Florida Senate - 2009 CS for SB 2614
By the Committee on Health Regulation; and Senator Gaetz
588-04450-09 20092614c1
1 A bill to be entitled
2 An act relating to the Healthy and Fit Florida Act;
3 amending s. 154.503, F.S.; conforming a cross
4 reference; repealing s. 381.0053, F.S., relating to a
5 comprehensive nutrition program; repealing s.
6 381.0054, F.S., relating to healthy lifestyles
7 promotion; repealing ss. 381.732, 381.733, and
8 381.734, F.S., relating to the Healthy Communities,
9 Healthy People Act; transferring, renumbering, and
10 amending s. 381.84, F.S., relating to the
11 Comprehensive Statewide Tobacco Education and Use
12 Prevention Program; revising definitions; revising
13 program components; requiring program components to
14 include efforts to educate youth and their parents
15 about tobacco use; requiring a youth-directed focus in
16 each program component; requiring the Tobacco
17 Education and Use Prevention Advisory Council to
18 adhere to state ethics laws; providing that meetings
19 of the council are subject to public-records and
20 public-meetings requirements; revising the duties of
21 the council; deleting a provision that prohibits a
22 member of the council from participating in a
23 discussion or decision with respect to a research
24 proposal by a firm, entity, or agency with which the
25 member is associated as a member of the governing body
26 or as an employee or with which the member has entered
27 into a contractual arrangement; revising the
28 submission date of an annual report; deleting an
29 expired provision relating to rulemaking authority of
30 the department; transferring and renumbering s.
31 381.91, F.S., relating to the Jessie Trice Cancer
32 Prevention Program; transferring, renumbering, and
33 amending s. 381.911, F.S., relating to the Prostate
34 Cancer Awareness Program; revising the criteria for
35 members of the prostate cancer advisory committee;
36 repealing s. 381.912, F.S., relating to the Cervical
37 Cancer Elimination Task Force; transferring and
38 renumbering s. 381.92, F.S., relating to the Florida
39 Cancer Council; transferring and renumbering s.
40 381.921, F.S., relating to the mission and duties of
41 the Florida Cancer Council; amending s. 381.922, F.S.;
42 conforming cross-references; transferring and
43 renumbering s. 381.93, F.S., relating to a breast and
44 cervical cancer early detection program; transferring
45 and renumbering s. 381.931, F.S., relating to an
46 annual report on Medicaid expenditures; renaming ch.
47 385, F.S., as the “Healthy and Fit Florida Act”;
48 amending s. 385.101, F.S.; renaming the “Chronic
49 Diseases Act” as the “Healthy and Fit Florida Act”;
50 amending s. 385.102, F.S.; revising legislative
51 intent; creating s. 385.1021, F.S.; providing
52 definitions; creating s. 385.1022, F.S.; requiring the
53 Department of Health to support public health programs
54 to reduce the incidence of mortality and morbidity
55 from chronic diseases; creating s. 385.1023, F.S.;
56 requiring the department to create state-level
57 programs that address the risk factors of certain
58 chronic diseases; providing required activities of the
59 state-level programs; amending s. 385.103, F.S.;
60 providing for community-level programs for the
61 prevention of chronic diseases; revising definitions;
62 requiring the department to develop and implement a
63 community-based chronic disease prevention and health
64 promotion program; providing the purpose of the
65 program; providing requirements for the program;
66 creating s. 385.105, F.S.; requiring the department to
67 develop programs to increase physical fitness, to work
68 with school districts, to develop partnerships that
69 allow the public to access recreational facilities and
70 public land areas suitable for physical activity, to
71 work with the Executive Office of the Governor and
72 Volunteer Florida, Inc., to promote school
73 initiatives, and to collaborate with the Department of
74 Education in recognizing nationally accepted best
75 practices for improving physical education in schools;
76 requiring the Department of Health to promote healthy
77 lifestyles to reduce obesity; requiring the department
78 to promote optimal nutritional status in all stages of
79 people’s lives, personal responsibility to prevent
80 chronic disease or slow its progression, and regular
81 health visits during a person’s life span; authorizing
82 state agencies to conduct employee wellness programs;
83 requiring the department to serve as a model to
84 develop and implement employee wellness programs;
85 requiring the department to assist state agencies to
86 develop the employee wellness programs; providing
87 equal access to the programs by agency employees;
88 requiring the department to coordinate efforts with
89 the Department of Management Services and other state
90 agencies; authorizing each state agency to establish
91 an employee wellness work group to design the wellness
92 program; requiring the department to provide
93 requirements for participation fees, collaborations
94 with businesses, and procurement of equipment and
95 incentives; amending s. 385.202, F.S.; requiring
96 facilities, laboratories, and practitioners to report
97 information; authorizing the department to adopt rules
98 regarding reporting requirements for the cancer
99 registry; providing immunity from liability for
100 facilities and practitioners reporting certain
101 information; requiring the department to adopt rules
102 regarding the establishment and operation of a
103 statewide cancer registry program; requiring the
104 department or contractual designee operating the
105 statewide cancer registry program to use or publish
106 material only for the purpose of public health
107 surveillance and advancing medical research or medical
108 education in the interest of reducing morbidity or
109 mortality; authorizing the department to exchange
110 personal data with any agency or contractual designee
111 for the purpose of public health surveillance and
112 medical or scientific research under certain
113 circumstances; clarifying that the department may
114 adopt rules regarding the classifications of
115 facilities related to reports made to the cancer
116 registry; requiring each facility and practitioner
117 that reports cancer cases to the department to make
118 their records available for onsite review; amending s.
119 385.203, F.S.; increasing the size of the Diabetes
120 Advisory Council to include one representative of the
121 Florida Academy of Family Physicians; amending s.
122 385.206, F.S.; renaming the “hematology-oncology care
123 center program” as the “Pediatric Hematology-Oncology
124 Center Program”; revising definitions; authorizing the
125 department to designate centers and provide funding to
126 maintain programs for the care of patients with
127 hematologic and oncologic disorders; clarifying
128 provisions related to grant-funding agreements and
129 grant disbursements; revising the department’s
130 requirement to evaluate services rendered by the
131 centers; requiring data from the centers and other
132 sources relating to pediatric cancer to be available
133 to the department for program planning and quality
134 assurance initiatives; amending s. 385.207, F.S.;
135 clarifying provisions that require the department to
136 collect information regarding the number of clients
137 served, the outcomes reached, the expense incurred,
138 and fees collected by providers of epilepsy services;
139 deleting the provision that requires the department to
140 limit administrative expenses from the Epilepsy
141 Services Trust Fund to a certain percentage of annual
142 receipts; amending s. 385.210, F.S.; revising
143 legislative findings regarding the economic costs of
144 treating arthritis and its complications; authorizing
145 the State Surgeon General to seek any federal waivers
146 that may be necessary to maximize funds from the
147 Federal Government to implement the Arthritis
148 Prevention and Education Program; creating s. 385.301,
149 F.S.; authorizing the department to adopt rules to
150 administer the act; amending s. 409.904, F.S.;
151 conforming a cross-reference; providing an effective
152 date.
153
154 Be It Enacted by the Legislature of the State of Florida:
155
156 Section 1. Paragraph (e) of subsection (2) of section
157 154.503, Florida Statutes, is amended to read:
158 154.503 Primary Care for Children and Families Challenge
159 Grant Program; creation; administration.—
160 (2) The department shall:
161 (e) Coordinate with the primary care program developed
162 pursuant to s. 154.011, the Florida Healthy Kids Corporation
163 program created in s. 624.91, the school health services program
164 created in ss. 381.0056 and 381.0057, the Healthy Communities,
165 Healthy People Program created in s. 381.734, and the volunteer
166 health care provider program developed pursuant to s. 766.1115.
167 Section 2. Sections 381.0053, 381.0054, 381.732, 381.733,
168 and 381.734, Florida Statutes, are repealed.
169 Section 3. Section 381.84, Florida Statutes, is
170 transferred, renumbered as section 385.106, Florida Statutes,
171 and amended to read:
172 385.106 381.84 Comprehensive Statewide Tobacco Education
173 and Use Prevention Program.—
174 (1) DEFINITIONS.—As used in this section and for purposes
175 of the provisions of s. 27, Art. X of the State Constitution,
176 the term:
177 (a) “AHEC network” means an area health education center
178 network established under s. 381.0402.
179 (b) “Best practices” means the Best Practices for
180 Comprehensive Tobacco Control Programs as established by the
181 CDC, as amended.
182 (c)(b) “CDC” means the United States Centers for Disease
183 Control and Prevention.
184 (d)(c) “Council” means the Tobacco Education and Use
185 Prevention Advisory Council.
186 (d) “Department” means the Department of Health.
187 (e) “Tobacco” means, without limitation, tobacco itself and
188 tobacco products that include tobacco and are intended or
189 expected for human use or consumption, including, but not
190 limited to, cigarettes, cigars, pipe tobacco, and smokeless
191 tobacco.
192 (f) “Youth” means minors and young adults.
193 (2) PURPOSE, FINDINGS, AND INTENT.—It is the purpose of
194 this section to implement s. 27, Art. X of the State
195 Constitution. The Legislature finds that s. 27, Art. X of the
196 State Constitution requires the funding of a statewide tobacco
197 education and use prevention program that focuses on tobacco use
198 by youth. The Legislature further finds that the primary goals
199 of the program are to reduce the prevalence of tobacco use among
200 youth, adults, and pregnant women; reduce per capita tobacco
201 consumption; and reduce exposure to environmental tobacco smoke.
202 Further, it is the intent of the Legislature to base increases
203 in funding for individual components of the program on the
204 results of assessments and evaluations. Recognizing that some
205 components will need to grow faster than inflation, it is the
206 intent of the Legislature to fund portions of the program on a
207 nonrecurring basis in the early years so that those components
208 that are most effective can be supported as the program matures.
209 (3) PROGRAM COMPONENTS AND REQUIREMENTS.—The department
210 shall conduct a comprehensive, statewide tobacco education and
211 use prevention program consistent with the recommendations for
212 effective program components contained in the 1999 Best
213 Practices for Comprehensive Tobacco Control Programs of the CDC,
214 as amended by the CDC. The program shall include the following
215 components, each of which shall focus on educating people,
216 particularly youth and their parents, about the health hazards
217 of tobacco and discouraging the use of tobacco. All program
218 components shall include efforts to educate youth and their
219 parents about tobacco use, and a youth-directed focus shall
220 exist in all components outlined in this subsection.:
221 (a) State and community interventions.—These interventions
222 shall include, but not be limited to, a statewide tobacco
223 control program that combines and coordinates community-based
224 interventions that focus on preventing initiation of tobacco use
225 among youth and young adults; promoting quitting among adults,
226 youth, and pregnant women; eliminating exposure to secondhand
227 smoke; identifying and eliminating tobacco-related disparities
228 among population groups; and promoting a range of collaborations
229 to prevent and alleviate the effects of chronic diseases.
230 Counter-marketing and advertising; cyberspace resource center.
231 The counter-marketing and advertising campaign shall include, at
232 a minimum, Internet, print, radio, and television advertising
233 and shall be funded with a minimum of one-third of the total
234 annual appropriation required by s. 27, Art. X of the State
235 Constitution. A cyberspace resource center for copyrighted
236 materials and information concerning tobacco education and use
237 prevention, including cessation, shall be maintained by the
238 program. Such resource center must be accessible to the public,
239 including parents, teachers, and students, at each level of
240 public and private schools, universities, and colleges in the
241 state and shall provide links to other relevant resources. The
242 Internet address for the resource center must be incorporated in
243 all advertising. The information maintained in the resource
244 center shall be used by the other components of the program.
245 (b) Health communication interventions.—Effective media and
246 health communication intervention efforts include, but are not
247 limited to, audience research to define themes and execute
248 messages for influential, high impact, and specifically targeted
249 campaigns; market research to identify the target market and the
250 behavioral theory motivating change; counter-marketing
251 surveillance; community tie-ins to support and reinforce the
252 statewide campaign; technologies such as viral marketing, social
253 networks, personal web pages, and web logs; traditional media;
254 process and outcome evaluation of the communication efforts; and
255 promotion of available services, including the state telephone
256 cessation quitline. Cessation programs, counseling, and
257 treatment.—This program component shall include two
258 subcomponents:
259 1. A statewide toll-free cessation service, which may
260 include counseling, referrals to other local resources and
261 support services, and treatment to the extent funds are
262 available for treatment services; and
263 2. A local community-based program to disseminate
264 information about smoking cessation, how smoking cessation
265 relates to prenatal care and obesity prevention, and other
266 chronic tobacco-related diseases.
267 (c) Cessation interventions.—Cessation interventions
268 include, but are not limited to, sustaining, expanding, and
269 promoting the service through population-based counseling and
270 treatment programs; encouraging public and private insurance
271 coverage for counseling and FDA-approved medication treatments
272 for tobacco-use cessation; eliminating cost and other barriers
273 to treatment for underserved populations; and making health care
274 system changes. Youth interventions to prevent tobacco-use
275 initiation and encourage cessation among young people are needed
276 in order to reshape the environment so that it supports tobacco
277 free norms. Because most people who start smoking are younger
278 than 18 years of age, intervening during adolescence is
279 critical. Community programs and school-based policies and
280 interventions should be a part of a comprehensive effort that is
281 implemented in coordination with community and school
282 environments and in conjunction with increasing the unit price
283 of tobacco products, sustaining anti-tobacco media campaigns,
284 making environments tobacco free, and engaging in other efforts
285 to create tobacco-free social norms. Surveillance and
286 evaluation.—The program shall conduct ongoing epidemiological
287 surveillance and shall contract for annual independent
288 evaluations of the effectiveness of the various components of
289 the program in meeting the goals as set forth in subsection (2).
290 (d) Surveillance and evaluation.—The surveillance and
291 evaluation of all program components shall monitor and document
292 short-term, intermediate, and long-term intervention outcomes to
293 inform program and policy direction and ensure accountability.
294 The surveillance and evaluation must be conducted objectively
295 through scientifically sound methodology. Youth school
296 programs.—School and after-school programs shall use current
297 evidence-based curricula and programs that involve youth to
298 educate youth about the health hazards of tobacco, help youth
299 develop skills to refuse tobacco, and demonstrate to youth how
300 to stop using tobacco.
301 (e) Administration and management.—Administration and
302 management activities include, but are not limited to, strategic
303 planning to guide program efforts and resources in order to
304 accomplish goals; recruiting and developing qualified and
305 diverse technical, program, and administrative staff; awarding
306 and monitoring program contracts and grants to coordinate
307 implementation across program areas; developing and maintaining
308 a fiscal-management system to track allocations and the
309 expenditure of funds; increasing capacity at the community level
310 through ongoing training and technical assistance; creating
311 effective communications internally among chronic disease
312 prevention programs and local coalitions and partners; and
313 educating the public and decisionmakers on the health effects of
314 tobacco and evidence-based effective program and policy
315 interventions. Community programs and chronic disease
316 prevention.—The department shall promote and support local
317 community-based partnerships that emphasize programs involving
318 youth, including programs for the prevention, detection, and
319 early intervention of smoking-related chronic diseases.
320 (f) Training.—The program shall include the training of
321 health care practitioners, smoking-cessation counselors, and
322 teachers by health professional students and other tobacco-use
323 prevention specialists who are trained in preventing tobacco use
324 and health education. Smoking-cessation counselors shall be
325 trained by specialists who are certified in tobacco-use
326 cessation.
327 (g) County health departments Administration, statewide
328 programs, and county health departments.—Each county health
329 department is eligible to receive a portion of the annual
330 appropriation, on a per capita basis, for coordinating tobacco
331 education and use prevention programs within that county.
332 Appropriated funds may be used to improve the infrastructure of
333 the county health department to implement the comprehensive,
334 statewide tobacco education and use prevention program. Each
335 county health department shall prominently display in all
336 treatment rooms and waiting rooms, counter-marketing and
337 advertisement materials in the form of wall posters, brochures,
338 television advertising if televisions are used in the lobby or
339 waiting room, and screensavers and Internet advertising if
340 computer kiosks are available for use or viewing by people at
341 the county health department.
342 (h) Enforcement and awareness of related laws.—In
343 coordination with the Department of Business and Professional
344 Regulation, the program shall monitor the enforcement of laws,
345 rules, and policies prohibiting the sale or other provision of
346 tobacco to minors, as well as the continued enforcement of the
347 Clean Indoor Air Act prescribed in chapter 386. The
348 advertisements produced in accordance with paragraph (b)
349 paragraph (a) may also include information designed to make the
350 public aware of these related laws and rules. The departments
351 may enter into interagency agreements to carry out this program
352 component.
353 (i) AHEC smoking-cessation initiative.—For the 2007-2008
354 and 2008-2009 fiscal years only, the AHEC network shall expand
355 the AHEC smoking-cessation initiative to each county within the
356 state and perform other activities as determined by the
357 department.
358 (4) ADVISORY COUNCIL; MEMBERS, APPOINTMENTS, AND MEETINGS.
359 The Tobacco Education and Use Prevention Advisory Council is
360 created within the department.
361 (a) The council shall consist of 23 members, including:
362 1. The State Surgeon General, who shall serve as the
363 chairperson.
364 2. One county health department director, appointed by the
365 State Surgeon General.
366 3. Two members appointed by the Commissioner of Education,
367 of whom one must be a school district superintendent.
368 4. The chief executive officer of the Florida Division of
369 the American Cancer Society, or his or her designee.
370 5. The chief executive officer of the Greater Southeast
371 Affiliate of the American Heart Association, or his or her
372 designee.
373 6. The chief executive officer of the American Lung
374 Association of Florida, or his or her designee.
375 7. The dean of the University of Miami School of Medicine,
376 or his or her designee.
377 8. The dean of the University of Florida College of
378 Medicine, or his or her designee.
379 9. The dean of the University of South Florida College of
380 Medicine, or his or her designee.
381 10. The dean of the Florida State University College of
382 Medicine, or his or her designee.
383 11. The dean of Nova Southeastern College of Osteopathic
384 Medicine, or his or her designee.
385 12. The dean of the Lake Erie College of Osteopathic
386 Medicine in Bradenton, Florida, or his or her designee.
387 13. The chief executive officer of the Campaign for Tobacco
388 Free Kids, or his or her designee.
389 14. The chief executive officer of the Legacy Foundation,
390 or his or her designee.
391 15. Four members appointed by the Governor, of whom two
392 must have expertise in the field of tobacco-use prevention and
393 education or smoking cessation and one individual who shall be
394 between the ages of 16 and 21 at the time of his or her
395 appointment.
396 16. Two members appointed by the President of the Senate,
397 of whom one must have expertise in the field of tobacco-use
398 prevention and education or smoking cessation.
399 17. Two members appointed by the Speaker of the House of
400 Representatives, of whom one must have expertise in the field of
401 tobacco-use prevention and education or smoking cessation.
402 (b) The appointments shall be for 3-year terms and shall
403 reflect the diversity of the state’s population. A vacancy shall
404 be filled by appointment by the original appointing authority
405 for the unexpired portion of the term.
406 (c) An appointed member may not serve more than two
407 consecutive terms.
408 (d) The council shall meet at least quarterly and upon the
409 call of the chairperson. Meetings may be held via teleconference
410 or other electronic means.
411 (e) Members of the council shall serve without
412 compensation, but are entitled to reimbursement for per diem and
413 travel expenses pursuant to s. 112.061. Members who are state
414 officers or employees or who are appointed by state officers or
415 employees shall be reimbursed for per diem and travel expenses
416 pursuant to s. 112.061 from the state agency through which they
417 serve.
418 (f) The council shall adhere to all state ethics laws.
419 Meetings of the council and the review panels are subject to
420 chapter 119, s. 286.011, and s. 24, Art. I of the State
421 Constitution. The department shall provide council members with
422 information and other assistance as is reasonably necessary to
423 assist the council in carrying out its responsibilities.
424 (5) COUNCIL DUTIES AND RESPONSIBILITIES.—The council shall
425 advise the State Surgeon General as to the direction and scope
426 of the Comprehensive Statewide Tobacco Education and Use
427 Prevention Program. The responsibilities of the council may
428 include, but are not limited to:
429 (a) Providing advice on program priorities and emphases.
430 (b) Providing advice on the overall program budget.
431 (c) Providing advice on copyrighted material, trademark,
432 and future transactions as they pertain to the tobacco education
433 and use prevention program.
434 (d) Reviewing, as requested by the department, broadcast
435 material prepared for the Internet, portable media players,
436 radio, and television advertisement as it relates to the
437 advertising component of the tobacco education and use
438 prevention program.
439 (e) Participating in periodic program evaluation, as
440 requested by the department.
441 (f) Assisting the department in developing the development
442 of guidelines to ensure fairness, neutrality, and adherence to
443 the principles of merit and quality in the conduct of the
444 program.
445 (g) Assisting the department in developing the development
446 of administrative procedures relating to solicitation, review,
447 and award of contracts and grants in order to ensure an
448 impartial, high-quality peer review system.
449 (h) Assisting the department in developing panels to review
450 and evaluate potential fund recipients the development and
451 supervision of peer review panels.
452 (i) Assisting the department in reviewing reports of peer
453 review panels and making recommendations for funding allocations
454 contracts and grants.
455 (j) Assisting the department in reviewing the activities
456 and evaluating the performance of the AHEC network to avoid
457 duplicative efforts using state funds.
458 (k) Recommending specific measureable outcomes meaningful
459 outcome measures through a regular review of evidence-based and
460 promising tobacco-use prevention and education strategies and
461 programs of other states and the Federal Government.
462 (l) Recommending policies to encourage a coordinated
463 response to tobacco use in this state, focusing specifically on
464 creating partnerships within and between the public and private
465 sectors.
466 (6) CONTRACT REQUIREMENTS.—Contracts or grants for the
467 program components or subcomponents described in paragraphs
468 (3)(a)-(f) shall be awarded by the State Surgeon General, after
469 consultation with the council, on the basis of merit, as
470 determined by an open, competitive, peer-reviewed process that
471 ensures objectivity, consistency, and high quality. The
472 department shall award such grants or contracts no later than
473 October 1 for each fiscal year. A recipient of a contract or
474 grant for the program component described in paragraph (3)(d)
475 (3)(c) is not eligible for a contract or grant award for any
476 other program component described in subsection (3) in the same
477 state fiscal year. A school or college of medicine that is
478 represented on the council is not eligible to receive a contract
479 or grant under this section. For the 2007-2008 and 2008-2009
480 fiscal years only, the department shall award a contract or
481 grant in the amount of $10 million to the AHEC network for the
482 purpose of developing the components described in paragraph
483 (3)(i). The AHEC network may apply for a competitive contract or
484 grant after the 2008-2009 fiscal year.
485 (a) In order to ensure that all proposals for funding are
486 appropriate and are evaluated fairly on the basis of merit, the
487 State Surgeon General, in consultation with the council, shall
488 appoint a peer review panel of independent, qualified experts in
489 the field of tobacco control to review the content of each
490 proposal and establish its priority score. The priority scores
491 shall be forwarded to the council and must be considered in
492 determining which proposals will be recommended for funding.
493 (b) The council and the peer review panel shall establish
494 and follow rigorous guidelines for ethical conduct and adhere to
495 a strict policy with regard to conflicts of interest. Council
496 members are subject to the applicable provisions of chapter 112.
497 A member of the council or panel may not participate in any
498 discussion or decision with respect to a research proposal by
499 any firm, entity, or agency with which the member is associated
500 as a member of the governing body or as an employee or with
501 which the member has entered into a contractual arrangement.
502 Meetings of the council and the peer review panels are subject
503 to chapter 119, s. 286.011, and s. 24, Art. I of the State
504 Constitution.
505 (c) In each contract or grant agreement, the department
506 shall limit the use of food and promotional items to no more
507 than 2.5 percent of the total amount of the contract or grant
508 and limit overhead or indirect costs to no more than 7.5 percent
509 of the total amount of the contract or grant. The department, in
510 consultation with the Department of Financial Services, shall
511 publish guidelines for appropriate food and promotional items.
512 (d) In each advertising contract, the department shall
513 limit the total of production fees, buyer commissions, and
514 related costs to no more than 10 percent of the total contract
515 amount.
516 (e) Notwithstanding the competitive process for contracts
517 prescribed in this subsection, each county health department is
518 eligible for core funding, on a per capita basis, to implement
519 tobacco education and use prevention activities within that
520 county.
521 (7) ANNUAL REPORT REQUIRED.—By February 28 January 31 of
522 each year, the department shall provide to the Governor, the
523 President of the Senate, and the Speaker of the House of
524 Representatives a report that evaluates the program’s
525 effectiveness in reducing and preventing tobacco use and that
526 recommends improvements to enhance the program’s effectiveness.
527 The report must contain, at a minimum, an annual survey of youth
528 attitudes and behavior toward tobacco, as well as a description
529 of the progress in reducing the prevalence of tobacco use among
530 youth, adults, and pregnant women; reducing per capita tobacco
531 consumption; and reducing exposure to environmental tobacco
532 smoke.
533 (8) LIMITATION ON ADMINISTRATIVE EXPENSES.—From the total
534 funds appropriated for the Comprehensive Statewide Tobacco
535 Education and Use Prevention Program in the General
536 Appropriations Act, an amount of up to 5 percent may be used by
537 the department for administrative expenses.
538 (9) RULEMAKING AUTHORIZED.—By January 1, 2008, the
539 department shall adopt rules pursuant to ss. 120.536(1) and
540 120.54 to administer this section.
541 Section 4. Section 381.91, Florida Statutes, is transferred
542 and renumbered as section 385.2024, Florida Statutes, to read:
543 385.2024 381.91 Jessie Trice Cancer Prevention Program.—
544 (1) It is the intent of the Legislature to:
545 (a) Reduce the rates of illness and death from lung cancer
546 and other cancers and improve the quality of life among low
547 income African-American and Hispanic populations through
548 increased access to early, effective screening and diagnosis,
549 education, and treatment programs.
550 (b) Create a community faith-based disease-prevention
551 program in conjunction with the Health Choice Network and other
552 community health centers to build upon the natural referral and
553 education networks in place within minority communities and to
554 increase access to health service delivery in Florida.
555 (c) Establish a funding source to build upon local private
556 participation to sustain the operation of the program.
557 (2)(a) There is created the Jessie Trice Cancer Prevention
558 Program, to be located, for administrative purposes, within the
559 Department of Health, and operated from the community health
560 centers within the Health Choice Network in Florida.
561 (b) Funding may be provided to develop contracts with
562 community health centers and local community faith-based
563 education programs to provide cancer screening, diagnosis,
564 education, and treatment services to low-income populations
565 throughout the state.
566 Section 5. Section 381.911, Florida Statutes, is
567 transferred, renumbered as section 385.2023, Florida Statutes,
568 and amended to read:
569 385.2023 381.911 Prostate Cancer Awareness Program.—
570 (1) To the extent that funds are specifically made
571 available for this purpose, the Prostate Cancer Awareness
572 Program is established within the Department of Health. The
573 purpose of this program is to implement the recommendations of
574 January 2000 of the Florida Prostate Cancer Task Force to
575 provide for statewide outreach and health education activities
576 to ensure that men are aware of and appropriately seek medical
577 counseling for prostate cancer as an early-detection health care
578 measure.
579 (2) For purposes of implementing the program, the
580 Department of Health and the Florida Public Health Foundation,
581 Inc., may:
582 (a) Conduct activities directly or enter into a contract
583 with a qualified nonprofit community education entity.
584 (b) Seek any available gifts, grants, or funds from the
585 state, the Federal Government, philanthropic foundations, and
586 industry or business groups.
587 (3) A prostate cancer advisory committee is created to
588 advise and assist the Department of Health and the Florida
589 Public Health Foundation, Inc., in implementing the program.
590 (a) The State Surgeon General shall appoint the advisory
591 committee members, who shall consist of:
592 1. Three persons from prostate cancer survivor groups or
593 cancer-related advocacy groups.
594 2. Three persons who are scientists or clinicians from
595 public or nonpublic universities or research organizations.
596 3. Three persons who are engaged in the practice of a
597 cancer-related medical specialty from health organizations
598 committed to cancer research and control.
599 (b) Members shall serve without compensation but are
600 entitled to reimbursement, pursuant to s. 112.061, for per diem
601 and travel expenses incurred in the performance of their
602 official duties.
603 (4) The program shall coordinate its efforts with those of
604 the Florida Public Health Foundation, Inc.
605 Section 6. Section 381.912, Florida Statutes, is repealed.
606 Section 7. Section 381.92, Florida Statutes, is transferred
607 and renumbered as section 385.2025, Florida Statutes, to read:
608 385.2025 381.92 Florida Cancer Council.—
609 (1) Effective July 1, 2004, the Florida Cancer Council
610 within the Department of Health is established for the purpose
611 of making the state a center of excellence for cancer research.
612 (2)(a) The council shall be representative of the state’s
613 cancer centers, hospitals, and patient groups and shall be
614 organized and shall operate in accordance with this act.
615 (b) The Florida Cancer Council may create not-for-profit
616 corporate subsidiaries to fulfill its mission. The council and
617 its subsidiaries are authorized to receive, hold, invest, and
618 administer property and any moneys acquired from private, local,
619 state, and federal sources, as well as technical and
620 professional income generated or derived from the mission
621 related activities of the council.
622 (c) The members of the council shall consist of:
623 1. The chair of the Florida Dialogue on Cancer, who shall
624 serve as the chair of the council;
625 2. The State Surgeon General or his or her designee;
626 3. The chief executive officer of the H. Lee Moffitt Cancer
627 Center or his or her designee;
628 4. The director of the University of Florida Shands Cancer
629 Center or his or her designee;
630 5. The chief executive officer of the University of Miami
631 Sylvester Comprehensive Cancer Center or his or her designee;
632 6. The chief executive officer of the Mayo Clinic,
633 Jacksonville, or his or her designee;
634 7. The chief executive officer of the American Cancer
635 Society, Florida Division, Inc., or his or her designee;
636 8. The president of the American Cancer Society, Florida
637 Division, Inc., Board of Directors or his or her designee;
638 9. The president of the Florida Society of Clinical
639 Oncology or his or her designee;
640 10. The president of the American College of Surgeons,
641 Florida Chapter, or his or her designee;
642 11. The chief executive officer of Enterprise Florida,
643 Inc., or his or her designee;
644 12. Five representatives from cancer programs approved by
645 the American College of Surgeons. Three shall be appointed by
646 the Governor, one shall be appointed by the Speaker of the House
647 of Representatives, and one shall be appointed by the President
648 of the Senate;
649 13. One member of the House of Representatives, to be
650 appointed by the Speaker of the House of Representatives; and
651 14. One member of the Senate, to be appointed by the
652 President of the Senate.
653 (d) Appointments made by the Speaker of the House of
654 Representatives and the President of the Senate pursuant to
655 paragraph (c) shall be for 2-year terms, concurrent with the
656 bienniums in which they serve as presiding officers.
657 (e) Appointments made by the Governor pursuant to paragraph
658 (c) shall be for 2-year terms, although the Governor may
659 reappoint members.
660 (f) Members of the council or any subsidiaries shall serve
661 without compensation, and each organization represented on the
662 council shall cover the expenses of its representatives.
663 (3) The council shall issue an annual report to the Center
664 for Universal Research to Eradicate Disease, the Governor, the
665 Speaker of the House of Representatives, and the President of
666 the Senate by December 15 of each year, with policy and funding
667 recommendations regarding cancer research capacity in Florida
668 and related issues.
669 Section 8. Section 381.921, Florida Statutes, is
670 transferred and renumbered as section 385.20251, Florida
671 Statutes, to read:
672 385.20251 381.921 Florida Cancer Council mission and
673 duties.—The council, which shall work in concert with the
674 Florida Center for Universal Research to Eradicate Disease to
675 ensure that the goals of the center are advanced, shall endeavor
676 to dramatically improve cancer research and treatment in this
677 state through:
678 (1) Efforts to significantly expand cancer research
679 capacity in the state by:
680 (a) Identifying ways to attract new research talent and
681 attendant national grant-producing researchers to cancer
682 research facilities in this state;
683 (b) Implementing a peer-reviewed, competitive process to
684 identify and fund the best proposals to expand cancer research
685 institutes in this state;
686 (c) Funding through available resources for those proposals
687 that demonstrate the greatest opportunity to attract federal
688 research grants and private financial support;
689 (d) Encouraging the employment of bioinformatics in order
690 to create a cancer informatics infrastructure that enhances
691 information and resource exchange and integration through
692 researchers working in diverse disciplines, to facilitate the
693 full spectrum of cancer investigations;
694 (e) Facilitating the technical coordination, business
695 development, and support of intellectual property as it relates
696 to the advancement of cancer research; and
697 (f) Aiding in other multidisciplinary research-support
698 activities as they inure to the advancement of cancer research.
699 (2) Efforts to improve both research and treatment through
700 greater participation in clinical trials networks by:
701 (a) Identifying ways to increase adult enrollment in cancer
702 clinical trials;
703 (b) Supporting public and private professional education
704 programs designed to increase the awareness and knowledge about
705 cancer clinical trials;
706 (c) Providing tools to cancer patients and community-based
707 oncologists to aid in the identification of cancer clinical
708 trials available in the state; and
709 (d) Creating opportunities for the state’s academic cancer
710 centers to collaborate with community-based oncologists in
711 cancer clinical trials networks.
712 (3) Efforts to reduce the impact of cancer on disparate
713 groups by:
714 (a) Identifying those cancers that disproportionately
715 impact certain demographic groups; and
716 (b) Building collaborations designed to reduce health
717 disparities as they relate to cancer.
718 Section 9. Paragraph (a) of subsection (2) and subsection
719 (5) of section 381.922, Florida Statutes, as amended by section
720 2 of chapter 2009-5, Laws of Florida, is amended to read:
721 381.922 William G. “Bill” Bankhead, Jr., and David Coley
722 Cancer Research Program.—
723 (2) The program shall provide grants for cancer research to
724 further the search for cures for cancer.
725 (a) Emphasis shall be given to the goals enumerated in s.
726 385.20251 s. 381.921, as those goals support the advancement of
727 such cures.
728 (5) For the 2008-2009 fiscal year and each fiscal year
729 thereafter, the sum of $6.75 million is appropriated annually
730 from recurring funds in the General Revenue Fund to the
731 Biomedical Research Trust Fund within the Department of Health
732 for purposes of the William G. “Bill” Bankhead, Jr., and David
733 Coley Cancer Research Program and shall be distributed pursuant
734 to this section to provide grants to researchers seeking cures
735 for cancer, with emphasis given to the goals enumerated in s.
736 385.20251 s. 381.921. From the total funds appropriated, an
737 amount of up to 10 percent may be used for administrative
738 expenses.
739 Section 10. Section 381.93, Florida Statutes, is
740 transferred and renumbered as section 385.2021, Florida
741 Statutes, to read:
742 385.2021 381.93 Breast and cervical cancer early detection
743 program.—This section may be cited as the “Mary Brogan Breast
744 and Cervical Cancer Early Detection Program Act.”
745 (1) It is the intent of the Legislature to reduce the rates
746 of death due to breast and cervical cancer through early
747 diagnosis and increased access to early screening, diagnosis,
748 and treatment programs.
749 (2) The Department of Health, using available federal funds
750 and state funds appropriated for that purpose, is authorized to
751 establish the Mary Brogan Breast and Cervical Cancer Screening
752 and Early Detection Program to provide screening, diagnosis,
753 evaluation, treatment, case management, and followup and
754 referral to the Agency for Health Care Administration for
755 coverage of treatment services.
756 (3) The Mary Brogan Breast and Cervical Cancer Early
757 Detection Program shall be funded through grants for such
758 screening and early detection purposes from the federal Centers
759 for Disease Control and Prevention under Title XV of the Public
760 Health Service Act, 42 U.S.C. ss. 300k et seq.
761 (4) The department shall limit enrollment in the program to
762 persons with incomes up to and including 200 percent of the
763 federal poverty level. The department shall establish an
764 eligibility process that includes an income-verification process
765 to ensure that persons served under the program meet income
766 guidelines.
767 (5) The department may provide other breast and cervical
768 cancer screening and diagnostic services; however, such services
769 shall be funded separately through other sources than this act.
770 Section 11. Section 381.931, Florida Statutes, is
771 transferred and renumbered as section 385.20211, Florida
772 Statutes, to read:
773 385.20211 381.931 Annual report on Medicaid expenditures.
774 The Department of Health and the Agency for Health Care
775 Administration shall monitor the total Medicaid expenditures for
776 services made under this act. If Medicaid expenditures are
777 projected to exceed the amount appropriated by the Legislature,
778 the Department of Health shall limit the number of screenings to
779 ensure Medicaid expenditures do not exceed the amount
780 appropriated. The Department of Health, in cooperation with the
781 Agency for Health Care Administration, shall prepare an annual
782 report that must include the number of women screened; the
783 percentage of positive and negative outcomes; the number of
784 referrals to Medicaid and other providers for treatment
785 services; the estimated number of women who are not screened or
786 not served by Medicaid due to funding limitations, if any; the
787 cost of Medicaid treatment services; and the estimated cost of
788 treatment services for women who were not screened or referred
789 for treatment due to funding limitations. The report shall be
790 submitted to the President of the Senate, the Speaker of the
791 House of Representatives, and the Executive Office of the
792 Governor by March 1 of each year.
793 Section 12. Chapter 385, Florida Statutes, entitled
794 “Chronic Diseases,” is renamed the “Healthy and Fit Florida
795 Act.”
796 Section 13. Section 385.101, Florida Statutes, is amended
797 to read:
798 385.101 Short title.—This chapter Sections 385.101-385.103
799 may be cited as the “Healthy and Fit Florida Chronic Diseases
800 Act.”
801 Section 14. Section 385.102, Florida Statutes, is amended
802 to read:
803 385.102 Legislative intent.—It is the finding of the
804 Legislature that:
805 (1) Chronic diseases continue to be the leading cause of
806 death and disability in this state and the country exist in high
807 proportions among the people of this state. These Chronic
808 diseases include, but are not limited to, arthritis,
809 cardiovascular disease heart disease, hypertension, diabetes,
810 renal disease, cancer, and chronic obstructive lung disease.
811 These diseases are often have the same preventable risk factors
812 interrelated, and they directly and indirectly account for a
813 high rate of death, disability, and underlying costs to the
814 state’s health care system illness.
815 (2) Chronic diseases have a significant impact on quality
816 of life, not only for the individuals who experience their
817 painful symptoms and resulting disabilities, but also for family
818 members and caregivers.
819 (3) Racial and ethnic minorities and other underserved
820 populations are disproportionately affected by chronic diseases.
821 (4) There are enormous medical costs and lost wages
822 associated with chronic diseases and their complications.
823 (5)(2) Advances in medical knowledge and technology assist
824 have assisted in the prevention, detection, and management of
825 chronic diseases. Comprehensive approaches that stress the
826 stressing application of current medical treatment, continuing
827 research, professional training, and patient education, and
828 community-level policy and environmental changes should be
829 implemented encouraged.
830 (6)(3) A comprehensive program dealing with the early
831 detection and prevention of chronic diseases is required to make
832 knowledge and therapy available to all people of this state. The
833 mobilization of scientific, medical, and educational resources,
834 along with the implementation of community-based policy under
835 one comprehensive chronic disease law, act will facilitate the
836 prevention, early intervention, and management treatment of
837 chronic these diseases and their symptoms. This integration of
838 resources and policy will and result in a decline in death and
839 disability illness among the people of this state.
840 (7) Chronic diseases account for 70 percent of all deaths
841 in the United States. The following chronic diseases are the
842 leading causes of death and disability:
843 (a) Heart disease and stroke, which have remained the first
844 and third leading causes of death for both men and women in the
845 United States for over seven decades and account for
846 approximately one-third of total deaths each year in this state.
847 (b) Cancer, which is the second leading cause of death and
848 is responsible for one in four deaths in this state.
849 (c) Lung disease, which is the third leading cause of death
850 and accounts for one in every six deaths in this state.
851 (d) Diabetes, which is the sixth leading cause of death in
852 this state.
853 (e) Arthritis, which is the leading cause of disability in
854 the United States, limiting daily activities for more than 19
855 million citizens. In this state, arthritis limits daily
856 activities for an estimated 1.3 million people.
857 (8) The department shall establish, promote, and maintain
858 state-level and local-level programs for chronic disease
859 prevention and health promotion to the extent that funds are
860 specifically made available for this purpose.
861 Section 15. Section 385.1021, Florida Statutes, is created
862 to read:
863 385.1021 Definitions.—As used in this chapter, the term:
864 (1) “CDC” means the United States Centers for Disease
865 Control and Prevention.
866 (2) “Chronic disease” means an illness that is prolonged,
867 does not resolve spontaneously, and is rarely cured completely.
868 (3) “Department” means the Department of Health.
869 (4) “Environmental changes” means changes to the economic,
870 social, or physical natural or built environments which
871 encourage or enable behaviors.
872 (5) “Policy change” means altering an informal or formal
873 agreement between public or private sectors which sets forth
874 values, behaviors, or resource allocation in order to improve
875 health.
876 (6) “Primary prevention” means an intervention that is
877 directed toward healthy populations and focuses on avoiding
878 disease before it occurs.
879 (7) “Risk factor” means a characteristic or condition
880 identified during the course of an epidemiological study of a
881 disease that appears to be statistically associated with a high
882 incidence of that disease.
883 (8) “Secondary prevention” means an intervention that is
884 designed to promote the early detection and management of
885 diseases and reduce the risks experienced by at-risk
886 populations.
887 (9) “System changes” means altering standard activities,
888 protocols, policies, processes, and structures carried out in
889 population-based settings, such as schools, worksites, health
890 care facilities, faith-based organizations, and the overall
891 community, which promote and support new behaviors.
892 (10) “Tertiary prevention” means an intervention that is
893 directed at rehabilitating and minimizing the effects of disease
894 in a chronically ill population.
895 (11) “Tobacco” means, without limitation, tobacco itself
896 and tobacco products that include tobacco and are intended or
897 expected for human use or consumption, including, but not
898 limited to, cigarettes, cigars, pipe tobacco, and smokeless
899 tobacco.
900 (12) “Wellness program” means a structured program that is
901 designed or approved by the department to offer intervention
902 activities on or off the worksite which help state employees
903 change certain behaviors or adopt healthy lifestyles.
904 (13) “Youth” means children and young adults, up through 24
905 years of age, inclusive.
906 Section 16. Section 385.1022, Florida Statutes, is created
907 to read:
908 385.1022 Chronic disease prevention program.—The department
909 shall support public health programs to reduce the incidence of
910 mortality and morbidity from diseases for which risk factors can
911 be identified. Such risk factors include, but are not limited
912 to, being overweight or obese, physical inactivity, poor
913 nutrition and diet, tobacco use, sun exposure, and other
914 practices that are detrimental to health. The programs shall
915 educate and screen the general public as well as groups at
916 particularly high risk of chronic diseases.
917 Section 17. Section 385.1023, Florida Statutes, is created
918 to read:
919 385.1023 State-level prevention programs for chronic
920 disease.—
921 (1) The department shall create state-level programs that
922 address the leading, preventable chronic disease risk factors of
923 poor nutrition and obesity, tobacco use, sun exposure, and
924 physical inactivity in order to decrease the incidence of
925 arthritis, cancer, diabetes, heart disease, lung disease,
926 stroke, and other chronic diseases.
927 (2) State-level programs shall address, but need not be
928 limited to, the following activities:
929 (a) Monitoring specific causal and behavioral risk factors
930 that affect the health of residents in the state.
931 (b) Analyzing data regarding chronic disease mortality and
932 morbidity to track changes over time.
933 (c) Promoting public awareness and increasing knowledge
934 concerning the causes of chronic diseases, the importance of
935 early detection, diagnosis, and appropriate evidence-based
936 prevention, management, and treatment strategies.
937 (d) Disseminating educational materials and information
938 concerning evidence-based results, available services, and
939 pertinent new research findings and prevention strategies to
940 patients, health insurers, health professionals, and the public.
941 (e) Using education and training resources and services
942 developed by organizations having appropriate expertise and
943 knowledge of chronic diseases for technical assistance.
944 (f) Evaluating the quality and accessibility of existing
945 community-based services for chronic disease.
946 (g) Increasing awareness among state and local officials
947 involved in health and human services, health professionals and
948 providers, and policymakers about evidence-based chronic-disease
949 prevention, tobacco cessation, and treatment strategies and
950 their benefits for people who have chronic diseases.
951 (h) Developing a partnership with state and local
952 governments, voluntary health organizations, hospitals, health
953 insurers, universities, medical centers, employer groups,
954 private companies, and health care providers to address the
955 burden of chronic disease in this state.
956 (i) Implementing and coordinating state-level policies in
957 order to reduce the burden of chronic disease.
958 (j) Providing lasting improvements in the delivery of
959 health care for individuals who have chronic disease and their
960 families, thus improving their quality of life while also
961 containing health care costs.
962 Section 18. Section 385.103, Florida Statutes, is amended
963 to read:
964 385.103 Community-level Community intervention programs for
965 chronic disease prevention and health promotion.—
966 (1) DEFINITIONS.—As used in this section, the term:
967 (a) “Chronic disease prevention and health promotion
968 control program” means a program that may include, but is not
969 limited to, including a combination of the following elements:
970 1. Staff who are sufficiently trained and skilled in public
971 health, community health, or school health education to
972 facilitate the operation of the program Health screening;
973 2. Community input into the planning, implementation, and
974 evaluation processes Risk factor detection;
975 3. Use of public health data to make decisions and to
976 develop and prioritize community-based interventions focusing on
977 chronic diseases and their risk factors; Appropriate
978 intervention to enable and encourage changes in behaviors that
979 create health risks; and
980 4. Adherence to a population-based approach by using a
981 socioecological model that addresses the influence on individual
982 behavior, interpersonal behavior, organizational behavior, the
983 community, and public policy; Counseling in nutrition, physical
984 activity, the effects of tobacco use, hypertension, blood
985 pressure control, and diabetes control and the provision of
986 other clinical prevention services.
987 5. Focus on at least the common preventable risk factors
988 for chronic disease, such as physical inactivity, obesity, poor
989 nutrition, and tobacco use;
990 6. Focus on developing and implementing interventions and
991 activities through communities, schools, worksites, faith-based
992 organizations, and health-care settings;
993 7. Use of evidence-based interventions as well as best and
994 promising practices to guide specific activities and effect
995 change, which may include guidelines developed by organizations,
996 volunteer scientists, and health care professionals who write
997 published medical, scientific statements on various chronic
998 disease topics. The statements shall be supported by scientific
999 studies published in recognized journals that have a rigorous
1000 review and approval process. Scientific statements generally
1001 include a review of data available on a specific subject and an
1002 evaluation of its relationship to overall chronic disease
1003 science;
1004 8. Use of policy, system, and environmental changes that
1005 support healthy behaviors so as to affect large segments of the
1006 population and encourage healthy choices;
1007 9. Development of extensive and comprehensive evaluation
1008 that is linked to program planning at the state level and the
1009 community level in order to determine the program’s
1010 effectiveness or necessary program modifications; and
1011 10. Reduction of duplication of efforts through
1012 coordination among appropriate entities for the efficient use of
1013 resources.
1014 (b) “Community Health education program” means a program
1015 that follows involving the planned and coordinated use of the
1016 educational standards and teaching methods resources available
1017 in a community in an effort to provide:
1018 1. Appropriate medical, research-based interventions to
1019 enable and encourage changes in behaviors which reduce or
1020 eliminate health risks;
1021 2. Counseling in nutrition, weight management, physical
1022 inactivity, and tobacco-use prevention and cessation strategies;
1023 hypertension, blood pressure, high cholesterol, and diabetes
1024 control; and other clinical prevention services;
1025 3.1. Motivation and assistance to individuals or groups in
1026 adopting and maintaining Motivate and assist citizens to adopt
1027 and maintain healthful practices and lifestyles; and
1028 4.2. Make available Learning opportunities that which will
1029 increase the ability of people to make informed decisions
1030 affecting their personal, family, and community well-being and
1031 that which are designed to facilitate voluntary adoption of
1032 behavior that which will improve or maintain health.;
1033 3. Reduce, through coordination among appropriate agencies,
1034 duplication of health education efforts; and
1035 4. Facilitate collaboration among appropriate agencies for
1036 efficient use of scarce resources.
1037 (c) “Community intervention program” means a program
1038 combining the required elements of a chronic disease prevention
1039 and health promotion control program and the principles of a
1040 community health education program that addresses system,
1041 policy, and environmental changes that ensure that communities
1042 provide support for healthy lifestyles into a unified program
1043 over which a single administrative entity has authority and
1044 responsibility.
1045 (d) “Department” means the Department of Health.
1046 (e) “Risk factor” means a factor identified during the
1047 course of an epidemiological study of a disease, which factor
1048 appears to be statistically associated with a high incidence of
1049 that disease.
1050 (2) OPERATION OF COMMUNITY-LEVEL COMMUNITY INTERVENTION
1051 PROGRAMS FOR CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION.—
1052 (a) The department shall develop and implement a
1053 comprehensive, community-based program for chronic disease
1054 prevention and health promotion. The program shall be designed
1055 to reduce major behavioral risk factors that are associated with
1056 chronic diseases by enhancing the knowledge, skills, motivation,
1057 and opportunities for individuals, organizations, health care
1058 providers, small businesses, health insurers, and communities to
1059 develop and maintain healthy lifestyles. The department shall
1060 assist the county health departments in developing and operating
1061 community intervention programs throughout the state. At a
1062 minimum, the community intervention programs shall address one
1063 to three of the following chronic diseases: cancer, diabetes,
1064 heart disease, stroke, hypertension, renal disease, and chronic
1065 obstructive lung disease.
1066 (b) The program shall include:
1067 1. Countywide assessments of specific, causal, and
1068 behavioral risk factors that affect the health of residents;
1069 2. The development of community-based programs for chronic
1070 disease prevention and health promotion which incorporate health
1071 promotion and preventive care practices that are supported in
1072 scientific and medical literature;
1073 3. The development and implementation of statewide age
1074 specific, disease-specific, and community-specific health
1075 promotion and preventive care strategies using primary,
1076 secondary, and tertiary prevention interventions;
1077 4. The promotion of community, research-based health
1078 promotion model programs that meet specific criteria, address
1079 major risk factors, and motivate individuals to permanently
1080 adopt healthy behaviors and increase social and personal
1081 responsibilities;
1082 5. The development of policies that encourage the use of
1083 alternative community delivery sites for health promotion,
1084 disease prevention, and preventive care programs and promote the
1085 use of neighborhood delivery sites that are close to work, home,
1086 and school; and
1087 6. An emphasis on the importance of healthy and physically
1088 active lifestyles to build self-esteem and reduce morbidity and
1089 mortality associated with chronic disease and being overweight
1090 or obese. Existing community resources, when available, shall be
1091 used to support the programs. The department shall seek funding
1092 for the programs from federal and state financial assistance
1093 programs which presently exist or which may be hereafter
1094 created. Additional services, as appropriate, may be
1095 incorporated into a program to the extent that resources are
1096 available. The department may accept gifts and grants in order
1097 to carry out a program.
1098 (c) Volunteers shall be used to the maximum extent possible
1099 in carrying out the programs. The department shall contract for
1100 the necessary insurance coverage to protect volunteers from
1101 personal liability while acting within the scope of their
1102 volunteer assignments under a program.
1103 (d) The department may contract for the provision of all or
1104 any portion of the services required by a program, and shall so
1105 contract whenever the services so provided are more cost
1106 efficient than those provided by the department.
1107 (e) If the department determines that it is necessary for
1108 clients to help pay for services provided by a program, the
1109 department may require clients to make contribution therefor in
1110 either money or personal services. The amount of money or value
1111 of the personal services shall be fixed according to a fee
1112 schedule established by the department or by the entity
1113 developing the program. In establishing the fee schedule, the
1114 department or the entity developing the program shall take into
1115 account the expenses and resources of a client and his or her
1116 overall ability to pay for the services.
1117 Section 19. Section 385.105, Florida Statutes, is created
1118 to read:
1119 385.105 Physical activity, obesity prevention, nutrition,
1120 other health-promotion services, and wellness programs.—
1121 (1) PHYSICAL ACTIVITY—.
1122 (a) The department shall develop programs for people at
1123 every stage of their lives to increase physical fitness and
1124 promote behavior changes.
1125 (b) The department shall work with school health advisory
1126 or wellness committees in each school district as established in
1127 s. 381.0056.
1128 (c) The department shall develop public and private
1129 partnerships that allow the public to easily access recreational
1130 facilities and public land areas that are suitable for physical
1131 activity.
1132 (d) The department shall work in collaboration with the
1133 Executive Office of the Governor and Volunteer Florida, Inc., to
1134 promote school initiatives, such as the Governor’s Fitness
1135 Challenge.
1136 (e) The department shall collaborate with the Department of
1137 Education in recognizing nationally accepted best practices for
1138 improving physical education in schools.
1139 (2) OBESITY PREVENTION.—The department shall promote
1140 healthy lifestyles to reduce the prevalence of excess weight
1141 gain and being overweight or obese through programs that are
1142 directed towards all residents of this state by:
1143 (a) Using all appropriate media to promote maximum public
1144 awareness of the latest research on healthy lifestyles and
1145 chronic diseases and disseminating relevant information through
1146 a statewide clearinghouse relating to wellness, physical
1147 activity, and nutrition and the effect of these factors on
1148 chronic diseases and disabling conditions.
1149 (b) Providing technical assistance, training, and resources
1150 on healthy lifestyles and chronic diseases to the public, health
1151 care providers, school districts, and other persons or entities,
1152 including faith-based organizations that request such assistance
1153 to promote physical activity, nutrition, and healthy lifestyle
1154 programs.
1155 (c) Developing, implementing, and using all available
1156 research methods to collect data, including, but not limited to,
1157 population-specific data, and tracking the incidence and effects
1158 of weight gain, obesity, and related chronic diseases. The
1159 department shall include an evaluation and data-collection
1160 component in all programs as appropriate. All research conducted
1161 under this paragraph is subject to review and approval as
1162 required by the department’s institutional review board under s.
1163 381.86.
1164 (d) Entering into partnerships with the Department of
1165 Education, local communities, school districts, and other
1166 entities to encourage schools in this state to promote
1167 activities during and after school to help students meet a
1168 minimum goal of 30 minutes of physical activity or physical
1169 fitness per day.
1170 (e) Entering into partnerships with the Department of
1171 Education, school districts, and the Florida Sports Foundation
1172 to develop a programs recognizing the schools at which students
1173 demonstrate excellent physical fitness or fitness improvement.
1174 (f) Collaborating with other state agencies to develop
1175 policies and strategies for preventing and treating obesity,
1176 which shall be incorporated into programs administered by each
1177 agency and shall include promoting healthy lifestyles of
1178 employees of each agency.
1179 (g) Advising, in accordance with s. 456.081, health care
1180 practitioners about the morbidity, mortality, and costs
1181 associated with being overweight or obese, informing such
1182 practitioners of promising clinical practices for preventing and
1183 treating obesity, and encouraging practitioners to counsel their
1184 patients regarding the adoption of healthy lifestyles.
1185 (h) Maximizing all local, state, and federal funding
1186 sources, including grants, public-private partnerships, and
1187 other mechanisms to strengthen the department’s programs
1188 promoting physical activity and nutrition.
1189 (3) NUTRITION.—The department shall promote optimal
1190 nutritional status in all stages of people’s lives by developing
1191 strategies to:
1192 (a) Promote and maintain optimal nutritional status in the
1193 population through activities, including, but not limited to:
1194 1. Nutrition screening and assessment and nutrition
1195 counseling, including nutrition therapy, followup, case
1196 management, and referrals for persons who have medical
1197 conditions or nutrition-risk factors and who are provided health
1198 services through public health programs or through referrals
1199 from private health care providers or facilities;
1200 2. Nutrition education to assist residents of the state in
1201 achieving optimal health and preventing chronic disease; and
1202 3. Consultative nutrition services to group facilities
1203 which promote the provision of safe and nutritionally adequate
1204 diets.
1205 (b) Monitor and conduct surveillance of the nutritional
1206 status of this state’s population.
1207 (c) Conduct or support research or evaluations related to
1208 public health nutrition. All research conducted under this
1209 paragraph is subject to review and approval as required by the
1210 department’s institutional review board under s. 381.86.
1211 (d) Establish policies and standards for public health
1212 nutrition practices.
1213 (e) Promote interagency cooperation, professional
1214 education, and consultation.
1215 (f) Provide technical assistance and advise state agencies,
1216 private institutions, and local organizations regarding public
1217 health nutrition standards.
1218 (g) Work with the Department of Agriculture and Consumer
1219 Services, the Department of Education, and the Department of
1220 Management Services to further the use of fresh produce from
1221 this state in schools and encourage the development of community
1222 gardens. Nutritional services shall be available to eligible
1223 persons in accordance with eligibility criteria adopted by the
1224 department. The department shall provide by rule requirements
1225 for the service fees, when applicable, which may not exceed the
1226 department’s actual costs.
1227
1228 The department may adopt rules to administer this subsection.
1229 (4) OTHER HEALTH-PROMOTION SERVICES.—
1230 (a) The department shall promote personal responsibility by
1231 encouraging residents of this state to be informed, follow
1232 health recommendations, seek medical consultations and health
1233 assessments, take healthy precautions, and comply with medical
1234 guidelines, including those that lead to earlier detection of
1235 chronic diseases in order to prevent chronic diseases or slow
1236 the progression of established chronic diseases.
1237 (b) The department shall promote regular health visits
1238 during a person’s lifetime, including annual physical
1239 examinations that include measuring body mass index and vital
1240 signs, blood work, immunizations, screenings, and dental
1241 examinations in order to reduce the financial, social, and
1242 personal burden of chronic disease.
1243 (5) WELLNESS PROGRAMS.—
1244 (a) Each state agency may conduct employee wellness
1245 programs in buildings and lands owned or leased by the state.
1246 The department shall serve as a model to develop and implement
1247 employee wellness programs that may include physical fitness,
1248 healthy nutrition, self-management of disease, education, and
1249 behavioral change. The department shall assist other state
1250 agencies to develop and implement employee wellness programs.
1251 These programs shall use existing resources, facilities, and
1252 programs or resources procured through grant funding and
1253 donations that are obtained in accordance with state ethics and
1254 procurement policies, and shall provide equal access to any such
1255 programs, resources, and facilities to all state employees.
1256 (b) The department shall coordinate its efforts with the
1257 Department of Management Services and other state agencies.
1258 (c) Each agency may establish an employee wellness work
1259 group to design the program. The department shall be available
1260 to provide policy guidance and assist in identifying effective
1261 wellness program strategies.
1262 (d) The department shall provide by rule requirements for
1263 nominal participation fees, when applicable, which may not
1264 exceed the department’s actual costs; collaborations with
1265 businesses; and the procurement of equipment and incentives.
1266 Section 20. Section 385.202, Florida Statutes, is amended
1267 to read:
1268 385.202 Statewide cancer registry.—
1269 (1) Each facility, laboratory, or practitioner licensed
1270 under chapter 395, chapter 458, chapter 459, chapter 464,
1271 chapter 483, and each freestanding radiation therapy center as
1272 defined in s. 408.07, shall report to the department of Health
1273 such information, specified by the department, by rule. The
1274 department may adopt rules regarding reporting requirements for
1275 the cancer registry, which shall include the data required, the
1276 timeframe for reporting, and those professionals who are
1277 responsible for ensuring compliance with reporting requirements,
1278 which indicates diagnosis, stage of disease, medical history,
1279 laboratory data, tissue diagnosis, and radiation, surgical, or
1280 other methods of diagnosis or treatment for each cancer
1281 diagnosed or treated by the facility or center. Failure to
1282 comply with this requirement may be cause for registration or
1283 licensure suspension or revocation.
1284 (2) The department shall establish, or cause to have
1285 established, by contract with a recognized medical organization
1286 in this state and its affiliated institutions, a statewide
1287 cancer registry program to ensure that cancer reports required
1288 under this section shall be maintained and available for use in
1289 the course of public health surveillance and any study for the
1290 purpose of reducing morbidity or mortality; and no liability of
1291 any kind or character for damages or other relief shall arise or
1292 be enforced against any facility or practitioner hospital by
1293 reason of having provided such information or material to the
1294 department.
1295 (3) The department may adopt rules regarding the
1296 establishment and operation of a statewide cancer registry
1297 program.
1298 (4)(3) The department or a contractual designee operating
1299 the statewide cancer registry program required by this section
1300 shall use or publish said material only for the purpose of
1301 public health surveillance and advancing medical research or
1302 medical education in the interest of reducing morbidity or
1303 mortality, except that a summary of such studies may be released
1304 for general publication. Information which discloses or could
1305 lead to the disclosure of the identity of any person whose
1306 condition or treatment has been reported and studied shall be
1307 confidential and exempt from the provisions of s. 119.07(1),
1308 except that:
1309 (a) Release may be made with the written consent of all
1310 persons to whom the information applies;
1311 (b) The department or a contractual designee may contact
1312 individuals for the purpose of epidemiologic investigation and
1313 monitoring, provided information that is confidential under this
1314 section is not further disclosed; or
1315 (c) The department may exchange personal data with any
1316 other governmental agency or a contractual designee for the
1317 purpose of public health surveillance and medical or scientific
1318 research, if provided such governmental agency or contractual
1319 designee does shall not further disclose information that is
1320 confidential under this section.
1321 (5)(4) Funds appropriated for this section shall be used
1322 for establishing, administering, compiling, processing, and
1323 providing biometric and statistical analyses to the reporting
1324 facilities and practitioners. Funds may also be used to ensure
1325 the quality and accuracy of the information reported and to
1326 provide management information to the reporting facilities and
1327 practitioners.
1328 (6)(5) The department may adopt rules regarding the
1329 classifications of, by rule, classify facilities that are
1330 responsible for making reports to the cancer registry, the
1331 content and frequency of the reports, and the penalty for
1332 failure to comply with these requirements for purposes of
1333 reports made to the cancer registry and specify the content and
1334 frequency of the reports. In classifying facilities, the
1335 department shall exempt certain facilities from reporting cancer
1336 information that was previously reported to the department or
1337 retrieved from existing state reports made to the department or
1338 the Agency for Health Care Administration. The provisions of
1339 This section does shall not apply to any facility whose primary
1340 function is to provide psychiatric care to its patients.
1341 (7) Notwithstanding subsection (1), each facility and
1342 practitioner that reports cancer cases to the department shall
1343 make their records available for onsite review by the department
1344 or its authorized representative.
1345 Section 21. Subsection (3) of section 385.203, Florida
1346 Statutes, is amended to read:
1347 385.203 Diabetes Advisory Council; creation; function;
1348 membership.—
1349 (3) The council shall be composed of 26 25 citizens of the
1350 state who have knowledge of, or work in, the area of diabetes
1351 mellitus as follows:
1352 (a) Five interested citizens, three of whom are affected by
1353 diabetes.
1354 (b) Twenty-one Twenty members, who must include one
1355 representative from each of the following areas: nursing with
1356 diabetes-educator certification; dietary with diabetes educator
1357 certification; podiatry; ophthalmology or optometry; psychology;
1358 pharmacy; adult endocrinology; pediatric endocrinology; the
1359 American Diabetes Association (ADA); the Juvenile Diabetes
1360 Foundation (JDF); the Florida Academy of Family Physicians; a
1361 community health center; a county health department; an American
1362 Diabetes Association recognized community education program;
1363 each medical school in the state; an osteopathic medical school;
1364 the insurance industry; a Children’s Medical Services diabetes
1365 regional program; and an employer.
1366 (c) One or more representatives from the Department of
1367 Health, who shall serve on the council as ex officio members.
1368 Section 22. Section 385.206, Florida Statutes, is amended
1369 to read:
1370 385.206 Pediatric Hematology-Oncology care Center Program.—
1371 (1) DEFINITIONS.—As used in this section, the term:
1372 (a) “Department” means the Department of Health.
1373 (b) “Hematology” means the study, diagnosis, and treatment
1374 of blood and blood-forming tissues.
1375 (c) “Oncology” means the study, diagnosis, and treatment of
1376 malignant neoplasms or cancer.
1377 (d) “Hemophilia” or “other hemostatic disorder” means a
1378 bleeding disorder resulting from a genetic abnormality of
1379 mechanisms related to the control of bleeding.
1380 (e) “Sickle-cell anemia or other hemoglobinopathy” means an
1381 hereditary, chronic disease caused by an abnormal type of
1382 hemoglobin.
1383 (f) “Patient” means a person under the age of 21 who is in
1384 need of hematologic-oncologic services and who is enrolled in
1385 the Children’s Medical Services Network declared medically and
1386 financially eligible by the department; or a person who received
1387 such services prior to age 21 and who requires long-term
1388 monitoring and evaluation to ascertain the sequelae and the
1389 effectiveness of treatment.
1390 (g) “Center” means a facility designated by the department
1391 as having a program specifically designed to provide a full
1392 range of medical and specialty services to patients with
1393 hematologic and oncologic disorders.
1394 (2) PEDIATRIC HEMATOLOGY-ONCOLOGY CARE CENTER PROGRAM;
1395 AUTHORITY.—The department may designate is authorized to make
1396 grants and reimbursements to designated centers and provide
1397 funding to establish and maintain programs for the care of
1398 patients with hematologic and oncologic disorders. Program
1399 administration costs shall be paid by the department from funds
1400 appropriated for this purpose.
1401 (3) GRANT FUNDING CONTRACTS GRANT AGREEMENTS; CONDITIONS.—
1402 (a) Funding provided A grant made under this section shall
1403 be pursuant to a contract contractual agreement made between a
1404 center and the department. Each contract agreement shall provide
1405 that patients will receive services specified types of treatment
1406 and care from the center without additional charge to the
1407 patients or their parents or guardians. Grants shall be
1408 disbursed in accordance with conditions set forth in the
1409 disbursement guidelines.
1410 (4) GRANT DISBURSEMENTS AND SPECIAL DISBURSEMENTS FOR LOCAL
1411 PROGRAMS.—
1412 (b)(a) Funding may be provided Grant disbursements may be
1413 made to centers that which meet the following criteria:
1414 1. The personnel shall include at least one board-certified
1415 pediatric hematologist-oncologist, at least one board-certified
1416 pediatric surgeon, at least one board-certified radiotherapist,
1417 and at least one board-certified pathologist.
1418 2. As approved by the department, The center shall actively
1419 participate in a national children’s cancer study group,
1420 maintain a pediatric tumor registry, have a multidisciplinary
1421 pediatric tumor board, and meet other guidelines for
1422 development, including, but not limited to, guidelines from such
1423 organizations as the American Academy of Pediatrics and the
1424 American Pediatric Surgical Association.
1425 (b) Programs shall also be established to provide care to
1426 hematology-oncology patients within each district of the
1427 department. The guidelines for local programs shall be
1428 formulated by the department. Special disbursements may be made
1429 by the program office to centers for educational programs
1430 designed for the districts of the department. These programs may
1431 include teaching total supportive care of the dying patient and
1432 his or her family, home therapy to hemophiliacs and patients
1433 with other hemostatic disorders, and screening and counseling
1434 for patients with sickle-cell anemia or other
1435 hemoglobinopathies.
1436 (4)(5) PROGRAM AND PEER REVIEW.—The department shall
1437 evaluate at least annually during the grant period the services
1438 rendered by the centers and the districts of the department.
1439 Data from the centers and other sources relating to pediatric
1440 cancer shall be reviewed annually by the Florida Association of
1441 Pediatric Tumor Programs, Inc.; and a written report with
1442 recommendations shall be made to the department. This database
1443 will be available to the department for program planning and
1444 quality assurance initiatives formulation of its annual program
1445 and financial evaluation report. A portion of the funds
1446 appropriated for this section may be used to provide statewide
1447 consultation, supervision, and evaluation of the programs of the
1448 centers, as well as central program office support personnel.
1449 Section 23. Paragraph (g) of subsection (2) and subsection
1450 (7) of section 385.207, Florida Statutes, are amended to read:
1451 385.207 Care and assistance of persons with epilepsy;
1452 establishment of programs in epilepsy control.—
1453 (2) The Department of Health shall:
1454 (g) Continue current programs and develop cooperative
1455 programs and services designed to enhance the vocational
1456 rehabilitation of epilepsy clients, including the current jobs
1457 programs. The department shall, as part of its contract with a
1458 provider of epilepsy services, collect information regarding the
1459 number of clients served, the outcomes reached, the expenses
1460 incurred, and the fees collected by such providers for the
1461 provision of services keep and make this information available
1462 to the Governor and the Legislature upon request information
1463 regarding the number of clients served, the outcome reached, and
1464 the expense incurred by such programs and services.
1465 (7) The department shall limit total administrative
1466 expenditures from the Epilepsy Services Trust Fund to 5 percent
1467 of annual receipts.
1468 Section 24. Paragraphs (b), (d), and (g) of subsection (2)
1469 and paragraph (b) of subsection (5) of section 385.210, Florida
1470 Statutes, are amended to read:
1471 385.210 Arthritis prevention and education.—
1472 (2) LEGISLATIVE FINDINGS.—The Legislature finds the
1473 following:
1474 (b) Arthritis is the leading cause of disability in the
1475 United States, limiting daily activities for more than 19 7
1476 million citizens.
1477 (d) There are enormous economic and social costs associated
1478 with treating arthritis and its complications; the economic
1479 costs are estimated at over $128 billion (2003) $116 billion
1480 (1997) annually in the United States.
1481 (g) The National Arthritis Foundation, the CDC Centers for
1482 Disease Control and Prevention, and the Association of State and
1483 Territorial Health Officials have led the development of a
1484 public health strategy, the National Arthritis Action Plan, to
1485 respond to this challenge.
1486 (5) FUNDING.—
1487 (b) The State Surgeon General may shall seek any federal
1488 waiver or waivers that may be necessary to maximize funds from
1489 the Federal Government to implement this program.
1490 Section 25. Section 385.301, Florida Statutes, is created
1491 to read:
1492 385.301 Rulemaking authority.—The department may adopt
1493 rules pursuant to chapter 120 to administer this chapter.
1494 Section 26. Subsection (9) of section 409.904, Florida
1495 Statutes, is amended to read:
1496 409.904 Optional payments for eligible persons.—The agency
1497 may make payments for medical assistance and related services on
1498 behalf of the following persons who are determined to be
1499 eligible subject to the income, assets, and categorical
1500 eligibility tests set forth in federal and state law. Payment on
1501 behalf of these Medicaid eligible persons is subject to the
1502 availability of moneys and any limitations established by the
1503 General Appropriations Act or chapter 216.
1504 (9) Eligible women with incomes at or below 200 percent of
1505 the federal poverty level and under age 65, for cancer treatment
1506 pursuant to the federal Breast and Cervical Cancer Prevention
1507 and Treatment Act of 2000, screened through the Mary Brogan
1508 Breast and Cervical Cancer Early Detection Program established
1509 under s. 385.2021 s. 381.93.
1510 Section 27. This act shall take effect July 1, 2009.