Florida Senate - 2012 COMMITTEE AMENDMENT
Bill No. SB 1646
Barcode 202368
LEGISLATIVE ACTION
Senate . House
Comm: RCS .
02/28/2012 .
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The Committee on Budget Subcommittee on Health and Human
Services Appropriations (Sobel) recommended the following:
1 Senate Amendment (with title amendment)
2
3 Between lines 55 and 56
4 insert:
5 Section 2. Section 1004.435, Florida Statutes, is amended
6 to read:
7 1004.435 Cancer control and resource advisory council
8 research.—
9 (1) SHORT TITLE.—This section shall be known and may be
10 cited as the “Florida Cancer Control and Research Act.”
11 (2) LEGISLATIVE INTENT.—It is The finding of the
12 Legislature finds that:
13 (a) Advances in scientific knowledge have led to the
14 development of preventive and therapeutic capabilities in the
15 control of cancer. Such knowledge and therapy must be made
16 available to all citizens of this state through educational and
17 therapeutic programs.
18 (b) The present state of our knowledge concerning the
19 prevalence, cause or associated factors, and treatment of cancer
20 have resulted primarily from a vast federal investment into
21 basic and clinical research, some of which is expended in this
22 state. These research activities must continue, but programs
23 must be established to extend this knowledge in preventive
24 measures and patient treatment throughout the state.
25 (c) Research in cancer has implicated the environment as a
26 causal factor for many types of cancer, i.e., sunshine, X rays,
27 diet, smoking, etc., and programs are needed to further document
28 such cause and effect relationships. Proven causes of cancer
29 should be publicized and be the subject of educational programs
30 for the prevention of cancer.
31 (b)(d) An effective cancer control program would mobilize
32 the scientific, educational, and medical resources that
33 presently exist into an intense attack against cancer this dread
34 disease.
35 (3) DEFINITIONS.—As The following words and phrases when
36 used in this section, the term have, unless the context clearly
37 indicates otherwise, the meanings given to them in this
38 subsection:
39 (a) “Cancer” means all malignant neoplasms, regardless of
40 the tissue of origin, including lymphoma and leukemia.
41 (b) “Council” means the Florida Cancer Control and Resource
42 Research Advisory Council, which is an advisory body appointed
43 to function on a continuing basis for the study of cancer and to
44 recommend which recommends solutions and policy alternatives to
45 the Board of Governors and the State Surgeon General and which
46 is established by this section.
47 (c) “Department” means the Department of Health.
48 (d) “Fund” means the Florida Cancer Control and Research
49 Fund established by this section.
50 (e) “Plan” means the Florida Cancer Plan.
51 (f)(e) “Qualified nonprofit association” means any
52 association, incorporated or unincorporated, which that has
53 received tax-exempt status from the Internal Revenue Service.
54 (4) FLORIDA CANCER CONTROL AND RESOURCE RESEARCH ADVISORY
55 COUNCIL; CREATION; COMPOSITION.—
56 (a) There is created within the H. Lee Moffitt Cancer
57 Center and Research Institute, Inc., the Florida Cancer Control
58 and Resource Research Advisory Council. The council shall serve
59 as a resource and clearinghouse for comprehensive cancer control
60 in the state and shall facilitate effective communication,
61 shared resources, and synergism between and among the cancer
62 stakeholder organizations and groups within the state.
63 1. The council shall consist of members representing the
64 various cancer constituencies in the state. The council shall
65 include three members representing the general public appointed
66 by the Governor, one member appointed by the President of the
67 Senate, one member appointed by the Speaker of the House of
68 Representatives, one member appointed by the State Surgeon
69 General, and 32 members representing cancer stakeholders in the
70 state who are appointed by the Governor. Of the 32 members, at
71 least 10 members must be individuals who are minority persons as
72 defined in s. 288.703. Each council member must be a resident of
73 the state, and all members are voting members of the council.
74 2. Of the three members representing the general public
75 appointed by the Governor, one shall serve an initial term of 2
76 years, one shall serve an initial term of 3 years, and one shall
77 serve an initial term of 4 years, beginning July 1, 2012;
78 thereafter, these gubernatorial appointments to the council
79 shall be for 4-year terms. The remaining members appointed by
80 the Governor and the members appointed by the President of the
81 Senate, the Speaker of the House of Representatives, and the
82 State Surgeon General shall serve 4-year terms. A chair and vice
83 chair shall each be elected by the council membership for 2-year
84 terms. The council shall consist of 35 members, which includes
85 the chairperson, all of whom must be residents of this state.
86 All members, except those appointed by the Speaker of the House
87 of Representatives and the President of the Senate, must be
88 appointed by the Governor. At least one of the members appointed
89 by the Governor must be 60 years of age or older. One member
90 must be a representative of the American Cancer Society; one
91 member must be a representative of the Florida Tumor Registrars
92 Association; one member must be a representative of the
93 Sylvester Comprehensive Cancer Center of the University of
94 Miami; one member must be a representative of the Department of
95 Health; one member must be a representative of the University of
96 Florida Shands Cancer Center; one member must be a
97 representative of the Agency for Health Care Administration; one
98 member must be a representative of the Florida Nurses
99 Association; one member must be a representative of the Florida
100 Osteopathic Medical Association; one member must be a
101 representative of the American College of Surgeons; one member
102 must be a representative of the School of Medicine of the
103 University of Miami; one member must be a representative of the
104 College of Medicine of the University of Florida; one member
105 must be a representative of NOVA Southeastern College of
106 Osteopathic Medicine; one member must be a representative of the
107 College of Medicine of the University of South Florida; one
108 member must be a representative of the College of Public Health
109 of the University of South Florida; one member must be a
110 representative of the Florida Society of Clinical Oncology; one
111 member must be a representative of the Florida Obstetric and
112 Gynecologic Society who has had training in the specialty of
113 gynecologic oncology; one member must be a representative of the
114 Florida Ovarian Cancer Alliance Speaks (FOCAS) organization; one
115 member must be a representative of the Florida Medical
116 Association; one member must be a member of the Florida
117 Pediatric Society; one member must be a representative of the
118 Florida Radiological Society; one member must be a
119 representative of the Florida Society of Pathologists; one
120 member must be a representative of the H. Lee Moffitt Cancer
121 Center and Research Institute, Inc.; three members must be
122 representatives of the general public acting as consumer
123 advocates; one member must be a member of the House of
124 Representatives appointed by the Speaker of the House of
125 Representatives; one member must be a member of the Senate
126 appointed by the President of the Senate; one member must be a
127 representative of the Florida Dental Association; one member
128 must be a representative of the Florida Hospital Association;
129 one member must be a representative of the Association of
130 Community Cancer Centers; one member shall be a representative
131 from a statutory teaching hospital affiliated with a community
132 based cancer center; one member must be a representative of the
133 Florida Association of Pediatric Tumor Programs, Inc.; one
134 member must be a representative of the Cancer Information
135 Service; one member must be a representative of the Florida
136 Agricultural and Mechanical University Institute of Public
137 Health; and one member must be a representative of the Florida
138 Society of Oncology Social Workers. Of the members of the
139 council appointed by the Governor, at least 10 must be
140 individuals who are minority persons as defined by s. 288.703.
141 (b) A nominating committee shall annually review applicants
142 for the council and make recommendations for gubernatorial
143 appointments to the council. The nominating committee shall be
144 comprised of a minimum of seven council members selected by, and
145 including, the vice chair. The nominating committee shall
146 constitute a subgroup of the council membership in that at least
147 one member shall represent each membership category identified
148 in paragraph (c). The individuals selected by the nominating
149 committee shall be forwarded for gubernatorial appointment and
150 are eligible for reappointment one time.
151 (c) The 32 members appointed by the Governor who represent
152 cancer stakeholders in the state shall be recommended by cancer
153 stakeholder organizations or groups, by council nomination, or
154 through self-referrals. The membership categories and the
155 maximum number of members in each category include:
156 1. Five members from university-based health care delivery
157 systems with major cancer programs, including the H. Lee Moffitt
158 Cancer Center and Research Institute, Inc., the University of
159 Florida Shands Cancer Center, and the University of Miami
160 Sylvester Comprehensive Cancer Center.
161 2. Five members from community-based health care delivery
162 systems or practices with American College of Surgeons
163 accredited cancer programs.
164 3. Four members from nonprofit or voluntary organizations,
165 including a representative from the American Cancer Society.
166 4. Three members from health and health care disparities
167 research and outreach cancer programs.
168 5. Five members from state governmental agencies, including
169 the Department of Health, the Department of Education, and the
170 Biomedical Research Advisory Council.
171 6. Five members from cancer-related professional
172 organizations, including the Florida Society of Clinical
173 Oncology, the Florida Society of Oncology Social Workers, the
174 Florida Society of Pathologists, the Florida Dental Association,
175 the Florida Medical Association, and the Florida Osteopathic
176 Medical Association.
177 7. Five members each representing one of the state regional
178 cancer collaboratives.
179 (d) An executive committee, which shall be responsible for
180 coordinating the activities and planning the direction of the
181 council, shall be comprised of the council’s chair and vice
182 chair, the appointee of the Speaker of the House of
183 Representatives, the appointee of the President of the Senate,
184 the appointee of the State Surgeon General, and four members
185 selected by the chair. The positions on the executive committee
186 shall be for terms of 2 years corresponding to the chair’s term
187 in office. Membership on the executive committee shall
188 constitute a subgroup of the council membership in that at least
189 one member shall represent each membership category identified
190 in paragraph (c). Additional members may serve at the discretion
191 of the chair.
192 (e) The council may invite additional state cancer
193 stakeholder organizations or groups or individuals with
194 expertise, experience, or resources to serve as consultants to
195 assist the council in accomplishing its mission. Such services
196 may include consultative participation in council activities,
197 associated task forces, or projects. Consultants do not have
198 voting rights on the council.
199 (b) The terms of the members shall be 4 years from their
200 respective dates of appointment.
201 (c) A chairperson shall be appointed by the Governor for a
202 term of 2 years. The chairperson shall appoint an executive
203 committee of no fewer than three persons to serve at the
204 pleasure of the chairperson. This committee will prepare
205 material for the council but make no final decisions.
206 (f)(d) The council shall meet at least no less than
207 semiannually at the call of the chair chairperson or, in his or
208 her absence or incapacity, at the call of the State Surgeon
209 General. Twenty Sixteen members constitute a quorum for the
210 purpose of exercising all of the powers of the council. A vote
211 of the majority of the members present is sufficient for all
212 actions of the council.
213 (g)(e) The council members shall serve without pay.
214 Pursuant to the provisions of s. 112.061, the council members
215 may be entitled to be reimbursed for per diem and travel
216 expenses.
217 (h)(f) A No member of the council may not shall participate
218 in any discussion or decision to recommend grants or contracts
219 to any qualified nonprofit association or to any agency of this
220 state or its political subdivisions with which the member is
221 associated as a member of the governing body or as an employee
222 or with which the member has entered into a contractual
223 arrangement.
224 (i)(g) The council may prescribe, amend, and repeal bylaws
225 governing the manner in which the business of the council is
226 conducted.
227 (j)(h) The council shall advise the Board of Governors, the
228 State Surgeon General, the Governor, and the Legislature with
229 respect to cancer control and resources research in this state.
230 (k)(i) The council shall approve each year a program for
231 cancer control and research to be known as the “Florida Cancer
232 Plan” which shall be consistent with the State Health Plan and
233 integrated and coordinated with existing or emerging programs in
234 this state. The council shall review and approve the plan at
235 least every 4 years.
236 (l)(j) The council shall formulate and recommend to the
237 State Surgeon General, the Governor, the President of the
238 Senate, and the Speaker of the House of Representatives a plan
239 for the prevention and early detection of cancer which is
240 evidence-based and consistent with standards of practice and
241 supported by evidence-based medicine care and treatment of
242 persons suffering from cancer and recommend the establishment of
243 standard requirements for the organization, equipment, and
244 conduct of cancer units or departments in hospitals and clinics
245 in this state. The council may recommend to the State Surgeon
246 General the designation of cancer units following a survey of
247 the needs and facilities for treatment of cancer in the various
248 localities throughout the state. The State Surgeon General shall
249 consider the plan in developing departmental priorities and
250 funding priorities and standards under chapter 395.
251 (m)(k) The council shall provide expertise and input in the
252 content and development of is responsible for including in the
253 Florida Cancer Plan, which is otherwise generated through the
254 Department of Health. Recommendations must include for the
255 coordination and integration of medical, nursing, paramedical,
256 lay, and other state efforts plans concerned with cancer control
257 and research. Committees may shall be formed to develop
258 strategies for taking action regarding by the council so that
259 the following areas will be established as entities for actions:
260 1. Cancer plan evaluation, including the creation of a:
261 tumor registry, data retrieval systems, and epidemiology of
262 cancer in the state and its relation to other areas.
263 2. Cancer prevention.
264 3. Cancer detection.
265 4. Cancer treatments patient management: treatment,
266 rehabilitation, terminal care, and other patient-oriented
267 activities.
268 5. Support services for cancer patients and caregivers
269 education: lay and professional.
270 6. Unproven methods of Cancer education for laypersons and
271 professionals therapy: quackery and unorthodox therapies.
272 7. Other cancer-control-related topics Investigator
273 initiated project research.
274 (n)(l) In order to implement in whole or in part the
275 Florida Cancer Plan, the council may shall recommend to the
276 Board of Governors or the State Surgeon General the awarding of
277 grants and contracts to qualified profit or nonprofit
278 associations or governmental agencies in order to plan,
279 establish, or conduct programs in cancer control or prevention
280 and, cancer education or and training, and cancer research.
281 (o) The council shall have input into the prioritization
282 and implementation of statewide programs and the allocation of
283 resources in the department’s comprehensive cancer control
284 program, consistent with the Florida Cancer Plan.
285 (p)(m) If funds are specifically appropriated by the
286 Legislature, the council shall develop or purchase standardized
287 written summaries, written in layperson’s terms and in language
288 easily understood by the average adult patient, informing
289 citizens and professionals on cancer prevention, detection,
290 treatment, and survivorship actual and high-risk breast cancer
291 patients, prostate cancer patients, and men who are considering
292 prostate cancer screening of the medically viable treatment
293 alternatives available to them in the effective management of
294 breast cancer and prostate cancer; describing such treatment
295 alternatives; and explaining the relative advantages,
296 disadvantages, and risks associated therewith. The breast cancer
297 summary, upon its completion, shall be printed in the form of a
298 pamphlet or booklet and made continuously available to
299 physicians and surgeons in this state for their use in
300 accordance with s. 458.324 and to osteopathic physicians in this
301 state for their use in accordance with s. 459.0125. The council
302 shall periodically update both summaries to reflect current
303 standards of medical practice in the treatment of breast cancer
304 and prostate cancer. The council shall develop and implement
305 educational programs and position statements, including
306 distribution of the summaries developed or purchased under this
307 paragraph, to inform citizen groups, associations, government
308 officials, and voluntary organizations about cancer-related
309 matters early detection and treatment of breast cancer and
310 prostate cancer.
311 (q)(n) The council may recommend to shall have the
312 responsibility to advise the Board of Governors and the State
313 Surgeon General, the Governor, the President of the Senate, and
314 the Speaker of the House of Representatives on methods of
315 enforcing and implementing laws already enacted and concerned
316 with cancer control, research, and education.
317 (r)(o) The council may recommend to the Board of Governors
318 or the State Surgeon General rules not inconsistent with law as
319 it may deem necessary for the performance of its duties and the
320 proper administration of this section.
321 (s)(p) The council shall formulate and put into effect a
322 continuing educational program for the prevention of cancer and
323 its early diagnosis and disseminate to hospitals, cancer
324 patients, and the public information concerning the proper
325 treatment of cancer.
326 (t)(q) The council shall be physically located at the H.
327 Lee Moffitt Cancer Center and Research Institute, Inc., at the
328 University of South Florida.
329 (u)(r) By December 1 On February 15 of each year, the
330 council shall report its findings and recommendations to the
331 State Surgeon General, the Governor, the President of the
332 Senate, and the Speaker of the House of Representatives and to
333 the Legislature.
334 (5) RESPONSIBILITIES OF THE BOARD OF GOVERNORS, THE H. LEE
335 MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC., AND THE
336 STATE SURGEON GENERAL, AND THE DEPARTMENT OF HEALTH.—
337 (a) The Board of Governors or The State Surgeon General,
338 after consultation with the council, may shall award grants and
339 contracts to qualified nonprofit associations and governmental
340 agencies in order to plan, establish, or conduct programs in
341 cancer control or and prevention and, cancer education or and
342 training, and cancer research.
343 (b) The H. Lee Moffitt Cancer Center and Research
344 Institute, Inc., shall provide a full-time executive director to
345 coordinate, facilitate, and communicate the mission and
346 responsibilities of the council. Additional administrative
347 support, information, and other assistance shall be provided
348 such staff, information, and other assistance as reasonably
349 necessary for the completion of the responsibilities of the
350 council.
351 (c) The Department of Health Board of Governors or the
352 State Surgeon General, after consultation with the council, may
353 adopt rules necessary for the implementation of this section.
354 (d) The Florida Cancer Plan is established within the
355 Department of Health. The department must utilize the council in
356 developing the plan, prioritizing goals, allocating resources,
357 and approving the plan in its final form. The State Surgeon
358 General, after consultation with the council, shall make rules
359 specifying to what extent and on what terms and conditions
360 cancer patients of the state may receive financial aid for the
361 diagnosis and treatment of cancer in any hospital or clinic
362 selected. The department may furnish to citizens of this state
363 who are afflicted with cancer financial aid to the extent of the
364 appropriation provided for that purpose in a manner which in its
365 opinion will afford the greatest benefit to those afflicted and
366 may make arrangements with hospitals, laboratories, or clinics
367 to afford proper care and treatment for cancer patients in this
368 state.
369 (6) FLORIDA CANCER CONTROL AND RESEARCH FUND.—
370 (a) There is created the Florida Cancer Control and
371 Research Fund consisting of funds appropriated therefor from the
372 General Revenue Fund and any gifts, grants, or funds received
373 from other sources.
374 (b) The fund shall be used exclusively for grants and
375 contracts to qualified nonprofit associations or governmental
376 agencies for the purpose of cancer control or and prevention,
377 cancer education or and training, cancer research, and all
378 expenses incurred in connection with the administration of this
379 section and the programs funded through the grants and contracts
380 authorized by the State Board of Education or the State Surgeon
381 General.
382 Section 3. Subsection (1) and paragraph (a) of subsection
383 (2) of section 458.324, Florida Statutes, are amended to read:
384 458.324 Breast cancer; information on treatment
385 alternatives.—
386 (1) DEFINITION.—As used in this section, the term
387 “medically viable,” as applied to treatment alternatives, means
388 modes of treatment generally considered by the medical
389 profession to be within the scope of current, acceptable
390 standards, including treatment alternatives described in the
391 written summary prepared by the Florida Cancer Control and
392 Resource Research Advisory Council in accordance with s.
393 1004.435(4)(p) 1004.435(4)(m).
394 (2) COMMUNICATION OF TREATMENT ALTERNATIVES.—Each physician
395 treating a patient who is, or in the judgment of the physician
396 is at high risk of being, diagnosed as having breast cancer
397 shall inform such patient of the medically viable treatment
398 alternatives available to such patient; shall describe such
399 treatment alternatives; and shall explain the relative
400 advantages, disadvantages, and risks associated with the
401 treatment alternatives to the extent deemed necessary to allow
402 the patient to make a prudent decision regarding such treatment
403 options. In compliance with this subsection:
404 (a) The physician may, in his or her discretion:
405 1. Orally communicate such information directly to the
406 patient or the patient’s legal representative;
407 2. Provide the patient or the patient’s legal
408 representative with a copy of the written summary prepared in
409 accordance with s. 1004.435(4)(p) 1004.435(4)(m) and express a
410 willingness to discuss the summary with the patient or the
411 patient’s legal representative; or
412 3. Both communicate such information directly and provide a
413 copy of the written summary to the patient or the patient’s
414 legal representative for further consideration and possible
415 later discussion.
416
417 Nothing in this subsection shall reduce other provisions of law
418 regarding informed consent.
419 Section 4. Subsection (1) and paragraph (a) of subsection
420 (2) of section 459.0125, Florida Statutes, are amended to read:
421 459.0125 Breast cancer; information on treatment
422 alternatives.—
423 (1) DEFINITION.—As used in this section, the term
424 “medically viable,” as applied to treatment alternatives, means
425 modes of treatment generally considered by the medical
426 profession to be within the scope of current, acceptable
427 standards, including treatment alternatives described in the
428 written summary prepared by the Florida Cancer Control and
429 Resource Research Advisory Council in accordance with s.
430 1004.435(4)(p) 1004.435(4)(m).
431 (2) COMMUNICATION OF TREATMENT ALTERNATIVES.—It is the
432 obligation of every physician treating a patient who is, or in
433 the judgment of the physician is at high risk of being,
434 diagnosed as having breast cancer to inform such patient of the
435 medically viable treatment alternatives available to such
436 patient; to describe such treatment alternatives; and to explain
437 the relative advantages, disadvantages, and risks associated
438 with the treatment alternatives to the extent deemed necessary
439 to allow the patient to make a prudent decision regarding such
440 treatment options. In compliance with this subsection:
441 (a) The physician may, in her or his discretion:
442 1. Orally communicate such information directly to the
443 patient or the patient’s legal representative;
444 2. Provide the patient or the patient’s legal
445 representative with a copy of the written summary prepared in
446 accordance with s. 1004.435(4)(p) 1004.435(4)(m) and express her
447 or his willingness to discuss the summary with the patient or
448 the patient’s legal representative; or
449 3. Both communicate such information directly and provide a
450 copy of the written summary to the patient or the patient’s
451 legal representative for further consideration and possible
452 later discussion.
453
454 Nothing in this subsection shall reduce other provisions of law
455 regarding informed consent.
456
457 ================= T I T L E A M E N D M E N T ================
458 And the title is amended as follows:
459 Delete line 5
460 and insert:
461 hospital inpatient rates; amending s. 1004.435, F.S.;
462 revising legislative intent to delete provisions
463 relating to research activities for cancer control;
464 changing the name of the cancer control and research
465 advisory council to the Florida Cancer Control and
466 Resource Advisory Council; providing for the
467 appointment and terms of council members and duties of
468 the council; providing for a nominating committee to
469 make recommendations for gubernatorial appointments to
470 the council; providing for council membership
471 categories; providing for an executive committee of
472 the council and duties of the committee; authorizing
473 consultants to the council; providing duties of the
474 council for the development, review, and approval of
475 the Florida Cancer Plan; deleting responsibilities of
476 the council and the Board of Governors of the State
477 University System relating to cancer research;
478 authorizing the Department of Health to adopt rules
479 for implementation of the section; providing
480 department duties relating to the development and
481 establishment of the Florida Cancer Plan; revising the
482 name of the cancer control fund and deleting the use
483 of funds for cancer research; amending ss. 458.324 and
484 459.0125, F.S.; conforming cross-references; providing
485 an effective date.