Florida Senate - 2009 CS for CS for SB 2614
By the Committees on Health and Human Services Appropriations;
and Health Regulation; and Senator Gaetz
603-05649-09 20092614c2
1 A bill to be entitled
2 An act relating to health care; amending s. 154.503,
3 F.S.; conforming a cross-reference; repealing s.
4 381.0053, F.S., relating to a comprehensive nutrition
5 program; repealing s. 381.0054, F.S., relating to
6 healthy lifestyles promotion; repealing ss. 381.732,
7 381.733, and 381.734, F.S., relating to the Healthy
8 Communities, Healthy People Act; amending s. 381.006,
9 F.S.; requiring the Department of Health, when
10 conducting an environmental health program inspection
11 of a certified domestic violence center to limit the
12 inspection of the domestic violence center to the
13 requirements set forth in the department’s rules
14 applicable to community-based residential facilities
15 with five or fewer residents; amending s. 381.0072,
16 F.S.; requiring the Department of Health, when
17 conducting a food service inspection of a certified
18 domestic violence center to limit the inspection of
19 the domestic violence center to the requirements set
20 forth in the department’s rules applicable to
21 community-based residential facilities with five or
22 fewer residents; amending s. 381.0203, F.S.; requiring
23 certain state agencies to purchase drugs through the
24 statewide purchasing contract administered by the
25 Department of Health; providing an exception;
26 requiring the department to establish and maintain
27 certain pharmacy services program; transferring,
28 renumbering, and amending s. 381.84, F.S., relating to
29 the Comprehensive Statewide Tobacco Education and Use
30 Prevention Program; revising definitions; revising
31 program components; requiring program components to
32 include efforts to educate youth and their parents
33 about tobacco use; requiring a youth-directed focus in
34 each program component; requiring the Tobacco
35 Education and Use Prevention Advisory Council to
36 adhere to state ethics laws; providing that meetings
37 of the council are subject to public-records and
38 public-meetings requirements; revising the duties of
39 the council; deleting a provision that prohibits a
40 member of the council from participating in a
41 discussion or decision with respect to a research
42 proposal by a firm, entity, or agency with which the
43 member is associated as a member of the governing body
44 or as an employee or with which the member has entered
45 into a contractual arrangement; revising the
46 submission date of an annual report; deleting an
47 expired provision relating to rulemaking authority of
48 the department; transferring and renumbering s.
49 381.91, F.S., relating to the Jessie Trice Cancer
50 Prevention Program; transferring, renumbering, and
51 amending s. 381.911, F.S., relating to the Prostate
52 Cancer Awareness Program; revising the criteria for
53 members of the prostate cancer advisory committee;
54 repealing s. 381.912, F.S., relating to the Cervical
55 Cancer Elimination Task Force; transferring and
56 renumbering s. 381.92, F.S., relating to the Florida
57 Cancer Council; transferring and renumbering s.
58 381.921, F.S., relating to the mission and duties of
59 the Florida Cancer Council; amending s. 381.922, F.S.;
60 conforming cross-references; transferring and
61 renumbering s. 381.93, F.S., relating to a breast and
62 cervical cancer early detection program; transferring
63 and renumbering s. 381.931, F.S., relating to an
64 annual report on Medicaid expenditures; renaming ch.
65 385, F.S., as the “Healthy and Fit Florida Act”;
66 amending s. 385.101, F.S.; renaming the “Chronic
67 Diseases Act” as the “Healthy and Fit Florida Act”;
68 amending s. 385.102, F.S.; revising legislative
69 intent; creating s. 385.1021, F.S.; providing
70 definitions; creating s. 385.1022, F.S.; requiring the
71 Department of Health to support public health programs
72 to reduce the incidence of mortality and morbidity
73 from chronic diseases; creating s. 385.1023, F.S.;
74 requiring the department to create state-level
75 programs that address the risk factors of certain
76 chronic diseases; providing required activities of the
77 state-level programs; amending s. 385.103, F.S.;
78 providing for community-level programs for the
79 prevention of chronic diseases; revising definitions;
80 requiring the department to develop and implement a
81 community-based chronic disease prevention and health
82 promotion program; providing the purpose of the
83 program; providing requirements for the program;
84 creating s. 385.105, F.S.; requiring the department to
85 develop programs to increase physical fitness, to work
86 with school districts, to develop partnerships that
87 allow the public to access recreational facilities and
88 public land areas suitable for physical activity, to
89 work with the Executive Office of the Governor and
90 Volunteer Florida, Inc., to promote school
91 initiatives, and to collaborate with the Department of
92 Education in recognizing nationally accepted best
93 practices for improving physical education in schools;
94 requiring the Department of Health to promote healthy
95 lifestyles to reduce obesity; requiring the department
96 to promote optimal nutritional status in all stages of
97 people’s lives, personal responsibility to prevent
98 chronic disease or slow its progression, and regular
99 health visits during a person’s life span; authorizing
100 state agencies to conduct employee wellness programs;
101 requiring the department to serve as a model to
102 develop and implement employee wellness programs;
103 requiring the department to assist state agencies to
104 develop the employee wellness programs; providing
105 equal access to the programs by agency employees;
106 requiring the department to coordinate efforts with
107 the Department of Management Services and other state
108 agencies; authorizing each state agency to establish
109 an employee wellness work group to design the wellness
110 program; requiring the department to provide
111 requirements for participation fees, collaborations
112 with businesses, and procurement of equipment and
113 incentives; amending s. 385.202, F.S.; requiring
114 facilities, laboratories, and practitioners to report
115 information; authorizing the department to adopt rules
116 regarding reporting requirements for the cancer
117 registry; providing immunity from liability for
118 facilities and practitioners reporting certain
119 information; requiring the department to adopt rules
120 regarding the establishment and operation of a
121 statewide cancer registry program; requiring the
122 department or contractual designee operating the
123 statewide cancer registry program to use or publish
124 material only for the purpose of public health
125 surveillance and advancing medical research or medical
126 education in the interest of reducing morbidity or
127 mortality; authorizing the department to exchange
128 personal data with any agency or contractual designee
129 for the purpose of public health surveillance and
130 medical or scientific research under certain
131 circumstances; clarifying that the department may
132 adopt rules regarding the classifications of
133 facilities related to reports made to the cancer
134 registry; requiring each facility and practitioner
135 that reports cancer cases to the department to make
136 their records available for onsite review; amending s.
137 385.203, F.S.; increasing the size of the Diabetes
138 Advisory Council to include one representative of the
139 Florida Academy of Family Physicians; amending s.
140 385.206, F.S.; renaming the “hematology-oncology care
141 center program” as the “Pediatric Hematology-Oncology
142 Center Program”; revising definitions; authorizing the
143 department to designate centers and provide funding to
144 maintain programs for the care of patients with
145 hematologic and oncologic disorders; clarifying
146 provisions related to grant-funding agreements and
147 grant disbursements; revising the department’s
148 requirement to evaluate services rendered by the
149 centers; requiring data from the centers and other
150 sources relating to pediatric cancer to be available
151 to the department for program planning and quality
152 assurance initiatives; amending s. 385.207, F.S.;
153 clarifying provisions that require the department to
154 collect information regarding the number of clients
155 served, the outcomes reached, the expense incurred,
156 and fees collected by providers of epilepsy services;
157 deleting the provision that requires the department to
158 limit administrative expenses from the Epilepsy
159 Services Trust Fund to a certain percentage of annual
160 receipts; amending s. 385.210, F.S.; revising
161 legislative findings regarding the economic costs of
162 treating arthritis and its complications; authorizing
163 the State Surgeon General to seek any federal waivers
164 that may be necessary to maximize funds from the
165 Federal Government to implement the Arthritis
166 Prevention and Education Program; creating s. 385.301,
167 F.S.; authorizing the department to adopt rules to
168 administer the act; creating s. 385.401, F.S.;
169 authorizing the department to establish a direct
170 support organization; providing definitions; providing
171 for a board of directors; providing terms; providing
172 for membership; authorizing the department to allow
173 the direct-support organization to use the
174 department’s fixed property and facilities within the
175 state public health system; providing an exception;
176 requiring that the direct-support organization submit
177 certain federal forms to the department; requiring
178 that the direct-support organization provide an annual
179 financial audit; amending s. 409.904, F.S.; conforming
180 a cross-reference; creating the Pharmacy and
181 Therapeutic Advisory Council within the Executive
182 Office of the Governor; providing duties of the
183 council; providing for the appointment and
184 qualification of members; providing for the use of
185 subject-matter experts when necessary; providing
186 requirements for voting and a quorum; providing for
187 quarterly meetings of the council; providing for
188 staffing; providing for reimbursement of per diem and
189 travel expenses for members of the council; amending
190 s. 499.003, F.S.; excluding from the definition of
191 “wholesale distribution” certain activities of state
192 agencies; providing an effective date.
193
194 Be It Enacted by the Legislature of the State of Florida:
195
196 Section 1. Paragraph (e) of subsection (2) of section
197 154.503, Florida Statutes, is amended to read:
198 154.503 Primary Care for Children and Families Challenge
199 Grant Program; creation; administration.—
200 (2) The department shall:
201 (e) Coordinate with the primary care program developed
202 pursuant to s. 154.011, the Florida Healthy Kids Corporation
203 program created in s. 624.91, the school health services program
204 created in ss. 381.0056 and 381.0057, the Healthy Communities,
205 Healthy People Program created in s. 381.734, and the volunteer
206 health care provider program developed pursuant to s. 766.1115.
207 Section 2. Sections 381.0053, 381.0054, 381.732, 381.733,
208 and 381.734, Florida Statutes, are repealed.
209 Section 3. Subsection (16) of section 381.006, Florida
210 Statutes, is amended to read:
211 381.006 Environmental health.—The department shall conduct
212 an environmental health program as part of fulfilling the
213 state’s public health mission. The purpose of this program is to
214 detect and prevent disease caused by natural and manmade factors
215 in the environment. The environmental health program shall
216 include, but not be limited to:
217 (16) A group-care-facilities function, where a group care
218 facility means any public or private school, housing, building
219 or buildings, section of a building, or distinct part of a
220 building or other place, whether operated for profit or not,
221 which undertakes, through its ownership or management, to
222 provide one or more personal services, care, protection, and
223 supervision to persons who require such services and who are not
224 related to the owner or administrator. The department may adopt
225 rules necessary to protect the health and safety of residents,
226 staff, and patrons of group care facilities, such as child care
227 facilities, family day care homes, assisted living facilities,
228 adult day care centers, adult family care homes, hospices,
229 residential treatment facilities, crisis stabilization units,
230 pediatric extended care centers, intermediate care facilities
231 for the developmentally disabled, group care homes, and, jointly
232 with the Department of Education, private and public schools.
233 These rules may include definitions of terms; provisions
234 relating to operation and maintenance of facilities, buildings,
235 grounds, equipment, furnishings, and occupant-space
236 requirements; lighting; heating, cooling, and ventilation; food
237 service; water supply and plumbing; sewage; sanitary facilities;
238 insect and rodent control; garbage; safety; personnel health,
239 hygiene, and work practices; and other matters the department
240 finds are appropriate or necessary to protect the safety and
241 health of the residents, staff, or patrons. The department may
242 not adopt rules that conflict with rules adopted by the
243 licensing or certifying agency. The department may enter and
244 inspect at reasonable hours to determine compliance with
245 applicable statutes or rules. An environmental health program
246 inspection of a certified domestic violence center shall be
247 limited to the requirements set forth in the department’s rules
248 applicable to community-based residential facilities with five
249 or fewer residents. In addition to any sanctions that the
250 department may impose for violations of rules adopted under this
251 section, the department shall also report such violations to any
252 agency responsible for licensing or certifying the group care
253 facility. The licensing or certifying agency may also impose any
254 sanction based solely on the findings of the department.
255
256 The department may adopt rules to carry out the provisions of
257 this section.
258 Section 4. Paragraph (a) of subsection (2) of section
259 381.0072, Florida Statutes, is amended to read:
260 381.0072 Food service protection.—It shall be the duty of
261 the Department of Health to adopt and enforce sanitation rules
262 consistent with law to ensure the protection of the public from
263 food-borne illness. These rules shall provide the standards and
264 requirements for the storage, preparation, serving, or display
265 of food in food service establishments as defined in this
266 section and which are not permitted or licensed under chapter
267 500 or chapter 509.
268 (2) DUTIES.—
269 (a) The department shall adopt rules, including definitions
270 of terms which are consistent with law prescribing minimum
271 sanitation standards and manager certification requirements as
272 prescribed in s. 509.039, and which shall be enforced in food
273 service establishments as defined in this section. The
274 sanitation standards must address the construction, operation,
275 and maintenance of the establishment; lighting, ventilation,
276 laundry rooms, lockers, use and storage of toxic materials and
277 cleaning compounds, and first-aid supplies; plan review; design,
278 construction, installation, location, maintenance, sanitation,
279 and storage of food equipment and utensils; employee training,
280 health, hygiene, and work practices; food supplies, preparation,
281 storage, transportation, and service, including access to the
282 areas where food is stored or prepared; and sanitary facilities
283 and controls, including water supply and sewage disposal;
284 plumbing and toilet facilities; garbage and refuse collection,
285 storage, and disposal; and vermin control. Public and private
286 schools, if the food service is operated by school employees;
287 hospitals licensed under chapter 395; nursing homes licensed
288 under part II of chapter 400; child care facilities as defined
289 in s. 402.301; residential facilities colocated with a nursing
290 home or hospital, if all food is prepared in a central kitchen
291 that complies with nursing or hospital regulations; and bars and
292 lounges, as defined by department rule, are exempt from the
293 rules developed for manager certification. The department shall
294 administer a comprehensive inspection, monitoring, and sampling
295 program to ensure such standards are maintained. With respect to
296 food service establishments permitted or licensed under chapter
297 500 or chapter 509, the department shall assist the Division of
298 Hotels and Restaurants of the Department of Business and
299 Professional Regulation and the Department of Agriculture and
300 Consumer Services with rulemaking by providing technical
301 information. Food service inspections of a certified domestic
302 violence center shall be limited to the requirements set forth
303 in the department’s rules applicable to community-based
304 residential facilities with five or fewer residents.
305 Section 5. Subsection (1) and paragraph (a) of subsection
306 (2) of section 381.0203, Florida Statutes, are amended to read:
307 381.0203 Pharmacy services.—
308 (1) The department must may contract on a statewide basis
309 for the purchase of drugs, as defined in s. 499.003, to be used
310 by state agencies and political subdivisions, and may adopt
311 rules to administer this section. Effective January 1, 2010, all
312 state agencies, except the Agency for Health Care
313 Administration, the Department of Veterans’ Affairs, and the
314 Department of Management Services, must purchase drugs through
315 the statewide contract unless:
316 (a) The Pharmacy and Therapeutic Advisory Council approves
317 a more cost-effective purchasing plan; or
318 (b) The drugs required are not available through the
319 statewide purchasing contract.
320 (2) The department must may establish and maintain a
321 pharmacy services program that includes, including, but is not
322 limited to:
323 (a) A central pharmacy to support pharmaceutical services
324 provided by the county health departments, including
325 pharmaceutical repackaging, dispensing, and the purchase and
326 distribution of immunizations and other pharmaceuticals. Such
327 services shall be provided to other state agencies and political
328 subdivisions of the state upon written agreement. Cost savings
329 realized by the state through utilization of the central
330 pharmacy may be used by the department to offset additional
331 costs.
332 Section 6. Section 381.84, Florida Statutes, is
333 transferred, renumbered as section 385.106, Florida Statutes,
334 and amended to read:
335 385.106 381.84 Comprehensive Statewide Tobacco Education
336 and Use Prevention Program.—
337 (1) DEFINITIONS.—As used in this section and for purposes
338 of the provisions of s. 27, Art. X of the State Constitution,
339 the term:
340 (a) “AHEC network” means an area health education center
341 network established under s. 381.0402.
342 (b) “Best practices” means the Best Practices for
343 Comprehensive Tobacco Control Programs as established by the
344 CDC, as amended.
345 (c)(b) “CDC” means the United States Centers for Disease
346 Control and Prevention.
347 (d)(c) “Council” means the Tobacco Education and Use
348 Prevention Advisory Council.
349 (d) “Department” means the Department of Health.
350 (e) “Tobacco” means, without limitation, tobacco itself and
351 tobacco products that include tobacco and are intended or
352 expected for human use or consumption, including, but not
353 limited to, cigarettes, cigars, pipe tobacco, and smokeless
354 tobacco.
355 (f) “Youth” means minors and young adults.
356 (2) PURPOSE, FINDINGS, AND INTENT.—It is the purpose of
357 this section to implement s. 27, Art. X of the State
358 Constitution. The Legislature finds that s. 27, Art. X of the
359 State Constitution requires the funding of a statewide tobacco
360 education and use prevention program that focuses on tobacco use
361 by youth. The Legislature further finds that the primary goals
362 of the program are to reduce the prevalence of tobacco use among
363 youth, adults, and pregnant women; reduce per capita tobacco
364 consumption; and reduce exposure to environmental tobacco smoke.
365 Further, it is the intent of the Legislature to base increases
366 in funding for individual components of the program on the
367 results of assessments and evaluations. Recognizing that some
368 components will need to grow faster than inflation, it is the
369 intent of the Legislature to fund portions of the program on a
370 nonrecurring basis in the early years so that those components
371 that are most effective can be supported as the program matures.
372 (3) PROGRAM COMPONENTS AND REQUIREMENTS.—The department
373 shall conduct a comprehensive, statewide tobacco education and
374 use prevention program consistent with the recommendations for
375 effective program components contained in the 1999 Best
376 Practices for Comprehensive Tobacco Control Programs of the CDC,
377 as amended by the CDC. The program shall include the following
378 components, each of which shall focus on educating people,
379 particularly youth and their parents, about the health hazards
380 of tobacco and discouraging the use of tobacco. All program
381 components shall include efforts to educate youth and their
382 parents about tobacco use, and a youth-directed focus shall
383 exist in all components outlined in this subsection.:
384 (a) State and community interventions.—These interventions
385 shall include, but not be limited to, a statewide tobacco
386 control program that combines and coordinates community-based
387 interventions that focus on preventing initiation of tobacco use
388 among youth and young adults; promoting quitting among adults,
389 youth, and pregnant women; eliminating exposure to secondhand
390 smoke; identifying and eliminating tobacco-related disparities
391 among population groups; and promoting a range of collaborations
392 to prevent and alleviate the effects of chronic diseases.
393 Counter-marketing and advertising; cyberspace resource center.
394 The counter-marketing and advertising campaign shall include, at
395 a minimum, Internet, print, radio, and television advertising
396 and shall be funded with a minimum of one-third of the total
397 annual appropriation required by s. 27, Art. X of the State
398 Constitution. A cyberspace resource center for copyrighted
399 materials and information concerning tobacco education and use
400 prevention, including cessation, shall be maintained by the
401 program. Such resource center must be accessible to the public,
402 including parents, teachers, and students, at each level of
403 public and private schools, universities, and colleges in the
404 state and shall provide links to other relevant resources. The
405 Internet address for the resource center must be incorporated in
406 all advertising. The information maintained in the resource
407 center shall be used by the other components of the program.
408 (b) Health communication interventions.—Effective media and
409 health communication intervention efforts include, but are not
410 limited to, audience research to define themes and execute
411 messages for influential, high impact, and specifically targeted
412 campaigns; market research to identify the target market and the
413 behavioral theory motivating change; counter-marketing
414 surveillance; community tie-ins to support and reinforce the
415 statewide campaign; technologies such as viral marketing, social
416 networks, personal web pages, and web logs; traditional media;
417 process and outcome evaluation of the communication efforts; and
418 promotion of available services, including the state telephone
419 cessation quitline. Cessation programs, counseling, and
420 treatment.—This program component shall include two
421 subcomponents:
422 1. A statewide toll-free cessation service, which may
423 include counseling, referrals to other local resources and
424 support services, and treatment to the extent funds are
425 available for treatment services; and
426 2. A local community-based program to disseminate
427 information about smoking cessation, how smoking cessation
428 relates to prenatal care and obesity prevention, and other
429 chronic tobacco-related diseases.
430 (c) Cessation interventions.—Cessation interventions
431 include, but are not limited to, sustaining, expanding, and
432 promoting the service through population-based counseling and
433 treatment programs; encouraging public and private insurance
434 coverage for counseling and FDA-approved medication treatments
435 for tobacco-use cessation; eliminating cost and other barriers
436 to treatment for underserved populations; and making health care
437 system changes. Youth interventions to prevent tobacco-use
438 initiation and encourage cessation among young people are needed
439 in order to reshape the environment so that it supports tobacco
440 free norms. Because most people who start smoking are younger
441 than 18 years of age, intervening during adolescence is
442 critical. Community programs and school-based policies and
443 interventions should be a part of a comprehensive effort that is
444 implemented in coordination with community and school
445 environments and in conjunction with increasing the unit price
446 of tobacco products, sustaining anti-tobacco media campaigns,
447 making environments tobacco free, and engaging in other efforts
448 to create tobacco-free social norms. Surveillance and
449 evaluation.—The program shall conduct ongoing epidemiological
450 surveillance and shall contract for annual independent
451 evaluations of the effectiveness of the various components of
452 the program in meeting the goals as set forth in subsection (2).
453 (d) Surveillance and evaluation.—The surveillance and
454 evaluation of all program components shall monitor and document
455 short-term, intermediate, and long-term intervention outcomes to
456 inform program and policy direction and ensure accountability.
457 The surveillance and evaluation must be conducted objectively
458 through scientifically sound methodology. Youth school
459 programs.—School and after-school programs shall use current
460 evidence-based curricula and programs that involve youth to
461 educate youth about the health hazards of tobacco, help youth
462 develop skills to refuse tobacco, and demonstrate to youth how
463 to stop using tobacco.
464 (e) Administration and management.—Administration and
465 management activities include, but are not limited to, strategic
466 planning to guide program efforts and resources in order to
467 accomplish goals; recruiting and developing qualified and
468 diverse technical, program, and administrative staff; awarding
469 and monitoring program contracts and grants to coordinate
470 implementation across program areas; developing and maintaining
471 a fiscal-management system to track allocations and the
472 expenditure of funds; increasing capacity at the community level
473 through ongoing training and technical assistance; creating
474 effective communications internally among chronic disease
475 prevention programs and local coalitions and partners; and
476 educating the public and decisionmakers on the health effects of
477 tobacco and evidence-based effective program and policy
478 interventions. Community programs and chronic disease
479 prevention.—The department shall promote and support local
480 community-based partnerships that emphasize programs involving
481 youth, including programs for the prevention, detection, and
482 early intervention of smoking-related chronic diseases.
483 (f) Training.—The program shall include the training of
484 health care practitioners, smoking-cessation counselors, and
485 teachers by health professional students and other tobacco-use
486 prevention specialists who are trained in preventing tobacco use
487 and health education. Smoking-cessation counselors shall be
488 trained by specialists who are certified in tobacco-use
489 cessation.
490 (g) County health departments Administration, statewide
491 programs, and county health departments.—Each county health
492 department is eligible to receive a portion of the annual
493 appropriation, on a per capita basis, for coordinating tobacco
494 education and use prevention programs within that county.
495 Appropriated funds may be used to improve the infrastructure of
496 the county health department to implement the comprehensive,
497 statewide tobacco education and use prevention program. Each
498 county health department shall prominently display in all
499 treatment rooms and waiting rooms, counter-marketing and
500 advertisement materials in the form of wall posters, brochures,
501 television advertising if televisions are used in the lobby or
502 waiting room, and screensavers and Internet advertising if
503 computer kiosks are available for use or viewing by people at
504 the county health department.
505 (h) Enforcement and awareness of related laws.—In
506 coordination with the Department of Business and Professional
507 Regulation, the program shall monitor the enforcement of laws,
508 rules, and policies prohibiting the sale or other provision of
509 tobacco to minors, as well as the continued enforcement of the
510 Clean Indoor Air Act prescribed in chapter 386. The
511 advertisements produced in accordance with paragraph (b)
512 paragraph (a) may also include information designed to make the
513 public aware of these related laws and rules. The departments
514 may enter into interagency agreements to carry out this program
515 component.
516 (i) AHEC smoking-cessation initiative.—For the 2007-2008
517 and 2008-2009 fiscal years only, The AHEC network shall expand
518 the AHEC smoking-cessation initiative to each county within the
519 state and perform other activities as determined by the
520 department.
521 (4) ADVISORY COUNCIL; MEMBERS, APPOINTMENTS, AND MEETINGS.
522 The Tobacco Education and Use Prevention Advisory Council is
523 created within the department.
524 (a) The council shall consist of 23 members, including:
525 1. The State Surgeon General, who shall serve as the
526 chairperson.
527 2. One county health department director, appointed by the
528 State Surgeon General.
529 3. Two members appointed by the Commissioner of Education,
530 of whom one must be a school district superintendent.
531 4. The chief executive officer of the Florida Division of
532 the American Cancer Society, or his or her designee.
533 5. The chief executive officer of the Greater Southeast
534 Affiliate of the American Heart Association, or his or her
535 designee.
536 6. The chief executive officer of the American Lung
537 Association of Florida, or his or her designee.
538 7. The dean of the University of Miami School of Medicine,
539 or his or her designee.
540 8. The dean of the University of Florida College of
541 Medicine, or his or her designee.
542 9. The dean of the University of South Florida College of
543 Medicine, or his or her designee.
544 10. The dean of the Florida State University College of
545 Medicine, or his or her designee.
546 11. The dean of Nova Southeastern College of Osteopathic
547 Medicine, or his or her designee.
548 12. The dean of the Lake Erie College of Osteopathic
549 Medicine in Bradenton, Florida, or his or her designee.
550 13. The chief executive officer of the Campaign for Tobacco
551 Free Kids, or his or her designee.
552 14. The chief executive officer of the Legacy Foundation,
553 or his or her designee.
554 15. Four members appointed by the Governor, of whom two
555 must have expertise in the field of tobacco-use prevention and
556 education or smoking cessation and one individual who shall be
557 between the ages of 16 and 21 at the time of his or her
558 appointment.
559 16. Two members appointed by the President of the Senate,
560 of whom one must have expertise in the field of tobacco-use
561 prevention and education or smoking cessation.
562 17. Two members appointed by the Speaker of the House of
563 Representatives, of whom one must have expertise in the field of
564 tobacco-use prevention and education or smoking cessation.
565 (b) The appointments shall be for 3-year terms and shall
566 reflect the diversity of the state’s population. A vacancy shall
567 be filled by appointment by the original appointing authority
568 for the unexpired portion of the term.
569 (c) An appointed member may not serve more than two
570 consecutive terms.
571 (d) The council shall meet at least quarterly and upon the
572 call of the chairperson. Meetings may be held via teleconference
573 or other electronic means.
574 (e) Members of the council shall serve without
575 compensation, but are entitled to reimbursement for per diem and
576 travel expenses pursuant to s. 112.061. Members who are state
577 officers or employees or who are appointed by state officers or
578 employees shall be reimbursed for per diem and travel expenses
579 pursuant to s. 112.061 from the state agency through which they
580 serve.
581 (f) The council shall adhere to all state ethics laws.
582 Meetings of the council and the review panels are subject to
583 chapter 119, s. 286.011, and s. 24, Art. I of the State
584 Constitution. The department shall provide council members with
585 information and other assistance as is reasonably necessary to
586 assist the council in carrying out its responsibilities.
587 (5) COUNCIL DUTIES AND RESPONSIBILITIES.—The council shall
588 advise the State Surgeon General as to the direction and scope
589 of the Comprehensive Statewide Tobacco Education and Use
590 Prevention Program. The responsibilities of the council may
591 include, but are not limited to:
592 (a) Providing advice on program priorities and emphases.
593 (b) Providing advice on the overall program budget.
594 (c) Providing advice on copyrighted material, trademark,
595 and future transactions as they pertain to the tobacco education
596 and use prevention program.
597 (d) Reviewing, as requested by the department, broadcast
598 material prepared for the Internet, portable media players,
599 radio, and television advertisement as it relates to the
600 advertising component of the tobacco education and use
601 prevention program.
602 (e) Participating in periodic program evaluation, as
603 requested by the department.
604 (f) Assisting the department in developing the development
605 of guidelines to ensure fairness, neutrality, and adherence to
606 the principles of merit and quality in the conduct of the
607 program.
608 (g) Assisting the department in developing the development
609 of administrative procedures relating to solicitation, review,
610 and award of contracts and grants in order to ensure an
611 impartial, high-quality peer review system.
612 (h) Assisting the department in developing panels to review
613 and evaluate potential fund recipients the development and
614 supervision of peer review panels.
615 (i) Assisting the department in reviewing reports of peer
616 review panels and making recommendations for funding allocations
617 contracts and grants.
618 (j) Assisting the department in reviewing the activities
619 and evaluating the performance of the AHEC network to avoid
620 duplicative efforts using state funds.
621 (k) Recommending specific measureable outcomes meaningful
622 outcome measures through a regular review of evidence-based and
623 promising tobacco-use prevention and education strategies and
624 programs of other states and the Federal Government.
625 (l) Recommending policies to encourage a coordinated
626 response to tobacco use in this state, focusing specifically on
627 creating partnerships within and between the public and private
628 sectors.
629 (6) CONTRACT REQUIREMENTS.—Contracts or grants for the
630 program components or subcomponents described in paragraphs
631 (3)(a)-(f) shall be awarded by the State Surgeon General, after
632 consultation with the council, on the basis of merit, as
633 determined by an open, competitive, peer-reviewed process that
634 ensures objectivity, consistency, and high quality. The
635 department shall award such grants or contracts no later than
636 October 1 for each fiscal year. A recipient of a contract or
637 grant for the program component described in paragraph (3)(d)
638 (3)(c) is not eligible for a contract or grant award for any
639 other program component described in subsection (3) in the same
640 state fiscal year. A school or college of medicine that is
641 represented on the council is not eligible to receive a contract
642 or grant under this section. For the 2007-2008 and 2008-2009
643 fiscal years only, The department shall award a contract or
644 grant in the amount of $11 $10 million to the AHEC network for
645 the purpose of developing the components described in paragraph
646 (3)(i). The AHEC network may apply for a competitive contract or
647 grant after the 2008-2009 fiscal year.
648 (a) In order to ensure that all proposals for funding are
649 appropriate and are evaluated fairly on the basis of merit, the
650 State Surgeon General, in consultation with the council, shall
651 appoint a peer review panel of independent, qualified experts in
652 the field of tobacco control to review the content of each
653 proposal and establish its priority score. The priority scores
654 shall be forwarded to the council and must be considered in
655 determining which proposals will be recommended for funding.
656 (b) The council and the peer review panel shall establish
657 and follow rigorous guidelines for ethical conduct and adhere to
658 a strict policy with regard to conflicts of interest. Council
659 members are subject to the applicable provisions of chapter 112.
660 A member of the council or panel may not participate in any
661 discussion or decision with respect to a research proposal by
662 any firm, entity, or agency with which the member is associated
663 as a member of the governing body or as an employee or with
664 which the member has entered into a contractual arrangement.
665 Meetings of the council and the peer review panels are subject
666 to chapter 119, s. 286.011, and s. 24, Art. I of the State
667 Constitution.
668 (c) In each contract or grant agreement, the department
669 shall limit the use of food and promotional items to no more
670 than 2.5 percent of the total amount of the contract or grant
671 and limit overhead or indirect costs to no more than 7.5 percent
672 of the total amount of the contract or grant. The department, in
673 consultation with the Department of Financial Services, shall
674 publish guidelines for appropriate food and promotional items.
675 (d) In each advertising contract, the department shall
676 limit the total of production fees, buyer commissions, and
677 related costs to no more than 10 percent of the total contract
678 amount.
679 (e) Notwithstanding the competitive process for contracts
680 prescribed in this subsection, each county health department is
681 eligible for core funding, on a per capita basis, to implement
682 tobacco education and use prevention activities within that
683 county.
684 (7) ANNUAL REPORT REQUIRED.—By February 28 January 31 of
685 each year, the department shall provide to the Governor, the
686 President of the Senate, and the Speaker of the House of
687 Representatives a report that evaluates the program’s
688 effectiveness in reducing and preventing tobacco use and that
689 recommends improvements to enhance the program’s effectiveness.
690 The report must contain, at a minimum, an annual survey of youth
691 attitudes and behavior toward tobacco, as well as a description
692 of the progress in reducing the prevalence of tobacco use among
693 youth, adults, and pregnant women; reducing per capita tobacco
694 consumption; and reducing exposure to environmental tobacco
695 smoke.
696 (8) LIMITATION ON ADMINISTRATIVE EXPENSES.—From the total
697 funds appropriated for the Comprehensive Statewide Tobacco
698 Education and Use Prevention Program in the General
699 Appropriations Act, an amount of up to 5 percent may be used by
700 the department for administrative expenses.
701 (9) RULEMAKING AUTHORIZED.—By January 1, 2008, the
702 department shall adopt rules pursuant to ss. 120.536(1) and
703 120.54 to administer this section.
704 Section 7. Section 381.91, Florida Statutes, is transferred
705 and renumbered as section 385.2024, Florida Statutes, to read:
706 385.2024 381.91 Jessie Trice Cancer Prevention Program.—
707 (1) It is the intent of the Legislature to:
708 (a) Reduce the rates of illness and death from lung cancer
709 and other cancers and improve the quality of life among low
710 income African-American and Hispanic populations through
711 increased access to early, effective screening and diagnosis,
712 education, and treatment programs.
713 (b) Create a community faith-based disease-prevention
714 program in conjunction with the Health Choice Network and other
715 community health centers to build upon the natural referral and
716 education networks in place within minority communities and to
717 increase access to health service delivery in Florida.
718 (c) Establish a funding source to build upon local private
719 participation to sustain the operation of the program.
720 (2)(a) There is created the Jessie Trice Cancer Prevention
721 Program, to be located, for administrative purposes, within the
722 Department of Health, and operated from the community health
723 centers within the Health Choice Network in Florida.
724 (b) Funding may be provided to develop contracts with
725 community health centers and local community faith-based
726 education programs to provide cancer screening, diagnosis,
727 education, and treatment services to low-income populations
728 throughout the state.
729 Section 8. Section 381.911, Florida Statutes, is
730 transferred, renumbered as section 385.2023, Florida Statutes,
731 and amended to read:
732 385.2023 381.911 Prostate Cancer Awareness Program.—
733 (1) To the extent that funds are specifically made
734 available for this purpose, the Prostate Cancer Awareness
735 Program is established within the Department of Health. The
736 purpose of this program is to implement the recommendations of
737 January 2000 of the Florida Prostate Cancer Task Force to
738 provide for statewide outreach and health education activities
739 to ensure that men are aware of and appropriately seek medical
740 counseling for prostate cancer as an early-detection health care
741 measure.
742 (2) For purposes of implementing the program, the
743 Department of Health and the Florida Public Health Foundation,
744 Inc., may:
745 (a) Conduct activities directly or enter into a contract
746 with a qualified nonprofit community education entity.
747 (b) Seek any available gifts, grants, or funds from the
748 state, the Federal Government, philanthropic foundations, and
749 industry or business groups.
750 (3) A prostate cancer advisory committee is created to
751 advise and assist the Department of Health and the Florida
752 Public Health Foundation, Inc., in implementing the program.
753 (a) The State Surgeon General shall appoint the advisory
754 committee members, who shall consist of:
755 1. Three persons from prostate cancer survivor groups or
756 cancer-related advocacy groups.
757 2. Three persons who are scientists or clinicians from
758 public or nonpublic universities or research organizations.
759 3. Three persons who are engaged in the practice of a
760 cancer-related medical specialty from health organizations
761 committed to cancer research and control.
762 (b) Members shall serve without compensation but are
763 entitled to reimbursement, pursuant to s. 112.061, for per diem
764 and travel expenses incurred in the performance of their
765 official duties.
766 (4) The program shall coordinate its efforts with those of
767 the Florida Public Health Foundation, Inc.
768 Section 9. Section 381.912, Florida Statutes, is repealed.
769 Section 10. Section 381.92, Florida Statutes, is
770 transferred and renumbered as section 385.2025, Florida
771 Statutes, to read:
772 385.2025 381.92 Florida Cancer Council.—
773 (1) Effective July 1, 2004, the Florida Cancer Council
774 within the Department of Health is established for the purpose
775 of making the state a center of excellence for cancer research.
776 (2)(a) The council shall be representative of the state’s
777 cancer centers, hospitals, and patient groups and shall be
778 organized and shall operate in accordance with this act.
779 (b) The Florida Cancer Council may create not-for-profit
780 corporate subsidiaries to fulfill its mission. The council and
781 its subsidiaries are authorized to receive, hold, invest, and
782 administer property and any moneys acquired from private, local,
783 state, and federal sources, as well as technical and
784 professional income generated or derived from the mission
785 related activities of the council.
786 (c) The members of the council shall consist of:
787 1. The chair of the Florida Dialogue on Cancer, who shall
788 serve as the chair of the council;
789 2. The State Surgeon General or his or her designee;
790 3. The chief executive officer of the H. Lee Moffitt Cancer
791 Center or his or her designee;
792 4. The director of the University of Florida Shands Cancer
793 Center or his or her designee;
794 5. The chief executive officer of the University of Miami
795 Sylvester Comprehensive Cancer Center or his or her designee;
796 6. The chief executive officer of the Mayo Clinic,
797 Jacksonville, or his or her designee;
798 7. The chief executive officer of the American Cancer
799 Society, Florida Division, Inc., or his or her designee;
800 8. The president of the American Cancer Society, Florida
801 Division, Inc., Board of Directors or his or her designee;
802 9. The president of the Florida Society of Clinical
803 Oncology or his or her designee;
804 10. The president of the American College of Surgeons,
805 Florida Chapter, or his or her designee;
806 11. The chief executive officer of Enterprise Florida,
807 Inc., or his or her designee;
808 12. Five representatives from cancer programs approved by
809 the American College of Surgeons. Three shall be appointed by
810 the Governor, one shall be appointed by the Speaker of the House
811 of Representatives, and one shall be appointed by the President
812 of the Senate;
813 13. One member of the House of Representatives, to be
814 appointed by the Speaker of the House of Representatives; and
815 14. One member of the Senate, to be appointed by the
816 President of the Senate.
817 (d) Appointments made by the Speaker of the House of
818 Representatives and the President of the Senate pursuant to
819 paragraph (c) shall be for 2-year terms, concurrent with the
820 bienniums in which they serve as presiding officers.
821 (e) Appointments made by the Governor pursuant to paragraph
822 (c) shall be for 2-year terms, although the Governor may
823 reappoint members.
824 (f) Members of the council or any subsidiaries shall serve
825 without compensation, and each organization represented on the
826 council shall cover the expenses of its representatives.
827 (3) The council shall issue an annual report to the Center
828 for Universal Research to Eradicate Disease, the Governor, the
829 Speaker of the House of Representatives, and the President of
830 the Senate by December 15 of each year, with policy and funding
831 recommendations regarding cancer research capacity in Florida
832 and related issues.
833 Section 11. Section 381.921, Florida Statutes, is
834 transferred and renumbered as section 385.20251, Florida
835 Statutes, to read:
836 385.20251 381.921 Florida Cancer Council mission and
837 duties.—The council, which shall work in concert with the
838 Florida Center for Universal Research to Eradicate Disease to
839 ensure that the goals of the center are advanced, shall endeavor
840 to dramatically improve cancer research and treatment in this
841 state through:
842 (1) Efforts to significantly expand cancer research
843 capacity in the state by:
844 (a) Identifying ways to attract new research talent and
845 attendant national grant-producing researchers to cancer
846 research facilities in this state;
847 (b) Implementing a peer-reviewed, competitive process to
848 identify and fund the best proposals to expand cancer research
849 institutes in this state;
850 (c) Funding through available resources for those proposals
851 that demonstrate the greatest opportunity to attract federal
852 research grants and private financial support;
853 (d) Encouraging the employment of bioinformatics in order
854 to create a cancer informatics infrastructure that enhances
855 information and resource exchange and integration through
856 researchers working in diverse disciplines, to facilitate the
857 full spectrum of cancer investigations;
858 (e) Facilitating the technical coordination, business
859 development, and support of intellectual property as it relates
860 to the advancement of cancer research; and
861 (f) Aiding in other multidisciplinary research-support
862 activities as they inure to the advancement of cancer research.
863 (2) Efforts to improve both research and treatment through
864 greater participation in clinical trials networks by:
865 (a) Identifying ways to increase adult enrollment in cancer
866 clinical trials;
867 (b) Supporting public and private professional education
868 programs designed to increase the awareness and knowledge about
869 cancer clinical trials;
870 (c) Providing tools to cancer patients and community-based
871 oncologists to aid in the identification of cancer clinical
872 trials available in the state; and
873 (d) Creating opportunities for the state’s academic cancer
874 centers to collaborate with community-based oncologists in
875 cancer clinical trials networks.
876 (3) Efforts to reduce the impact of cancer on disparate
877 groups by:
878 (a) Identifying those cancers that disproportionately
879 impact certain demographic groups; and
880 (b) Building collaborations designed to reduce health
881 disparities as they relate to cancer.
882 Section 12. Paragraph (a) of subsection (2) and subsection
883 (5) of section 381.922, Florida Statutes, as amended by section
884 2 of chapter 2009-5, Laws of Florida, is amended to read:
885 381.922 William G. “Bill” Bankhead, Jr., and David Coley
886 Cancer Research Program.—
887 (2) The program shall provide grants for cancer research to
888 further the search for cures for cancer.
889 (a) Emphasis shall be given to the goals enumerated in s.
890 385.20251 s. 381.921, as those goals support the advancement of
891 such cures.
892 (5) For the 2008-2009 fiscal year and each fiscal year
893 thereafter, the sum of $6.75 million is appropriated annually
894 from recurring funds in the General Revenue Fund to the
895 Biomedical Research Trust Fund within the Department of Health
896 for purposes of the William G. “Bill” Bankhead, Jr., and David
897 Coley Cancer Research Program and shall be distributed pursuant
898 to this section to provide grants to researchers seeking cures
899 for cancer, with emphasis given to the goals enumerated in s.
900 385.20251 s. 381.921. From the total funds appropriated, an
901 amount of up to 10 percent may be used for administrative
902 expenses.
903 Section 13. Section 381.93, Florida Statutes, is
904 transferred and renumbered as section 385.2021, Florida
905 Statutes, to read:
906 385.2021 381.93 Breast and cervical cancer early detection
907 program.—This section may be cited as the “Mary Brogan Breast
908 and Cervical Cancer Early Detection Program Act.”
909 (1) It is the intent of the Legislature to reduce the rates
910 of death due to breast and cervical cancer through early
911 diagnosis and increased access to early screening, diagnosis,
912 and treatment programs.
913 (2) The Department of Health, using available federal funds
914 and state funds appropriated for that purpose, is authorized to
915 establish the Mary Brogan Breast and Cervical Cancer Screening
916 and Early Detection Program to provide screening, diagnosis,
917 evaluation, treatment, case management, and followup and
918 referral to the Agency for Health Care Administration for
919 coverage of treatment services.
920 (3) The Mary Brogan Breast and Cervical Cancer Early
921 Detection Program shall be funded through grants for such
922 screening and early detection purposes from the federal Centers
923 for Disease Control and Prevention under Title XV of the Public
924 Health Service Act, 42 U.S.C. ss. 300k et seq.
925 (4) The department shall limit enrollment in the program to
926 persons with incomes up to and including 200 percent of the
927 federal poverty level. The department shall establish an
928 eligibility process that includes an income-verification process
929 to ensure that persons served under the program meet income
930 guidelines.
931 (5) The department may provide other breast and cervical
932 cancer screening and diagnostic services; however, such services
933 shall be funded separately through other sources than this act.
934 Section 14. Section 381.931, Florida Statutes, is
935 transferred and renumbered as section 385.20211, Florida
936 Statutes, to read:
937 385.20211 381.931 Annual report on Medicaid expenditures.
938 The Department of Health and the Agency for Health Care
939 Administration shall monitor the total Medicaid expenditures for
940 services made under this act. If Medicaid expenditures are
941 projected to exceed the amount appropriated by the Legislature,
942 the Department of Health shall limit the number of screenings to
943 ensure Medicaid expenditures do not exceed the amount
944 appropriated. The Department of Health, in cooperation with the
945 Agency for Health Care Administration, shall prepare an annual
946 report that must include the number of women screened; the
947 percentage of positive and negative outcomes; the number of
948 referrals to Medicaid and other providers for treatment
949 services; the estimated number of women who are not screened or
950 not served by Medicaid due to funding limitations, if any; the
951 cost of Medicaid treatment services; and the estimated cost of
952 treatment services for women who were not screened or referred
953 for treatment due to funding limitations. The report shall be
954 submitted to the President of the Senate, the Speaker of the
955 House of Representatives, and the Executive Office of the
956 Governor by March 1 of each year.
957 Section 15. Chapter 385, Florida Statutes, entitled
958 “Chronic Diseases,” is renamed the “Healthy and Fit Florida
959 Act.”
960 Section 16. Section 385.101, Florida Statutes, is amended
961 to read:
962 385.101 Short title.—This chapter Sections 385.101-385.103
963 may be cited as the “Healthy and Fit Florida Chronic Diseases
964 Act.”
965 Section 17. Section 385.102, Florida Statutes, is amended
966 to read:
967 385.102 Legislative intent.—It is the finding of the
968 Legislature that:
969 (1) Chronic diseases continue to be the leading cause of
970 death and disability in this state and the country exist in high
971 proportions among the people of this state. These Chronic
972 diseases include, but are not limited to, arthritis,
973 cardiovascular disease heart disease, hypertension, diabetes,
974 renal disease, cancer, and chronic obstructive lung disease,
975 including chronic obstructive pulmonary disease. These diseases
976 are often have the same preventable risk factors interrelated,
977 and they directly and indirectly account for a high rate of
978 death, disability, and underlying costs to the state’s health
979 care system illness.
980 (2) Chronic diseases have a significant impact on quality
981 of life, not only for the individuals who experience their
982 painful symptoms and resulting disabilities, but also for family
983 members and caregivers.
984 (3) Racial and ethnic minorities and other underserved
985 populations are disproportionately affected by chronic diseases.
986 (4) There are enormous medical costs and lost wages
987 associated with chronic diseases and their complications.
988 (5)(2) Advances in medical knowledge and technology assist
989 have assisted in the prevention, detection, and management of
990 chronic diseases. Comprehensive approaches that stress the
991 stressing application of current medical treatment, continuing
992 research, professional training, and patient education, and
993 community-level policy and environmental changes should be
994 implemented encouraged.
995 (6)(3) A comprehensive program dealing with the early
996 detection and prevention of chronic diseases is required to make
997 knowledge and therapy available to all people of this state. The
998 mobilization of scientific, medical, and educational resources,
999 along with the implementation of community-based policy under
1000 one comprehensive chronic disease law, act will facilitate the
1001 prevention, early intervention, and management treatment of
1002 chronic these diseases and their symptoms. This integration of
1003 resources and policy will and result in a decline in death and
1004 disability illness among the people of this state.
1005 (7) Chronic diseases account for 70 percent of all deaths
1006 in the United States. The following chronic diseases are the
1007 leading causes of death and disability:
1008 (a) Heart disease and stroke, which have remained the first
1009 and third leading causes of death for both men and women in the
1010 United States for over seven decades and account for
1011 approximately one-third of total deaths each year in this state.
1012 (b) Cancer, which is the second leading cause of death and
1013 is responsible for one in four deaths in this state.
1014 (c) Lung disease, which is the third leading cause of death
1015 and accounts for one in every six deaths in this state.
1016 (d) Diabetes, which is the sixth leading cause of death in
1017 this state.
1018 (e) Arthritis, which is the leading cause of disability in
1019 the United States, limiting daily activities for more than 19
1020 million citizens. In this state, arthritis limits daily
1021 activities for an estimated 1.3 million people.
1022 (8) The department shall establish, promote, and maintain
1023 state-level and local-level programs for chronic disease
1024 prevention and health promotion to the extent that funds are
1025 specifically made available for this purpose.
1026 Section 18. Section 385.1021, Florida Statutes, is created
1027 to read:
1028 385.1021 Definitions.—As used in this chapter, the term:
1029 (1) “CDC” means the United States Centers for Disease
1030 Control and Prevention.
1031 (2) “Chronic disease” means an illness that is prolonged,
1032 does not resolve spontaneously, and is rarely cured completely.
1033 (3) “Department” means the Department of Health.
1034 (4) “Environmental changes” means changes to the economic,
1035 social, or physical natural or built environments which
1036 encourage or enable behaviors.
1037 (5) “Policy change” means altering an informal or formal
1038 agreement between public or private sectors which sets forth
1039 values, behaviors, or resource allocation in order to improve
1040 health.
1041 (6) “Primary prevention” means an intervention that is
1042 directed toward healthy populations and focuses on avoiding
1043 disease before it occurs.
1044 (7) “Risk factor” means a characteristic or condition
1045 identified during the course of an epidemiological study of a
1046 disease that appears to be statistically associated with a high
1047 incidence of that disease.
1048 (8) “Secondary prevention” means an intervention that is
1049 designed to promote the early detection and management of
1050 diseases and reduce the risks experienced by at-risk
1051 populations.
1052 (9) “System changes” means altering standard activities,
1053 protocols, policies, processes, and structures carried out in
1054 population-based settings, such as schools, worksites, health
1055 care facilities, faith-based organizations, and the overall
1056 community, which promote and support new behaviors.
1057 (10) “Tertiary prevention” means an intervention that is
1058 directed at rehabilitating and minimizing the effects of disease
1059 in a chronically ill population.
1060 (11) “Tobacco” means, without limitation, tobacco itself
1061 and tobacco products that include tobacco and are intended or
1062 expected for human use or consumption, including, but not
1063 limited to, cigarettes, cigars, pipe tobacco, and smokeless
1064 tobacco.
1065 (12) “Wellness program” means a structured program that is
1066 designed or approved by the department to offer intervention
1067 activities on or off the worksite which help state employees
1068 change certain behaviors or adopt healthy lifestyles.
1069 (13) “Youth” means children and young adults, up through 24
1070 years of age, inclusive.
1071 Section 19. Section 385.1022, Florida Statutes, is created
1072 to read:
1073 385.1022 Chronic disease prevention program.—The department
1074 shall support public health programs to reduce the incidence of
1075 mortality and morbidity from diseases for which risk factors can
1076 be identified. Such risk factors include, but are not limited
1077 to, being overweight or obese, physical inactivity, poor
1078 nutrition and diet, tobacco use, sun exposure, and other
1079 practices that are detrimental to health. The programs shall
1080 educate and screen the general public as well as groups at
1081 particularly high risk of chronic diseases.
1082 Section 20. Section 385.1023, Florida Statutes, is created
1083 to read:
1084 385.1023 State-level prevention programs for chronic
1085 disease.—
1086 (1) The department shall create state-level programs that
1087 address the leading, preventable chronic disease risk factors of
1088 poor nutrition and obesity, tobacco use, sun exposure, and
1089 physical inactivity in order to decrease the incidence of
1090 arthritis, cancer, diabetes, heart disease, lung disease,
1091 stroke, and other chronic diseases.
1092 (2) State-level programs shall address, but need not be
1093 limited to, the following activities:
1094 (a) Monitoring specific causal and behavioral risk factors
1095 that affect the health of residents in the state.
1096 (b) Analyzing data regarding chronic disease mortality and
1097 morbidity to track changes over time.
1098 (c) Promoting public awareness and increasing knowledge
1099 concerning the causes of chronic diseases, the importance of
1100 early detection, diagnosis, and appropriate evidence-based
1101 prevention, management, and treatment strategies.
1102 (d) Disseminating educational materials and information
1103 concerning evidence-based results, available services, and
1104 pertinent new research findings and prevention strategies to
1105 patients, health insurers, health professionals, and the public.
1106 (e) Using education and training resources and services
1107 developed by organizations having appropriate expertise and
1108 knowledge of chronic diseases for technical assistance.
1109 (f) Evaluating the quality and accessibility of existing
1110 community-based services for chronic disease.
1111 (g) Increasing awareness among state and local officials
1112 involved in health and human services, health professionals and
1113 providers, and policymakers about evidence-based chronic-disease
1114 prevention, tobacco cessation, and treatment strategies and
1115 their benefits for people who have chronic diseases.
1116 (h) Developing a partnership with state and local
1117 governments, voluntary health organizations, hospitals, health
1118 insurers, universities, medical centers, employer groups,
1119 private companies, and health care providers to address the
1120 burden of chronic disease in this state.
1121 (i) Implementing and coordinating state-level policies in
1122 order to reduce the burden of chronic disease.
1123 (j) Providing lasting improvements in the delivery of
1124 health care for individuals who have chronic disease and their
1125 families, thus improving their quality of life while also
1126 containing health care costs.
1127 Section 21. Section 385.103, Florida Statutes, is amended
1128 to read:
1129 385.103 Community-level Community intervention programs for
1130 chronic disease prevention and health promotion.—
1131 (1) DEFINITIONS.—As used in this section, the term:
1132 (a) “Chronic disease prevention and health promotion
1133 control program” means a program that may include, but is not
1134 limited to, including a combination of the following elements:
1135 1. Staff who are sufficiently trained and skilled in public
1136 health, community health, or school health education to
1137 facilitate the operation of the program Health screening;
1138 2. Community input into the planning, implementation, and
1139 evaluation processes Risk factor detection;
1140 3. Use of public health data to make decisions and to
1141 develop and prioritize community-based interventions focusing on
1142 chronic diseases and their risk factors; Appropriate
1143 intervention to enable and encourage changes in behaviors that
1144 create health risks; and
1145 4. Adherence to a population-based approach by using a
1146 socioecological model that addresses the influence on individual
1147 behavior, interpersonal behavior, organizational behavior, the
1148 community, and public policy; Counseling in nutrition, physical
1149 activity, the effects of tobacco use, hypertension, blood
1150 pressure control, and diabetes control and the provision of
1151 other clinical prevention services.
1152 5. Focus on at least the common preventable risk factors
1153 for chronic disease, such as physical inactivity, obesity, poor
1154 nutrition, and tobacco use;
1155 6. Focus on developing and implementing interventions and
1156 activities through communities, schools, worksites, faith-based
1157 organizations, and health-care settings;
1158 7. Use of evidence-based interventions as well as best and
1159 promising practices to guide specific activities and effect
1160 change, which may include guidelines developed by organizations,
1161 volunteer scientists, and health care professionals who write
1162 published medical, scientific statements on various chronic
1163 disease topics. The statements shall be supported by scientific
1164 studies published in recognized journals that have a rigorous
1165 review and approval process. Scientific statements generally
1166 include a review of data available on a specific subject and an
1167 evaluation of its relationship to overall chronic disease
1168 science;
1169 8. Use of policy, system, and environmental changes that
1170 support healthy behaviors so as to affect large segments of the
1171 population and encourage healthy choices;
1172 9. Development of extensive and comprehensive evaluation
1173 that is linked to program planning at the state level and the
1174 community level in order to determine the program’s
1175 effectiveness or necessary program modifications; and
1176 10. Reduction of duplication of efforts through
1177 coordination among appropriate entities for the efficient use of
1178 resources.
1179 (b) “Community Health education program” means a program
1180 that follows involving the planned and coordinated use of the
1181 educational standards and teaching methods resources available
1182 in a community in an effort to provide:
1183 1. Appropriate medical, research-based interventions to
1184 enable and encourage changes in behaviors which reduce or
1185 eliminate health risks;
1186 2. Counseling in nutrition, weight management, physical
1187 inactivity, and tobacco-use prevention and cessation strategies;
1188 hypertension, blood pressure, high cholesterol, and diabetes
1189 control; and other clinical prevention services;
1190 3.1. Motivation and assistance to individuals or groups in
1191 adopting and maintaining Motivate and assist citizens to adopt
1192 and maintain healthful practices and lifestyles; and
1193 4.2. Make available Learning opportunities that which will
1194 increase the ability of people to make informed decisions
1195 affecting their personal, family, and community well-being and
1196 that which are designed to facilitate voluntary adoption of
1197 behavior that which will improve or maintain health.;
1198 3. Reduce, through coordination among appropriate agencies,
1199 duplication of health education efforts; and
1200 4. Facilitate collaboration among appropriate agencies for
1201 efficient use of scarce resources.
1202 (c) “Community intervention program” means a program
1203 combining the required elements of a chronic disease prevention
1204 and health promotion control program and the principles of a
1205 community health education program that addresses system,
1206 policy, and environmental changes that ensure that communities
1207 provide support for healthy lifestyles into a unified program
1208 over which a single administrative entity has authority and
1209 responsibility.
1210 (d) “Department” means the Department of Health.
1211 (e) “Risk factor” means a factor identified during the
1212 course of an epidemiological study of a disease, which factor
1213 appears to be statistically associated with a high incidence of
1214 that disease.
1215 (2) OPERATION OF COMMUNITY-LEVEL COMMUNITY INTERVENTION
1216 PROGRAMS FOR CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION.—
1217 (a) The department shall develop and implement a
1218 comprehensive, community-based program for chronic disease
1219 prevention and health promotion. The program shall be designed
1220 to reduce major behavioral risk factors that are associated with
1221 chronic diseases by enhancing the knowledge, skills, motivation,
1222 and opportunities for individuals, organizations, health care
1223 providers, small businesses, health insurers, and communities to
1224 develop and maintain healthy lifestyles. The department shall
1225 assist the county health departments in developing and operating
1226 community intervention programs throughout the state. At a
1227 minimum, the community intervention programs shall address one
1228 to three of the following chronic diseases: cancer, diabetes,
1229 heart disease, stroke, hypertension, renal disease, and chronic
1230 obstructive lung disease.
1231 (b) The program shall include:
1232 1. Countywide assessments of specific, causal, and
1233 behavioral risk factors that affect the health of residents;
1234 2. The development of community-based programs for chronic
1235 disease prevention and health promotion which incorporate health
1236 promotion and preventive care practices that are supported in
1237 scientific and medical literature;
1238 3. The development and implementation of statewide age
1239 specific, disease-specific, and community-specific health
1240 promotion and preventive care strategies using primary,
1241 secondary, and tertiary prevention interventions;
1242 4. The promotion of community, research-based health
1243 promotion model programs that meet specific criteria, address
1244 major risk factors, and motivate individuals to permanently
1245 adopt healthy behaviors and increase social and personal
1246 responsibilities;
1247 5. The development of policies that encourage the use of
1248 alternative community delivery sites for health promotion,
1249 disease prevention, and preventive care programs and promote the
1250 use of neighborhood delivery sites that are close to work, home,
1251 and school; and
1252 6. An emphasis on the importance of healthy and physically
1253 active lifestyles to build self-esteem and reduce morbidity and
1254 mortality associated with chronic disease and being overweight
1255 or obese. Existing community resources, when available, shall be
1256 used to support the programs. The department shall seek funding
1257 for the programs from federal and state financial assistance
1258 programs which presently exist or which may be hereafter
1259 created. Additional services, as appropriate, may be
1260 incorporated into a program to the extent that resources are
1261 available. The department may accept gifts and grants in order
1262 to carry out a program.
1263 (c) Volunteers shall be used to the maximum extent possible
1264 in carrying out the programs. The department shall contract for
1265 the necessary insurance coverage to protect volunteers from
1266 personal liability while acting within the scope of their
1267 volunteer assignments under a program.
1268 (d) The department may contract for the provision of all or
1269 any portion of the services required by a program, and shall so
1270 contract whenever the services so provided are more cost
1271 efficient than those provided by the department.
1272 (e) If the department determines that it is necessary for
1273 clients to help pay for services provided by a program, the
1274 department may require clients to make contribution therefor in
1275 either money or personal services. The amount of money or value
1276 of the personal services shall be fixed according to a fee
1277 schedule established by the department or by the entity
1278 developing the program. In establishing the fee schedule, the
1279 department or the entity developing the program shall take into
1280 account the expenses and resources of a client and his or her
1281 overall ability to pay for the services.
1282 Section 22. Section 385.105, Florida Statutes, is created
1283 to read:
1284 385.105 Physical activity, obesity prevention, nutrition,
1285 other health-promotion services, and wellness programs.—
1286 (1) PHYSICAL ACTIVITY—.
1287 (a) The department shall develop programs for people at
1288 every stage of their lives to increase physical fitness and
1289 promote behavior changes.
1290 (b) The department shall work with school health advisory
1291 or wellness committees in each school district as established in
1292 s. 381.0056.
1293 (c) The department shall develop public and private
1294 partnerships that allow the public to easily access recreational
1295 facilities and public land areas that are suitable for physical
1296 activity.
1297 (d) The department shall work in collaboration with the
1298 Executive Office of the Governor and Volunteer Florida, Inc., to
1299 promote school initiatives, such as the Governor’s Fitness
1300 Challenge.
1301 (e) The department shall collaborate with the Department of
1302 Education in recognizing nationally accepted best practices for
1303 improving physical education in schools.
1304 (2) OBESITY PREVENTION.—The department shall promote
1305 healthy lifestyles to reduce the prevalence of excess weight
1306 gain and being overweight or obese through programs that are
1307 directed towards all residents of this state by:
1308 (a) Using all appropriate media to promote maximum public
1309 awareness of the latest research on healthy lifestyles and
1310 chronic diseases and disseminating relevant information through
1311 a statewide clearinghouse relating to wellness, physical
1312 activity, and nutrition and the effect of these factors on
1313 chronic diseases and disabling conditions.
1314 (b) Providing technical assistance, training, and resources
1315 on healthy lifestyles and chronic diseases to the public, health
1316 care providers, school districts, and other persons or entities,
1317 including faith-based organizations that request such assistance
1318 to promote physical activity, nutrition, and healthy lifestyle
1319 programs.
1320 (c) Developing, implementing, and using all available
1321 research methods to collect data, including, but not limited to,
1322 population-specific data, and tracking the incidence and effects
1323 of weight gain, obesity, and related chronic diseases. The
1324 department shall include an evaluation and data-collection
1325 component in all programs as appropriate. All research conducted
1326 under this paragraph is subject to review and approval as
1327 required by the department’s institutional review board under s.
1328 381.86.
1329 (d) Entering into partnerships with the Department of
1330 Education, local communities, school districts, and other
1331 entities to encourage schools in this state to promote
1332 activities during and after school to help students meet a
1333 minimum goal of 30 minutes of physical activity or physical
1334 fitness per day.
1335 (e) Entering into partnerships with the Department of
1336 Education, school districts, and the Florida Sports Foundation
1337 to develop a programs recognizing the schools at which students
1338 demonstrate excellent physical fitness or fitness improvement.
1339 (f) Collaborating with other state agencies to develop
1340 policies and strategies for preventing and treating obesity,
1341 which shall be incorporated into programs administered by each
1342 agency and shall include promoting healthy lifestyles of
1343 employees of each agency.
1344 (g) Advising, in accordance with s. 456.081, health care
1345 practitioners about the morbidity, mortality, and costs
1346 associated with being overweight or obese, informing such
1347 practitioners of promising clinical practices for preventing and
1348 treating obesity, and encouraging practitioners to counsel their
1349 patients regarding the adoption of healthy lifestyles.
1350 (h) Maximizing all local, state, and federal funding
1351 sources, including grants, public-private partnerships, and
1352 other mechanisms to strengthen the department’s programs
1353 promoting physical activity and nutrition.
1354 (3) NUTRITION.—The department shall promote optimal
1355 nutritional status in all stages of people’s lives by developing
1356 strategies to:
1357 (a) Promote and maintain optimal nutritional status in the
1358 population through activities, including, but not limited to:
1359 1. Nutrition screening and assessment and nutrition
1360 counseling, including nutrition therapy, followup, case
1361 management, and referrals for persons who have medical
1362 conditions or nutrition-risk factors and who are provided health
1363 services through public health programs or through referrals
1364 from private health care providers or facilities;
1365 2. Nutrition education to assist residents of the state in
1366 achieving optimal health and preventing chronic disease; and
1367 3. Consultative nutrition services to group facilities
1368 which promote the provision of safe and nutritionally adequate
1369 diets.
1370 (b) Monitor and conduct surveillance of the nutritional
1371 status of this state’s population.
1372 (c) Conduct or support research or evaluations related to
1373 public health nutrition. All research conducted under this
1374 paragraph is subject to review and approval as required by the
1375 department’s institutional review board under s. 381.86.
1376 (d) Establish policies and standards for public health
1377 nutrition practices.
1378 (e) Promote interagency cooperation, professional
1379 education, and consultation.
1380 (f) Provide technical assistance and advise state agencies,
1381 private institutions, and local organizations regarding public
1382 health nutrition standards.
1383 (g) Work with the Department of Agriculture and Consumer
1384 Services, the Department of Education, and the Department of
1385 Management Services to further the use of fresh produce from
1386 this state in schools and encourage the development of community
1387 gardens. Nutritional services shall be available to eligible
1388 persons in accordance with eligibility criteria adopted by the
1389 department. The department shall provide by rule requirements
1390 for the service fees, when applicable, which may not exceed the
1391 department’s actual costs.
1392
1393 The department may adopt rules to administer this subsection.
1394 (4) OTHER HEALTH-PROMOTION SERVICES.—
1395 (a) The department shall promote personal responsibility by
1396 encouraging residents of this state to be informed, follow
1397 health recommendations, seek medical consultations and health
1398 assessments, take healthy precautions, and comply with medical
1399 guidelines, including those that lead to earlier detection of
1400 chronic diseases in order to prevent chronic diseases or slow
1401 the progression of established chronic diseases.
1402 (b) The department shall promote regular health visits
1403 during a person’s lifetime, including annual physical
1404 examinations that include measuring body mass index and vital
1405 signs, blood work, immunizations, screenings, and dental
1406 examinations in order to reduce the financial, social, and
1407 personal burden of chronic disease.
1408 (5) WELLNESS PROGRAMS.—
1409 (a) Each state agency may conduct employee wellness
1410 programs in buildings and lands owned or leased by the state.
1411 The department shall serve as a model to develop and implement
1412 employee wellness programs that may include physical fitness,
1413 healthy nutrition, self-management of disease, education, and
1414 behavioral change. The department shall assist other state
1415 agencies to develop and implement employee wellness programs.
1416 These programs shall use existing resources, facilities, and
1417 programs or resources procured through grant funding and
1418 donations that are obtained in accordance with state ethics and
1419 procurement policies, and shall provide equal access to any such
1420 programs, resources, and facilities to all state employees.
1421 (b) The department shall coordinate its efforts with the
1422 Department of Management Services and other state agencies.
1423 (c) Each agency may establish an employee wellness work
1424 group to design the program. The department shall be available
1425 to provide policy guidance and assist in identifying effective
1426 wellness program strategies.
1427 (d) The department shall provide by rule requirements for
1428 nominal participation fees, when applicable, which may not
1429 exceed the department’s actual costs; collaborations with
1430 businesses; and the procurement of equipment and incentives.
1431 Section 23. Section 385.202, Florida Statutes, is amended
1432 to read:
1433 385.202 Statewide cancer registry.—
1434 (1) Each facility, laboratory, or practitioner licensed
1435 under chapter 395, chapter 458, chapter 459, chapter 464,
1436 chapter 483, and each freestanding radiation therapy center as
1437 defined in s. 408.07, shall report to the department of Health
1438 such information, specified by the department, by rule. The
1439 department may adopt rules regarding reporting requirements for
1440 the cancer registry, which shall include the data required, the
1441 timeframe for reporting, and those professionals who are
1442 responsible for ensuring compliance with reporting requirements,
1443 which indicates diagnosis, stage of disease, medical history,
1444 laboratory data, tissue diagnosis, and radiation, surgical, or
1445 other methods of diagnosis or treatment for each cancer
1446 diagnosed or treated by the facility or center. Failure to
1447 comply with this requirement may be cause for registration or
1448 licensure suspension or revocation.
1449 (2) The department shall establish, or cause to have
1450 established, by contract with a recognized medical organization
1451 in this state and its affiliated institutions, a statewide
1452 cancer registry program to ensure that cancer reports required
1453 under this section shall be maintained and available for use in
1454 the course of public health surveillance and any study for the
1455 purpose of reducing morbidity or mortality; and no liability of
1456 any kind or character for damages or other relief shall arise or
1457 be enforced against any facility or practitioner hospital by
1458 reason of having provided such information or material to the
1459 department.
1460 (3) The department may adopt rules regarding the
1461 establishment and operation of a statewide cancer registry
1462 program.
1463 (4)(3) The department or a contractual designee operating
1464 the statewide cancer registry program required by this section
1465 shall use or publish said material only for the purpose of
1466 public health surveillance and advancing medical research or
1467 medical education in the interest of reducing morbidity or
1468 mortality, except that a summary of such studies may be released
1469 for general publication. Information which discloses or could
1470 lead to the disclosure of the identity of any person whose
1471 condition or treatment has been reported and studied shall be
1472 confidential and exempt from the provisions of s. 119.07(1),
1473 except that:
1474 (a) Release may be made with the written consent of all
1475 persons to whom the information applies;
1476 (b) The department or a contractual designee may contact
1477 individuals for the purpose of epidemiologic investigation and
1478 monitoring, provided information that is confidential under this
1479 section is not further disclosed; or
1480 (c) The department may exchange personal data with any
1481 other governmental agency or a contractual designee for the
1482 purpose of public health surveillance and medical or scientific
1483 research, if provided such governmental agency or contractual
1484 designee does shall not further disclose information that is
1485 confidential under this section.
1486 (5)(4) Funds appropriated for this section shall be used
1487 for establishing, administering, compiling, processing, and
1488 providing biometric and statistical analyses to the reporting
1489 facilities and practitioners. Funds may also be used to ensure
1490 the quality and accuracy of the information reported and to
1491 provide management information to the reporting facilities and
1492 practitioners.
1493 (6)(5) The department may adopt rules regarding the
1494 classifications of, by rule, classify facilities that are
1495 responsible for making reports to the cancer registry, the
1496 content and frequency of the reports, and the penalty for
1497 failure to comply with these requirements for purposes of
1498 reports made to the cancer registry and specify the content and
1499 frequency of the reports. In classifying facilities, the
1500 department shall exempt certain facilities from reporting cancer
1501 information that was previously reported to the department or
1502 retrieved from existing state reports made to the department or
1503 the Agency for Health Care Administration. The provisions of
1504 This section does shall not apply to any facility whose primary
1505 function is to provide psychiatric care to its patients.
1506 (7) Notwithstanding subsection (1), each facility and
1507 practitioner that reports cancer cases to the department shall
1508 make their records available for onsite review by the department
1509 or its authorized representative.
1510 Section 24. Subsection (3) of section 385.203, Florida
1511 Statutes, is amended to read:
1512 385.203 Diabetes Advisory Council; creation; function;
1513 membership.—
1514 (3) The council shall be composed of 26 25 citizens of the
1515 state who have knowledge of, or work in, the area of diabetes
1516 mellitus as follows:
1517 (a) Five interested citizens, three of whom are affected by
1518 diabetes.
1519 (b) Twenty-one Twenty members, who must include one
1520 representative from each of the following areas: nursing with
1521 diabetes-educator certification; dietary with diabetes educator
1522 certification; podiatry; ophthalmology or optometry; psychology;
1523 pharmacy; adult endocrinology; pediatric endocrinology; the
1524 American Diabetes Association (ADA); the Juvenile Diabetes
1525 Foundation (JDF); the Florida Academy of Family Physicians; a
1526 community health center; a county health department; an American
1527 Diabetes Association recognized community education program;
1528 each medical school in the state; an osteopathic medical school;
1529 the insurance industry; a Children’s Medical Services diabetes
1530 regional program; and an employer.
1531 (c) One or more representatives from the Department of
1532 Health, who shall serve on the council as ex officio members.
1533 Section 25. Section 385.206, Florida Statutes, is amended
1534 to read:
1535 385.206 Pediatric Hematology-Oncology care Center Program.—
1536 (1) DEFINITIONS.—As used in this section, the term:
1537 (a) “Department” means the Department of Health.
1538 (b) “Hematology” means the study, diagnosis, and treatment
1539 of blood and blood-forming tissues.
1540 (c) “Oncology” means the study, diagnosis, and treatment of
1541 malignant neoplasms or cancer.
1542 (d) “Hemophilia” or “other hemostatic disorder” means a
1543 bleeding disorder resulting from a genetic abnormality of
1544 mechanisms related to the control of bleeding.
1545 (e) “Sickle-cell anemia or other hemoglobinopathy” means an
1546 hereditary, chronic disease caused by an abnormal type of
1547 hemoglobin.
1548 (f) “Patient” means a person under the age of 21 who is in
1549 need of hematologic-oncologic services and who is enrolled in
1550 the Children’s Medical Services Network declared medically and
1551 financially eligible by the department; or a person who received
1552 such services prior to age 21 and who requires long-term
1553 monitoring and evaluation to ascertain the sequelae and the
1554 effectiveness of treatment.
1555 (g) “Center” means a facility designated by the department
1556 as having a program specifically designed to provide a full
1557 range of medical and specialty services to patients with
1558 hematologic and oncologic disorders.
1559 (2) PEDIATRIC HEMATOLOGY-ONCOLOGY CARE CENTER PROGRAM;
1560 AUTHORITY.—The department may designate is authorized to make
1561 grants and reimbursements to designated centers and provide
1562 funding to establish and maintain programs for the care of
1563 patients with hematologic and oncologic disorders. Program
1564 administration costs shall be paid by the department from funds
1565 appropriated for this purpose.
1566 (3) GRANT FUNDING CONTRACTS GRANT AGREEMENTS; CONDITIONS.—
1567 (a) Funding provided A grant made under this section shall
1568 be pursuant to a contract contractual agreement made between a
1569 center and the department. Each contract agreement shall provide
1570 that patients will receive services specified types of treatment
1571 and care from the center without additional charge to the
1572 patients or their parents or guardians. Grants shall be
1573 disbursed in accordance with conditions set forth in the
1574 disbursement guidelines.
1575 (4) GRANT DISBURSEMENTS AND SPECIAL DISBURSEMENTS FOR LOCAL
1576 PROGRAMS.—
1577 (b)(a) Funding may be provided Grant disbursements may be
1578 made to centers that which meet the following criteria:
1579 1. The personnel shall include at least one board-certified
1580 pediatric hematologist-oncologist, at least one board-certified
1581 pediatric surgeon, at least one board-certified radiotherapist,
1582 and at least one board-certified pathologist.
1583 2. As approved by the department, The center shall actively
1584 participate in a national children’s cancer study group,
1585 maintain a pediatric tumor registry, have a multidisciplinary
1586 pediatric tumor board, and meet other guidelines for
1587 development, including, but not limited to, guidelines from such
1588 organizations as the American Academy of Pediatrics and the
1589 American Pediatric Surgical Association.
1590 (b) Programs shall also be established to provide care to
1591 hematology-oncology patients within each district of the
1592 department. The guidelines for local programs shall be
1593 formulated by the department. Special disbursements may be made
1594 by the program office to centers for educational programs
1595 designed for the districts of the department. These programs may
1596 include teaching total supportive care of the dying patient and
1597 his or her family, home therapy to hemophiliacs and patients
1598 with other hemostatic disorders, and screening and counseling
1599 for patients with sickle-cell anemia or other
1600 hemoglobinopathies.
1601 (4)(5) PROGRAM AND PEER REVIEW.—The department shall
1602 evaluate at least annually during the grant period the services
1603 rendered by the centers and the districts of the department.
1604 Data from the centers and other sources relating to pediatric
1605 cancer shall be reviewed annually by the Florida Association of
1606 Pediatric Tumor Programs, Inc.; and a written report with
1607 recommendations shall be made to the department. This database
1608 will be available to the department for program planning and
1609 quality assurance initiatives formulation of its annual program
1610 and financial evaluation report. A portion of the funds
1611 appropriated for this section may be used to provide statewide
1612 consultation, supervision, and evaluation of the programs of the
1613 centers, as well as central program office support personnel.
1614 Section 26. Paragraph (g) of subsection (2) and subsection
1615 (7) of section 385.207, Florida Statutes, are amended to read:
1616 385.207 Care and assistance of persons with epilepsy;
1617 establishment of programs in epilepsy control.—
1618 (2) The Department of Health shall:
1619 (g) Continue current programs and develop cooperative
1620 programs and services designed to enhance the vocational
1621 rehabilitation of epilepsy clients, including the current jobs
1622 programs. The department shall, as part of its contract with a
1623 provider of epilepsy services, collect information regarding the
1624 number of clients served, the outcomes reached, the expenses
1625 incurred, and the fees collected by such providers for the
1626 provision of services keep and make this information available
1627 to the Governor and the Legislature upon request information
1628 regarding the number of clients served, the outcome reached, and
1629 the expense incurred by such programs and services.
1630 (7) The department shall limit total administrative
1631 expenditures from the Epilepsy Services Trust Fund to 5 percent
1632 of annual receipts.
1633 Section 27. Paragraphs (b), (d), and (g) of subsection (2)
1634 and paragraph (b) of subsection (5) of section 385.210, Florida
1635 Statutes, are amended to read:
1636 385.210 Arthritis prevention and education.—
1637 (2) LEGISLATIVE FINDINGS.—The Legislature finds the
1638 following:
1639 (b) Arthritis is the leading cause of disability in the
1640 United States, limiting daily activities for more than 19 7
1641 million citizens.
1642 (d) There are enormous economic and social costs associated
1643 with treating arthritis and its complications; the economic
1644 costs are estimated at over $128 billion (2003) $116 billion
1645 (1997) annually in the United States.
1646 (g) The National Arthritis Foundation, the CDC Centers for
1647 Disease Control and Prevention, and the Association of State and
1648 Territorial Health Officials have led the development of a
1649 public health strategy, the National Arthritis Action Plan, to
1650 respond to this challenge.
1651 (5) FUNDING.—
1652 (b) The State Surgeon General may shall seek any federal
1653 waiver or waivers that may be necessary to maximize funds from
1654 the Federal Government to implement this program.
1655 Section 28. Section 385.301, Florida Statutes, is created
1656 to read:
1657 385.301 Rulemaking authority.—The department may adopt
1658 rules pursuant to chapter 120 to administer this chapter.
1659 Section 29. Section 385.401, Florida Statutes, is created
1660 to read:
1661 385.401 Direct-support organization.—
1662 (1) DIRECT-SUPPORT ORGANIZATION ESTABLISHED.—The Department
1663 of Health may establish a direct-support organization to provide
1664 assistance, funding, and support for the department in carrying
1665 out its mission upon written approval by the State Surgeon
1666 General. This section governs the creation, use, powers, and
1667 duties of the direct-support organization.
1668 (2) DEFINITIONS.—As used in this section, the term:
1669 (a) “Department” means the Department of Health.
1670 (b) “Direct-support organization” means an organization
1671 that is:
1672 1. A Florida corporation, not for profit, incorporated
1673 under chapter 617, exempted from filing fees, and approved by
1674 the Department of State;
1675 2. Organized and operated to conduct programs and
1676 activities; to initiate developmental projects; to raise funds;
1677 to request and receive grants, gifts, and bequests of moneys; to
1678 acquire, receive, hold, invest, and administer in its own name
1679 securities, funds, or property; and to make expenditures to or
1680 for the direct or indirect benefit of the state public health
1681 system through the department or its individual county health
1682 departments;
1683 3. Determined by the department to be operating in a manner
1684 consistent with the priority issues and objectives of the
1685 department and in the best interest of the state; and
1686 4. Approved in writing by the State Surgeon General to
1687 operate for the direct or indirect benefit of the department or
1688 its individual county health departments. This approval shall be
1689 in a form determined by the department.
1690 (3) BOARD OF DIRECTORS.—The direct-support organization
1691 shall be governed by a board of directors.
1692 (a) The board of directors shall consist of no fewer than
1693 seven members appointed by the State Surgeon General. Networks
1694 and partnerships in this state which are involved in issues
1695 related to public health may recommend nominees to the State
1696 Surgeon General.
1697 (b) The term of office of the board members shall be 3
1698 years, except that the terms of the initial appointees shall be
1699 for 1 year, 2 years, or 3 years in order to achieve staggered
1700 terms. A member may be reappointed when his or her term expires.
1701 The State Surgeon General or his or her designee shall serve as
1702 an ex officio member of the board of directors.
1703 (c) Members must be current residents of this state. A
1704 majority of the members must be highly knowledgeable about the
1705 department, its service personnel, and its missions. The board
1706 must include members from county government, the health care
1707 industry, the medical community, and other components of the
1708 public health system. The State Surgeon General may remove any
1709 member of the board for cause and with the approval of a
1710 majority of the members of the board of directors. The State
1711 Surgeon General shall appoint a replacement for any vacancy that
1712 occurs.
1713 (4) USE OF PROPERTY.—
1714 (a) The department and each county health department in the
1715 state may allow, without charge, the use of the department’s
1716 fixed property and facilities within the state public health
1717 system by the direct-support organization, subject to this
1718 section. Use of the fixed property and facilities by the direct
1719 support organization may not interfere with use of the fixed
1720 property and facilities by the department’s clients or staff.
1721 (b) The department may not allow the use of its fixed
1722 property and facilities by any direct-support organization that
1723 is organized under this section and does not provide equal
1724 employment opportunities to all persons regardless of race,
1725 color, national origin, gender, age, or religion.
1726 (5) DIRECTIVES.—The direct-support organization that is
1727 organized under this section shall comply with directives and
1728 requirements established by the sources of its funding.
1729 (6) ANNUAL BUDGETS AND REPORTS.—
1730 (a) The fiscal year of the direct-support organization
1731 shall begin on July 1 of each year and end on June 30 of the
1732 following year.
1733 (b) The direct-support organization shall submit to the
1734 department its federal Internal Revenue Service Application for
1735 Recognition of Exemption form and its federal Internal Revenue
1736 Service Return of Organization Exempt from Income Tax form.
1737 (7) ANNUAL AUDIT.—The direct-support organization shall
1738 provide for an annual financial audit in accordance with s.
1739 215.981.
1740 Section 30. Subsection (9) of section 409.904, Florida
1741 Statutes, is amended to read:
1742 409.904 Optional payments for eligible persons.—The agency
1743 may make payments for medical assistance and related services on
1744 behalf of the following persons who are determined to be
1745 eligible subject to the income, assets, and categorical
1746 eligibility tests set forth in federal and state law. Payment on
1747 behalf of these Medicaid eligible persons is subject to the
1748 availability of moneys and any limitations established by the
1749 General Appropriations Act or chapter 216.
1750 (9) Eligible women with incomes at or below 200 percent of
1751 the federal poverty level and under age 65, for cancer treatment
1752 pursuant to the federal Breast and Cervical Cancer Prevention
1753 and Treatment Act of 2000, screened through the Mary Brogan
1754 Breast and Cervical Cancer Early Detection Program established
1755 under s. 385.2021 s. 381.93.
1756 Section 31. The Pharmacy and Therapeutic Advisory Council.—
1757 (1) The Pharmacy and Therapeutic Advisory Council is
1758 created within the Executive Office of the Governor to serve in
1759 an advisory capacity to the Department of Health and other
1760 governmental agencies. The council may not interfere with
1761 existing mandated Medicaid services and may not develop or
1762 implement new ones. Specifically, the council may not interfere
1763 with the work of the Agency for Health Care Administration as it
1764 complies with federal and state statutory obligations to develop
1765 a preferred drug list, to negotiate rebate agreements for
1766 medications included in the preferred drug list, and to protect
1767 the confidentiality of rebate agreements. The council may not
1768 interfere with the Medicaid Pharmacy and Therapeutics Committee
1769 or the Drug Utilization Review Board, which oversee clinical
1770 activities within the Bureau of Pharmacy Services if such
1771 interference would violate any federal or state statutory
1772 obligations.
1773 (2) The Pharmacy and Therapeutic Advisory Council shall use
1774 Medicaid processes within the existing Medicaid structure of the
1775 Agency for Health Care Administration as a guide for assisting
1776 state agencies in:
1777 (a) Developing an unbiased clinical perspective on drug
1778 evaluations and utilization protocols that are relevant to
1779 patient care provided through programs administered by state
1780 agencies.
1781 (b) Developing drug-utilization-review processes that are
1782 relevant to the agencies and those receiving care through
1783 programs administered by the agencies.
1784 (c) Building a formulary structure that enforces formulary
1785 compliance or adherence within each agency.
1786 (d) Performing pharmacoeconomic analyses on formulary
1787 management so that the state maximizes the cost-effectiveness of
1788 its pharmaceutical purchasing.
1789 (e) Reviewing new and existing therapies using criteria
1790 established for efficacy, safety, and quality in order to
1791 maximize cost-effective purchasing.
1792 (f) Reviewing state agency proposals to maximize the cost
1793 effectiveness of pharmaceutical purchasing in compliance with s.
1794 381.0203.
1795 (3) The council shall verify the cost-effectiveness and
1796 clinical efficacy of any state contracts under s. 381.0203(1),
1797 Florida Statutes, no less than once every 2 years.
1798 (4) The members of the council and the chair shall be
1799 appointed by the Governor to 4-year staggered terms or until
1800 their successors are appointed. Members may be appointed to more
1801 than one term. The Governor shall fill any vacancies for the
1802 remainder of the unexpired term in the same manner as the
1803 original appointment.
1804 (5) The council shall include voting and nonvoting members,
1805 and the chair, who is a voting member, must be a pharmacist
1806 employed by a state agency.
1807 (a) The voting members shall represent:
1808 1. The Agency for Health Care Administration.
1809 2. The Agency for Persons with Disabilities.
1810 3. The Department of Children and Family Services.
1811 4. The Department of Corrections.
1812 5. The Department of Elderly Affairs.
1813 6. The Department of Health.
1814 7. The Department of Juvenile Justice.
1815 8. The Bureau of Pharmacy Services within the Agency for
1816 Health Care Administration, which shall be represented by the
1817 bureau chief.
1818 9. The Bureau of Statewide Pharmaceutical Services within
1819 the Department of Health, which shall be represented by the
1820 bureau chief.
1821 (b) The nonvoting members shall be:
1822 1. A representative from the Agency for Health Care
1823 Administration’s drug contracting program.
1824 2. The contracting officer for the Department of Health’s
1825 drug procurement program.
1826 3. A clinical pharmacy program manager from the Agency for
1827 Health Care Administration.
1828 4. The chair of the Department of Health’s Pharmacy and
1829 Therapeutics Committee.
1830 5. The general counsel for the Agency for Health Care
1831 Administration or his or her designee.
1832 6. The general counsel for a state agency in the executive
1833 branch of state government, or his or her designee.
1834 7. A representative from the Executive Office of the
1835 Governor.
1836 8. The statewide pharmacy director of the Department of
1837 Corrections’ Office of Health Services.
1838 (6) Members of the council shall consist of at least one
1839 physician licensed under chapter 458 or chapter 459, Florida
1840 Statutes, at least one pharmacist licensed under chapter 465,
1841 Florida Statutes, and at least one registered nurse licensed
1842 under chapter 464, Florida Statutes. Each member designated in
1843 this subsection must have an active license in his or her
1844 profession and may not have been the subject of any agency
1845 disciplinary action.
1846 (7) Members, who must be residents of this state, shall be
1847 selected on the basis of specialty, board certification, prior
1848 pharmacy and therapeutic experience, experience treating medical
1849 assistance recipients, ability to represent a broad base of
1850 constituents, and number of years of practice. Members must not
1851 have any conflicts of interest due to their service on the
1852 council.
1853 (8) The council may request the participation of additional
1854 subject-matter experts to address specific drug, therapeutic, or
1855 drug-procurement issues under review by the council.
1856 (9) A majority of the members of the council constitutes a
1857 quorum, and an affirmative vote of a majority of the voting
1858 members is necessary to take action.
1859 (10) The council shall meet quarterly or at the call of the
1860 chair.
1861 (11) The council shall be staffed by the chair’s department
1862 or agency.
1863 (12) The council members shall serve without compensation,
1864 but are entitled to reimbursement for travel and per diem
1865 expenses incurred in the performance of their duties in
1866 accordance with s. 112.061, Florida Statutes.
1867 Section 32. Paragraph (g) is added to subsection (53) of
1868 section 499.003, Florida Statutes, to read:
1869 499.003 Definitions of terms used in this part.—As used in
1870 this part, the term:
1871 (53) “Wholesale distribution” means distribution of
1872 prescription drugs to persons other than a consumer or patient,
1873 but does not include:
1874 (g) The sale, purchase, trade, or transfer of a
1875 prescription drug among agencies and health care entities of the
1876 state to complete the dispensing of the prescription drug to a
1877 patient under the care of a state agency or health care entity,
1878 or to a patient for whom the state is responsible for providing
1879 or arranging health care services. The agency or health care
1880 entity that received the prescription drug on behalf of the
1881 patient is deemed the patient’s agent under s. 465.003(6).
1882 Section 33. This act shall take effect July 1, 2009.
1883