Florida Senate - 2012                                    SB 1350
       
       
       
       By Senator Sobel
       
       
       
       
       31-00888A-12                                          20121350__
    1                        A bill to be entitled                      
    2         An act relating to cancer control; amending s.
    3         1004.435, F.S.; revising legislative intent to delete
    4         provisions relating to research activities for cancer
    5         control; changing the name of the cancer control and
    6         research advisory council to the Florida Cancer
    7         Control and Resource Advisory Council; providing for
    8         the appointment and terms of council members and
    9         duties of the council; providing for a nominating
   10         committee to make recommendations for gubernatorial
   11         appointments to the council; providing for council
   12         membership categories; providing for an executive
   13         committee of the council and duties of the committee;
   14         authorizing consultants to the council; providing
   15         duties of the council for the development, review, and
   16         approval of the Florida Cancer Plan; deleting
   17         responsibilities of the council and the Board of
   18         Governors of the State University System relating to
   19         cancer research; authorizing the Department of Health
   20         to adopt rules for implementation of the section;
   21         providing department duties relating to the
   22         development and establishment of the Florida Cancer
   23         Plan; revising the name of the cancer control fund and
   24         deleting the use of funds for cancer research;
   25         amending ss. 458.324 and 459.0125, F.S.; conforming
   26         cross-references; providing an effective date.
   27  
   28  Be It Enacted by the Legislature of the State of Florida:
   29  
   30         Section 1. Section 1004.435, Florida Statutes, is amended
   31  to read:
   32         1004.435 Cancer control and resource advisory council
   33  research.—
   34         (1) SHORT TITLE.—This section shall be known and may be
   35  cited as the “Florida Cancer Control and Research Act.”
   36         (2) LEGISLATIVE INTENT.—It is the finding of the
   37  Legislature that:
   38         (a) Advances in scientific knowledge have led to the
   39  development of preventive and therapeutic capabilities in the
   40  control of cancer. Such knowledge and therapy must be made
   41  available to all citizens of this state through educational and
   42  therapeutic programs.
   43         (b) The present state of our knowledge concerning the
   44  prevalence, cause or associated factors, and treatment of cancer
   45  have resulted primarily from a vast federal investment into
   46  basic and clinical research, some of which is expended in this
   47  state. These research activities must continue, but programs
   48  must be established to extend this knowledge in preventive
   49  measures and patient treatment throughout the state.
   50         (c) Research in cancer has implicated the environment as a
   51  causal factor for many types of cancer, i.e., sunshine, X rays,
   52  diet, smoking, etc., and programs are needed to further document
   53  such cause and effect relationships. Proven causes of cancer
   54  should be publicized and be the subject of educational programs
   55  for the prevention of cancer.
   56         (b)(d) An effective cancer control program would mobilize
   57  the scientific, educational, and medical resources that
   58  presently exist into an intense attack against cancer this dread
   59  disease.
   60         (3) DEFINITIONS.—The following words and phrases when used
   61  in this section have, unless the context clearly indicates
   62  otherwise, the meanings given to them in this subsection:
   63         (a) “Cancer” means all malignant neoplasms, regardless of
   64  the tissue of origin, including lymphoma and leukemia.
   65         (b) “Council” means the Florida Cancer Control and Resource
   66  Research Advisory Council, which is an advisory body appointed
   67  to function on a continuing basis for the study of cancer and
   68  which recommends solutions and policy alternatives to the Board
   69  of Governors and the State Surgeon General and which is
   70  established by this section.
   71         (c) “Department” means the Department of Health.
   72         (d) “Fund” means the Florida Cancer Control and Research
   73  Fund established by this section.
   74         (e) “Plan” means the Florida Cancer Plan.
   75         (f)(e) “Qualified nonprofit association” means any
   76  association, incorporated or unincorporated, that has received
   77  tax-exempt status from the Internal Revenue Service.
   78         (4) FLORIDA CANCER CONTROL AND RESOURCE RESEARCH ADVISORY
   79  COUNCIL; CREATION; COMPOSITION.—
   80         (a)1. There is created within the H. Lee Moffitt Cancer
   81  Center and Research Institute, Inc., the Florida Cancer Control
   82  and Resource Research Advisory Council. The council shall serve
   83  as a resource and clearinghouse for comprehensive cancer control
   84  in the state and shall facilitate effective communication,
   85  shared resources, and synergism between and among the cancer
   86  stakeholder organizations and groups within the state. The
   87  council shall consist of members representing the various cancer
   88  constituencies in the state. The council shall include three
   89  members representing the general public appointed by the
   90  Governor, one member appointed by the President of the Senate,
   91  one member appointed by the Speaker of the House of
   92  Representatives, one member appointed by the State Surgeon
   93  General, and 32 members representing cancer stakeholders in the
   94  state who are appointed by the Governor. Of the 32 members, at
   95  least 10 members must be individuals who are minority persons as
   96  defined in s. 288.703. Each council member must be a resident of
   97  the state, and all members are voting members of the council.
   98         2. Of the three members representing the general public
   99  appointed by the Governor, one shall serve an initial term of 2
  100  years, one shall serve an initial term of 3 years, and one shall
  101  serve an initial term of 4 years, beginning July 1, 2012;
  102  thereafter, these gubernatorial appointments to the council
  103  shall be for 4-year terms. The remaining members appointed by
  104  the Governor and the members appointed by the President of the
  105  Senate, the Speaker of the House of Representatives, and the
  106  State Surgeon General shall serve 4-year terms. A chair and
  107  vice-chair shall each be elected by the council membership for
  108  2-year terms. The council shall consist of 35 members, which
  109  includes the chairperson, all of whom must be residents of this
  110  state. All members, except those appointed by the Speaker of the
  111  House of Representatives and the President of the Senate, must
  112  be appointed by the Governor. At least one of the members
  113  appointed by the Governor must be 60 years of age or older. One
  114  member must be a representative of the American Cancer Society;
  115  one member must be a representative of the Florida Tumor
  116  Registrars Association; one member must be a representative of
  117  the Sylvester Comprehensive Cancer Center of the University of
  118  Miami; one member must be a representative of the Department of
  119  Health; one member must be a representative of the University of
  120  Florida Shands Cancer Center; one member must be a
  121  representative of the Agency for Health Care Administration; one
  122  member must be a representative of the Florida Nurses
  123  Association; one member must be a representative of the Florida
  124  Osteopathic Medical Association; one member must be a
  125  representative of the American College of Surgeons; one member
  126  must be a representative of the School of Medicine of the
  127  University of Miami; one member must be a representative of the
  128  College of Medicine of the University of Florida; one member
  129  must be a representative of NOVA Southeastern College of
  130  Osteopathic Medicine; one member must be a representative of the
  131  College of Medicine of the University of South Florida; one
  132  member must be a representative of the College of Public Health
  133  of the University of South Florida; one member must be a
  134  representative of the Florida Society of Clinical Oncology; one
  135  member must be a representative of the Florida Obstetric and
  136  Gynecologic Society who has had training in the specialty of
  137  gynecologic oncology; one member must be a representative of the
  138  Florida Ovarian Cancer Alliance Speaks (FOCAS) organization; one
  139  member must be a representative of the Florida Medical
  140  Association; one member must be a member of the Florida
  141  Pediatric Society; one member must be a representative of the
  142  Florida Radiological Society; one member must be a
  143  representative of the Florida Society of Pathologists; one
  144  member must be a representative of the H. Lee Moffitt Cancer
  145  Center and Research Institute, Inc.; three members must be
  146  representatives of the general public acting as consumer
  147  advocates; one member must be a member of the House of
  148  Representatives appointed by the Speaker of the House of
  149  Representatives; one member must be a member of the Senate
  150  appointed by the President of the Senate; one member must be a
  151  representative of the Florida Dental Association; one member
  152  must be a representative of the Florida Hospital Association;
  153  one member must be a representative of the Association of
  154  Community Cancer Centers; one member shall be a representative
  155  from a statutory teaching hospital affiliated with a community
  156  based cancer center; one member must be a representative of the
  157  Florida Association of Pediatric Tumor Programs, Inc.; one
  158  member must be a representative of the Cancer Information
  159  Service; one member must be a representative of the Florida
  160  Agricultural and Mechanical University Institute of Public
  161  Health; and one member must be a representative of the Florida
  162  Society of Oncology Social Workers. Of the members of the
  163  council appointed by the Governor, at least 10 must be
  164  individuals who are minority persons as defined by s. 288.703.
  165         (b) A nominating committee shall review applicants for the
  166  council on an annual basis and make recommendations for
  167  gubernatorial appointments to the council. The nominating
  168  committee shall be comprised of a minimum of seven council
  169  members selected by, and including, the vice chair. The
  170  nominating committee shall constitute a subgroup of the council
  171  membership in that at least one member shall represent each
  172  membership category identified in paragraph (c). The individuals
  173  selected by the nominating committee shall be forwarded for
  174  gubernatorial appointment and are eligible for reappointment one
  175  time.
  176         (c) The 32 members appointed by the Governor who represent
  177  cancer stakeholders in the state shall be recommended by cancer
  178  stakeholder organizations or groups, by council nomination, or
  179  through self-referrals. The membership categories and the
  180  maximum number of members in each category include:
  181         1. Five members from university-based health care delivery
  182  systems with major cancer programs, including the H. Lee Moffitt
  183  Cancer Center and Research Institute, Inc., the University of
  184  Florida Shands Cancer Center, and the University of Miami
  185  Sylvester Comprehensive Cancer Center.
  186         2. Five members from community-based health care delivery
  187  systems or practices with American College of Surgeons
  188  accredited cancer programs.
  189         3. Four members from nonprofit or voluntary organizations,
  190  including a representative from the American Cancer Society.
  191         4. Three members from health and healthcare disparities
  192  research and outreach cancer programs.
  193         5. Five members from state governmental agencies, including
  194  the Department of Health, the Department of Education, and the
  195  Biomedical Research Advisory Council.
  196         6. Five members from cancer-related professional
  197  organizations, including the Florida Society of Clinical
  198  Oncology, the Florida Society of Oncology Social Workers, and
  199  the Florida Medical Association.
  200         7. Five members each representing one of the state regional
  201  cancer collaboratives.
  202         (d) An executive committee, which shall be responsible for
  203  coordinating the activities and planning the direction of the
  204  council, shall be comprised of the council’s chair and vice
  205  chair, the appointee of the Speaker of the House of
  206  Representatives, the appointee of the President of the Senate,
  207  the appointee of the State Surgeon General, and four members
  208  selected by the chair. The positions on the executive committee
  209  shall be for terms of 2 years corresponding to the chair’s term
  210  in office. Membership on the executive committee shall
  211  constitute a subgroup of the council membership in that at least
  212  one member shall represent each membership category identified
  213  in paragraph (c). Additional members may serve at the discretion
  214  of the chair.
  215         (e) The council may invite additional state cancer
  216  stakeholder organizations or groups or individuals with
  217  expertise, experience, or resources to serve as consultants to
  218  assist the council in accomplishing its mission. Such services
  219  may include consultative participation in council activities,
  220  associated task forces, or projects. Consultants have no voting
  221  rights on the council.
  222         (b) The terms of the members shall be 4 years from their
  223  respective dates of appointment.
  224         (c) A chairperson shall be appointed by the Governor for a
  225  term of 2 years. The chairperson shall appoint an executive
  226  committee of no fewer than three persons to serve at the
  227  pleasure of the chairperson. This committee will prepare
  228  material for the council but make no final decisions.
  229         (f)(d) The council shall meet no less than semiannually at
  230  the call of the chair chairperson or, in his or her absence or
  231  incapacity, at the call of the State Surgeon General. Twenty
  232  Sixteen members constitute a quorum for the purpose of
  233  exercising all of the powers of the council. A vote of the
  234  majority of the members present is sufficient for all actions of
  235  the council.
  236         (g)(e) The council members shall serve without pay.
  237  Pursuant to the provisions of s. 112.061, the council members
  238  may be entitled to be reimbursed for per diem and travel
  239  expenses.
  240         (h)(f)A No member of the council may not shall participate
  241  in any discussion or decision to recommend grants or contracts
  242  to any qualified nonprofit association or to any agency of this
  243  state or its political subdivisions with which the member is
  244  associated as a member of the governing body or as an employee
  245  or with which the member has entered into a contractual
  246  arrangement.
  247         (i)(g) The council may prescribe, amend, and repeal bylaws
  248  governing the manner in which the business of the council is
  249  conducted.
  250         (j)(h) The council shall advise the Board of Governors, the
  251  State Surgeon General, the Governor, and the Legislature with
  252  respect to cancer control and resources research in this state.
  253         (k)(i) The council shall approve each year a program for
  254  cancer control and research to be known as the “Florida Cancer
  255  Plan” which shall be consistent with the State Health Plan and
  256  integrated and coordinated with existing or emerging programs in
  257  this state. The council shall review and approve the plan at
  258  least every 4 years.
  259         (l)(j) The council shall formulate and recommend to the
  260  State Surgeon General, the Governor, the President of the
  261  Senate, and the Speaker of the House of Representatives a plan
  262  for the prevention and early detection of cancer which is
  263  evidence-based and consistent with standards of practice and
  264  supported by evidence-based medicine care and treatment of
  265  persons suffering from cancer and recommend the establishment of
  266  standard requirements for the organization, equipment, and
  267  conduct of cancer units or departments in hospitals and clinics
  268  in this state. The council may recommend to the State Surgeon
  269  General the designation of cancer units following a survey of
  270  the needs and facilities for treatment of cancer in the various
  271  localities throughout the state. The State Surgeon General shall
  272  consider the plan in developing departmental priorities and
  273  funding priorities and standards under chapter 395.
  274         (m)(k) The council shall provide expertise and input in the
  275  content and development of is responsible for including in the
  276  Florida Cancer Plan, which is otherwise generated through the
  277  Department of Health. Recommendations shall include for the
  278  coordination and integration of medical, nursing, paramedical,
  279  lay, and other state efforts plans concerned with cancer control
  280  and research. Committees may shall be formed to develop
  281  strategies for taking action regarding by the council so that
  282  the following areas will be established as entities for actions:
  283         1. Cancer plan evaluation, including the creation of a:
  284  tumor registry, data retrieval systems, and epidemiology of
  285  cancer in the state and its relation to other areas.
  286         2. Cancer prevention.
  287         3. Cancer detection.
  288         4. Cancer treatments patient management: treatment,
  289  rehabilitation, terminal care, and other patient-oriented
  290  activities.
  291         5. Support services for cancer patients and caregivers
  292  education: lay and professional.
  293         6. Unproven methods of Cancer education for laypersons and
  294  professionals therapy: quackery and unorthodox therapies.
  295         7. Other cancer-control-related topics Investigator
  296  initiated project research.
  297         (n)(l) In order to implement in whole or in part the
  298  Florida Cancer Plan, the council may shall recommend to the
  299  Board of Governors or the State Surgeon General the awarding of
  300  grants and contracts to qualified profit or nonprofit
  301  associations or governmental agencies in order to plan,
  302  establish, or conduct programs in cancer control or prevention
  303  and, cancer education or and training, and cancer research.
  304         (o) The council shall have input into the prioritization
  305  and implementation of statewide programs and the allocation of
  306  resources in the department’s comprehensive cancer control
  307  program, consistent with the Florida Cancer Plan.
  308         (p)(m) If funds are specifically appropriated by the
  309  Legislature, the council shall develop or purchase standardized
  310  written summaries, written in layperson’s terms and in language
  311  easily understood by the average adult patient, informing
  312  citizens and professionals on cancer prevention, detection,
  313  treatment, and survivorship actual and high-risk breast cancer
  314  patients, prostate cancer patients, and men who are considering
  315  prostate cancer screening of the medically viable treatment
  316  alternatives available to them in the effective management of
  317  breast cancer and prostate cancer; describing such treatment
  318  alternatives; and explaining the relative advantages,
  319  disadvantages, and risks associated therewith. The breast cancer
  320  summary, upon its completion, shall be printed in the form of a
  321  pamphlet or booklet and made continuously available to
  322  physicians and surgeons in this state for their use in
  323  accordance with s. 458.324 and to osteopathic physicians in this
  324  state for their use in accordance with s. 459.0125. The council
  325  shall periodically update both summaries to reflect current
  326  standards of medical practice in the treatment of breast cancer
  327  and prostate cancer. The council shall develop and implement
  328  educational programs and position statements, including
  329  distribution of the summaries developed or purchased under this
  330  paragraph, to inform citizen groups, associations, government
  331  officials, and voluntary organizations about cancer-related
  332  matters early detection and treatment of breast cancer and
  333  prostate cancer.
  334         (q)(n) The council may recommend to shall have the
  335  responsibility to advise the Board of Governors and the State
  336  Surgeon General, the Governor, the President of the Senate, and
  337  the Speaker of the House of Representatives on methods of
  338  enforcing and implementing laws already enacted and concerned
  339  with cancer control, research, and education.
  340         (r)(o) The council may recommend to the Board of Governors
  341  or the State Surgeon General rules not inconsistent with law as
  342  it may deem necessary for the performance of its duties and the
  343  proper administration of this section.
  344         (s)(p) The council shall formulate and put into effect a
  345  continuing educational program for the prevention of cancer and
  346  its early diagnosis and disseminate to hospitals, cancer
  347  patients, and the public information concerning the proper
  348  treatment of cancer.
  349         (t)(q) The council shall be physically located at the H.
  350  Lee Moffitt Cancer Center and Research Institute, Inc., at the
  351  University of South Florida.
  352         (u)(r)By December 1 On February 15 of each year, the
  353  council shall report its findings and recommendations to the
  354  State Surgeon General, the Governor, the President of the
  355  Senate, and the Speaker of the House of Representatives and to
  356  the Legislature.
  357         (5) RESPONSIBILITIES OF THE BOARD OF GOVERNORS, THE H. LEE
  358  MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC., AND THE
  359  STATE SURGEON GENERAL, AND THE DEPARTMENT OF HEALTH.—
  360         (a) The Board of Governors or The State Surgeon General,
  361  after consultation with the council, may shall award grants and
  362  contracts to qualified nonprofit associations and governmental
  363  agencies in order to plan, establish, or conduct programs in
  364  cancer control or and prevention and, cancer education or and
  365  training, and cancer research.
  366         (b) The H. Lee Moffitt Cancer Center and Research
  367  Institute, Inc., shall provide a full-time executive director to
  368  coordinate, facilitate, and communicate the mission and
  369  responsibilities of the council. Additional administrative
  370  support, information, and other assistance shall be provided
  371  such staff, information, and other assistance as reasonably
  372  necessary for the completion of the responsibilities of the
  373  council.
  374         (c) The Department of Health Board of Governors or the
  375  State Surgeon General, after consultation with the council, may
  376  adopt rules necessary for the implementation of this section.
  377         (d) The Florida Cancer Plan is established within the
  378  Department of Health. The department must utilize the council in
  379  developing the plan, prioritizing goals, allocating resources,
  380  and approving the plan in its final form. The State Surgeon
  381  General, after consultation with the council, shall make rules
  382  specifying to what extent and on what terms and conditions
  383  cancer patients of the state may receive financial aid for the
  384  diagnosis and treatment of cancer in any hospital or clinic
  385  selected. The department may furnish to citizens of this state
  386  who are afflicted with cancer financial aid to the extent of the
  387  appropriation provided for that purpose in a manner which in its
  388  opinion will afford the greatest benefit to those afflicted and
  389  may make arrangements with hospitals, laboratories, or clinics
  390  to afford proper care and treatment for cancer patients in this
  391  state.
  392         (6) FLORIDA CANCER CONTROL AND RESEARCH FUND.—
  393         (a) There is created the Florida Cancer Control and
  394  Research Fund consisting of funds appropriated therefor from the
  395  General Revenue Fund and any gifts, grants, or funds received
  396  from other sources.
  397         (b) The fund shall be used exclusively for grants and
  398  contracts to qualified nonprofit associations or governmental
  399  agencies for the purpose of cancer control or and prevention,
  400  cancer education or and training, cancer research, and all
  401  expenses incurred in connection with the administration of this
  402  section and the programs funded through the grants and contracts
  403  authorized by the State Board of Education or the State Surgeon
  404  General.
  405         Section 2. Subsection (1) and paragraph (a) of subsection
  406  (2) of section 458.324, Florida Statutes, are amended to read:
  407         458.324 Breast cancer; information on treatment
  408  alternatives.—
  409         (1) DEFINITION.—As used in this section, the term
  410  “medically viable,” as applied to treatment alternatives, means
  411  modes of treatment generally considered by the medical
  412  profession to be within the scope of current, acceptable
  413  standards, including treatment alternatives described in the
  414  written summary prepared by the Florida Cancer Control and
  415  Resource Research Advisory Council in accordance with s.
  416  1004.435(4)(p) 1004.435(4)(m).
  417         (2) COMMUNICATION OF TREATMENT ALTERNATIVES.—Each physician
  418  treating a patient who is, or in the judgment of the physician
  419  is at high risk of being, diagnosed as having breast cancer
  420  shall inform such patient of the medically viable treatment
  421  alternatives available to such patient; shall describe such
  422  treatment alternatives; and shall explain the relative
  423  advantages, disadvantages, and risks associated with the
  424  treatment alternatives to the extent deemed necessary to allow
  425  the patient to make a prudent decision regarding such treatment
  426  options. In compliance with this subsection:
  427         (a) The physician may, in his or her discretion:
  428         1. Orally communicate such information directly to the
  429  patient or the patient’s legal representative;
  430         2. Provide the patient or the patient’s legal
  431  representative with a copy of the written summary prepared in
  432  accordance with s. 1004.435(4)(p) 1004.435(4)(m) and express a
  433  willingness to discuss the summary with the patient or the
  434  patient’s legal representative; or
  435         3. Both communicate such information directly and provide a
  436  copy of the written summary to the patient or the patient’s
  437  legal representative for further consideration and possible
  438  later discussion.
  439  
  440  Nothing in this subsection shall reduce other provisions of law
  441  regarding informed consent.
  442         Section 3. Subsection (1) and paragraph (a) of subsection
  443  (2) of section 459.0125, Florida Statutes, are amended to read:
  444         459.0125 Breast cancer; information on treatment
  445  alternatives.—
  446         (1) DEFINITION.—As used in this section, the term
  447  “medically viable,” as applied to treatment alternatives, means
  448  modes of treatment generally considered by the medical
  449  profession to be within the scope of current, acceptable
  450  standards, including treatment alternatives described in the
  451  written summary prepared by the Florida Cancer Control and
  452  Resource Research Advisory Council in accordance with s.
  453  1004.435(4)(p) 1004.435(4)(m).
  454         (2) COMMUNICATION OF TREATMENT ALTERNATIVES.—It is the
  455  obligation of every physician treating a patient who is, or in
  456  the judgment of the physician is at high risk of being,
  457  diagnosed as having breast cancer to inform such patient of the
  458  medically viable treatment alternatives available to such
  459  patient; to describe such treatment alternatives; and to explain
  460  the relative advantages, disadvantages, and risks associated
  461  with the treatment alternatives to the extent deemed necessary
  462  to allow the patient to make a prudent decision regarding such
  463  treatment options. In compliance with this subsection:
  464         (a) The physician may, in her or his discretion:
  465         1. Orally communicate such information directly to the
  466  patient or the patient’s legal representative;
  467         2. Provide the patient or the patient’s legal
  468  representative with a copy of the written summary prepared in
  469  accordance with s. 1004.435(4)(p) 1004.435(4)(m) and express her
  470  or his willingness to discuss the summary with the patient or
  471  the patient’s legal representative; or
  472         3. Both communicate such information directly and provide a
  473  copy of the written summary to the patient or the patient’s
  474  legal representative for further consideration and possible
  475  later discussion.
  476  
  477  Nothing in this subsection shall reduce other provisions of law
  478  regarding informed consent.
  479         Section 4. This act shall take effect July 1, 2012.