public lodging establishment" includes a transient
1309	public lodging establishment as defined in subparagraph 1. and a
1310	nontransient public lodging establishment as defined in
1311	subparagraph 2.
1312	1.  "Transient public lodging establishment" means any
1313	unit, group of units, dwelling, building, or group of buildings
1314	within a single complex of buildings which is rented to guests
1315	more than three times in a calendar year for periods of less
1316	than 30 days or 1 calendar month, whichever is less, or which is
1317	advertised or held out to the public as a place regularly rented
1318	to guests.
1319	2.  "Nontransient public lodging establishment" means any
1320	unit, group of units, dwelling, building, or group of buildings
1321	within a single complex of buildings which is rented to guests
1322	for periods of at least 30 days or 1 calendar month, whichever
1323	is less, or which is advertised or held out to the public as a
1324	place regularly rented to guests for periods of at least 30 days
1325	or 1 calendar month.
1326
1327	License classifications of public lodging establishments, and
1328	the definitions therefor, are set out in s. 509.242. For the
1329	purpose of licensure, the term does not include condominium
1330	common elements as defined in s. 718.103.
1331	(b)  The following are excluded from the definitions in
1332	paragraph (a):
1333	1.  Any dormitory or other living or sleeping facility
1334	maintained by a public or private school, college, or university
1335	for the use of students, faculty, or visitors;
1336	2.  Any facility certified or licensed and regulated by the
1337	Agency for Health Care Administration or the Department of
1338	Children and Family Services hospital, nursing home, sanitarium,
1339	assisted living facility, or other similar place regulated under
1340	s. 381.0072;
1341	3.  Any place renting four rental units or less, unless the
1342	rental units are advertised or held out to the public to be
1343	places that are regularly rented to transients;
1344	4.  Any unit or group of units in a condominium,
1345	cooperative, or timeshare plan and any individually or
1346	collectively owned one-family, two-family, three-family, or
1347	four-family dwelling house or dwelling unit that is rented for
1348	periods of at least 30 days or 1 calendar month, whichever is
1349	less, and that is not advertised or held out to the public as a
1350	place regularly rented for periods of less than 1 calendar
1351	month, provided that no more than four rental units within a
1352	single complex of buildings are available for rent;
1353	5.  Any migrant labor camp or residential migrant housing
1354	permitted by the Department of Health; under ss. 381.008-
1355	381.00895; and
1356	6.  Any establishment inspected by the Department of Health
1357	and regulated by chapter 513.
1358	(5)(a)  "Public food service establishment" means any
1359	building, vehicle, place, or structure, or any room or division
1360	in a building, vehicle, place, or structure where food is
1361	prepared, served, or sold for immediate consumption on or in the
1362	vicinity of the premises; called for or taken out by customers;
1363	or prepared prior to being delivered to another location for
1364	consumption.
1365	(b)  The following are excluded from the definition in
1366	paragraph (a):
1367	1.  Any place maintained and operated by a public or
1368	private school, college, or university:
1369	a.  For the use of students and faculty; or
1370	b.  Temporarily to serve such events as fairs, carnivals,
1371	and athletic contests.
1372	2.  Any eating place maintained and operated by a church or
1373	a religious, nonprofit fraternal, or nonprofit civic
1374	organization:
1375	a.  For the use of members and associates; or
1376	b.  Temporarily to serve such events as fairs, carnivals,
1377	or athletic contests.
1378	3.  Any eating place located on an airplane, train, bus, or
1379	watercraft which is a common carrier.
1380	4.  Any eating place maintained by a facility certified or
1381	licensed and regulated by the Agency for Health Care
1382	Administration or the Department of Children and Family Services
1383	hospital, nursing home, sanitarium, assisted living facility,
1384	adult day care center, or other similar place that is regulated
1385	under s. 381.0072.
1386	5.  Any place of business issued a permit or inspected by
1387	the Department of Agriculture and Consumer Services under s.
1388	500.12.
1389	6.  Any place of business where the food available for
1390	consumption is limited to ice, beverages with or without
1391	garnishment, popcorn, or prepackaged items sold without
1392	additions or preparation.
1393	7.  Any theater, if the primary use is as a theater and if
1394	patron service is limited to food items customarily served to
1395	the admittees of theaters.
1396	8.  Any vending machine that dispenses any food or
1397	beverages other than potentially hazardous foods, as defined by
1398	division rule.
1399	9.  Any vending machine that dispenses potentially
1400	hazardous food and which is located in a facility regulated
1401	under s. 381.0072.
1402	10.  Any research and development test kitchen limited to
1403	the use of employees and which is not open to the general
1404	public.
1405	Section 26.  The Department of Health shall develop a plan
1406	that exclusively uses private and nonstate public hospitals to
1407	provide treatment to cure, hospitalization, and isolation for
1408	persons with contagious cases of tuberculosis who pose a threat
1409	to the public. The department shall submit the plan to the
1410	Governor, the President of the Senate, and the Speaker of the
1411	House of Representatives by November 1, 2010. The plan shall
1412	include the following elements:
1413	(1)  Identification of hospitals functionally capable of
1414	caring for such patients.
1415	(2)  Reimbursement for hospital inpatient services at the
1416	Medicaid rate and reimbursement for other medically necessary
1417	services that are not hospital inpatient services at the
1418	relevant Medicaid rate.
1419	(3)  Projected cost estimates.
1420	(4)  A transition plan for closing the A. G. Holley State
1421	Hospital and transferring patients to private and nonstate
1422	public hospitals over a 90-day period of time.
1423	Section 27.  (1)  All of the statutory powers, duties, and
1424	functions, records, personnel, property, and unexpended balances
1425	of appropriations, allocations, or other funds for the
1426	administration of chapter 499, Florida Statutes, relating to
1427	drugs, devices, cosmetics, and household products shall be
1428	transferred by a type two transfer, as defined in s. 20.06(2),
1429	Florida Statutes, from the Department of Health to the
1430	Department of Business and Professional Regulation.
1431	(2)  The transfer of regulatory authority under chapter
1432	499, Florida Statutes, provided by this section shall not affect
1433	the validity of any judicial or administrative action pending as
1434	of 11:59 p.m. on the day before the effective date of this
1435	section to which the Department of Health is at that time a
1436	party, and the Department of Business and Professional
1437	Regulation shall be substituted as a party in interest in any
1438	such action.
1439	(3)  All lawful orders issued by the Department of Health
1440	implementing or enforcing or otherwise in regard to any
1441	provision of chapter 499, Florida Statutes, issued prior to the
1442	effective date of this section shall remain in effect and be
1443	enforceable after the effective date of this section unless
1444	thereafter modified in accordance with law.
1445	(4)  The rules of the Department of Health relating to the
1446	implementation of chapter 499, Florida Statutes, that were in
1447	effect at 11:59 p.m. on the day prior to the effective date of
1448	this section shall become the rules of the Department of
1449	Business and Professional Regulation and shall remain in effect
1450	until amended or repealed in the manner provided by law.
1451	(5)  Notwithstanding the transfer of regulatory authority
1452	under chapter 499, Florida Statutes, provided by this section,
1453	persons and entities holding in good standing any permit under
1454	chapter 499, Florida Statutes, as of 11:59 p.m. on the day prior
1455	to the effective date of this section shall, as of the effective
1456	date of this section, be deemed to hold in good standing a
1457	permit in the same capacity as that for which the permit was
1458	formerly issued.
1459	(6)  Notwithstanding the transfer of regulatory authority
1460	under chapter 499, Florida Statutes, provided by this section,
1461	persons holding in good standing any certification under chapter
1462	499, Florida Statutes, as of 11:59 p.m. on the day prior to the
1463	effective date of this section shall, as of the effective date
1464	of this section, be deemed to be certified in the same capacity
1465	in which they were formerly certified.
1466	(7)  This section shall take effect October 1, 2011.
1467	Section 28.  Paragraph (a) of subsection (3) and
1468	subsections (9) and (10) of section 381.0403, Florida Statutes,
1469	are amended to read:
1470	381.0403  The Community Hospital Education Act.-
1471	(3)  PROGRAM FOR COMMUNITY HOSPITAL EDUCATION; STATE AND
1472	LOCAL PLANNING.-
1473	(a)  There is established under the Department of Health a
1474	program for statewide graduate medical education. It is intended
1475	that continuing graduate medical education programs for interns
1476	and residents be established on a statewide basis. The program
1477	shall provide financial support for primary care specialty
1478	interns and residents based on policies recommended and approved
1479	by the Community Hospital Education Council, herein established,
1480	and the Department of Health. Only those programs with at least
1481	three residents or interns in each year of the training program
1482	are qualified to apply for financial support. Programs with
1483	fewer than three residents or interns per training year are
1484	qualified to apply for financial support, but only if the
1485	appropriate accrediting entity for the particular specialty has
1486	approved the program for fewer positions. Programs added after
1487	fiscal year 1997-1998 shall have 5 years to attain the requisite
1488	number of residents or interns. When feasible and to the extent
1489	allowed through the General Appropriations Act, state funds
1490	shall be used to generate federal matching funds under Medicaid,
1491	or other federal programs, and the resulting combined state and
1492	federal funds shall be allocated to participating hospitals for
1493	the support of graduate medical education. The department may
1494	spend up to $75,000 of the state appropriation for
1495	administrative costs associated with the production of the
1496	annual report as specified in subsection (9), and for
1497	administration of the program.
1498	(9)  ANNUAL REPORT ON GRADUATE MEDICAL EDUCATION;
1499	COMMITTEE.-The Executive Office of the Governor, the Department
1500	of Health, and the Agency for Health Care Administration shall
1501	collaborate to establish a committee that shall produce an
1502	annual report on graduate medical education. The committee shall
1503	be comprised of 11 members: five members shall be deans of the
1504	medical schools or their designees; the Governor shall appoint
1505	two members, one of whom must be a representative of the Florida
1506	Medical Association who has supervised or currently supervises
1507	residents or interns and one of whom must be a representative of
1508	the Florida Hospital Association; the Secretary of Health Care
1509	Administration shall appoint two members, one of whom must be a
1510	representative of a statutory teaching hospital and one of whom
1511	must be a physician who has supervised or is currently
1512	supervising residents or interns; and the State Surgeon General
1513	shall appoint two members, one of whom must be a representative
1514	of a statutory family practice teaching hospital and one of whom
1515	must be a physician who has supervised or is currently
1516	supervising residents or interns. With the exception of the
1517	deans, members shall serve 4-year terms. In order to stagger the
1518	terms, the Governor's appointees shall serve initial terms of 4
1519	years, the State Surgeon General's appointees shall serve
1520	initial terms of 3 years, and the Secretary of Health Care
1521	Administration's appointees shall serve initial terms of 2
1522	years. A member's term shall be deemed terminated when the
1523	member's representative status no longer exists. Once the
1524	committee is appointed, it shall elect a chair to serve for a 1-
1525	year term. The report shall be provided to the Governor, the
1526	President of the Senate, and the Speaker of the House of
1527	Representatives by January 15 annually. Committee members shall
1528	serve without compensation. The report shall address the
1529	following:
1530	(a)  The role of residents and medical faculty in the
1531	provision of health care.
1532	(b)  The relationship of graduate medical education to the
1533	state's physician workforce.
1534	(c)  The costs of training medical residents for hospitals,
1535	medical schools, teaching hospitals, including all hospital-
1536	medical affiliations, practice plans at all of the medical
1537	schools, and municipalities.
1538	(d)  The availability and adequacy of all sources of
1539	revenue to support graduate medical education and recommend
1540	alternative sources of funding for graduate medical education.
1541	(e)  The use of state and federal appropriated funds for
1542	graduate medical education by hospitals receiving such funds.
1543	(9)(10)  RULEMAKING.-The department has authority to adopt
1544	rules pursuant to ss. 120.536(1) and 120.54 to implement the
1545	provisions of this section.
1546	Section 29.  Section 381.4018, Florida Statutes, is amended
1547	to read:
1548	381.4018  Physician workforce assessment and development.-
1549	(1)  DEFINITIONS.-As used in this section, the term:
1550	(a)  "Consortium" or "consortia" means a combination of
1551	statutory teaching hospitals, specialty children's hospitals,
1552	statutory rural hospitals, other hospitals, accredited medical
1553	schools, clinics operated by the Department of Health, clinics
1554	operated by the Department of Veterans' Affairs, area health
1555	education centers, community health centers, federally qualified
1556	health centers, prison clinics, local community clinics, or
1557	other programs. At least one member of the consortium shall be a
1558	sponsoring institution accredited or currently seeking
1559	accreditation by the Accreditation Council for Graduate Medical
1560	Education or the American Osteopathic Association.
1561	(b)  "Council" means the Physician Workforce Advisory
1562	Council.
1563	(c)  "Department" means the Department of Health.
1564	(d)  "Graduate medical education program" means a program
1565	accredited by the Accreditation Council for Graduate Medical
1566	Education or the American Osteopathic Association.
1567	(e)  "Primary care specialty" means emergency medicine,
1568	family practice, internal medicine, pediatrics, psychiatry,
1569	geriatrics, general surgery, obstetrics and gynecology, and
1570	combined pediatrics and internal medicine and other specialties
1571	as determined by the Physician Workforce Advisory Council or the
1572	Department of Health.
1573	(2)(1)  LEGISLATIVE INTENT.-The Legislature recognizes that
1574	physician workforce planning is an essential component of
1575	ensuring that there is an adequate and appropriate supply of
1576	well-trained physicians to meet this state's future health care
1577	service needs as the general population and elderly population
1578	of the state increase. The Legislature finds that items to
1579	consider relative to assessing the physician workforce may
1580	include physician practice status; specialty mix; geographic
1581	distribution; demographic information, including, but not
1582	limited to, age, gender, race, and cultural considerations; and
1583	needs of current or projected medically underserved areas in the
1584	state. Long-term strategic planning is essential as the period
1585	from the time a medical student enters medical school to
1586	completion of graduate medical education may range from 7 to 10
1587	years or longer. The Legislature recognizes that strategies to
1588	provide for a well-trained supply of physicians must include
1589	ensuring the availability and capacity of quality graduate
1590	medical schools and graduate medical education programs in this
1591	state, as well as using new or existing state and federal
1592	programs providing incentives for physicians to practice in
1593	needed specialties and in underserved areas in a manner that
1594	addresses projected needs for physician manpower.
1595	(3)(2)  PURPOSE.-The department of Health shall serve as a
1596	coordinating and strategic planning body to actively assess the
1597	state's current and future physician workforce needs and work
1598	with multiple stakeholders to develop strategies and
1599	alternatives to address current and projected physician
1600	workforce needs.
1601	(4)(3)  GENERAL FUNCTIONS.-The department shall maximize
1602	the use of existing programs under the jurisdiction of the
1603	department and other state agencies and coordinate governmental
1604	and nongovernmental stakeholders and resources in order to
1605	develop a state strategic plan and assess the implementation of
1606	such strategic plan. In developing the state strategic plan, the
1607	department shall:
1608	(a)  Monitor, evaluate, and report on the supply and
1609	distribution of physicians licensed under chapter 458 or chapter
1610	459. The department shall maintain a database to serve as a
1611	statewide source of data concerning the physician workforce.
1612	(b)  Develop a model and quantify, on an ongoing basis, the
1613	adequacy of the state's current and future physician workforce
1614	as reliable data becomes available. Such model must take into
1615	account demographics, physician practice status, place of
1616	education and training, generational changes, population growth,
1617	economic indicators, and issues concerning the "pipeline" into
1618	medical education.
1619	(c)  Develop and recommend strategies to determine whether
1620	the number of qualified medical school applicants who might
1621	become competent, practicing physicians in this state will be
1622	sufficient to meet the capacity of the state's medical schools.
1623	If appropriate, the department shall, working with
1624	representatives of appropriate governmental and nongovernmental
1625	entities, develop strategies and recommendations and identify
1626	best practice programs that introduce health care as a
1627	profession and strengthen skills needed for medical school
1628	admission for elementary, middle, and high school students, and
1629	improve premedical education at the precollege and college level
1630	in order to increase this state's potential pool of medical
1631	students.
1632	(d)  Develop strategies to ensure that the number of
1633	graduates from the state's public and private allopathic and
1634	osteopathic medical schools is are adequate to meet physician
1635	workforce needs, based on the analysis of the physician
1636	workforce data, so as to provide a high-quality medical
1637	education to students in a manner that recognizes the uniqueness
1638	of each new and existing medical school in this state.
1639	(e)  Pursue strategies and policies to create, expand, and
1640	maintain graduate medical education positions in the state based
1641	on the analysis of the physician workforce data. Such strategies
1642	and policies must take into account the effect of federal
1643	funding limitations on the expansion and creation of positions
1644	in graduate medical education. The department shall develop
1645	options to address such federal funding limitations. The
1646	department shall consider options to provide direct state
1647	funding for graduate medical education positions in a manner
1648	that addresses requirements and needs relative to accreditation
1649	of graduate medical education programs. The department shall
1650	consider funding residency positions as a means of addressing
1651	needed physician specialty areas, rural areas having a shortage
1652	of physicians, and areas of ongoing critical need, and as a
1653	means of addressing the state's physician workforce needs based
1654	on an ongoing analysis of physician workforce data.
1655	(f)  Develop strategies to maximize federal and state
1656	programs that provide for the use of incentives to attract
1657	physicians to this state or retain physicians within the state.
1658	Such strategies should explore and maximize federal-state
1659	partnerships that provide incentives for physicians to practice
1660	in federally designated shortage areas. Strategies shall also
1661	consider the use of state programs, such as the Florida Health
1662	Service Corps established pursuant to s. 381.0302 and the
1663	Medical Education Reimbursement and Loan Repayment Program
1664	pursuant to s. 1009.65, which provide for education loan
1665	repayment or loan forgiveness and provide monetary incentives
1666	for physicians to relocate to underserved areas of the state.
1667	(g)  Coordinate and enhance activities relative to
1668	physician workforce needs, undergraduate medical education, and
1669	graduate medical education, and reentry of retired military and
1670	other physicians into the physician workforce provided by the
1671	Division of Medical Quality Assurance, the Community Hospital
1672	Education Program and the Graduate Medical Education Committee
1673	established pursuant to s. 381.0403, area health education
1674	center networks established pursuant to s. 381.0402, and other
1675	offices and programs within the department of Health as
1676	designated by the State Surgeon General.
1677	(h)  Work in conjunction with and act as a coordinating
1678	body for governmental and nongovernmental stakeholders to
1679	address matters relating to the state's physician workforce
1680	assessment and development for the purpose of ensuring an
1681	adequate supply of well-trained physicians to meet the state's
1682	future needs. Such governmental stakeholders shall include, but
1683	need not be limited to, the State Surgeon General or his or her
1684	designee, the Commissioner of Education or his or her designee,
1685	the Secretary of Health Care Administration or his or her
1686	designee, and the Chancellor of the State University System or
1687	his or her designee from the Board of Governors of the State
1688	University System, and, at the discretion of the department,
1689	other representatives of state and local agencies that are
1690	involved in assessing, educating, or training the state's
1691	current or future physicians. Other stakeholders shall include,
1692	but need not be limited to, organizations representing the
1693	state's public and private allopathic and osteopathic medical
1694	schools; organizations representing hospitals and other
1695	institutions providing health care, particularly those that
1696	currently provide or have an interest in providing accredited
1697	medical education and graduate medical education to medical
1698	students and medical residents; organizations representing
1699	allopathic and osteopathic practicing physicians; and, at the
1700	discretion of the department, representatives of other
1701	organizations or entities involved in assessing, educating, or
1702	training the state's current or future physicians.
1703	(i)  Serve as a liaison with other states and federal
1704	agencies and programs in order to enhance resources available to
1705	the state's physician workforce and medical education continuum.
1706	(j)  Act as a clearinghouse for collecting and
1707	disseminating information concerning the physician workforce and
1708	medical education continuum in this state.
1709	(5)  PHYSICIAN WORKFORCE ADVISORY COUNCIL.-There is created
1710	in the department the Physician Workforce Advisory Council, an
1711	advisory council as defined in s. 20.03. The council shall
1712	comply with the requirements of s. 20.052, except as otherwise
1713	provided in this section.
1714	(a)  The council shall consist of 19 members. Members
1715	appointed by the State Surgeon General shall include:
1716	1.  A designee from the department who is a physician
1717	licensed under chapter 458 or chapter 459 and recommended by the
1718	State Surgeon General.
1719	2.  An individual who is affiliated with the Science
1720	Students Together Reaching Instructional Diversity and
1721	Excellence program and recommended by the area health education
1722	center network.
1723	3.  Two individuals recommended by the Council of Florida
1724	Medical School Deans, one representing a college of allopathic
1725	medicine and one representing a college of osteopathic medicine.
1726	4.  One individual recommended by the Florida Hospital
1727	Association, representing a hospital that is licensed under
1728	chapter 395, has an accredited graduate medical education
1729	program, and is not a statutory teaching hospital.
1730	5.  One individual representing a statutory teaching
1731	hospital as defined in s. 408.07 and recommended by the Safety
1732	Net Hospital Alliance.
1733	6.  One individual representing a family practice teaching
1734	hospital as defined in s. 395.805 and recommended by the Council
1735	of Family Medicine and Community Teaching Hospitals.
1736	7.  Two individuals recommended by the Florida Medical
1737	Association, one representing a primary care specialty and one
1738	representing a nonprimary care specialty.
1739	8.  Two individuals recommended by the Florida Osteopathic
1740	Medical Association, one representing a primary care specialty
1741	and one representing a nonprimary care specialty.
1742	9.  Two individuals who are program directors of accredited
1743	graduate medical education programs, one representing a program
1744	that is accredited by the Accreditation Council for Graduate
1745	Medical Education and one representing a program that is
1746	accredited by the American Osteopathic Association.
1747	10.  An individual recommended by the Florida Association
1748	of Community Health Centers representing a federally qualified
1749	health center located in a rural area as defined in s.
1750	381.0406(2)(a).
1751	11.  An individual recommended by the Florida Academy of
1752	Family Physicians.
1753	12.  An individual recommended by the Florida Alliance for
1754	Health Professions Diversity.
1755	13.  The Chancellor of the State University System or his
1756	or her designee.
1757	14.  A layperson member as determined by the State Surgeon
1758	General.
1759
1760	Appointments to the council shall be made by the State Surgeon
1761	General. Each entity authorized to make recommendations under
1762	this subsection shall make at least two recommendations to the
1763	State Surgeon General for each appointment to the council. The
1764	State Surgeon General shall name one appointee for each position
1765	from the recommendations made by each authorized entity.
1766	(b)  Each council member shall be appointed to a 4-year
1767	term. An individual may not serve more than two terms. Any
1768	council member may be removed from office for malfeasance;
1769	misfeasance; neglect of duty; incompetence; permanent inability
1770	to perform official duties; or pleading guilty or nolo
1771	contendere to, or being found guilty of, a felony. Any council
1772	member who meets the criteria for removal, or who is otherwise
1773	unwilling or unable to properly fulfill the duties of the
1774	office, shall be succeeded by an individual chosen by the State
1775	Surgeon General to serve out the remainder of the council
1776	member's term. If the remainder of the replaced council member's
1777	term is less than 18 months, notwithstanding the provisions of
1778	this paragraph, the succeeding council member may be reappointed
1779	twice by the State Surgeon General.
1780	(c)  The chair of the council is the State Surgeon General,
1781	who shall designate a vice chair from the membership of the
1782	council to serve in the absence of the State Surgeon General. A
1783	vacancy shall be filled for the remainder of the unexpired term
1784	in the same manner as the original appointment.
1785	(d)  Council members are not entitled to receive
1786	compensation or reimbursement for per diem or travel expenses.
1787	(e)  The council shall meet at least twice a year in person
1788	or by teleconference.
1789	(f)  The council shall:
1790	1.  Advise the State Surgeon General and the department on
1791	matters concerning current and future physician workforce needs
1792	in this state;
1793	2.  Review survey materials and the compilation of survey
1794	information;
1795	3.  Annually review the number, location, cost, and
1796	reimbursement of graduate medical education programs and
1797	positions;
1798	4.  Provide recommendations to the department regarding the
1799	survey completed by physicians licensed under chapter 458 or
1800	chapter 459;
1801	5.  Assist the department in preparing the annual report to
1802	the Legislature pursuant to ss. 458.3192 and 459.0082;
1803	6.  Assist the department in preparing an initial strategic
1804	plan, conduct ongoing strategic planning in accordance with this
1805	section, and provide ongoing advice on implementing the
1806	recommendations;
1807	7.  Monitor and provide recommendations regarding the need
1808	for an increased number of primary care or other physician
1809	specialties to provide the necessary current and projected
1810	health and medical services for the state; and
1811	8.  Monitor and make recommendations regarding the status
1812	of the needs relating to graduate medical education in this
1813	state.
1814	Section 30.  Section 458.3192, Florida Statutes, is amended
1815	to read:
1816	458.3192  Analysis of survey results; report.-
1817	(1)  Each year, the Department of Health shall analyze the
1818	results of the physician survey required by s. 458.3191 and
1819	determine by geographic area and specialty the number of
1820	physicians who:
1821	(a)  Perform deliveries of children in this state Florida.
1822	(b)  Read mammograms and perform breast-imaging-guided
1823	procedures in this state Florida.
1824	(c)  Perform emergency care on an on-call basis for a
1825	hospital emergency department.
1826	(d)  Plan to reduce or increase emergency on-call hours in
1827	a hospital emergency department.
1828	(e)  Plan to relocate their allopathic or osteopathic
1829	practice outside the state.
1830	(f)  Practice medicine in this state.
1831	(g)  Plan to reduce or modify the scope of their practice.
1832	(2)  The Department of Health must report its findings to
1833	the Governor, the President of the Senate, and the Speaker of
1834	the House of Representatives by November 1 each year. The
1835	department shall also include in its report findings,
1836	recommendations, and strategic planning activities as provided
1837	in s. 381.4018. The department may also include other
1838	information requested by the Physician Workforce Advisory
1839	Council.
1840	Section 31.  Section 459.0082, Florida Statutes, is amended
1841	to read:
1842	459.0082  Analysis of survey results; report.-
1843	(1)  Each year, the Department of Health shall analyze the
1844	results of the physician survey required by s. 459.0081 and
1845	determine by geographic area and specialty the number of
1846	physicians who:
1847	(a)  Perform deliveries of children in this state Florida.
1848	(b)  Read mammograms and perform breast-imaging-guided
1849	procedures in this state Florida.
1850	(c)  Perform emergency care on an on-call basis for a
1851	hospital emergency department.
1852	(d)  Plan to reduce or increase emergency on-call hours in
1853	a hospital emergency department.
1854	(e)  Plan to relocate their allopathic or osteopathic
1855	practice outside the state.
1856	(f)  Practice medicine in this state.
1857	(g)  Plan to reduce or modify the scope of their practice.
1858	(2)  The Department of Health must report its findings to
1859	the Governor, the President of the Senate, and the Speaker of
1860	the House of Representatives by November 1 each year. The
1861	department shall also include in its report findings,
1862	recommendations, and strategic planning activities as provided
1863	in s. 381.4018. The department may also include other
1864	information requested by the Physician Workforce Advisory
1865	Council.
1866	Section 32.  Section 458.315, Florida Statutes, is amended
1867	to read:
1868	458.315   Temporary certificate for practice in areas of
1869	critical need.-
1870	(1)  Any physician who:
1871	(a)  Is licensed to practice in any jurisdiction in the
1872	United States and other state, whose license is currently valid;
1873	or,
1874	(b)  Has served as a physician in the United States Armed
1875	Forces for at least 10 years and received an honorable discharge
1876	from the military;
1877
1878	and who pays an application fee of $300 may be issued a
1879	temporary certificate for to practice in areas of communities of
1880	Florida where there is a critical need for physicians.
1881	(2)  A certificate may be issued to a physician who:
1882	(a)  Will practice in an area of critical need;
1883	(b)  Will be employed by or practice in a county health
1884	department, correctional facility, Department of Veterans'
1885	Affairs clinic, community health center funded by s. 329, s.
1886	330, or s. 340 of the United States Public Health Services Act,
1887	or other agency or institution that is approved by the State
1888	Surgeon General and provides health care to meet the needs of
1889	underserved populations in this state; or
1890	(c)  Will practice for a limited time to address critical
1891	physician-specialty, demographic, or geographic needs for this
1892	state's physician workforce as determined by the State Surgeon
1893	General entity that provides health care to indigents and that
1894	is approved by the State Health Officer.
1895	(3)  The Board of Medicine may issue this temporary
1896	certificate with the following restrictions:
1897	(a)(1)  The State Surgeon General board shall determine the
1898	areas of critical need, and the physician so certified may
1899	practice in any of those areas for a time to be determined by
1900	the board. Such areas shall include, but are not be limited to,
1901	health professional shortage areas designated by the United
1902	States Department of Health and Human Services.
1903	1.(a)  A recipient of a temporary certificate for practice
1904	in areas of critical need may use the certificate license to
1905	work for any approved entity employer in any area of
1906	need or as authorized by the State Surgeon General approved by
1907	the board.
1908	2.(b)  The recipient of a temporary certificate for
1909	practice in areas of critical need shall, within 30 days after
1910	accepting employment, notify the board of all approved
1911	institutions in which the licensee practices and of all approved
1912	institutions where practice privileges have been denied.
1913	(b)(2)  The board may administer an abbreviated oral
1914	examination to determine the physician's competency, but a no
1915	written regular examination is not required necessary. Within 60
1916	days after receipt of an application for a temporary
1917	certificate, the board shall review the application and issue
1918	the temporary certificate, or notify the applicant of denial, or
1919	notify the applicant that the board recommends additional
1920	assessment, training, education, or other requirements as a
1921	condition of certification. If the applicant has not actively
1922	practiced during the prior 3 years and the board determines that
1923	the applicant may lack clinical competency, possess diminished
1924	or inadequate skills, lack necessary medical knowledge, or
1925	exhibit patterns of deficits in clinical decisionmaking, the
1926	board may:
1927	1.  Deny the application;
1928	2.  Issue a temporary certificate having reasonable
1929	restrictions that may include, but are not limited to, a
1930	requirement for the applicant to practice under the supervision
1931	of a physician approved by the board; or
1932	3.  Issue a temporary certificate upon receipt of
1933	documentation confirming that the applicant has met any
1934	reasonable conditions of the board which may include, but are
1935	not limited to, completing continuing education or undergoing an
1936	assessment of skills and training.
1937	(c)(3)  Any certificate issued under this section is shall
1938	be valid only so long as the State Surgeon General determines
1939	that the reason area for which it was is issued remains a an
1940	area of critical need to the state. The Board of Medicine shall
1941	review each temporary certificateholder not the service within
1942	said area not less than annually to ascertain that the minimum
1943	requirements of the Medical Practice Act and its adopted the
1944	rules and regulations promulgated thereunder are being complied
1945	with. If it is determined that such minimum requirements are not
1946	being met, the board shall forthwith revoke such certificate or
1947	shall impose restrictions or conditions, or both, as a condition
1948	of continued practice under the certificate.
1949	(d)(4)  The board may shall not issue a temporary
1950	certificate for practice in an area of critical need to any
1951	physician who is under investigation in any jurisdiction in the
1952	United States another state for an act that which would
1953	constitute a violation of this chapter until such time as the
1954	investigation is complete, at which time the provisions of s.
1955	458.331 shall apply.
1956	(4)(5)  The application fee and all licensure fees,
1957	including neurological injury compensation assessments, shall be
1958	waived for those persons obtaining a temporary certificate to
1959	practice in areas of critical need for the purpose of providing
1960	volunteer, uncompensated care for low-income residents
1961	Floridians. The applicant must submit an affidavit from the
1962	employing agency or institution stating that the physician will
1963	not receive any compensation for any service involving the
1964	practice of medicine.
1965	Section 33.  Section 459.0076, Florida Statutes, is created
1966	to read:
1967	459.0076  Temporary certificate for practice in areas of
1968	critical need.-
1969	(1)  Any physician who:
1970	(a)  Is licensed to practice in any jurisdiction in the
1971	United States and whose license is currently valid; or
1972	(b)  Has served as a physician in the United States Armed
1973	Forces for at least 10 years and received an honorable discharge
1974	from the military;
1975
1976	and who pays an application fee of $300 may be issued a
1977	temporary certificate for practice in areas of critical need.
1978	(2)  A certificate may be issued to a physician who:
1979	(a)  Will practice in an area of critical need;
1980	(b)  Will be employed by or practice in a county health
1981	department, correctional facility, Department of Veterans'
1982	Affairs clinic, community health center funded by s. 329, s.
1983	330, or s. 340 of the United States Public Health Services Act,
1984	or other agency or institution that is approved by the State
1985	Surgeon General and provides health care to meet the needs of
1986	underserved populations in this state; or
1987	(c)  Will practice for a limited time to address critical
1988	physician-specialty, demographic, or geographic needs for this
1989	state's physician workforce as determined by the State Surgeon
1990	General.
1991	(3)  The Board of Osteopathic Medicine may issue this
1992	temporary certificate with the following restrictions:
1993	(a)  The State Surgeon General shall determine the areas of
1994	critical need. Such areas include, but are not limited to,
1995	health professional shortage areas designated by the United
1996	States Department of Health and Human Services.
1997	1.  A recipient of a temporary certificate for practice in
1998	areas of critical need may use the certificate to work for any
1999	approved entity in any area of critical need or as authorized by
2000	the State Surgeon General.
2001	2.  The recipient of a temporary certificate for practice
2002	in areas of critical need shall, within 30 days after accepting
2003	employment, notify the board of all approved institutions in
2004	which the licensee practices and of all approved institutions
2005	where practice privileges have been denied.
2006	(b)  The board may administer an abbreviated oral
2007	examination to determine the physician's competency, but a
2008	written regular examination is not required. Within 60 days
2009	after receipt of an application for a temporary certificate, the
2010	board shall review the application and issue the temporary
2011	certificate, notify the applicant of denial, or notify the
2012	applicant that the board recommends additional assessment,
2013	training, education, or other requirements as a condition of
2014	certification. If the applicant has not actively practiced
2015	during the prior 3 years and the board determines that the
2016	applicant may lack clinical competency, possess diminished or
2017	inadequate skills, lack necessary medical knowledge, or exhibit
2018	patterns of deficits in clinical decisionmaking, the board may:
2019	1.  Deny the application;
2020	2.  Issue a temporary certificate having reasonable
2021	restrictions that may include, but are not limited to, a
2022	requirement for the applicant to practice under the supervision
2023	of a physician approved by the board; or
2024	3.  Issue a temporary certificate upon receipt of
2025	documentation confirming that the applicant has met any
2026	reasonable conditions of the board which may include, but are
2027	not limited to, completing continuing education or undergoing an
2028	assessment of skills and training.
2029	(c)  Any certificate issued under this section is valid
2030	only so long as the State Surgeon General determines that the
2031	reason for which it was issued remains a critical need to the
2032	state. The Board of Osteopathic Medicine shall review each
2033	temporary certificateholder not less than annually to ascertain
2034	that the minimum requirements of the Osteopathic Medical
2035	Practice Act and its adopted rules are being complied with. If
2036	it is determined that such minimum requirements are not being
2037	met, the board shall revoke such certificate or shall impose
2038	restrictions or conditions, or both, as a condition of continued
2039	practice under the certificate.
2040	(d)  The board may not issue a temporary certificate for
2041	practice in an area of critical need to any physician who is
2042	under investigation in any jurisdiction in the United States for
2043	an act that would constitute a violation of this chapter until
2044	such time as the investigation is complete, at which time the
2045	provisions of s. 459.015 apply.
2046	(4)  The application fee and all licensure fees, including
2047	neurological injury compensation assessments, shall be waived
2048	for those persons obtaining a temporary certificate to practice
2049	in areas of critical need for the purpose of providing
2050	volunteer, uncompensated care for low-income residents. The
2051	applicant must submit an affidavit from the employing agency or
2052	institution stating that the physician will not receive any
2053	compensation for any service involving the practice of medicine.
2054	Section 34.  (1)  The Department of Health shall conduct an
2055	evaluation and justification review of each division established
2056	under s. 20.43, Florida Statutes. The review shall be
2057	comprehensive in its scope and, at a minimum, must be conducted
2058	in such a manner as to specifically determine the following, and
2059	to consider and determine what changes, if any, are needed with
2060	respect thereto:
2061	(a)  The identifiable cost of each division and programs
2062	within the division.
2063	(b)  The specific purpose of each division and programs
2064	within the division, and the specific public health benefit
2065	derived therefrom.
2066	(c)  Progress toward achieving the outputs and outcomes
2067	associated with each division and programs within the division.
2068	(d)  An explanation of circumstances contributing to the
2069	department's ability to achieve, not achieve, or exceed its
2070	projected outputs and outcomes, as defined in s. 216.011,
2071	associated with each division and programs within the division.
2072	(e)  Alternate courses of action that would result in
2073	administration of the same program in a more efficient or
2074	effective manner. The courses of action to be considered must
2075	include, but are not limited to:
2076	1.  Whether the department could be organized in a more
2077	efficient and effective manner, including whether each
2078	division's mission, goals, or objectives should be redefined.
2079	The report must include a rationale for each department division
2080	and programs within the division, the return on investment of
2081	each division and programs within the division, the relatedness
2082	of the division and programs within the division to a public
2083	health function, and any federal funding support for each
2084	division and programs within the division. The review should
2085	recommend the reduction and restructuring of department bureaus
2086	and divisions.
2087	2.  Whether the division and programs within the division
2088	could be administered more efficiently or effectively to avoid
2089	duplication of activities and ensure that activities are
2090	adequately coordinated.
2091	3.  Whether the division and programs within that division
2092	could be performed more efficiently or more effectively by
2093	another unit of government or a private entity.
2094	4.  When compared to costs, whether effectiveness warrants
2095	elimination of the division or programs within the division or,
2096	if the division or a program within the division serves a
2097	limited interest, whether the division or program should be
2098	redesigned to require users to finance program costs.
2099	5.  Whether the cost to administer the division or program
2100	within the division exceeds license and other fee revenues paid
2101	by those being regulated.
2102	6.  Whether other changes could improve the efficiency and
2103	effectiveness of the division or program within the division.
2104	(f)  The consequences of discontinuing such division or
2105	programs within the division. If any discontinuation is
2106	recommended, such recommendation must be accompanied by a
2107	description of alternatives to implement such recommendation,
2108	including an implementation schedule for discontinuation and
2109	recommended procedures for assisting state agency employees
2110	affected by the discontinuation.
2111	(g)  Whether current performance measures and standards
2112	should be reviewed or amended to assist department efforts in
2113	achieving outputs and outcome measures.
2114	(h)  Whether the information reported as part of the
2115	state's performance-based program budgeting system has relevance
2116	and utility for the evaluation of each division and programs
2117	within the division.
2118	(i)  Whether department management has established control
2119	systems sufficient to ensure that performance data are
2120	maintained and supported by department records and accurately
2121	presented in department performance reports.
2122	(3)  No later than March 1, 2011, the department shall
2123	submit a report on its evaluation and justification review
2124	findings and recommendations to the President of the Senate, the
2125	Speaker of the House of Representatives, the chairs of the
2126	appropriate substantive committees, the chairs of the
2127	appropriations committees, the Legislative Auditing Committee,
2128	the Governor, and the State Surgeon General.
2129	Section 35.  Subsection (3) is added to section 381.00315,
2130	Florida Statutes, to read:
2131	381.00315  Public health advisories; public health
2132	emergencies.-The State Health Officer is responsible for
2133	declaring public health emergencies and issuing public health
2134	advisories.
2135	(3)  To facilitate effective emergency management, when the
2136	United States Department of Health and Human Services contracts
2137	for the manufacture and delivery of licensable products in
2138	response to a public health emergency and the terms of those
2139	contracts are made available to the states, the department shall
2140	accept funds provided by counties, municipalities, and other
2141	entities designated in the state emergency management plan
2142	required under s. 252.35(2)(a) for the purpose of participation
2143	in those contracts. The department shall deposit those funds in
2144	the Grants and Donations Trust Fund and expend those funds on
2145	behalf of the donor  county, municipality, or other entity for
2146	the purchase of the licensable products made available under the
2147	contract.
2148	Section 36.  For fiscal year 2010-2011 only, and
2149	notwithstanding s. 216.181, Florida Statutes, the Department of
2150	Health is authorized to submit a budget amendment requesting
2151	additional Grants and Donations Trust Fund budget authority for
2152	the Florida Center for Nursing to make expenditures supported by
2153	grants and donations.
2154	Section 37.  Paragraph (a) of subsection (1) of section
2155	409.9201, Florida Statutes, is amended to read:
2156	409.9201  Medicaid fraud.-
2157	(1)  As used in this section, the term:
2158	(a)  "Prescription drug" means any drug, including, but not
2159	limited to, finished dosage forms or active ingredients that are
2160	subject to, defined by, or described by s. 503(b) of the Federal
2161	Food, Drug, and Cosmetic Act or by s. 465.003(8), s.
2162	499.003(46)(45) or (53) (52), or s. 499.007(13).
2163
2164	The value of individual items of the legend drugs or goods or
2165	services involved in distinct transactions committed during a
2166	single scheme or course of conduct, whether involving a single
2167	person or several persons, may be aggregated when determining
2168	the punishment for the offense.
2169	Section 38.  Subsection (3) of section 465.0265, Florida
2170	Statutes, is amended to read:
2171	465.0265  Centralized prescription filling.-
2172	(3)  The filling, delivery, and return of a prescription by
2173	one pharmacy for another pursuant to this section shall not be
2174	construed as the filling of a transferred prescription as set
2175	forth in s. 465.026 or as a wholesale distribution as set forth
2176	in s. 499.003(54)(53).
2177	Section 39.  Paragraph (g) of subsection (2) of section
2178	499.01, Florida Statutes, are amended to read:
2179	499.01  Permits.-
2180	(2)  The following permits are established:
2181	(g)  Restricted prescription drug distributor permit.-A
2182	restricted prescription drug distributor permit is required for
2183	any person that engages in the distribution of a prescription
2184	drug, which distribution is not considered "wholesale
2185	distribution" under s. 499.003(54)(53)(a).
2186	1.  A person who engages in the receipt or distribution of
2187	a prescription drug in this state for the purpose of processing
2188	its return or its destruction must obtain a permit as a
2189	restricted prescription drug distributor if such person is not
2190	the person initiating the return, the prescription drug
2191	wholesale supplier of the person initiating the return, or the
2192	manufacturer of the drug.
2193	2.  Storage, handling, and recordkeeping of these
2194	distributions must comply with the requirements for wholesale
2195	distributors under s. 499.0121, but not those set forth in s.
2196	499.01212.
2197	3.  A person who applies for a permit as a restricted
2198	prescription drug distributor, or for the renewal of such a
2199	permit, must provide to the department the information required
2200	under s. 499.012.
2201	4.  The department may adopt rules regarding the
2202	distribution of prescription drugs by hospitals, health care
2203	entities, charitable organizations, or other persons not
2204	involved in wholesale distribution, which rules are necessary
2205	for the protection of the public health, safety, and welfare.
2206	Section 40.  Paragraph (d) of subsection (4) of section
2207	499.0121, Florida Statutes, is amended to read:
2208	499.0121  Storage and handling of prescription drugs;
2209	recordkeeping.-The department shall adopt rules to implement
2210	this section as necessary to protect the public health, safety,
2211	and welfare. Such rules shall include, but not be limited to,
2212	requirements for the storage and handling of prescription drugs
2213	and for the establishment and maintenance of prescription drug
2214	distribution records.
2215	(4)  EXAMINATION OF MATERIALS AND RECORDS.-
2216	(d)  Upon receipt, a wholesale distributor must review
2217	records required under this section for the acquisition of
2218	prescription drugs for accuracy and completeness, considering
2219	the total facts and circumstances surrounding the transactions
2220	and the wholesale distributors involved. This includes
2221	authenticating each transaction listed on a pedigree paper, as
2222	defined in s. 499.003(37)(36).
2223	Section 41.  Paragraphs (a) and (b) of subsection (2) of
2224	section 499.01211, Florida Statutes, are amended to read:
2225	499.01211  Drug Wholesale Distributor Advisory Council.-
2226	(2)  The State Surgeon General, or his or her designee, and
2227	the Secretary of Health Care Administration, or her or his
2228	designee, shall be members of the council. The State Surgeon
2229	General shall appoint nine additional members to the council who
2230	shall be appointed to a term of 4 years each, as follows:
2231	(a)  Three different persons each of whom is employed by a
2232	different prescription drug wholesale distributor licensed under
2233	this part which operates nationally and is a primary wholesale
2234	distributor, as defined in s. 499.003(47)(46).
2235	(b)  One person employed by a prescription drug wholesale
2236	distributor licensed under this part which is a secondary
2237	wholesale distributor, as defined in s. 499.003(52)(51).
2238	Section 42.  Subsection (1) of section 499.03, Florida
2239	Statutes, is amended to read:
2240	499.03  Possession of certain drugs without prescriptions
2241	unlawful; exemptions and exceptions.-
2242	(1)  A person may not possess, or possess with intent to
2243	sell, dispense, or deliver, any habit-forming, toxic, harmful,
2244	or new drug subject to s. 499.003(33)(32), or prescription drug
2245	as defined in s. 499.003(43)(42), unless the possession of the
2246	drug has been obtained by a valid prescription of a practitioner
2247	licensed by law to prescribe the drug. However, this section
2248	does not apply to the delivery of such drugs to persons included
2249	in any of the classes named in this subsection, or to the agents
2250	or employees of such persons, for use in the usual course of
2251	their businesses or practices or in the performance of their
2252	official duties, as the case may be; nor does this section apply
2253	to the possession of such drugs by those persons or their agents
2254	or employees for such use:
2255	(a)  A licensed pharmacist or any person under the licensed
2256	pharmacist's supervision while acting within the scope of the
2257	licensed pharmacist's practice;
2258	(b)  A licensed practitioner authorized by law to prescribe
2259	prescription drugs or any person under the licensed
2260	practitioner's supervision while acting within the scope of the
2261	licensed practitioner's practice;
2262	(c)  A qualified person who uses prescription drugs for
2263	lawful research, teaching, or testing, and not for resale;
2264	(d)  A licensed hospital or other institution that procures
2265	such drugs for lawful administration or dispensing by
2266	practitioners;
2267	(e)  An officer or employee of a federal, state, or local
2268	government; or
2269	(f)  A person that holds a valid permit issued by the
2270	department pursuant to this part which authorizes that person to
2271	possess prescription drugs.
2272	Section 43.  Paragraphs (i) and (m) of subsection (1) of
2273	section 499.05, Florida Statutes, are amended to read:
2274	499.05  Rules.-
2275	(1)  The department shall adopt rules to implement and
2276	enforce this part with respect to:
2277	(i)  Additional conditions that qualify as an emergency
2278	medical reason under s. 499.003(54)(53)(b)2.
2279	(m)  The recordkeeping, storage, and handling with respect
2280	to each of the distributions of prescription drugs specified in
2281	s. 499.003(54)(53)(a)-(d).
2282	Section 44.  Subsection (1) of section 794.075, Florida
2283	Statutes, is amended to read:
2284	794.075  Sexual predators; erectile dysfunction drugs.-
2285	(1)  A person may not possess a prescription drug, as
2286	defined in s. 499.003(43)(42), for the purpose of treating
2287	erectile dysfunction if the person is designated as a sexual
2288	predator under s. 775.21.
2289	Section 45.  Except as otherwise expressly provided in this
2290	act, this act shall take effect July 1, 2010.

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