HB 593

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

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