Florida Senate - 2012                                     SB 526
       By Senator Jones
       13-00415-12                                            2012526__
    1                        A bill to be entitled                      
    2         An act relating to health care; amending ss. 20.435,
    3         154.503, and 215.5602, F.S.; conforming cross
    4         references; transferring, renumbering, and amending s.
    5         381.91, F.S., relating to the Jessie Trice Cancer
    6         Prevention Program; transferring and renumbering s.
    7         381.911, F.S., relating to the Prostate Cancer
    8         Awareness Program; transferring and renumbering s.
    9         381.922, F.S., relating to the William G. “Bill”
   10         Bankhead, Jr., and David Coley Cancer Research
   11         Program; transferring and renumbering s. 381.93, F.S.,
   12         relating to a breast and cervical cancer early
   13         detection program; transferring, renumbering, and
   14         amending s. 381.931, F.S., relating to an annual
   15         report on Medicaid expenditures; removing a provision
   16         limiting the number of breast and cervical cancer
   17         screenings based on projected Medicaid expenditures;
   18         transferring, renumbering, and amending s. 381.932,
   19         F.S., relating to the breast cancer early detection
   20         and treatment referral program; renaming ch. 385,
   21         F.S., as the “Healthy and Fit Florida Act”; amending
   22         s. 385.101, F.S.; revising the short title; amending
   23         s. 385.102, F.S.; revising legislative intent with
   24         regard to chronic diseases and health promotion;
   25         creating s. 385.1021, F.S.; providing definitions;
   26         creating s. 385.1022, F.S.; requiring the Department
   27         of Health to support the creation of public health
   28         programs at the state and community levels to reduce
   29         the incidence of mortality and morbidity from chronic
   30         diseases; creating s. 385.1023, F.S.; requiring the
   31         department to create a state-level program to address
   32         the preventable risk factors associated with chronic
   33         diseases; requiring the program to perform certain
   34         activities; creating s. 385.1035, F.S.; requiring the
   35         department to develop and implement a community-level
   36         program for the prevention of chronic diseases and the
   37         promotion of health; providing the purpose of the
   38         program; providing requirements for the program;
   39         creating s. 385.104, F.S.; requiring the department to
   40         develop programs to promote physical fitness, healthy
   41         lifestyles, and weight control; requiring the
   42         department to promote programs to increase physical
   43         fitness and encourage healthy behavior changes;
   44         requiring the department to promote healthy lifestyles
   45         to reduce the rate of obesity and encourage weight
   46         control and weight reduction; requiring the department
   47         to promote personal responsibility and regular health
   48         visits; authorizing state agencies to conduct employee
   49         wellness programs; requiring the department to serve
   50         as a model for the development and implementation of
   51         wellness programs; requiring the department to assist
   52         state agencies in developing and implementing wellness
   53         programs; providing equal access to the programs by
   54         agency employees; requiring the department to
   55         coordinate efforts with the Department of Management
   56         Services and other state agencies; authorizing each
   57         state agency to establish an employee wellness
   58         workgroup to design the agency’s wellness program;
   59         requiring the department to adopt rules to provide
   60         requirements for participation fees, collaboration
   61         with businesses, and procurement of equipment and
   62         incentives; amending s. 385.202, F.S.; requiring
   63         licensed laboratories and practitioners to report
   64         certain information to the department; removing a
   65         provision that provides for registration or licensure
   66         suspension or revocation for failure to comply with
   67         such requirements; providing immunity from liability
   68         for facilities, laboratories, and practitioners
   69         reporting certain information; authorizing the
   70         department to adopt rules regarding the establishment
   71         and operation of a statewide cancer registry program;
   72         permitting the department or contractual designee
   73         operating the statewide cancer registry program to use
   74         or publish information contained in the registry for
   75         the purpose of public health surveillance under
   76         certain circumstances; authorizing the department to
   77         exchange personal data with an agency or contractual
   78         designee for the purpose of public health surveillance
   79         under certain circumstances; authorizing additional
   80         uses for funds appropriated for the program;
   81         clarifying that the department may adopt rules
   82         regarding the classifications of facilities,
   83         laboratories, and practitioners related to reports
   84         made to the statewide cancer registry; removing an
   85         exemption from reporting requirements for certain
   86         facilities; requiring each facility, laboratory, and
   87         practitioner that reports cancer cases to the
   88         department to make their records available for onsite
   89         review; amending s. 409.904, F.S.; conforming a cross
   90         reference; repealing s. 381.0054, F.S., relating to
   91         the promotion of healthy lifestyles; repealing ss.
   92         381.732 and 381.733, F.S., relating to the Healthy
   93         Communities, Healthy People Act; repealing s. 381.734,
   94         F.S., relating to the Healthy Communities, Healthy
   95         People Program; repealing s. 381.87, F.S., relating to
   96         the Osteoporosis Prevention and Education Program;
   97         repealing s. 385.103, F.S., relating to community
   98         intervention programs; providing an effective date.
  100         WHEREAS, chronic diseases, not infectious diseases, are the
  101  leading causes of death, accounting for 70 percent of all deaths
  102  in the United States, and
  103         WHEREAS, heart disease and stroke have remained the first
  104  and third leading causes of death in the United States for more
  105  than 7 decades and are responsible for approximately one-third
  106  of total deaths each year in this state, and
  107         WHEREAS, cancer is the second leading cause of death and is
  108  responsible for one in every four deaths in this state, and
  109         WHEREAS, lung disease is the fourth leading cause of death
  110  and is responsible for one in every six deaths in this state,
  111  and
  112         WHEREAS, diabetes is the sixth leading cause of death in
  113  this state, and
  114         WHEREAS, oral disease, specifically dental caries, commonly
  115  known as tooth decay, is the single most common chronic disease
  116  in children. Dental caries are the most prevalent chronic
  117  disease experienced by children which is not self-limiting or
  118  amenable to a short-term course of antibiotics, despite the fact
  119  that dental caries are usually preventable, and
  120         WHEREAS, arthritis is the leading cause of disability in
  121  the United States, limiting the daily activities of more than
  122  1.7 million people in this state alone, NOW, THEREFORE,
  124  Be It Enacted by the Legislature of the State of Florida:
  126         Section 1. Paragraph (a) of subsection (8) of section
  127  20.435, Florida Statutes, is amended to read:
  128         20.435 Department of Health; trust funds.—The following
  129  trust funds shall be administered by the Department of Health:
  130         (8) Biomedical Research Trust Fund.
  131         (a) Funds to be credited to the trust fund shall consist of
  132  funds deposited pursuant to s. 215.5601 and any other funds
  133  appropriated by the Legislature. Funds shall be used for the
  134  purposes of the James and Esther King Biomedical Research
  135  Program and the William G. “Bill” Bankhead, Jr., and David Coley
  136  Cancer Research Program as specified in ss. 215.5602, 288.955,
  137  and 385.20252 381.922. The trust fund is exempt from the service
  138  charges imposed by s. 215.20.
  139         Section 2. Paragraph (e) of subsection (2) of section
  140  154.503, Florida Statutes, is amended to read:
  141         154.503 Primary Care for Children and Families Challenge
  142  Grant Program; creation; administration.—
  143         (2) The department shall:
  144         (e) Coordinate with the primary care program developed
  145  pursuant to s. 154.011, the Florida Healthy Kids Corporation
  146  program created in s. 624.91, the school health services program
  147  created in ss. 381.0056 and 381.0057, the Healthy Communities,
  148  Healthy People Program created in s. 381.734, and the volunteer
  149  health care provider program developed pursuant to s. 766.1115.
  150         Section 3. Subsections (11) and (12) of section 215.5602,
  151  Florida Statutes, are amended to read:
  152         215.5602 James and Esther King Biomedical Research
  153  Program.—
  154         (11) The council shall award grants for cancer research
  155  through the William G. “Bill” Bankhead, Jr., and David Coley
  156  Cancer Research Program created in s. 385.20252 381.922.
  157         (12) From funds appropriated to accomplish the goals of
  158  this section, up to $250,000 shall be available for the
  159  operating costs of the Florida Center for Universal Research to
  160  Eradicate Disease. Beginning in the 2011-2012 fiscal year and
  161  thereafter, $25 million from the revenue deposited into the
  162  Health Care Trust Fund pursuant to ss. 210.011(9) and 210.276(7)
  163  shall be reserved for research of tobacco-related or cancer
  164  related illnesses. Of the revenue deposited in the Health Care
  165  Trust Fund pursuant to this section, $25 million shall be
  166  transferred to the Biomedical Research Trust Fund within the
  167  Department of Health. Subject to annual appropriations in the
  168  General Appropriations Act, $5 million shall be appropriated to
  169  the James and Esther King Biomedical Research Program, $5
  170  million shall be appropriated to the William G. “Bill” Bankhead,
  171  Jr., and David Coley Cancer Research Program created under s.
  172  385.20252 381.922, $5 million shall be appropriated to the H.
  173  Lee Moffitt Cancer Center and Research Institute established
  174  under s. 1004.43, $5 million shall be appropriated to the
  175  Sylvester Comprehensive Cancer Center of the University of
  176  Miami, and $5 million shall be appropriated to the University of
  177  Florida Shands Cancer Center.
  178         Section 4. Section 381.91, Florida Statutes, is
  179  transferred, renumbered as section 385.2023, Florida Statutes,
  180  and amended to read:
  181         385.2023 381.91 Jessie Trice Cancer Prevention Program.—
  182         (1) It is the intent of the Legislature to:
  183         (a) Reduce the rates of illness and death from lung cancer
  184  and other cancers and improve the quality of life among low
  185  income African-American and Hispanic populations through
  186  increased access to early, effective screening and diagnosis,
  187  education, and treatment programs.
  188         (b) Create a community faith-based disease-prevention
  189  program in conjunction with the Health Choice Network and other
  190  community health centers to build upon the natural referral and
  191  education networks in place within minority communities and to
  192  increase access to health service delivery in this state
  193  Florida.
  194         (c) Establish a funding source to build upon local private
  195  participation to sustain the operation of the program.
  196         (2)(a) There is created the Jessie Trice Cancer Prevention
  197  Program, to be located, for administrative purposes, within the
  198  Department of Health, and operated from the community health
  199  centers within the Health Choice Network in this state Florida.
  200         (b) Funding may be provided to develop contracts with
  201  community health centers and local community faith-based
  202  education programs to provide cancer screening, diagnosis,
  203  education, and treatment services to low-income populations
  204  throughout the state.
  205         Section 5. Section 381.911, Florida Statutes, is
  206  transferred and renumbered as section 385.2024, Florida
  207  Statutes, to read:
  208         385.2024 381.911 Prostate Cancer Awareness Program.—
  209         (1) The purpose of this program is to provide statewide
  210  outreach, promote prostate cancer awareness, communicate the
  211  advantages of early detection, report recent progress in
  212  prostate cancer research and the availability of clinical
  213  trials, minimize health disparities through outreach and
  214  education, communicate best practices principles to physicians
  215  involved in the care of prostate cancer patients, and establish
  216  a communication platform for patients and their advocates.
  217         (2) For purposes of implementing the program, the
  218  University of Florida Prostate Disease Center may work with
  219  other agencies, organizations, and institutions to create a
  220  systematic approach to community education and increase public
  221  awareness regarding prostate cancer by:
  222         (a) Conducting activities directly or entering into a
  223  contract with qualified nonprofit community education entities.
  224         (b) Seeking any available gifts, private grants, or funds
  225  from the Federal Government, philanthropic foundations, and
  226  industry or business groups.
  227         (3) The University of Florida Prostate Disease Center
  228  (UFPDC) shall establish the UFPDC Prostate Cancer Advisory
  229  Council and lead the advisory council in developing and
  230  implementing strategies to improve outreach and education and
  231  thereby reduce the number of patients who develop prostate
  232  cancer.
  233         (a) The executive director of the University of Florida
  234  Prostate Disease Center shall appoint, in consultation with the
  235  Department of Health’s Comprehensive Cancer Control Program and
  236  the State Surgeon General, a geographically and institutionally
  237  diverse advisory council, which shall consist of:
  238         1. Two persons from prostate cancer survivor groups or
  239  cancer-related advocacy groups.
  240         2. Four persons, one of whom is a physician licensed under
  241  chapter 458, one of whom is a physician licensed under chapter
  242  459, one of whom is a scientist, and one of whom is the
  243  executive director of the University of Florida Prostate Disease
  244  Center or a designee.
  245         3. Three persons who are engaged in the practice of a
  246  cancer-related medical specialty from health organizations
  247  committed to cancer research and control.
  248         (b) Members shall serve as volunteers without compensation.
  249         (c) Each member of the advisory council shall be appointed
  250  to a 4-year term; however, for the purpose of providing
  251  staggered terms, of the initial appointments, four members shall
  252  be appointed to 2-year terms and four members shall be appointed
  253  to 4-year terms. The remaining seat shall be filled by the
  254  executive director of the University of Florida Prostate Disease
  255  Center or a designee.
  256         (d) The advisory council shall meet annually and at other
  257  times at the call of the executive director of the University of
  258  Florida Prostate Disease Center or by a majority vote of the
  259  members of the advisory council.
  260         (e) Five of the members of the advisory council constitute
  261  a quorum, and an affirmative vote of a majority of the members
  262  present is required for final action.
  263         (f) The advisory council shall:
  264         1. Present prostate-cancer-related policy recommendations
  265  to the Department of Health and other appropriate governmental
  266  entities.
  267         2. Assess the accuracy of prostate cancer information
  268  disseminated to the public.
  269         3. Develop effective communication channels among all
  270  private and public entities in the state involved in prostate
  271  cancer education, research, treatment, and patient advocacy.
  272         4. Plan, develop, and implement activities designed to
  273  heighten awareness and educate residents of the state,
  274  especially those in underserved areas, regarding the importance
  275  of prostate cancer awareness.
  276         5. Disseminate information about recent progress in
  277  prostate cancer research and the availability of clinical
  278  trials.
  279         6. Minimize health disparities through outreach and
  280  education.
  281         7. Communicate best practices principles to physicians
  282  involved in the care of patients with prostate cancer.
  283         8. Establish a communication platform for patients and
  284  their advocates.
  285         9. Solicit private grants or philanthropic funding to
  286  conduct an annual prostate cancer symposium that brings
  287  physicians, researchers, community leaders, prostate cancer
  288  survivors, and prostate cancer advocates together to highlight
  289  recent advances in prostate cancer research, clinical trials,
  290  and best practices used for the prevention of prostate cancer
  291  and to promote strategies for successful rural and urban
  292  outreach, community education, and increased awareness.
  293         10. Submit and present an annual report to the Governor,
  294  the President of the Senate, the Speaker of the House of
  295  Representatives, and the State Surgeon General by January 15,
  296  2012, and by January 15 of each following year, which contains
  297  recommendations for legislative changes necessary to decrease
  298  the incidence of prostate cancer, decrease racial and ethnic
  299  disparities among persons diagnosed with prostate cancer, and
  300  promote increased community education and awareness regarding
  301  this disease.
  302         (4) The University of Florida Prostate Disease Center
  303  (UFPDC) and the UFPDC Prostate Cancer Advisory Council shall be
  304  funded within existing resources of the university.
  305         Section 6. Section 381.922, Florida Statutes, is
  306  transferred and renumbered as section 385.20252, Florida
  307  Statutes, to read:
  308         385.20252 381.922 William G. “Bill” Bankhead, Jr., and
  309  David Coley Cancer Research Program.—
  310         (1) The William G. “Bill” Bankhead, Jr., and David Coley
  311  Cancer Research Program, which may be otherwise cited as the
  312  “Bankhead-Coley Program,” is created within the Department of
  313  Health. The purpose of the program shall be to advance progress
  314  towards cures for cancer through grants awarded through a peer
  315  reviewed, competitive process.
  316         (2) The program shall provide grants for cancer research to
  317  further the search for cures for cancer.
  318         (a) Emphasis shall be given to the following goals, as
  319  those goals support the advancement of such cures:
  320         1. Efforts to significantly expand cancer research capacity
  321  in the state by:
  322         a. Identifying ways to attract new research talent and
  323  attendant national grant-producing researchers to cancer
  324  research facilities in this state;
  325         b. Implementing a peer-reviewed, competitive process to
  326  identify and fund the best proposals to expand cancer research
  327  institutes in this state;
  328         c. Funding through available resources for those proposals
  329  that demonstrate the greatest opportunity to attract federal
  330  research grants and private financial support;
  331         d. Encouraging the employment of bioinformatics in order to
  332  create a cancer informatics infrastructure that enhances
  333  information and resource exchange and integration through
  334  researchers working in diverse disciplines, to facilitate the
  335  full spectrum of cancer investigations;
  336         e. Facilitating the technical coordination, business
  337  development, and support of intellectual property as it relates
  338  to the advancement of cancer research; and
  339         f. Aiding in other multidisciplinary research-support
  340  activities as they inure to the advancement of cancer research.
  341         2. Efforts to improve both research and treatment through
  342  greater participation in clinical trials networks by:
  343         a. Identifying ways to increase adult enrollment in cancer
  344  clinical trials;
  345         b. Supporting public and private professional education
  346  programs designed to increase the awareness and knowledge about
  347  cancer clinical trials;
  348         c. Providing tools to cancer patients and community-based
  349  oncologists to aid in the identification of cancer clinical
  350  trials available in the state; and
  351         d. Creating opportunities for the state’s academic cancer
  352  centers to collaborate with community-based oncologists in
  353  cancer clinical trials networks.
  354         3. Efforts to reduce the impact of cancer on disparate
  355  groups by:
  356         a. Identifying those cancers that disproportionately impact
  357  certain demographic groups; and
  358         b. Building collaborations designed to reduce health
  359  disparities as they relate to cancer.
  360         (b) Preference may be given to grant proposals that foster
  361  collaborations among institutions, researchers, and community
  362  practitioners, as such proposals support the advancement of
  363  cures through basic or applied research, including clinical
  364  trials involving cancer patients and related networks.
  365         (3)(a) Applications for funding for cancer research may be
  366  submitted by any university or established research institute in
  367  the state. All qualified investigators in the state, regardless
  368  of institutional affiliation, shall have equal access and
  369  opportunity to compete for the research funding. Collaborative
  370  proposals, including those that advance the program’s goals
  371  enumerated in subsection (2), may be given preference. Grants
  372  shall be awarded by the State Surgeon General, after
  373  consultation with the Biomedical Research Advisory Council, on
  374  the basis of scientific merit, as determined by an open,
  375  competitive peer review process that ensures objectivity,
  376  consistency, and high quality. The following types of
  377  applications shall be considered for funding:
  378         1. Investigator-initiated research grants.
  379         2. Institutional research grants.
  380         3. Collaborative research grants, including those that
  381  advance the finding of cures through basic or applied research.
  382         (b) In order to ensure that all proposals for research
  383  funding are appropriate and are evaluated fairly on the basis of
  384  scientific merit, the State Surgeon General, in consultation
  385  with the council, shall appoint a peer review panel of
  386  independent, scientifically qualified individuals to review the
  387  scientific content of each proposal and establish its priority
  388  score. The priority scores shall be forwarded to the council and
  389  must be considered in determining which proposals shall be
  390  recommended for funding.
  391         (c) The council and the peer review panel shall establish
  392  and follow rigorous guidelines for ethical conduct and adhere to
  393  a strict policy with regard to conflicts of interest. A member
  394  of the council or panel may not participate in any discussion or
  395  decision with respect to a research proposal by any firm,
  396  entity, or agency with which the member is associated as a
  397  member of the governing body or as an employee or with which the
  398  member has entered into a contractual arrangement. Meetings of
  399  the council and the peer review panels are subject to chapter
  400  119, s. 286.011, and s. 24, Art. I of the State Constitution.
  401         (4) By December 15 of each year, the Department of Health
  402  shall submit to the Governor, the President of the Senate, and
  403  the Speaker of the House of Representatives a report indicating
  404  progress towards the program’s mission and making
  405  recommendations that further its purpose.
  406         (5) The William G. “Bill” Bankhead, Jr., and David Coley
  407  Cancer Research Program is funded pursuant to s. 215.5602(12).
  408  Funds appropriated for the William G. “Bill” Bankhead, Jr., and
  409  David Coley Cancer Research Program shall be distributed
  410  pursuant to this section to provide grants to researchers
  411  seeking cures for cancer and cancer-related illnesses, with
  412  emphasis given to the goals enumerated in this section. From the
  413  total funds appropriated, an amount of up to 10 percent may be
  414  used for administrative expenses. From funds appropriated to
  415  accomplish the goals of this section, up to $250,000 shall be
  416  available for the operating costs of the Florida Center for
  417  Universal Research to Eradicate Disease.
  418         Section 7. Section 381.93, Florida Statutes, is transferred
  419  and renumbered as section 385.20253, Florida Statutes, to read:
  420         385.20253 381.93 Breast and cervical cancer early detection
  421  program.—This section may be cited as the “Mary Brogan Breast
  422  and Cervical Cancer Early Detection Program Act.”
  423         (1) It is the intent of the Legislature to reduce the rates
  424  of death due to breast and cervical cancer through early
  425  diagnosis and increased access to early screening, diagnosis,
  426  and treatment programs.
  427         (2) The Department of Health, using available federal funds
  428  and state funds appropriated for that purpose, is authorized to
  429  establish the Mary Brogan Breast and Cervical Cancer Screening
  430  and Early Detection Program to provide screening, diagnosis,
  431  evaluation, treatment, case management, and followup and
  432  referral to the Agency for Health Care Administration for
  433  coverage of treatment services.
  434         (3) The Mary Brogan Breast and Cervical Cancer Early
  435  Detection Program shall be funded through grants for such
  436  screening and early detection purposes from the federal Centers
  437  for Disease Control and Prevention under Title XV of the Public
  438  Health Service Act, 42 U.S.C. ss. 300k et seq.
  439         (4) The department shall limit enrollment in the program to
  440  persons with incomes up to and including 200 percent of the
  441  federal poverty level. The department shall establish an
  442  eligibility process that includes an income-verification process
  443  to ensure that persons served under the program meet income
  444  guidelines.
  445         (5) The department may provide other breast and cervical
  446  cancer screening and diagnostic services; however, such services
  447  shall be funded separately through other sources than this act.
  448         Section 8. Section 381.931, Florida Statutes, is
  449  transferred, renumbered as section 385.20254, Florida Statutes,
  450  and amended to read:
  451         385.20254 381.931 Annual report on Medicaid expenditures.
  452  The Department of Health and the Agency for Health Care
  453  Administration shall monitor the total Medicaid expenditures for
  454  services made under this act. If Medicaid expenditures are
  455  projected to exceed the amount appropriated by the Legislature,
  456  the Department of Health shall limit the number of screenings to
  457  ensure Medicaid expenditures do not exceed the amount
  458  appropriated.
  459         Section 9. Section 381.932, Florida Statutes, is
  460  transferred, renumbered as section 385.20255, Florida Statutes,
  461  and amended to read:
  462         385.20255 381.932 Breast cancer early detection and
  463  treatment referral program.—
  464         (1) For purposes of this section, the term:
  465         (a) “Breast cancer screening and referral services” means
  466  necessary breast cancer screening and referral services for a
  467  procedure intended to treat cancer of the human breast,
  468  including, but not limited to, surgery, radiation therapy,
  469  chemotherapy, hormonal therapy, and related medical followup
  470  services.
  471         (b) “Unserved or underserved populations” means women who
  472  are:
  473         1. At or below 200 percent of the federal poverty level for
  474  individuals;
  475         2. Without health insurance that covers breast cancer
  476  screenings; and
  477         3. Nineteen to 64 years of age, inclusive.
  478         (2) There is established, within existing or specific
  479  appropriations, a breast cancer early detection and treatment
  480  referral program within the Department of Health. The purposes
  481  of the program are to:
  482         (a) Promote referrals for the screening, detection, and
  483  treatment of breast cancer among unserved or underserved
  484  populations.
  485         (b) Educate the public regarding breast cancer and the
  486  benefits of early detection.
  487         (c) Provide referral services for persons seeking
  488  treatment.
  489         (3) The program shall include, but is not be limited to,
  490  the:
  491         (a) Establishment of a public education and outreach
  492  initiative to publicize breast cancer early detection services,
  493  the benefits of early detection of breast cancer, and the
  494  recommended frequency for receiving screening services,
  495  including clinical breast examinations and mammography
  496  guidelines established by the United States Preventive Services
  497  Task Force.
  498         (b) Development of professional education programs that
  499  include information regarding the benefits of the early
  500  detection of breast cancer and the recommended frequency for
  501  receiving a mammogram, as recommended in the most current breast
  502  cancer screening guidelines established by the United States
  503  Preventive Services Task Force.
  504         (c) Establishment of a system to track and monitor all
  505  women screened for breast cancer in the program. The system
  506  shall include, but is not be limited to, monitoring abnormal
  507  screening tests, referring women for treatment when needed, and
  508  tracking women to be screened at recommended screening
  509  intervals.
  510         (4) The State Surgeon General shall submit an annual report
  511  to the appropriate substantive committees of the Legislature.
  512  The report shall include, but is not be limited to, a
  513  description of the rate of breast cancer morbidity and mortality
  514  in the state and the extent to which women are participating in
  515  breast cancer screening as reported by the Behavioral Risk
  516  Factor Surveillance System.
  517         Section 10. Chapter 385, Florida Statutes, entitled
  518  “Chronic Diseases,” is renamed the “Healthy and Fit Florida
  519  Act.”
  520         Section 11. Section 385.101, Florida Statutes, is amended
  521  to read:
  522         385.101 Short title.—This chapter Sections 385.101-385.103
  523  may be cited as the “Healthy and Fit Florida Chronic Diseases
  524  Act.”
  525         Section 12. Section 385.102, Florida Statutes, is amended
  526  to read:
  527         385.102 Legislative intent.—It is the finding of the
  528  Legislature that:
  529         (1) Chronic diseases continue to be the leading causes of
  530  death and disability in the state and the nation exist in high
  531  proportions among the people of this state. These Chronic
  532  diseases include, but are not limited to, arthritis,
  533  cardiovascular disease heart disease, hypertension, diabetes,
  534  renal disease, oral diseases, cancer, and chronic obstructive
  535  lung disease, including chronic obstructive pulmonary disease
  536  and asthma. These diseases are often have the same preventable
  537  risk factors and interrelated, and they directly and indirectly
  538  account for a high rate of death and disability, which results
  539  in higher costs to the state’s health care system illness.
  540         (2) Chronic diseases have a significant impact on quality
  541  of life, not only for the individuals who experience the painful
  542  symptoms and resulting disabilities, but also for family members
  543  and caregivers.
  544         (3) Racial and ethnic minorities and other underserved
  545  populations are disproportionately affected by chronic diseases.
  546         (4) Chronic diseases and the complications associated with
  547  these diseases result in increased medical costs and lost wages.
  548         (5)(2) Advances in medical knowledge and technology assist
  549  have assisted in the prevention, detection, and management of
  550  chronic diseases. Comprehensive approaches that stress the
  551  stressing application of current medical treatment, continuing
  552  research, professional training, and patient education, and
  553  state and local policy and environmental changes should be
  554  implemented encouraged.
  555         (6)(3)A comprehensive program dealing with the early
  556  detection and prevention of chronic diseases is required to make
  557  knowledge and therapy available to all people of this state. The
  558  mobilization of scientific, medical, and educational resources
  559  and the implementation of state and local policies relating to
  560  chronic diseases under one comprehensive law chronic disease act
  561  will facilitate the prevention, early intervention, and
  562  management of chronic and treatment of these diseases and their
  563  symptoms. This integration of resources and policy will and
  564  result in a decline in death and disability illness among the
  565  people of this state.
  566         (7) The department shall establish, promote, and maintain
  567  programs at the state and community levels for chronic disease
  568  prevention and health promotion as described in this chapter to
  569  the extent that funds are specifically made available for this
  570  purpose.
  571         Section 13. Section 385.1021, Florida Statutes, is created
  572  to read:
  573         385.1021 Definitions.—As used in this chapter, the term:
  574         (1) “Best and promising practices” means specific
  575  activities used to effect change, which may include guidelines
  576  developed by organizations, volunteer scientists, and health
  577  care professionals who have published medical or scientific
  578  articles on topics relating to chronic diseases in a generally
  579  available scientific journal that has a rigorous review and
  580  approval process.
  581         (2) “Chronic disease” means an illness that is prolonged,
  582  does not resolve spontaneously, and is rarely cured completely.
  583         (3) “Department” means the Department of Health.
  584         (4) “Environmental changes” means alterations to the
  585  economic, social, or physical natural or built environment that
  586  encourage or enable healthy behavior.
  587         (5) “Evidence-based” means the preferential use of
  588  physical, mental, and behavioral health interventions for which
  589  systematic empirical research has provided evidence of
  590  statistically significant effectiveness as treatments for
  591  specific problems.
  592         (7) “Policy change” means altering an informal or formal
  593  agreement between the public or private sector to identify
  594  values, behaviors, or resource allocation in order to improve
  595  health.
  596         (8) “Risk factor” means a characteristic or condition
  597  identified during the course of an epidemiological study of a
  598  disease which appears to be statistically associated with a high
  599  incidence of that disease.
  600         (9) “System change” means altering standard activities,
  601  protocols, policies, processes, and structures carried out in
  602  population-based settings, such as schools, worksites, health
  603  care facilities, faith-based organizations, and the overall
  604  community, which promote and support new behaviors.
  605         (10) “Wellness program” means a structured program that is
  606  designed or approved by the department to offer intervention
  607  activities on or off the worksite which help state and local
  608  government employees change certain behaviors or adopt healthy
  609  lifestyles.
  610         Section 14. Section 385.1022, Florida Statutes, is created
  611  to read:
  612         385.1022 Chronic disease prevention and health promotion
  613  program.—The department shall support the creation of public
  614  health programs at the state and community levels in order to
  615  reduce the incidence of mortality and morbidity from chronic
  616  diseases for which risk factors can be identified. Such risk
  617  factors include, but are not limited to, being overweight or
  618  obese, physical inactivity, poor diet and nutrition habits, sun
  619  exposure, poor oral hygiene, and other practices that are
  620  detrimental to health.
  621         Section 15. Section 385.1023, Florida Statutes, is created
  622  to read:
  623         385.1023 State-level program for chronic disease
  624  prevention.—The department shall create a state-level program
  625  that promotes healthy lifestyles and prevents chronic diseases
  626  and disabilities caused by chronic diseases. The program must
  627  address preventable chronic disease risk factors, such as being
  628  overweight or obese, physical inactivity, poor diet and
  629  nutrition habits, sun exposure, poor oral hygiene, and other
  630  practices that are detrimental to health, in order to decrease
  631  the incidence of arthritis, cancer, diabetes, heart disease,
  632  lung disease, including chronic obstructive pulmonary disease
  633  and asthma, stroke, and other chronic diseases. The state-level
  634  program must include, but is not limited to:
  635         (1) Monitoring specific causal and behavioral risk factors
  636  that affect the health of residents of this state.
  637         (2) Analyzing data regarding chronic disease mortality and
  638  morbidity to track changes.
  639         (3) Disseminating educational materials and information
  640  concerning evidence-based results, available services, and
  641  pertinent new research findings and prevention strategies to
  642  patients, health insurers, health professionals, and the public.
  643         (4) Increasing awareness among state and local officials
  644  involved in health and human services, health professionals and
  645  providers, and policymakers regarding evidence-based chronic
  646  disease prevention, treatment strategies, and benefits for
  647  persons who have chronic diseases.
  648         (5) Developing a partnership with state and local
  649  governments, voluntary health organizations, hospitals, health
  650  insurers, universities, medical centers, faith-based
  651  organizations, employer groups, private companies, and health
  652  care providers to address the issue of chronic diseases in this
  653  state.
  654         (6) Evaluating the quality and accessibility of existing
  655  community-based services for persons who have chronic diseases.
  656         (7) Implementing and coordinating state-level policies in
  657  order to reduce the impact of chronic diseases.
  658         (8) Maximizing all local, state, and federal funding
  659  sources, including seeking grants, public-private partnerships,
  660  and other mechanisms, to strengthen the department’s programs
  661  that promote physical activity and nutrition.
  662         (9) Providing lasting improvements in the delivery of
  663  health care for individuals who have chronic diseases and their
  664  families, thus improving their quality of life while also
  665  containing health care costs.
  666         Section 16. Section 385.1035, Florida Statutes, is created
  667  to read:
  668         385.1035 Community-level program for chronic disease
  669  prevention and health promotion.—The department shall develop
  670  and implement a comprehensive, community-level program for
  671  chronic disease prevention and health promotion. The program
  672  shall be designed to reduce major behavioral risk factors
  673  associated with chronic diseases by enhancing knowledge, skills,
  674  motivation, and opportunities to enable individuals,
  675  organizations, health care providers, small businesses, health
  676  insurers, and communities to develop and maintain healthy
  677  lifestyles. A community-level program for chronic disease
  678  prevention and health promotion must include, but is not limited
  679  to:
  680         (1) The employment of skilled staff who are trained in
  681  public health, community health, or school health education to
  682  facilitate the operation of the program.
  683         (2) A method of soliciting community input into the
  684  planning, implementation, and evaluation processes.
  685         (3) The use of local and statewide data as a basis for
  686  decisionmaking and the development and prioritization of
  687  community-based interventions focused on the risk factors
  688  associated with chronic diseases.
  689         (4) The development and implementation of interventions and
  690  activities through community organizations, schools, worksites,
  691  faith-based organizations, and health care settings.
  692         (5) The use of evidence-based interventions as well as best
  693  and promising practices.
  694         (6) The use of policy changes, system changes, and
  695  environmental changes that support healthy behaviors in order to
  696  affect large segments of the population and encourage healthy
  697  choices.
  698         Section 17. Section 385.104, Florida Statutes, is created
  699  to read:
  700         385.104 Physical activity, obesity prevention, nutrition,
  701  and other health-promotion services and wellness programs.—
  702         (1) PHYSICAL ACTIVITY.—The department shall promote
  703  programs for people at every stage of their lives to increase
  704  physical fitness and encourage healthy behavior changes by:
  705         (a) Working with school health advisory committees in each
  706  school district as established in s. 381.0056 to encourage the
  707  physical activity of students, staff, and teachers.
  708         (b) Developing public and private partnerships that allow
  709  the public to easily access recreational facilities and public
  710  land areas that are suitable for physical activity.
  711         (c) Collaborating with the Department of Education in
  712  recognizing nationally accepted best practices for improving
  713  physical education in schools.
  714         (2) OBESITY PREVENTION.—The department shall promote
  715  healthy lifestyles to reduce the rate of obesity and encourage
  716  weight control and weight reduction through programs that are
  717  directed towards all residents of this state by:
  718         (a) Using all appropriate media to promote maximum public
  719  awareness of the latest research on healthy lifestyles and
  720  chronic diseases and disseminating relevant information relating
  721  to wellness, physical activity, and nutrition and the effect of
  722  these factors on chronic diseases and disabling conditions
  723  through a statewide clearinghouse.
  724         (b) Providing technical assistance, training, and resources
  725  on healthy lifestyles and chronic diseases to the public, health
  726  care providers, school districts, and other persons or entities,
  727  including faith-based organizations, that request such
  728  assistance to promote physical activity, nutrition, and healthy
  729  lifestyle programs.
  730         (c) Developing, implementing, and using all available
  731  research methods to collect data, including, but not limited to,
  732  population-specific data, and tracking the incidence and effects
  733  of weight gain, obesity, and related chronic diseases. All
  734  research conducted under this paragraph is subject to review and
  735  approval as required by the department’s Institutional Review
  736  Board under s. 381.86.
  737         (d) Entering into partnerships with the Department of
  738  Education, local communities, school districts, and other
  739  entities to encourage schools in the state to promote activities
  740  during and after school to help students meet a minimum goal of
  741  30 minutes of physical fitness activities per day.
  742         (e) Collaborating with other state agencies to develop
  743  policies and strategies for preventing and treating obesity,
  744  which shall be incorporated into programs administered by each
  745  agency and shall include promoting healthy lifestyles among the
  746  employees of each agency.
  747         (f) Advising, in accordance with s. 456.081, health care
  748  practitioners about the morbidity, mortality, and costs
  749  associated with being overweight or obese; informing
  750  practitioners of promising clinical practices for preventing and
  751  treating obesity; and encouraging practitioners to counsel their
  752  patients regarding the adoption of healthy lifestyles.
  753         (g) Maximizing all local, state, and federal funding
  754  sources, including seeking grants, public-private partnerships,
  755  and other mechanisms, to strengthen the department’s programs
  756  that promote physical activity and nutrition.
  757         (3) OTHER HEALTH PROMOTION SERVICES.—The department shall:
  758         (a) Promote personal responsibility by encouraging
  759  residents of this state to be informed, follow health
  760  recommendations, seek medical consultations and health
  761  assessments, and comply with medical guidelines, including those
  762  that lead to earlier detection of chronic diseases, in order to
  763  prevent chronic diseases or slow the progression of established
  764  chronic diseases.
  765         (b) Promote regular health visits during a person’s
  766  lifetime, including annual physical examinations that include
  767  measuring body mass index and vital signs, blood work,
  768  immunizations, screenings, and dental examinations, in order to
  769  reduce the financial, social, and personal burden of chronic
  770  disease.
  771         (4) WELLNESS PROGRAMS.—
  772         (a) Each state agency may conduct employee wellness
  773  programs in buildings and on lands owned or leased by the state.
  774  The department shall serve as a model for the development and
  775  implementation of employee wellness programs that may include
  776  physical fitness, healthy nutrition, self-management of disease,
  777  wellness and fitness education, and behavioral change elements.
  778  The department shall assist other state agencies in developing
  779  and implementing employee wellness programs. These programs
  780  shall use existing resources, facilities, and programs or
  781  resources procured through grant funding and donations that are
  782  obtained in accordance with state ethics and procurement
  783  policies, and shall provide equal access to any such programs,
  784  resources, and facilities to all state employees.
  785         (b) The department shall coordinate its efforts with the
  786  Department of Management Services and other state agencies.
  787         (c) Each state agency may establish an employee wellness
  788  workgroup to design the agency’s wellness program. The
  789  department shall provide policy guidance and assist in
  790  identifying effective wellness program strategies.
  791         (d) The department shall provide by rule requirements for
  792  nominal participation fees, when applicable, which may not
  793  exceed the department’s actual costs, collaboration with
  794  businesses, and the procurement of equipment and incentives.
  795         Section 18. Section 385.202, Florida Statutes, is amended
  796  to read:
  797         385.202 Statewide cancer registry.—
  798         (1) Each facility, laboratory, or practitioner licensed
  799  under chapter 395, chapter 458, chapter 459, chapter 464,
  800  chapter 483, or chapter 485, and each freestanding radiation
  801  therapy center as defined in s. 408.07, shall report to the
  802  department of Health such information, specified by the
  803  department, by rule. The department may adopt rules regarding
  804  reporting requirements for the statewide cancer registry, which
  805  shall include the data required, the timeframe for reporting,
  806  and those professionals who are responsible for ensuring
  807  compliance with reporting requirements, which indicates
  808  diagnosis, stage of disease, medical history, laboratory data,
  809  tissue diagnosis, and radiation, surgical, or other methods of
  810  diagnosis or treatment for each cancer diagnosed or treated by
  811  the facility or center. Failure to comply with this requirement
  812  may be cause for registration or licensure suspension or
  813  revocation.
  814         (2) The department shall establish, or cause to have
  815  established, by contract with a recognized medical organization
  816  in this state and its affiliated institutions, a statewide
  817  cancer registry program to ensure that cancer reports required
  818  under this section shall be maintained and available for use in
  819  the course of public health surveillance and any study for the
  820  purpose of reducing morbidity or mortality; and no liability of
  821  any kind or character for damages or other relief shall arise or
  822  be enforced against any facility, laboratory, or practitioner
  823  hospital by reason of having provided such information or
  824  material to the department.
  825         (3) The department or a contractual designee operating the
  826  statewide cancer registry program required by this section shall
  827  use or publish such said material only for the purpose of public
  828  health surveillance and advancing medical research or medical
  829  education in the interest of reducing morbidity or mortality,
  830  except that a summary of such studies may be released for
  831  general publication. Information which discloses or could lead
  832  to the disclosure of the identity of any person whose condition
  833  or treatment has been reported and studied shall be confidential
  834  and exempt from the provisions of s. 119.07(1), except that:
  835         (a) Release may be made with the written consent of all
  836  persons to whom the information applies;
  837         (b) The department or a contractual designee may contact
  838  individuals for the purpose of epidemiologic investigation and
  839  monitoring, provided information that is confidential under this
  840  section is not further disclosed; or
  841         (c) The department may exchange personal data with any
  842  other governmental agency or a contractual designee for the
  843  purpose of public health surveillance and medical or scientific
  844  research if, provided such governmental agency or contractual
  845  designee does shall not further disclose information that is
  846  confidential under this section.
  847         (4) Funds appropriated for this section shall be used for
  848  establishing, administering, compiling, processing, and
  849  providing biometric and statistical analyses to the reporting
  850  facilities, laboratories, and practitioners. Funds may also be
  851  used to ensure the quality and accuracy of the information
  852  reported and to provide management information to the reporting
  853  facilities, laboratories, and practitioners.
  854         (5) The department may adopt rules regarding the
  855  classifications of, by rule, classify facilities, laboratories,
  856  and practitioners that are responsible for making reports to the
  857  statewide cancer registry, the content and frequency of the
  858  reports, and the penalty for failure to comply with these
  859  requirements for purposes of reports made to the cancer registry
  860  and specify the content and frequency of the reports. In
  861  classifying facilities, the department shall exempt certain
  862  facilities from reporting cancer information that was previously
  863  reported to the department or retrieved from existing state
  864  reports made to the department or the Agency for Health Care
  865  Administration. The provisions of This section does shall not
  866  apply to any facility whose primary function is to provide
  867  psychiatric care to its patients.
  868         (6) Notwithstanding subsection (1), each facility,
  869  laboratory, and practitioner that reports cancer cases to the
  870  department must make their records available for onsite review
  871  by the department or its authorized representative.
  872         Section 19. Subsection (9) of section 409.904, Florida
  873  Statutes, is amended to read:
  874         409.904 Optional payments for eligible persons.—The agency
  875  may make payments for medical assistance and related services on
  876  behalf of the following persons who are determined to be
  877  eligible subject to the income, assets, and categorical
  878  eligibility tests set forth in federal and state law. Payment on
  879  behalf of these Medicaid eligible persons is subject to the
  880  availability of moneys and any limitations established by the
  881  General Appropriations Act or chapter 216.
  882         (9) Eligible women with incomes at or below 200 percent of
  883  the federal poverty level and under age 65, for cancer treatment
  884  pursuant to the federal Breast and Cervical Cancer Prevention
  885  and Treatment Act of 2000, screened through the Mary Brogan
  886  Breast and Cervical Cancer Early Detection Program established
  887  under s. 385.20253 s. 381.93.
  888         Section 20. Section 381.0054, Florida Statutes, is
  889  repealed.
  890         Section 21. Section 381.732, Florida Statutes, is repealed.
  891         Section 22. Section 381.733, Florida Statutes, is repealed.
  892         Section 23. Section 381.734, Florida Statutes, is repealed.
  893         Section 24. Section 381.87, Florida Statutes, is repealed.
  894         Section 25. Section 385.103, Florida Statutes, is repealed.
  895         Section 26. This act shall take effect July 1, 2012.