Florida Senate - 2012 CS for SB 1350
By the Committee on Health Regulation; and Senator Sobel
588-03235B-12 20121350c1
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 health care 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, the
199 Florida Society of Pathologists, the Florida Dental Association,
200 and the Florida Medical Association.
201 7. Five members each representing one of the state regional
202 cancer collaboratives.
203 (d) An executive committee, which shall be responsible for
204 coordinating the activities and planning the direction of the
205 council, shall be comprised of the council’s chair and vice
206 chair, the appointee of the Speaker of the House of
207 Representatives, the appointee of the President of the Senate,
208 the appointee of the State Surgeon General, and four members
209 selected by the chair. The positions on the executive committee
210 shall be for terms of 2 years corresponding to the chair’s term
211 in office. Membership on the executive committee shall
212 constitute a subgroup of the council membership in that at least
213 one member shall represent each membership category identified
214 in paragraph (c). Additional members may serve at the discretion
215 of the chair.
216 (e) The council may invite additional state cancer
217 stakeholder organizations or groups or individuals with
218 expertise, experience, or resources to serve as consultants to
219 assist the council in accomplishing its mission. Such services
220 may include consultative participation in council activities,
221 associated task forces, or projects. Consultants have no voting
222 rights on the council.
223 (b) The terms of the members shall be 4 years from their
224 respective dates of appointment.
225 (c) A chairperson shall be appointed by the Governor for a
226 term of 2 years. The chairperson shall appoint an executive
227 committee of no fewer than three persons to serve at the
228 pleasure of the chairperson. This committee will prepare
229 material for the council but make no final decisions.
230 (f)(d) The council shall meet no less than semiannually at
231 the call of the chair chairperson or, in his or her absence or
232 incapacity, at the call of the State Surgeon General. Twenty
233 Sixteen members constitute a quorum for the purpose of
234 exercising all of the powers of the council. A vote of the
235 majority of the members present is sufficient for all actions of
236 the council.
237 (g)(e) The council members shall serve without pay.
238 Pursuant to the provisions of s. 112.061, the council members
239 may be entitled to be reimbursed for per diem and travel
240 expenses.
241 (h)(f) A No member of the council may not shall participate
242 in any discussion or decision to recommend grants or contracts
243 to any qualified nonprofit association or to any agency of this
244 state or its political subdivisions with which the member is
245 associated as a member of the governing body or as an employee
246 or with which the member has entered into a contractual
247 arrangement.
248 (i)(g) The council may prescribe, amend, and repeal bylaws
249 governing the manner in which the business of the council is
250 conducted.
251 (j)(h) The council shall advise the Board of Governors, the
252 State Surgeon General, the Governor, and the Legislature with
253 respect to cancer control and resources research in this state.
254 (k)(i) The council shall approve each year a program for
255 cancer control and research to be known as the “Florida Cancer
256 Plan” which shall be consistent with the State Health Plan and
257 integrated and coordinated with existing or emerging programs in
258 this state. The council shall review and approve the plan at
259 least every 4 years.
260 (l)(j) The council shall formulate and recommend to the
261 State Surgeon General, the Governor, the President of the
262 Senate, and the Speaker of the House of Representatives a plan
263 for the prevention and early detection of cancer which is
264 evidence-based and consistent with standards of practice and
265 supported by evidence-based medicine care and treatment of
266 persons suffering from cancer and recommend the establishment of
267 standard requirements for the organization, equipment, and
268 conduct of cancer units or departments in hospitals and clinics
269 in this state. The council may recommend to the State Surgeon
270 General the designation of cancer units following a survey of
271 the needs and facilities for treatment of cancer in the various
272 localities throughout the state. The State Surgeon General shall
273 consider the plan in developing departmental priorities and
274 funding priorities and standards under chapter 395.
275 (m)(k) The council shall provide expertise and input in the
276 content and development of is responsible for including in the
277 Florida Cancer Plan, which is otherwise generated through the
278 Department of Health. Recommendations shall include for the
279 coordination and integration of medical, nursing, paramedical,
280 lay, and other state efforts plans concerned with cancer control
281 and research. Committees may shall be formed to develop
282 strategies for taking action regarding by the council so that
283 the following areas will be established as entities for actions:
284 1. Cancer plan evaluation, including the creation of a:
285 tumor registry, data retrieval systems, and epidemiology of
286 cancer in the state and its relation to other areas.
287 2. Cancer prevention.
288 3. Cancer detection.
289 4. Cancer treatments patient management: treatment,
290 rehabilitation, terminal care, and other patient-oriented
291 activities.
292 5. Support services for cancer patients and caregivers
293 education: lay and professional.
294 6. Unproven methods of Cancer education for laypersons and
295 professionals therapy: quackery and unorthodox therapies.
296 7. Other cancer-control-related topics Investigator
297 initiated project research.
298 (n)(l) In order to implement in whole or in part the
299 Florida Cancer Plan, the council may shall recommend to the
300 Board of Governors or the State Surgeon General the awarding of
301 grants and contracts to qualified profit or nonprofit
302 associations or governmental agencies in order to plan,
303 establish, or conduct programs in cancer control or prevention
304 and, cancer education or and training, and cancer research.
305 (o) The council shall have input into the prioritization
306 and implementation of statewide programs and the allocation of
307 resources in the department’s comprehensive cancer control
308 program, consistent with the Florida Cancer Plan.
309 (p)(m) If funds are specifically appropriated by the
310 Legislature, the council shall develop or purchase standardized
311 written summaries, written in layperson’s terms and in language
312 easily understood by the average adult patient, informing
313 citizens and professionals on cancer prevention, detection,
314 treatment, and survivorship actual and high-risk breast cancer
315 patients, prostate cancer patients, and men who are considering
316 prostate cancer screening of the medically viable treatment
317 alternatives available to them in the effective management of
318 breast cancer and prostate cancer; describing such treatment
319 alternatives; and explaining the relative advantages,
320 disadvantages, and risks associated therewith. The breast cancer
321 summary, upon its completion, shall be printed in the form of a
322 pamphlet or booklet and made continuously available to
323 physicians and surgeons in this state for their use in
324 accordance with s. 458.324 and to osteopathic physicians in this
325 state for their use in accordance with s. 459.0125. The council
326 shall periodically update both summaries to reflect current
327 standards of medical practice in the treatment of breast cancer
328 and prostate cancer. The council shall develop and implement
329 educational programs and position statements, including
330 distribution of the summaries developed or purchased under this
331 paragraph, to inform citizen groups, associations, government
332 officials, and voluntary organizations about cancer-related
333 matters early detection and treatment of breast cancer and
334 prostate cancer.
335 (q)(n) The council may recommend to shall have the
336 responsibility to advise the Board of Governors and the State
337 Surgeon General, the Governor, the President of the Senate, and
338 the Speaker of the House of Representatives on methods of
339 enforcing and implementing laws already enacted and concerned
340 with cancer control, research, and education.
341 (r)(o) The council may recommend to the Board of Governors
342 or the State Surgeon General rules not inconsistent with law as
343 it may deem necessary for the performance of its duties and the
344 proper administration of this section.
345 (s)(p) The council shall formulate and put into effect a
346 continuing educational program for the prevention of cancer and
347 its early diagnosis and disseminate to hospitals, cancer
348 patients, and the public information concerning the proper
349 treatment of cancer.
350 (t)(q) The council shall be physically located at the H.
351 Lee Moffitt Cancer Center and Research Institute, Inc., at the
352 University of South Florida.
353 (u)(r) By December 1 On February 15 of each year, the
354 council shall report its findings and recommendations to the
355 State Surgeon General, the Governor, the President of the
356 Senate, and the Speaker of the House of Representatives and to
357 the Legislature.
358 (5) RESPONSIBILITIES OF THE BOARD OF GOVERNORS, THE H. LEE
359 MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC., AND THE
360 STATE SURGEON GENERAL, AND THE DEPARTMENT OF HEALTH.—
361 (a) The Board of Governors or The State Surgeon General,
362 after consultation with the council, may shall award grants and
363 contracts to qualified nonprofit associations and governmental
364 agencies in order to plan, establish, or conduct programs in
365 cancer control or and prevention and, cancer education or and
366 training, and cancer research.
367 (b) The H. Lee Moffitt Cancer Center and Research
368 Institute, Inc., shall provide a full-time executive director to
369 coordinate, facilitate, and communicate the mission and
370 responsibilities of the council. Additional administrative
371 support, information, and other assistance shall be provided
372 such staff, information, and other assistance as reasonably
373 necessary for the completion of the responsibilities of the
374 council.
375 (c) The Department of Health Board of Governors or the
376 State Surgeon General, after consultation with the council, may
377 adopt rules necessary for the implementation of this section.
378 (d) The Florida Cancer Plan is established within the
379 Department of Health. The department must utilize the council in
380 developing the plan, prioritizing goals, allocating resources,
381 and approving the plan in its final form. The State Surgeon
382 General, after consultation with the council, shall make rules
383 specifying to what extent and on what terms and conditions
384 cancer patients of the state may receive financial aid for the
385 diagnosis and treatment of cancer in any hospital or clinic
386 selected. The department may furnish to citizens of this state
387 who are afflicted with cancer financial aid to the extent of the
388 appropriation provided for that purpose in a manner which in its
389 opinion will afford the greatest benefit to those afflicted and
390 may make arrangements with hospitals, laboratories, or clinics
391 to afford proper care and treatment for cancer patients in this
392 state.
393 (6) FLORIDA CANCER CONTROL AND RESEARCH FUND.—
394 (a) There is created the Florida Cancer Control and
395 Research Fund consisting of funds appropriated therefor from the
396 General Revenue Fund and any gifts, grants, or funds received
397 from other sources.
398 (b) The fund shall be used exclusively for grants and
399 contracts to qualified nonprofit associations or governmental
400 agencies for the purpose of cancer control or and prevention,
401 cancer education or and training, cancer research, and all
402 expenses incurred in connection with the administration of this
403 section and the programs funded through the grants and contracts
404 authorized by the State Board of Education or the State Surgeon
405 General.
406 Section 2. Subsection (1) and paragraph (a) of subsection
407 (2) of section 458.324, Florida Statutes, are amended to read:
408 458.324 Breast cancer; information on treatment
409 alternatives.—
410 (1) DEFINITION.—As used in this section, the term
411 “medically viable,” as applied to treatment alternatives, means
412 modes of treatment generally considered by the medical
413 profession to be within the scope of current, acceptable
414 standards, including treatment alternatives described in the
415 written summary prepared by the Florida Cancer Control and
416 Resource Research Advisory Council in accordance with s.
417 1004.435(4)(p) 1004.435(4)(m).
418 (2) COMMUNICATION OF TREATMENT ALTERNATIVES.—Each physician
419 treating a patient who is, or in the judgment of the physician
420 is at high risk of being, diagnosed as having breast cancer
421 shall inform such patient of the medically viable treatment
422 alternatives available to such patient; shall describe such
423 treatment alternatives; and shall explain the relative
424 advantages, disadvantages, and risks associated with the
425 treatment alternatives to the extent deemed necessary to allow
426 the patient to make a prudent decision regarding such treatment
427 options. In compliance with this subsection:
428 (a) The physician may, in his or her discretion:
429 1. Orally communicate such information directly to the
430 patient or the patient’s legal representative;
431 2. Provide the patient or the patient’s legal
432 representative with a copy of the written summary prepared in
433 accordance with s. 1004.435(4)(p) 1004.435(4)(m) and express a
434 willingness to discuss the summary with the patient or the
435 patient’s legal representative; or
436 3. Both communicate such information directly and provide a
437 copy of the written summary to the patient or the patient’s
438 legal representative for further consideration and possible
439 later discussion.
440
441 Nothing in this subsection shall reduce other provisions of law
442 regarding informed consent.
443 Section 3. Subsection (1) and paragraph (a) of subsection
444 (2) of section 459.0125, Florida Statutes, are amended to read:
445 459.0125 Breast cancer; information on treatment
446 alternatives.—
447 (1) DEFINITION.—As used in this section, the term
448 “medically viable,” as applied to treatment alternatives, means
449 modes of treatment generally considered by the medical
450 profession to be within the scope of current, acceptable
451 standards, including treatment alternatives described in the
452 written summary prepared by the Florida Cancer Control and
453 Resource Research Advisory Council in accordance with s.
454 1004.435(4)(p) 1004.435(4)(m).
455 (2) COMMUNICATION OF TREATMENT ALTERNATIVES.—It is the
456 obligation of every physician treating a patient who is, or in
457 the judgment of the physician is at high risk of being,
458 diagnosed as having breast cancer to inform such patient of the
459 medically viable treatment alternatives available to such
460 patient; to describe such treatment alternatives; and to explain
461 the relative advantages, disadvantages, and risks associated
462 with the treatment alternatives to the extent deemed necessary
463 to allow the patient to make a prudent decision regarding such
464 treatment options. In compliance with this subsection:
465 (a) The physician may, in her or his discretion:
466 1. Orally communicate such information directly to the
467 patient or the patient’s legal representative;
468 2. Provide the patient or the patient’s legal
469 representative with a copy of the written summary prepared in
470 accordance with s. 1004.435(4)(p) 1004.435(4)(m) and express her
471 or his willingness to discuss the summary with the patient or
472 the patient’s legal representative; or
473 3. Both communicate such information directly and provide a
474 copy of the written summary to the patient or the patient’s
475 legal representative for further consideration and possible
476 later discussion.
477
478 Nothing in this subsection shall reduce other provisions of law
479 regarding informed consent.
480 Section 4. This act shall take effect July 1, 2012.