Senate Bill 2034

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    Florida Senate - 2000                                  SB 2034

    By Senator Clary





    7-882B-00

  1                      A bill to be entitled

  2         An act relating to the Department of Health;

  3         amending s. 20.43, F.S.; requiring the

  4         department to include certain assessments,

  5         projections, and recommendations in the

  6         department's strategic plan rather than in the

  7         state health plan; amending s. 39.303, F.S.;

  8         providing duties of the Children's Medical

  9         Services Program within the department with

10         respect to child protection teams; amending s.

11         120.80, F.S.; revising procedures for hearings

12         conducted with respect to the Brain and Spinal

13         Cord Injury Program; amending s. 154.011, F.S.;

14         revising duties of the department with respect

15         to monitoring and administering certain primary

16         care programs; amending s. 215.5602, F.S.;

17         revising the goals of and expenditures for the

18         Florida Biomedical Research Program within the

19         Lawton Chiles Endowment Fund; amending s.

20         381.0011, F.S.; providing requirements for the

21         department's strategic plan; amending s.

22         381.003, F.S.; requiring the department to

23         develop an immunization registry; requiring

24         that the registry include all children born in

25         this state; providing procedures under which a

26         parent or guardian may elect not to participate

27         in the immunization registry; providing for the

28         electronic transfer of records between health

29         care professionals and other agencies;

30         authorizing the department to adopt rules for

31         administering the registry; amending s.

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  1         381.0031, F.S.; authorizing the department to

  2         obtain and inspect copies of certain medical

  3         records and information, notwithstanding laws

  4         governing the confidentiality of patient

  5         records; exempting health care practitioners,

  6         health care facilities, and agents and

  7         employees thereof from liability for the

  8         authorized release of patient records; amending

  9         s. 381.004, F.S.; revising requirements for the

10         release of certain preliminary test results for

11         human immunodeficiency virus; revising the

12         definition of the term "medical personnel" to

13         include additional personnel; amending s.

14         381.0059, F.S.; defining the term "person who

15         provides services under a school health

16         services plan" for purposes of background

17         screening requirements for school health

18         services personnel; amending s. 381.0101, F.S.;

19         revising certification requirements for certain

20         environmental health professionals; amending s.

21         381.731, F.S.; requiring that the department

22         include certain strategies in the department's

23         strategic plan rather than in the Healthy

24         Communities, Healthy People Plan; amending s.

25         381.734, F.S.; revising the requirements of the

26         Healthy Communities, Healthy People Program;

27         transferring, renumbering, and amending s.

28         413.46, F.S.; revising legislative intent with

29         respect to the brain and spinal cord injury

30         program; creating s. 381.745, F.S.; providing

31         definitions for purposes of the Charlie Mack

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  1         Overstreet Brain or Spinal Cord Injuries Act;

  2         amending s. 381.75, F.S., relating to duties of

  3         the department under the brain and spinal cord

  4         injury program; conforming provisions to

  5         changes made by the act; creating s. 381.755,

  6         F.S.; providing that the right to benefits

  7         under the program is not assignable; amending

  8         s. 381.76, F.S.; revising eligibility

  9         requirements for the brain and spinal cord

10         injury program; creating s. 381.765, F.S.;

11         authorizing the department to retain title to

12         property and equipment and to dispose of

13         surplus equipment; authorizing the department

14         to adopt rules; creating s. 381.775, F.S.;

15         continuing the confidentiality provided for

16         records and information that pertains to

17         applicants for and recipients of services under

18         the brain and spinal cord injury program;

19         specifying circumstances under which the

20         department may release such records or

21         information; amending s. 381.78, F.S., relating

22         to the advisory council on brain and spinal

23         cord injuries; authorizing reimbursement for

24         per diem and travel expenses for members of the

25         council; prohibiting a council member from

26         voting on matters that provide a financial

27         benefit or create a conflict of interest;

28         providing for removal of members for cause;

29         creating s. 381.785, F.S.; authorizing the

30         department to recover third-party payments for

31         funded services; providing for the enforcement

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  1         of such right to recovery pursuant to a lien;

  2         requiring the department to adopt rules

  3         governing the recovery of payments; amending s.

  4         381.79, F.S., relating to the Brain and Spinal

  5         Cord Injury Rehabilitation Trust Fund;

  6         redesignating the fund as the "Brain and Spinal

  7         Cord Injury Program Trust Fund"; providing

  8         additional purposes for which moneys in the

  9         trust fund may be used; authorizing the

10         department to accept certain gifts; amending s.

11         385.103, F.S.; providing for the department to

12         operate community intervention programs rather

13         than comprehensive health improvement projects;

14         revising definitions; revising duties of the

15         department in operating such services;

16         requiring the department to adopt rules

17         governing the operation of community

18         intervention programs; amending s. 385.207,

19         F.S., relating to programs in epilepsy control;

20         conforming a cross-reference; amending s.

21         392.545, F.S.; prohibiting law enforcement

22         agencies from releasing the names of persons

23         subject to proceedings under the Tuberculosis

24         Control Act; creating s. 392.566, F.S.;

25         providing for the appointment of a guardian

26         advocate for persons who are hospitalized due

27         to active tuberculosis; providing for a

28         hearing; providing for a right to counsel;

29         providing qualifications for a person appointed

30         as a guardian advocate; providing requirements

31         for the department and the guardian advocate

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  1         with respect to giving consent to the treatment

  2         of a hospitalized person; providing

  3         requirements for the court in selecting a

  4         guardian advocate; providing for the discharge

  5         of the guardian advocate; amending s. 402.181,

  6         F.S.; providing for certain damages and

  7         injuries caused by patients of institutions

  8         under the Department of Health and specified

  9         other state agencies to be reimbursed under the

10         State Institutions Claims Program; amending s.

11         514.021, F.S.; requiring the department to

12         review rules; providing an effective date.

13

14  Be It Enacted by the Legislature of the State of Florida:

15

16         Section 1.  Paragraph (l) of subsection (1) of section

17  20.43, Florida Statutes, is amended to read:

18         20.43  Department of Health.--There is created a

19  Department of Health.

20         (1)  The purpose of the Department of Health is to

21  promote and protect the health of all residents and visitors

22  in the state through organized state and community efforts,

23  including cooperative agreements with counties.  The

24  department shall:

25         (l)  Include in the department's strategic plan

26  developed under s. 186.021 an assessment of Biennially

27  publish, and annually update, a state health plan that

28  assesses current health programs, systems, and costs; makes

29  projections of future problems and opportunities; and

30  recommended recommends changes that are needed in the health

31  care system to improve the public health.

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  1         Section 2.  Section 39.303, Florida Statutes, is

  2  amended to read:

  3         39.303  Child protection teams; services; eligible

  4  cases.--The Children's Medical Services Program in the

  5  Department of Health shall develop, maintain, and coordinate

  6  the services of one or more multidisciplinary child protection

  7  teams in each of the service districts of the Department of

  8  Children and Family Services.  Such teams may be composed of

  9  appropriate representatives of school districts and

10  appropriate health, mental health, social service, legal

11  service, and law enforcement agencies. The Legislature finds

12  that optimal coordination of child protection teams and sexual

13  abuse treatment programs requires collaboration between the

14  Department of Health and the Department of Children and Family

15  Services. The two departments shall maintain an interagency

16  agreement that establishes protocols for oversight and

17  operations of child protection teams and sexual abuse

18  treatment programs. The Secretary of Health and the Deputy

19  Secretary director of Children's Medical Services, in

20  consultation with the Secretary of Children and Family

21  Services, shall maintain the responsibility for the screening,

22  employment, and, if necessary, the termination of child

23  protection team medical directors, at headquarters and in the

24  15 districts. Child protection team medical directors shall be

25  responsible for oversight of the teams in the districts.

26         (1)  The Department of Health shall utilize and convene

27  the teams to supplement the assessment and protective

28  supervision activities of the family safety and preservation

29  program of the Department of Children and Family Services.

30  Nothing in this section shall be construed to remove or reduce

31  the duty and responsibility of any person to report pursuant

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  1  to this chapter all suspected or actual cases of child abuse,

  2  abandonment, or neglect or sexual abuse of a child.  The role

  3  of the teams shall be to support activities of the program and

  4  to provide services deemed by the teams to be necessary and

  5  appropriate to abused, abandoned, and neglected children upon

  6  referral.  The specialized diagnostic assessment, evaluation,

  7  coordination, consultation, and other supportive services that

  8  a child protection team shall be capable of providing include,

  9  but are not limited to, the following:

10         (a)  Medical diagnosis and evaluation services,

11  including provision or interpretation of X rays and laboratory

12  tests, and related services, as needed, and documentation of

13  findings relative thereto.

14         (b)  Telephone consultation services in emergencies and

15  in other situations.

16         (c)  Medical evaluation related to abuse, abandonment,

17  or neglect, as defined by policy or rule of the Department of

18  Health.

19         (d)  Such psychological and psychiatric diagnosis and

20  evaluation services for the child or the child's parent or

21  parents, legal custodian or custodians, or other caregivers,

22  or any other individual involved in a child abuse,

23  abandonment, or neglect case, as the team may determine to be

24  needed.

25         (e)  Expert medical, psychological, and related

26  professional testimony in court cases.

27         (f)  Case staffings to develop treatment plans for

28  children whose cases have been referred to the team.  A child

29  protection team may provide consultation with respect to a

30  child who is alleged or is shown to be abused, abandoned, or

31  neglected, which consultation shall be provided at the request

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  1  of a representative of the family safety and preservation

  2  program or at the request of any other professional involved

  3  with a child or the child's parent or parents, legal custodian

  4  or custodians, or other caregivers.  In every such child

  5  protection team case staffing, consultation, or staff activity

  6  involving a child, a family safety and preservation program

  7  representative shall attend and participate.

  8         (g)  Case service coordination and assistance,

  9  including the location of services available from other public

10  and private agencies in the community.

11         (h)  Such training services for program and other

12  employees of the Department of Children and Family Services,

13  employees of the Department of Health, and other medical

14  professionals as is deemed appropriate to enable them to

15  develop and maintain their professional skills and abilities

16  in handling child abuse, abandonment, and neglect cases.

17         (i)  Educational and community awareness campaigns on

18  child abuse, abandonment, and neglect in an effort to enable

19  citizens more successfully to prevent, identify, and treat

20  child abuse, abandonment, and neglect in the community.

21         (2)  The child abuse, abandonment, and neglect reports

22  that must be referred by the Department of Children and Family

23  Services to child protection teams of the Department of Health

24  for medical evaluation and available support services as set

25  forth in subsection (1) must include cases involving:

26         (a)  Bruises, burns, or fractures in a child of any

27  age.

28         (b)  Sexual abuse of a child in which vaginal or anal

29  penetration is alleged or in which other unlawful sexual

30  conduct has been determined to have occurred.

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  1         (c)  Venereal disease, or any other sexually

  2  transmitted disease, in a prepubescent child.

  3         (d)  Reported malnutrition of a child and failure of a

  4  child to thrive.

  5         (e)  Reported medical, physical, or emotional neglect

  6  of a child.

  7         (f)  Any family in which one or more children have been

  8  pronounced dead on arrival at a hospital or other health care

  9  facility, or have been injured and later died, as a result of

10  suspected abuse, abandonment, or neglect, when any sibling or

11  other child remains in the home.

12         (g)  Symptoms of serious emotional problems in a child

13  when emotional or other abuse, abandonment, or neglect is

14  suspected.

15         (h)  Injuries to a child's head.

16         (3)  All abuse and neglect cases transmitted for

17  investigation to a district by the hotline must be

18  simultaneously transmitted to the Department of Health child

19  protection team for review. All cases transmitted to the child

20  protection team which meet the criteria in subsection (2) must

21  be timely reviewed by a board-certified pediatrician or

22  registered nurse practitioner under the supervision of such

23  pediatrician for the purpose of determining whether a

24  face-to-face medical evaluation by a child protection team is

25  necessary.  Such face-to-face medical evaluation is not

26  necessary only if it is determined that the child was examined

27  by a physician for the alleged abuse or neglect, and a

28  consultation between the child protection team board-certified

29  pediatrician or nurse practitioner and the examining physician

30  concludes that a further medical evaluation is unnecessary.

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  1         (4)  In all instances in which a child protection team

  2  is providing certain services to abused, abandoned, or

  3  neglected children, other offices and units of the Department

  4  of Health, and offices and units of the Department of Children

  5  and Family Services, shall avoid duplicating the provision of

  6  those services.

  7         Section 3.  Subsection (15) of section 120.80, Florida

  8  Statutes, is amended to read:

  9         120.80  Exceptions and special requirements;

10  agencies.--

11         (15)  DEPARTMENT OF HEALTH.--Notwithstanding s.

12  120.57(1)(a), formal hearings may not be conducted by the

13  Secretary of Health, the director of the Agency for Health

14  Care Administration, or a board or member of a board within

15  the Department of Health or the Agency for Health Care

16  Administration for matters relating to the regulation of

17  professions, as defined by part II of chapter 455.

18  Notwithstanding s. 120.57(1)(a), hearings conducted within the

19  Department of Health in execution of the Special Supplemental

20  Nutrition Program for Women, Infants, and Children; Child Care

21  Food Program; Children's Medical Services Program; the Brain

22  and Spinal Cord Injury Program; and the exemption from

23  disqualification reviews for certified nurse assistants

24  program need not be conducted by an administrative law judge

25  assigned by the division. The Department of Health may

26  contract with the Department of Children and Family Services

27  for a hearing officer in these matters.

28         Section 4.  Subsections (2) and (5) of section 154.011,

29  Florida Statutes, are amended to read:

30         154.011  Primary care services.--

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  1         (2)  The department shall monitor, measure, and

  2  evaluate be responsible for monitoring, measuring, and

  3  evaluating the quality of care, cost-effectiveness, services,

  4  and geographic accessibility provided by each primary care

  5  program and shall utilize the resulting data when

  6  renegotiating contracts with counties.

  7         (5)  The department shall adopt rules to govern the

  8  operation of primary care programs authorized by this section.

  9  Such rules shall include, but not be limited to, quality of

10  care, case management, a definition of income used to

11  determine eligibility or sliding fees, and Medicaid

12  participation and shall be developed by the State Health

13  Officer. Rules governing services to clients under 21 years of

14  age shall be developed in conjunction with children's medical

15  services and shall at a minimum include preventive services as

16  set forth in s. 627.6579.

17         Section 5.  Paragraphs (a) and (b) of subsection (1)

18  and subsection (2) of section 215.5602, Florida Statutes, are

19  amended to read:

20         215.5602  Florida Biomedical Research Program.--

21         (1)  There is established within the Lawton Chiles

22  Endowment Fund the Florida Biomedical Research Program to

23  support research initiatives that address the health care

24  problems of Floridians in the areas of cancer, cardiovascular

25  disease, stroke, and pulmonary disease. The long-term goals of

26  the program are to:

27         (a)  Improve the health of Floridians by researching

28  better prevention, diagnoses, and treatments for cancer,

29  cardiovascular disease, stroke, and pulmonary disease.

30         (b)  Expand the foundation of biomedical knowledge

31  relating to the prevention, diagnosis, and treatment of

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  1  diseases related to tobacco use, including cancer,

  2  cardiovascular disease, stroke, and pulmonary disease.

  3         (2)  Funds appropriated from the Lawton Chiles

  4  Endowment Fund to the Department of Health for the purposes of

  5  this section shall be used exclusively for the award of grants

  6  and fellowships under the program established in this section;

  7  for research relating to the prevention, diagnosis, and

  8  treatment of diseases related to tobacco use, including

  9  cancer, cardiovascular disease, stroke, and pulmonary disease;

10  and for expenses incurred in the administration of this

11  section.

12         Section 6.  Subsection (3) of section 381.0011, Florida

13  Statutes, is amended to read:

14         381.0011  Duties and powers of the Department of

15  Health.--It is the duty of the Department of Health to:

16         (3)  Include in the department's strategic plan

17  developed under s. 186.021 a summary of Develop a

18  comprehensive public health plan that addresses all aspects of

19  the public health mission and establishes health status

20  objectives to direct the use of public health resources with

21  an emphasis on prevention.

22         Section 7.  Paragraph (e) of subsection (1) and

23  subsection (2) of section 381.003, Florida Statutes, is

24  amended to read:

25         381.003  Communicable disease and acquired immune

26  deficiency syndrome prevention and control.--

27         (1)  The department shall conduct a communicable

28  disease prevention and control program as part of fulfilling

29  its public health mission. A communicable disease is any

30  disease caused by transmission of a specific infectious agent,

31  or its toxic products, from an infected person, an infected

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  1  animal, or the environment to a susceptible host, either

  2  directly or indirectly. The communicable disease program must

  3  include, but need not be limited to:

  4         (e)  Programs for the prevention and control of

  5  vaccine-preventable diseases, including programs to immunize

  6  school children as required by s. 232.032 and the development

  7  of an automated, electronic, and centralized database or

  8  registry of immunizations. The department shall ensure that

  9  all children in this state are immunized against

10  vaccine-preventable diseases. The immunization registry shall

11  allow the department to enhance current immunization

12  activities for the purpose of improving the immunization of

13  all children in this state.

14         1.  Except as provided in subparagraph 2., the

15  department shall include all children born in this state in

16  the immunization registry by using the birth records from the

17  Office of Vital Statistics. The department shall add other

18  children to the registry as immunization services are

19  provided.

20         2.  The parent or guardian of a child may refuse to

21  participate in the immunization registry by signing a form

22  obtained from the department, or from the health care

23  practitioner or entity that provides the immunization, which

24  indicates that the parent or guardian does not wish to

25  participate in the immunization registry. The decision to not

26  participate in the immunization registry must be noted in the

27  registry.

28         3.  The immunization registry shall allow for

29  immunization records to be electronically transferred to

30  entities that are required by law to have such records,

31  including schools, licensed child care facilities, and any

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  1  other entity that is required by law to obtain proof of a

  2  child's immunizations.

  3         4.  Any health care practitioner licensed under chapter

  4  458, chapter 459, or chapter 464 in this state who is

  5  authorized by the department to access the immunization

  6  registry may, through the immunization registry, directly

  7  access immunization records and update a child's immunization

  8  history or exchange immunization information with another

  9  authorized practitioner, entity, or agency involved in a

10  child's care. The information included in the immunization

11  registry must include the child's name, date of birth,

12  address, and any other unique identifier necessary to

13  correctly identify the child; the immunization record,

14  including the date, type of administered vaccine, and vaccine

15  lot number; and the presence or absence of any adverse

16  reaction or contraindication related to the immunization.

17  Information received by the department for the immunization

18  registry retains its status as confidential medical

19  information and the department must maintain the

20  confidentiality of that information in accordance with this

21  section and s. 455.667. A health care practitioner or other

22  agency that obtains information from the immunization registry

23  must maintain the confidentiality of any medical records in

24  accordance with s. 455.667 or as otherwise required by law.

25         (2)  The department may adopt, repeal, and amend rules

26  related to the prevention and control of communicable diseases

27  and the administration of the immunization registry. Such

28  rules may include, including procedures for investigating

29  disease, timeframes for reporting disease, requirements for

30  followup reports of known or suspected exposure to disease,

31  and procedures for providing access to confidential

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  1  information necessary for disease investigations. For purposes

  2  of the immunization registry, the rules may include procedures

  3  for a health care practitioner to obtain authorization to use

  4  the immunization registry, methods for a parent or guardian to

  5  elect not to participate in the immunization registry, and

  6  procedures for a health care practitioner licensed under

  7  chapter 458, chapter 459, or chapter 464 to access and share

  8  electronic immunization records with other entities allowed by

  9  law to have access to the records.

10         Section 8.  Section 381.0031, Florida Statutes, is

11  amended to read:

12         381.0031  Report of diseases of public health

13  significance to department.--

14         (1)  Any practitioner licensed in this state to

15  practice medicine, osteopathic medicine, chiropractic

16  medicine, naturopathy, or veterinary medicine; any hospital

17  licensed under part I of chapter 395; or any laboratory

18  licensed under chapter 483 that diagnoses or suspects the

19  existence of a disease of public health significance shall

20  immediately report the fact to the Department of Health.

21         (2)  Periodically the department shall issue a list of

22  infectious or noninfectious diseases determined by it to be a

23  threat to public health and therefore of significance to

24  public health and shall furnish a copy of the list to the

25  practitioners listed in subsection (1).

26         (3)  Reports required by this section must be in

27  accordance with methods specified by rule of the department.

28         (4)  Information submitted in reports required by this

29  section is confidential, exempt from the provisions of s.

30  119.07(1), and is to be made public only when necessary to

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  1  public health. A report so submitted is not a violation of the

  2  confidential relationship between practitioner and patient.

  3         (5)  The department may obtain and inspect copies of

  4  medical records, records of laboratory tests, and other

  5  medical-related information for reported cases of diseases of

  6  public health significance described in subsection (2). The

  7  department shall examine the records of a person who has a

  8  disease of public health significance only for purposes of

  9  preventing and eliminating outbreaks of disease and making

10  epidemiological investigations of reported cases of diseases

11  of public health significance, notwithstanding any other law

12  to the contrary. Health care practitioners, licensed health

13  care facilities, and laboratories shall allow the department

14  to inspect and obtain copies of such medical records and

15  medical-related information, notwithstanding any other law to

16  the contrary. Release of medical records and medical-related

17  information to the department by a health care practitioner,

18  licensed health care facility, or laboratory, or by an

19  authorized employee or agent thereof, does not constitute a

20  violation of the confidentiality of patient records. A health

21  care practitioner, health care facility, or laboratory, or any

22  employee or agent thereof, may not be held liable in any

23  manner for damages and is not subject to criminal penalties

24  for providing patient records to the department as authorized

25  by this section.

26         (6)(5)  The department may adopt rules related to

27  reporting diseases of significance to public health, which

28  must specify the information to be included in the report, who

29  is required to report, the method and time period for

30  reporting, requirements for enforcement, and required followup

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  1  activities by the department which are necessary to protect

  2  public health.

  3

  4  This section does not affect s. 384.25.

  5         Section 9.  Paragraphs (d) and (h) of subsection (3) of

  6  section 381.004, Florida Statutes, are amended to read:

  7         381.004  Testing for human immunodeficiency virus.--

  8         (3)  HUMAN IMMUNODEFICIENCY VIRUS TESTING; INFORMED

  9  CONSENT; RESULTS; COUNSELING; CONFIDENTIALITY.--

10         (d)  No test result shall be determined as positive,

11  and no positive test result shall be revealed to any person,

12  without corroborating or confirmatory tests being conducted

13  except in the following situations:

14         1.  Preliminary test results may be released to

15  licensed physicians or the medical or nonmedical personnel

16  subject to the significant exposure for purposes of

17  subparagraphs (h)10., 11., and 12.

18         2.  Preliminary test results may be released to health

19  care providers and to the person tested when decisions about

20  medical care or treatment of the person tested cannot await

21  the results of confirmatory testing.  Positive preliminary HIV

22  test results shall not be characterized to the patient as a

23  diagnosis of HIV infection.  Justification for the use of

24  preliminary test results must be documented in the medical

25  record by the health care provider who ordered the test.  This

26  subparagraph does not authorize the release of preliminary

27  test results for the purpose of routine identification of

28  HIV-infected individuals or when HIV testing is incidental to

29  the preliminary diagnosis or care of a patient.  Corroborating

30  or confirmatory testing must be conducted as followup to a

31  positive preliminary test.  Results shall be communicated to

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  1  the patient according to statute regardless of the outcome.

  2  Except as provided in this section, test results are

  3  confidential and exempt from the provisions of s. 119.07(1).

  4         (h)  Notwithstanding the provisions of paragraph (a),

  5  informed consent is not required:

  6         1.  When testing for sexually transmissible diseases is

  7  required by state or federal law, or by rule including the

  8  following situations:

  9         a.  HIV testing pursuant to s. 796.08 of persons

10  convicted of prostitution or of procuring another to commit

11  prostitution.

12         b.  Testing for HIV by a medical examiner in accordance

13  with s. 406.11.

14         2.  Those exceptions provided for blood, plasma,

15  organs, skin, semen, or other human tissue pursuant to s.

16  381.0041.

17         3.  For the performance of an HIV-related test by

18  licensed medical personnel in bona fide medical emergencies

19  when the test results are necessary for medical diagnostic

20  purposes to provide appropriate emergency care or treatment to

21  the person being tested and the patient is unable to consent,

22  as supported by documentation in the medical record.

23  Notification of test results in accordance with paragraph (c)

24  is required.

25         4.  For the performance of an HIV-related test by

26  licensed medical personnel for medical diagnosis of acute

27  illness where, in the opinion of the attending physician,

28  obtaining informed consent would be detrimental to the

29  patient, as supported by documentation in the medical record,

30  and the test results are necessary for medical diagnostic

31  purposes to provide appropriate care or treatment to the

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  1  person being tested. Notification of test results in

  2  accordance with paragraph (c) is required if it would not be

  3  detrimental to the patient.  This subparagraph does not

  4  authorize the routine testing of patients for HIV infection

  5  without informed consent.

  6         5.  When HIV testing is performed as part of an autopsy

  7  for which consent was obtained pursuant to s. 872.04.

  8         6.  For the performance of an HIV test upon a defendant

  9  pursuant to the victim's request in a prosecution for any type

10  of sexual battery where a blood sample is taken from the

11  defendant voluntarily, pursuant to court order for any

12  purpose, or pursuant to the provisions of s. 775.0877, s.

13  951.27, or s. 960.003; however, the results of any HIV test

14  performed shall be disclosed solely to the victim and the

15  defendant, except as provided in ss. 775.0877, 951.27, and

16  960.003.

17         7.  When an HIV test is mandated by court order.

18         8.  For epidemiological research pursuant to s.

19  381.0032, for research consistent with institutional review

20  boards created by 45 C.F.R. part 46, or for the performance of

21  an HIV-related test for the purpose of research, if the

22  testing is performed in a manner by which the identity of the

23  test subject is not known and may not be retrieved by the

24  researcher.

25         9.  When human tissue is collected lawfully without the

26  consent of the donor for corneal removal as authorized by s.

27  732.9185 or enucleation of the eyes as authorized by s.

28  732.919.

29         10.  For the performance of an HIV test upon an

30  individual who comes into contact with medical personnel in

31  such a way that a significant exposure has occurred during the

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  1  course of employment or within the scope of practice and where

  2  a blood sample is available that was taken from that

  3  individual voluntarily by medical personnel for other

  4  purposes.  The term "medical personnel" includes a licensed or

  5  certified health care professional; an employee of a health

  6  care professional or, health care facility; employees of a

  7  laboratory licensed under chapter 483; personnel of a, or

  8  blood bank or plasma center; a medical student or other

  9  student who is receiving training as a health care

10  professional at a health care facility; and a paramedic or

11  emergency medical technician certified by the department to

12  perform life-support procedures under as defined in s. 401.23.

13         a.  Prior to performance of an HIV test on a

14  voluntarily obtained blood sample, the individual from whom

15  the blood was obtained shall be requested to consent to the

16  performance of the test and to the release of the results.

17  The individual's refusal to consent and all information

18  concerning the performance of an HIV test and any HIV test

19  result shall be documented only in the medical personnel's

20  record unless the individual gives written consent to entering

21  this information on the individual's medical record.

22         b.  Reasonable attempts to locate the individual and to

23  obtain consent shall be made and all attempts must be

24  documented. If the individual cannot be found, an HIV test may

25  be conducted on the available blood sample. If the individual

26  does not voluntarily consent to the performance of an HIV

27  test, the individual shall be informed that an HIV test will

28  be performed, and counseling shall be furnished as provided in

29  this section.  However, HIV testing shall be conducted only

30  after a licensed physician documents, in the medical record of

31  the medical personnel, that there has been a significant

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  1  exposure and that, in the physician's medical judgment, the

  2  information is medically necessary to determine the course of

  3  treatment for the medical personnel.

  4         c.  Costs of any HIV test of a blood sample performed

  5  with or without the consent of the individual, as provided in

  6  this subparagraph, shall be borne by the medical personnel or

  7  the employer of the medical personnel. However, costs of

  8  testing or treatment not directly related to the initial HIV

  9  tests or costs of subsequent testing or treatment shall not be

10  borne by the medical personnel or the employer of the medical

11  personnel.

12         d.  In order to utilize the provisions of this

13  subparagraph, the medical personnel must either be tested for

14  HIV pursuant to this section or provide the results of an HIV

15  test taken within 6 months prior to the significant exposure

16  if such test results are negative.

17         e.  A person who receives the results of an HIV test

18  pursuant to this subparagraph shall maintain the

19  confidentiality of the information received and of the persons

20  tested.  Such confidential information is exempt from s.

21  119.07(1).

22         f.  If the source of the exposure will not voluntarily

23  submit to HIV testing and a blood sample is not available, the

24  medical personnel or the employer of such person acting on

25  behalf of the employee may seek a court order directing the

26  source of the exposure to submit to HIV testing.  A sworn

27  statement by a physician licensed under chapter 458 or chapter

28  459 that a significant exposure has occurred and that, in the

29  physician's medical judgment, testing is medically necessary

30  to determine the course of treatment constitutes probable

31  cause for the issuance of an order by the court.  The results

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  1  of the test shall be released to the source of the exposure

  2  and to the person who experienced the exposure.

  3         11.  For the performance of an HIV test upon an

  4  individual who comes into contact with medical personnel in

  5  such a way that a significant exposure has occurred during the

  6  course of employment or within the scope of practice of the

  7  medical personnel while the medical personnel provides

  8  emergency medical treatment to the individual; or who comes

  9  into contact with nonmedical personnel in such a way that a

10  significant exposure has occurred while the nonmedical

11  personnel provides emergency medical assistance during a

12  medical emergency.  For the purposes of this subparagraph, a

13  medical emergency means an emergency medical condition outside

14  of a hospital or health care facility that provides physician

15  care. The test may be performed only during the course of

16  treatment for the medical emergency.

17         a.  An individual who is capable of providing consent

18  shall be requested to consent to an HIV test prior to the

19  testing. The individual's refusal to consent, and all

20  information concerning the performance of an HIV test and its

21  result, shall be documented only in the medical personnel's

22  record unless the individual gives written consent to entering

23  this information on the individual's medical record.

24         b.  HIV testing shall be conducted only after a

25  licensed physician documents, in the medical record of the

26  medical personnel or nonmedical personnel, that there has been

27  a significant exposure and that, in the physician's medical

28  judgment, the information is medically necessary to determine

29  the course of treatment for the medical personnel or

30  nonmedical personnel.

31

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  1         c.  Costs of any HIV test performed with or without the

  2  consent of the individual, as provided in this subparagraph,

  3  shall be borne by the medical personnel or the employer of the

  4  medical personnel or nonmedical personnel. However, costs of

  5  testing or treatment not directly related to the initial HIV

  6  tests or costs of subsequent testing or treatment shall not be

  7  borne by the medical personnel or the employer of the medical

  8  personnel or nonmedical personnel.

  9         d.  In order to utilize the provisions of this

10  subparagraph, the medical personnel or nonmedical personnel

11  shall be tested for HIV pursuant to this section or shall

12  provide the results of an HIV test taken within 6 months prior

13  to the significant exposure if such test results are negative.

14         e.  A person who receives the results of an HIV test

15  pursuant to this subparagraph shall maintain the

16  confidentiality of the information received and of the persons

17  tested.  Such confidential information is exempt from s.

18  119.07(1).

19         f.  If the source of the exposure will not voluntarily

20  submit to HIV testing and a blood sample was not obtained

21  during treatment for the medical emergency, the medical

22  personnel, the employer of the medical personnel acting on

23  behalf of the employee, or the nonmedical personnel may seek a

24  court order directing the source of the exposure to submit to

25  HIV testing.  A sworn statement by a physician licensed under

26  chapter 458 or chapter 459 that a significant exposure has

27  occurred and that, in the physician's medical judgment,

28  testing is medically necessary to determine the course of

29  treatment constitutes probable cause for the issuance of an

30  order by the court.  The results of the test shall be released

31

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  1  to the source of the exposure and to the person who

  2  experienced the exposure.

  3         12.  For the performance of an HIV test by the medical

  4  examiner or attending physician upon an individual who expired

  5  or could not be resuscitated while receiving emergency medical

  6  assistance or care and who was the source of a significant

  7  exposure to medical or nonmedical personnel providing such

  8  assistance or care.

  9         a.  HIV testing may be conducted only after a licensed

10  physician documents in the medical record of the medical

11  personnel or nonmedical personnel that there has been a

12  significant exposure and that, in the physician's medical

13  judgment, the information is medically necessary to determine

14  the course of treatment for the medical personnel or

15  nonmedical personnel.

16         b.  Costs of any HIV test performed under this

17  subparagraph may not be charged to the deceased or to the

18  family of the deceased person.

19         c.  For the provisions of this subparagraph to be

20  applicable, the medical personnel or nonmedical personnel must

21  be tested for HIV under this section or must provide the

22  results of an HIV test taken within 6 months before the

23  significant exposure if such test results are negative.

24         d.  A person who receives the results of an HIV test

25  pursuant to this subparagraph shall comply with paragraph (e).

26         13.  For the performance of an HIV-related test

27  medically indicated by licensed medical personnel for medical

28  diagnosis of a hospitalized infant as necessary to provide

29  appropriate care and treatment of the infant when, after a

30  reasonable attempt, a parent cannot be contacted to provide

31  consent. The medical records of the infant shall reflect the

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  1  reason consent of the parent was not initially obtained.  Test

  2  results shall be provided to the parent when the parent is

  3  located.

  4         14.  For the performance of HIV testing conducted to

  5  monitor the clinical progress of a patient previously

  6  diagnosed to be HIV positive.

  7         15.  For the performance of repeated HIV testing

  8  conducted to monitor possible conversion from a significant

  9  exposure.

10         Section 10.  Section 381.0059, Florida Statutes, is

11  amended to read:

12         381.0059  Background screening requirements for school

13  health services personnel.--

14         (1)(a)  Any person who provides services under a school

15  health services plan pursuant to s. 381.0056 must complete

16  level 2 screening as provided in chapter 435. A person may

17  satisfy the requirements of this subsection by submitting

18  proof of compliance with the requirements of level 2 screening

19  under s. 435.04, conducted within 12 months before the date

20  that person initially provides services under a school health

21  services plan pursuant to s. 381.0056. Any person who provides

22  services under a school health services plan pursuant to s.

23  381.0056 shall be on probationary status pending the results

24  of the level 2 screening.

25         (b)  In order to conduct level 2 screening, any person

26  who provides services under a school health services plan

27  pursuant to s. 381.0056 must furnish to the Department of

28  Health a full set of fingerprints to enable the department to

29  conduct a criminal background investigation. Each person who

30  provides services under a school health services plan pursuant

31  to s. 381.0056 must file a complete set of fingerprints taken

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  1  by an authorized law enforcement officer and must provide

  2  sufficient information for a statewide criminal records

  3  correspondence check through the Florida Department of Law

  4  Enforcement. The Department of Health shall submit the

  5  fingerprints to the Florida Department of Law Enforcement for

  6  a statewide criminal history check, and the Florida Department

  7  of Law Enforcement shall forward the fingerprints to the

  8  Federal Bureau of Investigation for a national criminal

  9  history check.

10         (c)  The person subject to the required background

11  screening or his or her employer must pay the fees required to

12  obtain the background screening. Payment for the screening and

13  the abuse registry check must be submitted to the Department

14  of Health. The Florida Department of Law Enforcement shall

15  charge the Department of Health for a level 2 screening at a

16  rate sufficient to cover the costs of such screening pursuant

17  to s. 943.053(3). The Department of Health shall establish a

18  schedule of fees to cover the costs of the level 2 screening

19  and the abuse registry check. The applicant or his or her

20  employer who pays for the required screening may be reimbursed

21  by the Department of Health from funds designated for this

22  purpose.

23         (2)(a)  When the Department of Health has reasonable

24  cause to believe that grounds exist for the disqualification

25  of any person providing services under a school health

26  services plan pursuant to s. 381.0056, as a result of

27  background screening, it shall notify the person in writing,

28  stating the specific record that indicates noncompliance with

29  the level 2 screening standards. The Department of Health must

30  disqualify any person from providing services under a school

31  health services plan pursuant to s. 381.0056 if the department

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  1  finds that the person is not in compliance with the level 2

  2  screening standards. A person who provides services under a

  3  school health plan pursuant to s. 381.0056 on a probationary

  4  status and who is disqualified because of the results of his

  5  or her background screening may contest that disqualification.

  6         (b)  As provided in s. 435.07, the Department of Health

  7  may grant an exemption from disqualification to a person

  8  providing services under a school health services plan

  9  pursuant to s. 381.0056 who has not received a professional

10  license or certification from the Department of Health.

11         (c)  As provided in s. 435.07, the Department of Health

12  may grant an exemption from disqualification to a person

13  providing services under a school health services plan

14  pursuant to s. 381.0056 who has received a professional

15  license or certification from the Department of Health.

16         (3)  Any person who is required to undergo the

17  background screening to provide services under a school health

18  plan pursuant to s. 381.0056 who refuses to cooperate in such

19  screening or refuses to submit the information necessary to

20  complete the screening, including fingerprints, shall be

21  disqualified for employment or volunteering in such position

22  or, if employed, shall be dismissed.

23         (4)  Under penalty of perjury, each person who provides

24  services under a school health plan pursuant to s. 381.0056

25  must attest to meeting the level 2 screening requirements for

26  participation under the plan and agree to inform the

27  Department of Health immediately if convicted of any

28  disqualifying offense while providing services under a school

29  health services plan pursuant to s. 381.0056.

30         (5)  As used in this section, the term "person who

31  provides services under a school health services plan" does

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  1  not include an unpaid volunteer who lectures students in group

  2  settings on health education topics.

  3         Section 11.  Paragraphs (a) and (d) of subsection (5)

  4  of section 381.0101, Florida Statutes, are amended to read:

  5         381.0101  Environmental health professionals.--

  6         (5)  STANDARDS FOR CERTIFICATION.--The department shall

  7  adopt rules that establish minimum standards of education,

  8  training, or experience for those persons subject to this

  9  section. The rules shall also address the process for

10  application, examination, issuance, expiration, and renewal of

11  certification and ethical standards of practice for the

12  profession.

13         (a)  Persons employed as environmental health

14  professionals shall exhibit a knowledge of rules and

15  principles of environmental and public health law in Florida

16  through examination.  A person may not conduct environmental

17  health evaluations in a primary program area unless he or she

18  is currently certified in that program area or works under the

19  direct supervision of a certified environmental health

20  professional.

21         1.  All persons who begin employment in a primary

22  environmental health program on or after September 21, 1994,

23  must be certified in that program within 6 months after

24  employment.

25         2.  Persons employed in the a primary environmental

26  health program of a food protection program or an onsite

27  sewage treatment and disposal system prior to September 21,

28  1994, shall be considered certified while employed in that

29  position and shall be required to adhere to any professional

30  standards established by the department pursuant to paragraph

31  (b), complete any continuing education requirements imposed

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  1  under paragraph (d), and pay the certificate renewal fee

  2  imposed under subsection (7).

  3         3.  Persons employed in the a primary environmental

  4  health program of a food protection program or an onsite

  5  sewage treatment and disposal system prior to September 21,

  6  1994, who change positions or program areas and transfer into

  7  another primary environmental health program area on or after

  8  September 21, 1994, must be certified in that program within 6

  9  months after such transfer, except that they will not be

10  required to possess the college degree required under

11  paragraph (e).

12         4.  Registered sanitarians shall be considered

13  certified and shall be required to adhere to any professional

14  standards established by the department pursuant to paragraph

15  (b).

16         (d)  Persons who are certified shall renew their

17  certification biennially by completing not less than 24

18  contact hours of continuing education for each program area in

19  which they maintain certification, subject to a maximum of 48

20  hours for multiprogram certification.

21         Section 12.  Section 381.731, Florida Statutes, is

22  amended to read:

23         381.731  Strategic planning Healthy Communities,

24  Healthy People Plan.--

25         (1)  The Department of Health shall include

26  population-based health-promotion strategies in the

27  department's strategic plan developed under s. 186.021 develop

28  a biennial Healthy Communities, Healthy People Plan that shall

29  be submitted to the Governor, the President of the Senate, and

30  the Speaker of the House of Representatives by December 31 of

31  each even-numbered year.

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  1         (2)  The strategic plan must include data on the health

  2  status of the state's population, health status objectives and

  3  outcome measures, and public health strategies, including

  4  health promotion strategies.  The strategic plan must also

  5  provide an overall conceptual framework for the state's health

  6  promotion programs that considers available information on

  7  mortality, morbidity, disability, and behavioral risk factors

  8  associated with chronic diseases and conditions; proposals for

  9  public and private health insurance reforms needed to fully

10  implement the state's health promotion initiative; the best

11  health promotion practices of the county health departments

12  and other states; and proposed educational reforms needed to

13  promote healthy behaviors among the state's school-age

14  children.

15         Section 13.  Section 381.734, Florida Statutes, is

16  amended to read:

17         381.734  Healthy Communities, Healthy People Program.--

18         (1)  The department shall develop and implement the

19  Healthy Communities, Healthy People Program, a comprehensive

20  and community-based health promotion and wellness program.

21  The program shall be designed to reduce major behavioral risk

22  factors associated with chronic diseases, including those

23  chronic diseases identified in chapter 385, and injuries and

24  accidents, by enhancing the knowledge, skills, motivation, and

25  opportunities for individuals, organizations, and communities

26  to develop and maintain healthy lifestyles.

27         (2)  The department shall consolidate and use existing

28  resources, programs, and program data to develop this program,

29  to avoid duplication of efforts or services.  Such resources,

30  programs, and program data shall include the community

31  intervention programs operated, but not be limited to, s.

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  1  381.103, the comprehensive health improvement project under s.

  2  385.103, and the comprehensive public health plan, public

  3  information, and statewide injury control plan under s.

  4  381.0011(3), (8), and (12).

  5         (3)  The program shall include:

  6         (a)  Biennial Statewide assessments of specific,

  7  causal, and behavioral risk factors that affect the health of

  8  residents of the state.

  9         (b)  The development of community-based health

10  promotion programs, incorporating health promotion and

11  preventive care practices supported in scientific and medical

12  literature.

13         (c)  The development and implementation of statewide

14  age-specific, disease-specific, and community-specific health

15  promotion and preventive care strategies using primary,

16  secondary, and tertiary prevention interventions.

17         (d)  The development and implementation of models for

18  testing statewide health promotion of community-based

19  health-promotion model programs that meet specific criteria

20  and address major risk factors in the state and motivate

21  individuals to permanently adopt healthy behaviors, enhance

22  self-esteem, and increase social and personal

23  responsibilities.

24         (e)  The enhancement of the department's State Health

25  Office's special initiatives to develop the mental, emotional,

26  and social competencies of children and adolescents, using

27  innovative school-based and neighborhood-based approaches to

28  build self-esteem and prevent later problems such as drug

29  abuse, poor school performance, criminal behavior, and other

30  behavioral problems.

31

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  1         (f)  The development and implementation of a statewide

  2  health education program to educate the public and communities

  3  about health risks and assist them in modifying unhealthy

  4  behaviors.

  5         (g)  The establishment of a comprehensive program to

  6  inform the public, health care professionals, and communities

  7  about the prevalence of chronic diseases in the state; known

  8  and potential risks, including social and behavioral risks;

  9  and behavior changes that would reduce risks.

10         (h)  The development and implementation of a program

11  for enhancing self-help organizations and volunteer programs

12  that enlist the support of volunteers in health promotion

13  activities, particularly persons who serve as role models

14  because of their public visibility or because of their

15  recovery from or skill in coping with disease.

16         (i)  The development of policies that encourage the use

17  of alternative community delivery sites for health promotion

18  and preventive care programs and promote the use of

19  neighborhood delivery sites that are close to work, home, and

20  school.

21         (j)  An emphasis on the importance of a physically

22  active lifestyle to build self-esteem, reduce morbidity and

23  mortality associated with chronic disease, and reduce obesity.

24         Section 14.  Section 413.46, Florida Statutes, is

25  transferred, renumbered as section 381.7395, Florida Statutes,

26  and amended to read:

27         381.7395 413.46  Legislative intent.--It is the intent

28  of the Legislature to ensure the referral of individuals

29  persons who have moderate-to-severe brain or spinal cord

30  injuries to the brain and spinal cord injury program, a

31  coordinated rehabilitation program developed and administered

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  1  by the department division. The program shall provide eligible

  2  persons, as defined in s. 381.76 s. 413.507, the opportunity

  3  to obtain the necessary rehabilitative services enabling them

  4  to be referred to a vocational rehabilitation program or to

  5  return to an appropriate level of functioning in their

  6  community. Further, it is intended that permanent disability

  7  be avoided, whenever possible, through prevention, early

  8  identification, skilled emergency medical services and

  9  transport evacuation procedures, and proper medical and

10  rehabilitative treatment.

11         Section 15.  Section 381.745, Florida Statutes, is

12  created to read:

13         381.745  Definitions.--As used in ss. 381.739-381.79,

14  the term:

15         (1)  "Activity of daily living" means an activity

16  required on a frequent basis which permits an individual to

17  secure or maintain independence. Such activities include, but

18  are not limited to, personal home care, transportation,

19  personal-assistance services, housekeeping, shopping,

20  attending school, communication, and employment.

21         (2)  "Brain or spinal cord injury" means:

22         (a)  A lesion to the spinal cord or cauda equina,

23  resulting from external trauma, with evidence of significant

24  involvement of two of the following deficits or dysfunctions:

25         1.  Motor deficit.

26         2.  Sensory deficit.

27         3.  Bowel and bladder dysfunction.

28         (b)  An insult to the skull, brain, or its covering,

29  resulting from external trauma that produces an altered state

30  of consciousness or anatomic motor, sensory, cognitive, or

31  behavioral deficits.

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  1         (3)  "Emergency medical evacuation system" means a

  2  department-approved transportation system that provides timely

  3  and skilled emergency care and movement of individuals

  4  believed to have sustained a brain or spinal cord injury.

  5         (4)  "Personal-assistance services" means a range of

  6  services, provided by one or more individuals, which are

  7  designed to assist an individual who has a disability to

  8  perform activities of daily living.

  9         (5)  "Funded services" means services paid for through

10  the brain and spinal cord injury program.

11         (6)  "Designated facility" means a facility approved by

12  the brain and spinal cord injury program which meets the

13  criteria and standards of care of the brain and spinal cord

14  injury program for individuals who have sustained a brain or

15  spinal cord injury.

16         (7)  "Third-party coverage" means any claim for, right

17  to receive payment for, or any coverage for the payment of any

18  services under the brain and spinal cord injury program.

19         (8)  "Third-party payment" means any and all payments

20  received or due as a result of any third-party obligation

21  created by gift, coverage or other contract, settlement or

22  judicial decision, or action of law.

23         (9)  "Transitional living facility" means a

24  state-approved facility, as defined and licensed under chapter

25  400, or a facility approved by the brain and spinal cord

26  injury program in accordance with this chapter.

27         (10)  "Trauma center" means a department-approved acute

28  care facility that provides diagnosis and treatment of

29  individuals who have sustained a brain or spinal cord injury.

30         Section 16.  Section 381.75, Florida Statutes, is

31  amended to read:

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  1         381.75  Duties and responsibilities of the department,

  2  of transitional living facilities, and of

  3  residents.--Consistent with the mandate of s. 381.7395 s.

  4  413.46, the department shall develop and administer a

  5  multilevel treatment program for individuals persons who

  6  sustain have brain or spinal cord injuries and who are

  7  referred to the brain and spinal cord injury program.

  8         (1)  Within 15 days after any report of an individual a

  9  person who has sustained a brain or spinal cord injury, the

10  department shall notify the individual or the most immediate

11  available family members of their right to assistance from the

12  state, the services available, and the eligibility

13  requirements.

14         (2)  The department shall refer individuals persons who

15  have brain or spinal cord injuries to other state agencies to

16  assure that rehabilitative services, if desired, are obtained

17  by that individual person.

18         (3)  The department, in consultation with emergency

19  medical service, shall develop standards for an emergency

20  medical evacuation system that will ensure that all

21  individuals persons who sustain traumatic brain or spinal cord

22  injuries are transported to a department-approved trauma

23  center that meets the standards and criteria established by

24  the emergency medical service and the acute-care standards of

25  the brain and spinal cord injury program.

26         (4)  The department shall develop standards for

27  designation of rehabilitation centers to provide

28  rehabilitation services for individuals persons who have brain

29  or spinal cord injuries.

30         (5)  The department shall determine the appropriate

31  number of designated acute-care facilities, inpatient

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  1  rehabilitation centers, and outpatient rehabilitation centers,

  2  needed based on incidence, volume of admissions, and other

  3  appropriate criteria.

  4         (6)  The department shall develop standards for

  5  designation of transitional living facilities to provide

  6  individuals the opportunity to adjust to their disabilities

  7  and to develop physical and functional skills in a supported

  8  living environment.

  9         (a)  The Agency for Health Care Administration, in

10  consultation with the department, shall develop rules for the

11  licensure of transitional living facilities for individuals

12  persons who have brain or spinal cord injuries.

13         (b)  The goal of a transitional living program for

14  individuals persons who have brain or spinal cord injuries is

15  to assist each individual person who has such a disability to

16  achieve a higher level of independent functioning and to

17  enable that person to reenter the community. The program shall

18  be focused on preparing participants to return to community

19  living.

20         (c)  A transitional living facility for an individual a

21  person who has a brain or spinal cord injury shall provide to

22  such individual person, in a residential setting, a

23  goal-oriented treatment program designed to improve the

24  individual's person's physical, cognitive, communicative,

25  behavioral, psychological, and social functioning, as well as

26  to provide necessary support and supervision. A transitional

27  living facility shall offer at least the following therapies:

28  physical, occupational, speech, neuropsychology, independent

29  living skills training, behavior analysis for programs serving

30  brain-injured individuals persons, health education, and

31  recreation.

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  1         (d)  All residents shall use the transitional living

  2  facility as a temporary measure and not as a permanent home or

  3  domicile. The transitional living facility shall develop an

  4  initial treatment plan for each resident within 3 days after

  5  the resident's admission. The transitional living facility

  6  shall develop a comprehensive plan of treatment and a

  7  discharge plan for each resident as soon as practical, but no

  8  later than 30 days after the resident's admission. Each

  9  comprehensive treatment plan and discharge plan must be

10  reviewed and updated as necessary, but no less often than

11  quarterly. This subsection does not require the discharge of

12  an individual who continues to require any of the specialized

13  services described in paragraph (c) or who is making

14  measurable progress in accordance with that individual's

15  comprehensive treatment plan. The transitional living facility

16  shall discharge any individual who has an appropriate

17  discharge site and who has achieved the goals of his or her

18  discharge plan or who is no longer making progress toward the

19  goals established in the comprehensive treatment plan and the

20  discharge plan. The discharge location must be the least

21  restrictive environment in which an individual's health,

22  well-being, and safety is preserved.

23         (7)  Recipients of services, under this section, from

24  any of the facilities referred to in this section shall pay a

25  fee based on ability to pay.

26         Section 17.  Section 381.755, Florida Statutes, is

27  created to read:

28         381.755  Benefits not assignable.--The right of an

29  eligible individual to any services provided by the brain and

30  spinal cord injury program is not transferable or assignable,

31  and any benefits, including money, goods, or chattels,

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  1  received as services under the brain and spinal cord injury

  2  program are exempt from all state, county, and municipal taxes

  3  and from sale under the process of any court, except for

  4  obligations contracted for the purchase of such property.

  5         Section 18.  Section 381.76, Florida Statutes, is

  6  amended to read:

  7         381.76  Eligibility for the brain and spinal cord

  8  injury program.--

  9         (1)  An individual shall be accepted as eligible for

10  the brain and spinal cord injury program following

11  certification by the department that the individual:

12         (a)  Has been referred to the central registry pursuant

13  to s. 381.74; s. 413.48.

14         (b)  Is a legal resident of this state at the time of

15  application for services;.

16         (c)  Has sustained a brain or spinal cord suffered a

17  traumatic injury; as defined in s. 413.20.

18         (d)  Is medically stable; and as defined by rules of

19  the department.

20         (e)  Is reasonably expected to achieve reintegration

21  into the community through rehabilitative services provided by

22  the brain and spinal cord injury program.

23         (2)  If In the event the department is unable to

24  provide services to all eligible individuals, the department

25  may establish an order of selection.

26         Section 19.  Section 381.765, Florida Statutes, is

27  created to read:

28         381.765  Retention of title to and disposal of

29  equipment.--

30         (1)  The department may retain title to any property,

31  tools, instruments, training supplies, equipment, or other

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  1  items of value acquired for services provided under the brain

  2  and spinal cord injury program or for personnel employed in

  3  operating the brain and spinal cord injury program, and may

  4  repossess or transfer such property, tools, instruments,

  5  supplies, equipment, or other items of value.

  6         (2)  The department may offer for sale any surplus

  7  items acquired in operating the brain and spinal cord injury

  8  program when they are no longer necessary or exchange them for

  9  necessary items that may be used to greater advantage. When

10  any such surplus equipment is sold or exchanged, a receipt for

11  the equipment shall be taken from the purchaser showing the

12  consideration given for such equipment and forwarded to the

13  Treasurer, and any funds received by the brain and spinal cord

14  injury program pursuant to any such transaction shall be

15  deposited in the Brain and Spinal Cord Injury Rehabilitation

16  Trust Fund and shall be available for expenditure for any

17  purpose consistent with this part.

18         (3)  The department may adopt rules relating to records

19  and recordkeeping for department-owned property referenced in

20  subsections (1) and (2).

21         Section 20.  Section 381.775, Florida Statutes, is

22  created to read:

23         381.775  Applicant and recipient records; confidential

24  and privileged.--

25         (1)  All oral and written records, information,

26  letters, and reports received, made, or maintained by the

27  department relative to any applicant for or recipient of

28  services under the brain and spinal cord injury program are

29  privileged, confidential, and exempt from s. 119.07(1). Any

30  person who discloses or releases such records, information, or

31  communications in violation of this section commits a

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  1  misdemeanor of the second degree, punishable as provided in s.

  2  775.082 or s. 775.083. Such records may not be released,

  3  except that:

  4         (a)  Records may be released to the applicant or

  5  recipient, or his or her representative, upon receipt of a

  6  written waiver from the applicant or recipient. Medical,

  7  psychological, or other information that the department

  8  believes may be harmful to an applicant or recipient may not

  9  be released directly to him or her, but must be provided

10  through a licensed health care professional designated by the

11  applicant or recipient.

12         (b)  Records that do not identify applicants or

13  recipients may be released for the purpose of research, when

14  the research is approved by the department.

15         (c)  Records used in administering the brain and spinal

16  cord injury program may be released as required to administer

17  the program or as required by an agency or political

18  subdivision of the state in the performance of its duties. Any

19  agency or political subdivision to which records are released

20  under this paragraph may not disclose the records to third

21  parties.

22         (d)  Records may be released upon the order of an

23  administrative law judge, a hearing officer, a judge of

24  compensation claims, an agency head exercising quasi-judicial

25  authority, or a judge of a court of competent jurisdiction

26  following a finding in an in camera proceeding that the

27  records are relevant to the inquiry before the court and

28  should be released. The in camera proceeding and all records

29  relating thereto are confidential and exempt from s.

30  119.07(1).

31

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  1         (e)  Whenever an applicant for or recipient of services

  2  under the brain and spinal cord injury program has declared

  3  any intention to harm other persons or property, such

  4  declaration may be disclosed.

  5         (f)  The department may release personal information

  6  about an applicant for or recipient of services under the

  7  brain and spinal cord injury program in order to protect him

  8  or her or others when the applicant or recipient poses a

  9  threat to his or her own safety or to the safety of others and

10  shall, upon official request, release such information to law

11  enforcement agencies investigating the commission of a crime.

12         (2)  Records that come into the possession of the

13  department and that are confidential by other provisions of

14  law are confidential and exempt from s. 119.07(1), and may not

15  be released by the department, except as provided in this

16  section.

17         Section 21.  Section 381.78, Florida Statutes, is

18  amended to read:

19         381.78  Advisory council on brain and spinal cord

20  injuries.--

21         (1)  There is created within the department a 16-member

22  advisory council on brain and spinal cord injuries. The

23  council shall be composed of a minimum of four individuals

24  persons who have brain injuries or are family members of

25  individuals persons who have brain injuries, a minimum of four

26  individuals persons who have spinal cord injuries or are

27  family members of individuals persons who have spinal cord

28  injuries, and a minimum of two individuals persons who

29  represent the special needs of children who have brain or

30  spinal cord injuries. The balance of the council members shall

31  be physicians, other allied health professionals,

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  1  administrators of brain and spinal cord injury programs, and

  2  representatives from support groups that have expertise in

  3  areas related to the rehabilitation of individuals persons who

  4  have brain or spinal cord injuries.

  5         (2)  Members of the council shall be appointed to serve

  6  by the Secretary of Health. All members' terms shall be for 4

  7  years. An individual may not serve more than two terms.

  8         (a)  Eight members of the first appointed council shall

  9  serve an initial term of 2 years. This group shall include two

10  persons who have brain injuries or are family members of

11  persons who have brain injuries, two persons who have spinal

12  cord injuries or are family members of persons who have spinal

13  cord injuries, and four other persons from the previous

14  council.

15         (b)  The remaining members of the first appointed

16  council shall serve an initial term of 4 years. Thereafter all

17  members' terms shall be for 4 years.

18         (c)  Any council member who is unwilling or unable to

19  properly fulfill the duties of the office shall be succeeded

20  by an individual a person chosen by the secretary to serve out

21  the unexpired balance of the replaced council member's term.

22  If the unexpired balance of the replaced council member's term

23  is less than 18 months, then, notwithstanding the provisions

24  of this subsection, the succeeding council member may be

25  reappointed by the secretary twice.

26         (3)  The council shall meet at least two times

27  annually.

28         (4)  The council shall:

29         (a)  Provide advice and expertise to the department

30  division in the preparation, implementation, and periodic

31

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  1  review of the brain and spinal cord injury program as

  2  referenced in s. 413.49.

  3         (b)  Annually appoint a five-member committee composed

  4  of one individual person who has a brain injury or has a

  5  family member with a brain injury, one individual person who

  6  has a spinal cord injury or has a family member with a spinal

  7  cord injury, and three members who shall be chosen from among

  8  these representative groups: physicians, other allied health

  9  professionals, administrators of brain and spinal cord injury

10  programs, and representatives from support groups with

11  expertise in areas related to the rehabilitation of

12  individuals persons who have brain or spinal cord injuries,

13  except that one and only one member of the committee shall be

14  an administrator of a transitional living facility. Membership

15  on the council is not a prerequisite for membership on this

16  committee.

17         1.  The committee shall perform onsite visits to those

18  transitional living facilities identified by the Agency for

19  Health Care Administration as being in possible violation of

20  the statutes and rules regulating such facilities. The

21  committee members have the same rights of entry and inspection

22  granted under s. 400.805(7) to designated representatives of

23  the agency.

24         2.  Factual findings of the committee resulting from an

25  onsite investigation of a facility pursuant to subparagraph 1.

26  shall be adopted by the agency in developing its

27  administrative response regarding enforcement of statutes and

28  rules regulating the operation of the facility.

29         3.  Onsite investigations by the committee shall be

30  funded by the Health Care Trust Fund.

31

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  1         4.  Travel expenses for committee members shall be

  2  reimbursed in accordance with s. 112.061.

  3         5.  Members of the committee shall recuse themselves

  4  from participating in any investigation that would create a

  5  conflict of interest under state law, and the council shall

  6  replace the member, either temporarily or permanently.

  7         (5)  Members of the advisory council are entitled to

  8  reimbursement for per diem and travel expenses for required

  9  attendance at council meetings in accordance with s. 112.061.

10  Reasonable expenses for personal-assistance services and

11  interpreters needed by members during required attendance at

12  council meetings shall be reimbursed. A member may not receive

13  any compensation for performing duties specified in, or

14  arising out of, her or his duties as a council member under

15  this part, except as otherwise specified in this part.

16         (6)  A member of the advisory council may not cast a

17  vote on any matter that would provide direct financial benefit

18  to the member or create a conflict of interest under state

19  law.

20         (7)  A member of the advisory council may be removed

21  from office by the Secretary of Health for malfeasance,

22  misfeasance, neglect of duty, incompetence, or permanent

23  inability to perform official duties or for pleading nolo

24  contendere to, or being found guilty of, a crime. Malfeasance

25  includes, but is not limited to, a violation of any specific

26  prohibition within this part.

27         Section 22.  Section 381.785, Florida Statutes, is

28  created to read:

29         381.785  Recovery of third-party payments for funded

30  services.--

31

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  1         (1)  Third-party coverage for funded services

  2  constitutes primary coverage.

  3         (2)  An applicant for or recipient of services funded

  4  under the brain and spinal cord injury program must inform the

  5  brain and spinal cord injury program of any rights she or he

  6  has to third-party payments for such services, and the brain

  7  and spinal cord injury program shall be subrogated to her or

  8  his rights to such third-party payments. The brain and spinal

  9  cord injury program may recover directly from:

10         (a)  Any third party that is liable to make a benefit

11  payment to the provider of the recipient's funded services or

12  to the recipient under the terms of any contract, settlement,

13  or award;

14         (b)  The recipient, if she or he has received a

15  third-party payment for funded services provided to her or

16  him; or

17         (c)  The provider of the recipient's funded services,

18  if third-party payment for such services has been recovered by

19  the provider.

20         (3)  An applicant for or a recipient of funded services

21  is deemed to have assigned to the brain and spinal cord injury

22  program her or his rights to any payments for such services

23  from a third party and to have authorized the brain and spinal

24  cord injury program to release information with respect to

25  such services for the sole purpose of obtaining reimbursement.

26         (4)  The brain and spinal cord injury program may, in

27  order to enforce its rights under this section, institute,

28  intervene in, or join any legal proceeding against a third

29  party against whom recovery rights arise. Action taken by the

30  brain and spinal cord injury program does not preclude the

31  recipient's recovery for that portion of her or his damages

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  1  not subrogated to the brain and spinal cord injury program,

  2  and action taken by the recipient does not prejudice the

  3  rights of the brain and spinal cord injury program.

  4         (5)  When the brain and spinal cord injury program

  5  provides, pays for, or becomes liable for funded services, it

  6  has a lien for the amount of such services upon all causes of

  7  action that accrue to the recipient or to her or his legal

  8  representatives as a result of sickness, injury, disease,

  9  disability, or death due to the liability of a third party

10  which necessitated funded services. To perfect such lien, a

11  notice of lien must be filed with the clerk of the circuit

12  court in the recipient's county of residence. The notice of

13  lien must contain the name and address of the person to whom

14  services were furnished and the name, address, and telephone

15  number of a person at the brain and spinal cord injury program

16  from whom information regarding the lien can be obtained.

17  Failure of the brain and spinal cord injury program to file a

18  notice of lien does not affect the program's other rights

19  provided in this section. Any notice of lien filed as provided

20  under this subsection is valid for 5 years after filing, and

21  may be extended for an additional 5-year period by filing a

22  new notice of lien at any time prior to the expiration of the

23  original notice of lien.

24         (6)  In recovering any payments in accordance with this

25  section, the brain and spinal cord injury program may make

26  appropriate settlements.

27         (7)  Notwithstanding any other law to the contrary,

28  payments made for funded services are neither collateral

29  payments nor collateral sources within the meaning of chapter

30  86-160, Laws of Florida, or chapter 88-1, Laws of Florida.

31

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  1         (8)  Notwithstanding any other law to the contrary, the

  2  brain and spinal cord injury program retains all rights and

  3  remedies granted under this section as against moneys paid

  4  under chapter 440.

  5         (9)  The department shall adopt rules to administer

  6  this section.

  7         Section 23.  Section 381.79, Florida Statutes, is

  8  amended to read:

  9         381.79  Brain and Spinal Cord Injury Program

10  Rehabilitation Trust Fund.--

11         (1)  There is created in the State Treasury the Brain

12  and Spinal Cord Injury Program Rehabilitation Trust Fund.

13  Moneys in the fund shall be appropriated to the department for

14  the purpose of providing the cost of care for brain or spinal

15  cord injuries as a payor of last resort to residents of this

16  state, for multilevel programs of care established pursuant to

17  s. 381.75 s. 413.49.

18         (a)  Authorization of expenditures for brain or spinal

19  cord injury care shall be made only by the department.

20         (b)  Authorized expenditures include acute care,

21  rehabilitation, transitional living, equipment, and supplies

22  necessary for activities of daily living, public information,

23  prevention, education, and research. In addition, the

24  department may provide matching funds for public or private

25  assistance provided under the brain and spinal cord injury

26  program and may provide funds for any approved expansion of

27  services for treating individuals who have sustained a brain

28  or spinal cord injury.

29         (2)  The department shall issue a report to the

30  President of the Senate and the Speaker of the House of

31

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  1  Representatives by March 1 of each year, summarizing the

  2  activities supported by the trust fund.

  3         (3)  Annually, 5 percent of the revenues deposited

  4  monthly in the fund pursuant to s. 318.21(2)(d) shall be

  5  appropriated to the University of Florida and 5 percent to the

  6  University of Miami for spinal cord injury and brain injury

  7  research. The amount to be distributed to the universities

  8  shall be calculated based on the deposits into the fund for

  9  each quarter in the fiscal year, but may not exceed $500,000

10  per university per year. Funds distributed under this

11  subsection shall be made in quarterly payments at the end of

12  each quarter during the fiscal year.

13         (4)  The Board of Regents shall establish a program

14  administration process which shall include: an annual

15  prospective program plan with goals, research design, proposed

16  outcomes, a proposed budget, an annual report of research

17  activities and findings, and an annual end-of-year financial

18  statement. Prospective program plans shall be submitted to the

19  Board of Regents, and funds shall be released upon acceptance

20  of the proposed program plans. The annual report of research

21  activities and findings shall be submitted to the Board of

22  Regents, with the executive summaries submitted to the

23  President of the Senate, the Speaker of the House of

24  Representatives, and the Secretary of the Department of

25  Health.

26         (5)  Moneys received under s. 381.785 shall be

27  deposited into the trust fund and used for the purposes

28  specified in subsection (1).

29         (6)  The department may accept, deposit into the trust

30  fund, and use for carrying out the purposes of this part gifts

31  made unconditionally by will or otherwise. Any gift made under

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  1  conditions that, in the judgment of the department, are proper

  2  and consistent with this section, the laws of the United

  3  States, and the laws of this state may be accepted and shall

  4  be held, invested, reinvested, and used in accordance with the

  5  conditions of the gift.

  6         Section 24.  Section 385.103, Florida Statutes, is

  7  amended to read:

  8         385.103  Community intervention programs Chronic

  9  disease control program.--

10         (1)  DEFINITIONS.--As used in this section, the term

11  act:

12         (a)  "Chronic disease prevention and control program"

13  means a program including a combination of at least the

14  following elements:

15         1.  Health screening;

16         2.  Risk factor detection;

17         3.  Appropriate intervention to enable and encourage

18  changes in behaviors that create health risks risk factor

19  reversal; and

20         4.  Counseling in nutrition, physical activity, the

21  effects of tobacco use, hypertension, blood pressure control,

22  and diabetes control and the provision of other clinical

23  prevention services counseling.

24         (b)  "Community health education program" means a

25  program involving the planned and coordinated use of the

26  educational resources available in a community in an effort

27  to:

28         1.  Motivate and assist citizens to adopt and maintain

29  healthful practices and lifestyles;

30         2.  Make available learning opportunities which will

31  increase the ability of people to make informed decisions

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  1  affecting their personal, family, and community well-being and

  2  which are designed to facilitate voluntary adoption of

  3  behavior which will improve or maintain health;

  4         3.  Reduce, through coordination among appropriate

  5  agencies, duplication of health education efforts; and

  6         4.  Facilitate collaboration among appropriate agencies

  7  for efficient use of scarce resources.

  8         (c)  "Community intervention program" "Comprehensive

  9  health improvement project" means a program combining the

10  required elements of both a chronic disease prevention and

11  control program and a community health education program into

12  a unified program over which a single administrative entity

13  has authority and responsibility.

14         (d)  "Department" means the Department of Health.

15         (e)  "District" means a service district of the

16  department.

17         (e)(f)  "Risk factor" means a factor identified during

18  the course of an epidemiological study of a disease, which

19  factor appears to be statistically associated with a high

20  incidence of that disease.

21         (2)  OPERATION OF COMMUNITY INTERVENTION PROGRAMS

22  COMPREHENSIVE HEALTH IMPROVEMENT PROJECTS.--

23         (a)  The department shall assist the county health

24  departments in developing and operating community intervention

25  programs comprehensive health improvement projects throughout

26  the state.  At a minimum, the community intervention programs

27  comprehensive health improvement projects shall address one to

28  three of the following the chronic diseases: of cancer,

29  diabetes, heart disease, stroke, hypertension, renal disease,

30  and chronic obstructive lung disease.

31

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  1         (b)  Existing community resources, when available,

  2  shall be used to support the programs. The department shall

  3  seek funding for the programs from federal and state financial

  4  assistance programs which presently exist or which may be

  5  hereafter created. Additional services, as appropriate, may be

  6  incorporated into a program to the extent that resources are

  7  available.  The department may accept gifts and grants in

  8  order to carry out a program.

  9         (c)  Volunteers shall be used to the maximum extent

10  possible in carrying out the programs.  The department shall

11  contract for the necessary insurance coverage to protect

12  volunteers from personal liability while acting within the

13  scope of their volunteer assignments under a program.

14         (d)  The department may contract for the provision of

15  all or any portion of the services required by a program, and

16  shall so contract whenever the services so provided are more

17  cost-efficient than those provided by the department.

18         (e)  If the department determines that it is necessary

19  for clients to help pay for services provided by a program,

20  the department may require clients to make contribution

21  therefor in either money or personal services. The amount of

22  money or value of the personal services shall be fixed

23  according to a fee schedule established by the department or

24  by the entity developing the program.  In establishing the fee

25  schedule, the department or the entity developing the program

26  shall take into account the expenses and resources of a client

27  and his or her overall ability to pay for the services.

28         (f)  The department shall adopt rules governing the

29  operation of the community intervention programs health

30  improvement projects.  These rules shall include guidelines

31  for intake and enrollment of clients into the projects.

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  1         Section 25.  Subsection (3) of section 385.207, Florida

  2  Statutes, is amended to read:

  3         385.207  Care and assistance of persons with epilepsy;

  4  establishment of programs in epilepsy control.--

  5         (3)  Revenue for statewide implementation of programs

  6  for epilepsy prevention and education pursuant to this section

  7  shall be derived pursuant to the provisions of s. 318.21(6) s.

  8  318.18(12) and shall be deposited in the Epilepsy Services

  9  Trust Fund, which is hereby established to be administered by

10  the Department of Health.  All funds deposited into the trust

11  fund shall be invested pursuant to the provisions of s.

12  18.125. Interest income accruing to such invested funds shall

13  increase the total funds available under this subsection.

14         Section 26.  Subsection (3) of section 392.545, Florida

15  Statutes, is amended to read:

16         392.545  Naming of persons subject to proceedings.--

17         (3)  The department, its authorized representatives,

18  the court, any law enforcement agency, and other parties to

19  the lawsuit may shall not reveal the name or identity of any

20  person subject to these proceedings except as permitted in s.

21  392.65. Such information is exempt from s. 119.07(1).

22         Section 27.  Section 392.566, Florida Statutes, is

23  created to read:

24         392.566  Guardian advocate.--

25         (1)  The department may petition the court to appoint a

26  guardian advocate if, in the opinion of the person's treating

27  physician, the person lacks judgment and insight to consent to

28  health care decisions that may affect the person's medical

29  treatment. If the court finds that the person lacks the

30  judgment and insight to consent to treatment and has not been

31  adjudicated incapacitated and had a guardian appointed who can

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  1  consent to the person's treatment, the court shall appoint a

  2  guardian advocate.

  3         (a)  The person has a right to be represented by

  4  counsel at the hearing. If the person is indigent, as

  5  determined under the criteria in s. 27.52, the court shall

  6  appoint legal counsel.

  7         (b)  The person has the right to attend the hearing,

  8  testify, cross-examine witnesses, and present witnesses. After

  9  review and consultation by the court, counsel for the person

10  may waive the client's presence.

11         (2)  A guardian advocate must meet the qualifications

12  of a guardian contained in part IV of chapter 744, except that

13  a professional referred to in part I of chapter 394, an

14  employee of the department, or a member of the district human

15  rights advocacy committee may not be appointed. A person who

16  is appointed as a guardian advocate must agree to the

17  appointment.

18         (3)  Before a guardian advocate is appointed, the

19  department must provide the prospective guardian advocate with

20  information about the duties and responsibilities of guardian

21  advocates.

22         (a)  Before a guardian advocate exercises his or her

23  authority, the guardian advocate must successfully complete a

24  training course. The training course must include, at minimum,

25  information about the person's rights, psychotropic

26  medications, diagnosis of illnesses, the ethics of medical

27  decisionmaking, and the duties of guardian advocates. This

28  training course shall take the place of the training required

29  for guardians appointed under chapter 744.

30

31

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  1         (b)  The training course for guardian advocates must be

  2  developed by the department and approved by the chief judge of

  3  the circuit court.

  4         (c)  The court may, in its discretion, waive some or

  5  all of the training requirements for a guardian advocate or

  6  impose additional requirements. The court shall make its

  7  decision on a case-by-case basis and, in making its decision,

  8  shall consider the experience and education of the guardian

  9  advocate, the duties assigned to the guardian advocate, and

10  the needs of the person.

11         (4)  Before asking a guardian advocate to give consent

12  to treatment for a person, the department shall provide to the

13  guardian advocate sufficient information so that the guardian

14  advocate can decide whether to give express and informed

15  consent to treatment. The information must include indications

16  that the treatment is essential to treat the person's

17  tuberculosis and that the treatment does not present an

18  unreasonable risk of serious, hazardous, or irreversible side

19  effects. Before giving consent to treatment, the guardian

20  advocate must meet and talk with the person and the person's

21  physician in person, if possible, and by telephone if not. The

22  decision of the guardian advocate may be reviewed by the

23  court, upon petition by the person's attorney, the person's

24  family, or the department.

25         (5)  In selecting a guardian advocate, the court shall

26  give preference to a health care surrogate, if one has been

27  designated by the person. If the person has not previously

28  selected a health care surrogate, except for good cause

29  documented in the court record, the selection shall be made

30  from the following list, in the order of listing:

31         (a)  The person's spouse.

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  1         (b)  An adult child of the person.

  2         (c)  A parent of the person.

  3         (d)  The adult next of kin of the person.

  4         (e)  An adult friend of the person.

  5         (f)  An adult trained and willing to serve as guardian

  6  advocate for the person.

  7         (6)  The guardian advocate shall be discharged when the

  8  department files a notice with the court stating that the

  9  person has been discharged from the department's tuberculosis

10  hospital or residential facility, or upon sufficient evidence

11  that the person has regained the judgment and insight to

12  consent to medical treatment, which may be documented by a

13  notarized statement or affidavit signed by the person's

14  treating physician and one other person licensed under chapter

15  458 or chapter 490.

16         Section 28.  Section 402.181, Florida Statutes, is

17  amended to read:

18         402.181  State Institutions Claims Program.--

19         (1)  There is created a State Institutions Claims

20  Program, for the purpose of making restitution for property

21  damages and direct medical expenses for injuries caused by

22  shelter children or foster children, or escapees, or inmates,

23  or patients of state institutions under the Department of

24  Children and Family Services, the Department of Health, the

25  Department of Juvenile Justice, or the Department of

26  Corrections.

27         (2)  Claims for restitution may be filed with the

28  Department of Legal Affairs at its office in accordance with

29  regulations prescribed by the Department of Legal Affairs. The

30  Department of Legal Affairs shall have full power and

31  authority to hear, investigate, and determine all questions in

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  1  respect to such claims and is authorized, within the limits of

  2  current appropriations, to pay individual claims up to $1,000

  3  or, with respect to children in foster care and their

  4  families, individual claims up to $1,500. Claims in excess of

  5  these amounts shall continue to require legislative approval.

  6         (3)(a)  The Department of Legal Affairs shall make or

  7  cause to be made such investigations as it considers necessary

  8  in respect to such claims. Hearings shall be held in

  9  accordance with chapter 120.

10         (b)  The Department of Legal Affairs shall work with

11  the Department of Children and Family Services, the Department

12  of Health, the Department of Juvenile Justice, and the

13  Department of Corrections to streamline the process of

14  investigations, hearings, and determinations with respect to

15  claims under this section, to ensure that eligible claimants

16  receive restitution within a reasonable time.

17         Section 29.  Section 514.021, Florida Statutes, is

18  amended to read:

19         514.021  Department authorization.--The department is

20  authorized to adopt and enforce rules to protect the health,

21  safety, or welfare of persons using public swimming pools and

22  bathing places.  The department shall review and revise such

23  rules as necessary, but not less than biennially biannually.

24  Sanitation and safety standards shall include, but not be

25  limited to, matters relating to structure; appurtenances;

26  operation; source of water supply; bacteriological, chemical,

27  and physical quality of water in the pool or bathing area;

28  method of water purification, treatment, and disinfection;

29  lifesaving apparatus; measures to ensure safety of bathers;

30  and measures to ensure the personal cleanliness of bathers.

31         Section 30.  This act shall take effect July 1, 2000.

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  1            *****************************************

  2                          SENATE SUMMARY

  3    Revises provisions governing various programs
      administered by the Department of Health. Provides
  4    requirements for the department's strategic plan.
      Requires that the department develop an immunization
  5    registry to provide for the electronic transfer of
      immunization records between health care professionals
  6    and other agencies. Authorizes the Department of Health
      to obtain copies of certain medical records and
  7    information. Exempts health care practitioners and others
      from liability for the authorized release of patient
  8    records. Revises the Charlie Mack Overstreet Brain or
      Spinal Cord Injuries Act. Revises eligibility
  9    requirements for the department's brain and spinal cord
      injury program. Requires that the department operate
10    community intervention programs. Provides for the court
      to appoint a guardian advocate for persons who are
11    hospitalized due to active tuberculosis. Provides
      procedures and requirements for the court in selecting a
12    guardian advocate. Authorizes additional reimbursements
      under the State Institutions Claims Program. (See bill
13    for details.)

14

15

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19

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21

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23

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