Florida Senate - 2009                          SENATOR AMENDMENT
       Bill No. CS/HB 1471, 2nd Eng.
       
       
       
       
       
       
                                Barcode 780200                          
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
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                Floor: 3/AD/3R         .                                
             05/01/2009 10:57 AM       .                                
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       Senator Gaetz moved the following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Paragraph (e) of subsection (2) of section
    6  154.503, Florida Statutes, is amended to read:
    7         154.503 Primary Care for Children and Families Challenge
    8  Grant Program; creation; administration.—
    9         (2) The department shall:
   10         (e) Coordinate with the primary care program developed
   11  pursuant to s. 154.011, the Florida Healthy Kids Corporation
   12  program created in s. 624.91, the school health services program
   13  created in ss. 381.0056 and 381.0057, the Healthy Communities,
   14  Healthy People Program created in s. 381.734, and the volunteer
   15  health care provider program developed pursuant to s. 766.1115.
   16         Section 2. Sections 381.0053, 381.0054, 381.732, 381.733,
   17  and 381.734, Florida Statutes, are repealed.
   18         Section 3. Subsection (16) of section 381.006, Florida
   19  Statutes, is amended, and subsection (18) is added to that
   20  section, to read:
   21         381.006 Environmental health.—The department shall conduct
   22  an environmental health program as part of fulfilling the
   23  state’s public health mission. The purpose of this program is to
   24  detect and prevent disease caused by natural and manmade factors
   25  in the environment. The environmental health program shall
   26  include, but not be limited to:
   27         (16) A group-care-facilities function, where a group care
   28  facility means any public or private school, housing, building
   29  or buildings, section of a building, or distinct part of a
   30  building or other place, whether operated for profit or not,
   31  which undertakes, through its ownership or management, to
   32  provide one or more personal services, care, protection, and
   33  supervision to persons who require such services and who are not
   34  related to the owner or administrator. The department may adopt
   35  rules necessary to protect the health and safety of residents,
   36  staff, and patrons of group care facilities, such as child care
   37  facilities, family day care homes, assisted living facilities,
   38  adult day care centers, adult family care homes, hospices,
   39  residential treatment facilities, crisis stabilization units,
   40  pediatric extended care centers, intermediate care facilities
   41  for the developmentally disabled, group care homes, and, jointly
   42  with the Department of Education, private and public schools.
   43  These rules may include definitions of terms; provisions
   44  relating to operation and maintenance of facilities, buildings,
   45  grounds, equipment, furnishings, and occupant-space
   46  requirements; lighting; heating, cooling, and ventilation; food
   47  service; water supply and plumbing; sewage; sanitary facilities;
   48  insect and rodent control; garbage; safety; personnel health,
   49  hygiene, and work practices; and other matters the department
   50  finds are appropriate or necessary to protect the safety and
   51  health of the residents, staff, or patrons. The department may
   52  not adopt rules that conflict with rules adopted by the
   53  licensing or certifying agency. The department may enter and
   54  inspect at reasonable hours to determine compliance with
   55  applicable statutes or rules. An environmental health program
   56  inspection of a certified domestic violence center or
   57  residential child-caring agency licensed by the Department of
   58  Children and Family Services pursuant to chapter 409 shall be
   59  limited to the requirements set forth in the department’s rules
   60  applicable to community-based residential facilities with five
   61  or fewer residents. In addition to any sanctions that the
   62  department may impose for violations of rules adopted under this
   63  section, the department shall also report such violations to any
   64  agency responsible for licensing or certifying the group care
   65  facility. The licensing or certifying agency may also impose any
   66  sanction based solely on the findings of the department.
   67  
   68  The department may adopt rules to carry out the provisions of
   69  this section.
   70         (18)A function related to air quality inside an enclosed
   71  ice rink to protect the health and safety of visitors and
   72  employees of an enclosed ice skating rink from dangers
   73  associated with oxides of nitrogen (NOX), hydrocarbons (CXHX),
   74  carbon monoxide (CO), carbon dioxide (CO2), and other harmful
   75  gasses, vapors, or particles as identified by the department
   76  which change the air quality due to the operation of the ice
   77  rink. The department may adopt rules, including definitions; air
   78  quality standards and requirements for monitoring, testing, and
   79  recordkeeping; maintenance and operation requirements for
   80  equipment that affects air quality; ventilation of the facility;
   81  operators’ required response activities to the exceedance of an
   82  air quality standard; and assessment of fees. The department may
   83  enter and inspect an enclosed ice skating rink at reasonable
   84  hours to determine compliance with applicable statutes or rules.
   85  The department may assess a fee no greater than $300 to cover
   86  the actual costs of the annual inspection and review of the air
   87  quality of enclosed ice skating rinks. The air quality standards
   88  adopted by the department must be consistent with risk values or
   89  exposure guidelines recommended by the United States
   90  Environmental Protection Agency or the United States Centers for
   91  Disease Control and Prevention.
   92         Section 4. Subsection (1) of section 381.0061, Florida
   93  Statutes, is amended to read:
   94         381.0061 Administrative fines.—
   95         (1) In addition to any administrative action authorized by
   96  chapter 120 or by other law, the department may impose a fine,
   97  which shall not exceed $500 for each violation, for a violation
   98  of s. 381.006(16), s. 381.006(18), s. 381.0065, s. 381.0066, s.
   99  381.0072, or part III of chapter 489, for a violation of any
  100  rule adopted under this chapter, or for a violation of any of
  101  the provisions of chapter 386. Notice of intent to impose such
  102  fine shall be given by the department to the alleged violator.
  103  Each day that a violation continues may constitute a separate
  104  violation.
  105         Section 5. Paragraph (a) of subsection (2) of section
  106  381.0072, Florida Statutes, is amended to read:
  107         381.0072 Food service protection.—It shall be the duty of
  108  the Department of Health to adopt and enforce sanitation rules
  109  consistent with law to ensure the protection of the public from
  110  food-borne illness. These rules shall provide the standards and
  111  requirements for the storage, preparation, serving, or display
  112  of food in food service establishments as defined in this
  113  section and which are not permitted or licensed under chapter
  114  500 or chapter 509.
  115         (2) DUTIES.—
  116         (a) The department shall adopt rules, including definitions
  117  of terms which are consistent with law prescribing minimum
  118  sanitation standards and manager certification requirements as
  119  prescribed in s. 509.039, and which shall be enforced in food
  120  service establishments as defined in this section. The
  121  sanitation standards must address the construction, operation,
  122  and maintenance of the establishment; lighting, ventilation,
  123  laundry rooms, lockers, use and storage of toxic materials and
  124  cleaning compounds, and first-aid supplies; plan review; design,
  125  construction, installation, location, maintenance, sanitation,
  126  and storage of food equipment and utensils; employee training,
  127  health, hygiene, and work practices; food supplies, preparation,
  128  storage, transportation, and service, including access to the
  129  areas where food is stored or prepared; and sanitary facilities
  130  and controls, including water supply and sewage disposal;
  131  plumbing and toilet facilities; garbage and refuse collection,
  132  storage, and disposal; and vermin control. Public and private
  133  schools, if the food service is operated by school employees;
  134  hospitals licensed under chapter 395; nursing homes licensed
  135  under part II of chapter 400; child care facilities as defined
  136  in s. 402.301; residential facilities colocated with a nursing
  137  home or hospital, if all food is prepared in a central kitchen
  138  that complies with nursing or hospital regulations; and bars and
  139  lounges, as defined by department rule, are exempt from the
  140  rules developed for manager certification. The department shall
  141  administer a comprehensive inspection, monitoring, and sampling
  142  program to ensure such standards are maintained. With respect to
  143  food service establishments permitted or licensed under chapter
  144  500 or chapter 509, the department shall assist the Division of
  145  Hotels and Restaurants of the Department of Business and
  146  Professional Regulation and the Department of Agriculture and
  147  Consumer Services with rulemaking by providing technical
  148  information. Food service inspections of a certified domestic
  149  violence center shall be limited to the requirements set forth
  150  in the department’s rules applicable to community-based
  151  residential facilities with five or fewer residents.
  152         Section 6. Subsection (1) and paragraph (a) of subsection
  153  (2) of section 381.0203, Florida Statutes, are amended to read:
  154         381.0203 Pharmacy services.—
  155         (1) The department must may contract on a statewide basis
  156  for the purchase of drugs, as defined in s. 499.003, to be used
  157  by state agencies and political subdivisions, and may adopt
  158  rules to administer this section. Effective January 1, 2010, all
  159  state agencies, except the Agency for Health Care
  160  Administration, the Department of Veterans’ Affairs, and the
  161  Department of Management Services, must purchase drugs through
  162  the statewide contract unless:
  163         (a)The Pharmacy and Therapeutic Advisory Council approves
  164  a more cost-effective purchasing plan; or
  165         (b)The drugs required are not available through the
  166  statewide purchasing contract.
  167         (2) The department must may establish and maintain a
  168  pharmacy services program that includes, including, but is not
  169  limited to:
  170         (a) A central pharmacy to support pharmaceutical services
  171  provided by the county health departments, including
  172  pharmaceutical repackaging, dispensing, and the purchase and
  173  distribution of immunizations and other pharmaceuticals. Such
  174  services shall be provided to other state agencies and political
  175  subdivisions of the state upon written agreement. State agencies
  176  purchasing pharmaceutical services shall purchase pharmaceutical
  177  services, including pharmaceutical repackaging and dispensing
  178  services in the most cost-effective manner consistent with the
  179  delivery of quality medical care. Nothing in this subsection
  180  prohibits state agencies from contracting with vendors to
  181  provide these pharmaceutical services. Cost savings realized by
  182  the state through utilization of the central pharmacy may be
  183  used by the department to offset additional costs.
  184         Section 7. Section 381.84, Florida Statutes, is
  185  transferred, renumbered as section 385.106, Florida Statutes,
  186  and amended to read:
  187         385.106 381.84 Comprehensive Statewide Tobacco Education
  188  and Use Prevention Program.—
  189         (1) DEFINITIONS.—As used in this section and for purposes
  190  of the provisions of s. 27, Art. X of the State Constitution,
  191  the term:
  192         (a) “AHEC network” means an area health education center
  193  network established under s. 381.0402.
  194         (b)“Best practices” means the Best Practices for
  195  Comprehensive Tobacco Control Programs as established by the
  196  CDC, as amended.
  197         (c)(b) “CDC” means the United States Centers for Disease
  198  Control and Prevention.
  199         (d)(c) “Council” means the Tobacco Education and Use
  200  Prevention Advisory Council.
  201         (d)“Department” means the Department of Health.
  202         (e)“Tobacco” means, without limitation, tobacco itself and
  203  tobacco products that include tobacco and are intended or
  204  expected for human use or consumption, including, but not
  205  limited to, cigarettes, cigars, pipe tobacco, and smokeless
  206  tobacco.
  207         (f)“Youth” means minors and young adults.
  208         (2) PURPOSE, FINDINGS, AND INTENT.—It is the purpose of
  209  this section to implement s. 27, Art. X of the State
  210  Constitution. The Legislature finds that s. 27, Art. X of the
  211  State Constitution requires the funding of a statewide tobacco
  212  education and use prevention program that focuses on tobacco use
  213  by youth. The Legislature further finds that the primary goals
  214  of the program are to reduce the prevalence of tobacco use among
  215  youth, adults, and pregnant women; reduce per capita tobacco
  216  consumption; and reduce exposure to environmental tobacco smoke.
  217  Further, it is the intent of the Legislature to base increases
  218  in funding for individual components of the program on the
  219  results of assessments and evaluations. Recognizing that some
  220  components will need to grow faster than inflation, it is the
  221  intent of the Legislature to fund portions of the program on a
  222  nonrecurring basis in the early years so that those components
  223  that are most effective can be supported as the program matures.
  224         (3) PROGRAM COMPONENTS AND REQUIREMENTS.—The department
  225  shall conduct a comprehensive, statewide tobacco education and
  226  use prevention program consistent with the recommendations for
  227  effective program components contained in the 1999 Best
  228  Practices for Comprehensive Tobacco Control Programs of the CDC,
  229  as amended by the CDC. The program shall include the following
  230  components, each of which shall focus on educating people,
  231  particularly youth and their parents, about the health hazards
  232  of tobacco and discouraging the use of tobacco. All program
  233  components shall include efforts to educate youth and their
  234  parents about tobacco use, and a youth-directed focus shall
  235  exist in all components outlined in this subsection.:
  236         (a) State and community interventions.—These interventions
  237  shall include, but not be limited to, a statewide tobacco
  238  control program that combines and coordinates community-based
  239  interventions that focus on preventing initiation of tobacco use
  240  among youth and young adults; promoting quitting among adults,
  241  youth, and pregnant women; eliminating exposure to secondhand
  242  smoke; identifying and eliminating tobacco-related disparities
  243  among population groups; and promoting a range of collaborations
  244  to prevent and alleviate the effects of chronic diseases.
  245  Counter-marketing and advertising; cyberspace resource center.
  246  The counter-marketing and advertising campaign shall include, at
  247  a minimum, Internet, print, radio, and television advertising
  248  and shall be funded with a minimum of one-third of the total
  249  annual appropriation required by s. 27, Art. X of the State
  250  Constitution. A cyberspace resource center for copyrighted
  251  materials and information concerning tobacco education and use
  252  prevention, including cessation, shall be maintained by the
  253  program. Such resource center must be accessible to the public,
  254  including parents, teachers, and students, at each level of
  255  public and private schools, universities, and colleges in the
  256  state and shall provide links to other relevant resources. The
  257  Internet address for the resource center must be incorporated in
  258  all advertising. The information maintained in the resource
  259  center shall be used by the other components of the program.
  260         (b) Health communication interventions.—Effective media and
  261  health communication intervention efforts include, but are not
  262  limited to, audience research to define themes and execute
  263  messages for influential, high impact, and specifically targeted
  264  campaigns; market research to identify the target market and the
  265  behavioral theory motivating change; counter-marketing
  266  surveillance; community tie-ins to support and reinforce the
  267  statewide campaign; technologies such as viral marketing, social
  268  networks, personal web pages, and web logs; traditional media;
  269  process and outcome evaluation of the communication efforts; and
  270  promotion of available services, including the state telephone
  271  cessation quitline. Cessation programs, counseling, and
  272  treatment.—This program component shall include two
  273  subcomponents:
  274         1.A statewide toll-free cessation service, which may
  275  include counseling, referrals to other local resources and
  276  support services, and treatment to the extent funds are
  277  available for treatment services; and
  278         2.A local community-based program to disseminate
  279  information about smoking cessation, how smoking cessation
  280  relates to prenatal care and obesity prevention, and other
  281  chronic tobacco-related diseases.
  282         (c) Cessation interventions.—Cessation interventions
  283  include, but are not limited to, sustaining, expanding, and
  284  promoting the service through population-based counseling and
  285  treatment programs; encouraging public and private insurance
  286  coverage for counseling and FDA-approved medication treatments
  287  for tobacco-use cessation; eliminating cost and other barriers
  288  to treatment for underserved populations; and making health care
  289  system changes. Youth interventions to prevent tobacco-use
  290  initiation and encourage cessation among young people are needed
  291  in order to reshape the environment so that it supports tobacco
  292  free norms. Because most people who start smoking are younger
  293  than 18 years of age, intervening during adolescence is
  294  critical. Community programs and school-based policies and
  295  interventions should be a part of a comprehensive effort that is
  296  implemented in coordination with community and school
  297  environments and in conjunction with increasing the unit price
  298  of tobacco products, sustaining anti-tobacco media campaigns,
  299  making environments tobacco free, and engaging in other efforts
  300  to create tobacco-free social norms. Surveillance and
  301  evaluation.The program shall conduct ongoing epidemiological
  302  surveillance and shall contract for annual independent
  303  evaluations of the effectiveness of the various components of
  304  the program in meeting the goals as set forth in subsection (2).
  305         (d) Surveillance and evaluation.—The surveillance and
  306  evaluation of all program components shall monitor and document
  307  short-term, intermediate, and long-term intervention outcomes to
  308  inform program and policy direction and ensure accountability.
  309  The surveillance and evaluation must be conducted objectively
  310  through scientifically sound methodology. Youth school
  311  programs.School and after-school programs shall use current
  312  evidence-based curricula and programs that involve youth to
  313  educate youth about the health hazards of tobacco, help youth
  314  develop skills to refuse tobacco, and demonstrate to youth how
  315  to stop using tobacco.
  316         (e) Administration and management.—Administration and
  317  management activities include, but are not limited to, strategic
  318  planning to guide program efforts and resources in order to
  319  accomplish goals; recruiting and developing qualified and
  320  diverse technical, program, and administrative staff; awarding
  321  and monitoring program contracts and grants to coordinate
  322  implementation across program areas; developing and maintaining
  323  a fiscal-management system to track allocations and the
  324  expenditure of funds; increasing capacity at the community level
  325  through ongoing training and technical assistance; creating
  326  effective communications internally among chronic disease
  327  prevention programs and local coalitions and partners; and
  328  educating the public and decisionmakers on the health effects of
  329  tobacco and evidence-based effective program and policy
  330  interventions. Community programs and chronic disease
  331  prevention.—The department shall promote and support local
  332  community-based partnerships that emphasize programs involving
  333  youth, including programs for the prevention, detection, and
  334  early intervention of smoking-related chronic diseases.
  335         (f) Training.—The program shall include the training of
  336  health care practitioners, smoking-cessation counselors, and
  337  teachers by health professional students and other tobacco-use
  338  prevention specialists who are trained in preventing tobacco use
  339  and health education. Smoking-cessation counselors shall be
  340  trained by specialists who are certified in tobacco-use
  341  cessation.
  342         (g) County health departments Administration, statewide
  343  programs, and county health departments.—Each county health
  344  department is eligible to receive a portion of the annual
  345  appropriation, on a per capita basis, for coordinating tobacco
  346  education and use prevention programs within that county.
  347  Appropriated funds may be used to improve the infrastructure of
  348  the county health department to implement the comprehensive,
  349  statewide tobacco education and use prevention program. Each
  350  county health department shall prominently display in all
  351  treatment rooms and waiting rooms, counter-marketing and
  352  advertisement materials in the form of wall posters, brochures,
  353  television advertising if televisions are used in the lobby or
  354  waiting room, and screensavers and Internet advertising if
  355  computer kiosks are available for use or viewing by people at
  356  the county health department.
  357         (h) Enforcement and awareness of related laws.—In
  358  coordination with the Department of Business and Professional
  359  Regulation, the program shall monitor the enforcement of laws,
  360  rules, and policies prohibiting the sale or other provision of
  361  tobacco to minors, as well as the continued enforcement of the
  362  Clean Indoor Air Act prescribed in chapter 386. The
  363  advertisements produced in accordance with paragraph (b)
  364  paragraph (a) may also include information designed to make the
  365  public aware of these related laws and rules. The departments
  366  may enter into interagency agreements to carry out this program
  367  component.
  368         (i) AHEC smoking-cessation initiative.For the 2007-2008
  369  and 2008-2009 fiscal years only, The AHEC network shall expand
  370  the AHEC smoking-cessation initiative to each county within the
  371  state and perform other activities as determined by the
  372  department.
  373         (4) ADVISORY COUNCIL; MEMBERS, APPOINTMENTS, AND MEETINGS.
  374  The Tobacco Education and Use Prevention Advisory Council is
  375  created within the department.
  376         (a) The council shall consist of 23 members, including:
  377         1. The State Surgeon General, who shall serve as the
  378  chairperson.
  379         2. One county health department director, appointed by the
  380  State Surgeon General.
  381         3. Two members appointed by the Commissioner of Education,
  382  of whom one must be a school district superintendent.
  383         4. The chief executive officer of the Florida Division of
  384  the American Cancer Society, or his or her designee.
  385         5. The chief executive officer of the Greater Southeast
  386  Affiliate of the American Heart Association, or his or her
  387  designee.
  388         6. The chief executive officer of the American Lung
  389  Association of Florida, or his or her designee.
  390         7. The dean of the University of Miami School of Medicine,
  391  or his or her designee.
  392         8. The dean of the University of Florida College of
  393  Medicine, or his or her designee.
  394         9. The dean of the University of South Florida College of
  395  Medicine, or his or her designee.
  396         10. The dean of the Florida State University College of
  397  Medicine, or his or her designee.
  398         11. The dean of Nova Southeastern College of Osteopathic
  399  Medicine, or his or her designee.
  400         12. The dean of the Lake Erie College of Osteopathic
  401  Medicine in Bradenton, Florida, or his or her designee.
  402         13. The chief executive officer of the Campaign for Tobacco
  403  Free Kids, or his or her designee.
  404         14. The chief executive officer of the Legacy Foundation,
  405  or his or her designee.
  406         15. Four members appointed by the Governor, of whom two
  407  must have expertise in the field of tobacco-use prevention and
  408  education or smoking cessation and one individual who shall be
  409  between the ages of 16 and 21 at the time of his or her
  410  appointment.
  411         16. Two members appointed by the President of the Senate,
  412  of whom one must have expertise in the field of tobacco-use
  413  prevention and education or smoking cessation.
  414         17. Two members appointed by the Speaker of the House of
  415  Representatives, of whom one must have expertise in the field of
  416  tobacco-use prevention and education or smoking cessation.
  417         (b) The appointments shall be for 3-year terms and shall
  418  reflect the diversity of the state’s population. A vacancy shall
  419  be filled by appointment by the original appointing authority
  420  for the unexpired portion of the term.
  421         (c) An appointed member may not serve more than two
  422  consecutive terms.
  423         (d) The council shall meet at least quarterly and upon the
  424  call of the chairperson. Meetings may be held via teleconference
  425  or other electronic means.
  426         (e) Members of the council shall serve without
  427  compensation, but are entitled to reimbursement for per diem and
  428  travel expenses pursuant to s. 112.061. Members who are state
  429  officers or employees or who are appointed by state officers or
  430  employees shall be reimbursed for per diem and travel expenses
  431  pursuant to s. 112.061 from the state agency through which they
  432  serve.
  433         (f) The council shall adhere to all state ethics laws.
  434  Meetings of the council and the review panels are subject to
  435  chapter 119, s. 286.011, and s. 24, Art. I of the State
  436  Constitution. The department shall provide council members with
  437  information and other assistance as is reasonably necessary to
  438  assist the council in carrying out its responsibilities.
  439         (5) COUNCIL DUTIES AND RESPONSIBILITIES.—The council shall
  440  advise the State Surgeon General as to the direction and scope
  441  of the Comprehensive Statewide Tobacco Education and Use
  442  Prevention Program. The responsibilities of the council may
  443  include, but are not limited to:
  444         (a) Providing advice on program priorities and emphases.
  445         (b) Providing advice on the overall program budget.
  446         (c) Providing advice on copyrighted material, trademark,
  447  and future transactions as they pertain to the tobacco education
  448  and use prevention program.
  449         (d) Reviewing, as requested by the department, broadcast
  450  material prepared for the Internet, portable media players,
  451  radio, and television advertisement as it relates to the
  452  advertising component of the tobacco education and use
  453  prevention program.
  454         (e) Participating in periodic program evaluation, as
  455  requested by the department.
  456         (f) Assisting the department in developing the development
  457  of guidelines to ensure fairness, neutrality, and adherence to
  458  the principles of merit and quality in the conduct of the
  459  program.
  460         (g) Assisting the department in developing the development
  461  of administrative procedures relating to solicitation, review,
  462  and award of contracts and grants in order to ensure an
  463  impartial, high-quality peer review system.
  464         (h) Assisting the department in developing panels to review
  465  and evaluate potential fund recipients the development and
  466  supervision of peer review panels.
  467         (i) Assisting the department in reviewing reports of peer
  468  review panels and making recommendations for funding allocations
  469  contracts and grants.
  470         (j) Assisting the department in reviewing the activities
  471  and evaluating the performance of the AHEC network to avoid
  472  duplicative efforts using state funds.
  473         (k) Recommending specific measureable outcomes meaningful
  474  outcome measures through a regular review of evidence-based and
  475  promising tobacco-use prevention and education strategies and
  476  programs of other states and the Federal Government.
  477         (l) Recommending policies to encourage a coordinated
  478  response to tobacco use in this state, focusing specifically on
  479  creating partnerships within and between the public and private
  480  sectors.
  481         (6) CONTRACT REQUIREMENTS.—Contracts or grants for the
  482  program components or subcomponents described in paragraphs
  483  (3)(a)-(f) shall be awarded by the State Surgeon General, after
  484  consultation with the council, on the basis of merit, as
  485  determined by an open, competitive, peer-reviewed process that
  486  ensures objectivity, consistency, and high quality. The
  487  department shall award such grants or contracts no later than
  488  October 1 for each fiscal year. A recipient of a contract or
  489  grant for the program component described in paragraph (3)(d)
  490  (3)(c) is not eligible for a contract or grant award for any
  491  other program component described in subsection (3) in the same
  492  state fiscal year. A school or college of medicine that is
  493  represented on the council is not eligible to receive a contract
  494  or grant under this section. For the 2007-2008 and 2008-2009
  495  fiscal years only, The department shall award a contract or
  496  grant in the amount of $10 million to the AHEC network for the
  497  purpose of developing the components described in paragraph
  498  (3)(i). The AHEC network may apply for a competitive contract or
  499  grant after the 2008-2009 fiscal year.
  500         (a) In order to ensure that all proposals for funding are
  501  appropriate and are evaluated fairly on the basis of merit, the
  502  State Surgeon General, in consultation with the council, shall
  503  appoint a peer review panel of independent, qualified experts in
  504  the field of tobacco control to review the content of each
  505  proposal and establish its priority score. The priority scores
  506  shall be forwarded to the council and must be considered in
  507  determining which proposals will be recommended for funding.
  508         (b) The council and the peer review panel shall establish
  509  and follow rigorous guidelines for ethical conduct and adhere to
  510  a strict policy with regard to conflicts of interest. Council
  511  members are subject to the applicable provisions of chapter 112.
  512  A member of the council or panel may not participate in any
  513  discussion or decision with respect to a research proposal by
  514  any firm, entity, or agency with which the member is associated
  515  as a member of the governing body or as an employee or with
  516  which the member has entered into a contractual arrangement.
  517  Meetings of the council and the peer review panels are subject
  518  to chapter 119, s. 286.011, and s. 24, Art. I of the State
  519  Constitution.
  520         (c) In each contract or grant agreement, the department
  521  shall limit the use of food and promotional items to no more
  522  than 2.5 percent of the total amount of the contract or grant
  523  and limit overhead or indirect costs to no more than 7.5 percent
  524  of the total amount of the contract or grant. The department, in
  525  consultation with the Department of Financial Services, shall
  526  publish guidelines for appropriate food and promotional items.
  527         (d) In each advertising contract, the department shall
  528  limit the total of production fees, buyer commissions, and
  529  related costs to no more than 10 percent of the total contract
  530  amount.
  531         (e) Notwithstanding the competitive process for contracts
  532  prescribed in this subsection, each county health department is
  533  eligible for core funding, on a per capita basis, to implement
  534  tobacco education and use prevention activities within that
  535  county.
  536         (7) ANNUAL REPORT REQUIRED.—By February 28 January 31 of
  537  each year, the department shall provide to the Governor, the
  538  President of the Senate, and the Speaker of the House of
  539  Representatives a report that evaluates the program’s
  540  effectiveness in reducing and preventing tobacco use and that
  541  recommends improvements to enhance the program’s effectiveness.
  542  The report must contain, at a minimum, an annual survey of youth
  543  attitudes and behavior toward tobacco, as well as a description
  544  of the progress in reducing the prevalence of tobacco use among
  545  youth, adults, and pregnant women; reducing per capita tobacco
  546  consumption; and reducing exposure to environmental tobacco
  547  smoke.
  548         (8) LIMITATION ON ADMINISTRATIVE EXPENSES.—From the total
  549  funds appropriated for the Comprehensive Statewide Tobacco
  550  Education and Use Prevention Program in the General
  551  Appropriations Act, an amount of up to 5 percent may be used by
  552  the department for administrative expenses.
  553         (9)RULEMAKING AUTHORIZED.—By January 1, 2008, the
  554  department shall adopt rules pursuant to ss. 120.536(1) and
  555  120.54 to administer this section.
  556         Section 8. Section 381.91, Florida Statutes, is transferred
  557  and renumbered as section 385.2024, Florida Statutes, to read:
  558         385.2024 381.91 Jessie Trice Cancer Prevention Program.—
  559         (1) It is the intent of the Legislature to:
  560         (a) Reduce the rates of illness and death from lung cancer
  561  and other cancers and improve the quality of life among low
  562  income African-American and Hispanic populations through
  563  increased access to early, effective screening and diagnosis,
  564  education, and treatment programs.
  565         (b) Create a community faith-based disease-prevention
  566  program in conjunction with the Health Choice Network and other
  567  community health centers to build upon the natural referral and
  568  education networks in place within minority communities and to
  569  increase access to health service delivery in Florida.
  570         (c) Establish a funding source to build upon local private
  571  participation to sustain the operation of the program.
  572         (2)(a) There is created the Jessie Trice Cancer Prevention
  573  Program, to be located, for administrative purposes, within the
  574  Department of Health, and operated from the community health
  575  centers within the Health Choice Network in Florida.
  576         (b) Funding may be provided to develop contracts with
  577  community health centers and local community faith-based
  578  education programs to provide cancer screening, diagnosis,
  579  education, and treatment services to low-income populations
  580  throughout the state.
  581         Section 9. Section 381.911, Florida Statutes, is
  582  transferred, renumbered as section 385.2023, Florida Statutes,
  583  and amended to read:
  584         385.2023 381.911 Prostate Cancer Awareness Program.—
  585         (1) To the extent that funds are specifically made
  586  available for this purpose, the Prostate Cancer Awareness
  587  Program is established within the Department of Health. The
  588  purpose of this program is to implement the recommendations of
  589  January 2000 of the Florida Prostate Cancer Task Force to
  590  provide for statewide outreach and health education activities
  591  to ensure that men are aware of and appropriately seek medical
  592  counseling for prostate cancer as an early-detection health care
  593  measure.
  594         (2) For purposes of implementing the program, the
  595  Department of Health and the Florida Public Health Foundation,
  596  Inc., may:
  597         (a) Conduct activities directly or enter into a contract
  598  with a qualified nonprofit community education entity.
  599         (b) Seek any available gifts, grants, or funds from the
  600  state, the Federal Government, philanthropic foundations, and
  601  industry or business groups.
  602         (3) A prostate cancer advisory committee is created to
  603  advise and assist the Department of Health and the Florida
  604  Public Health Foundation, Inc., in implementing the program.
  605         (a) The State Surgeon General shall appoint the advisory
  606  committee members, who shall consist of:
  607         1. Three persons from prostate cancer survivor groups or
  608  cancer-related advocacy groups.
  609         2. Three persons who are scientists or clinicians from
  610  public or nonpublic universities or research organizations.
  611         3. Three persons who are engaged in the practice of a
  612  cancer-related medical specialty from health organizations
  613  committed to cancer research and control.
  614         (b) Members shall serve without compensation but are
  615  entitled to reimbursement, pursuant to s. 112.061, for per diem
  616  and travel expenses incurred in the performance of their
  617  official duties.
  618         (4) The program shall coordinate its efforts with those of
  619  the Florida Public Health Foundation, Inc.
  620         Section 10. Section 381.912, Florida Statutes, is repealed.
  621         Section 11. Section 381.92, Florida Statutes, is
  622  transferred and renumbered as section 385.2025, Florida
  623  Statutes, to read:
  624         385.2025 381.92 Florida Cancer Council.—
  625         (1) Effective July 1, 2004, the Florida Cancer Council
  626  within the Department of Health is established for the purpose
  627  of making the state a center of excellence for cancer research.
  628         (2)(a) The council shall be representative of the state’s
  629  cancer centers, hospitals, and patient groups and shall be
  630  organized and shall operate in accordance with this act.
  631         (b) The Florida Cancer Council may create not-for-profit
  632  corporate subsidiaries to fulfill its mission. The council and
  633  its subsidiaries are authorized to receive, hold, invest, and
  634  administer property and any moneys acquired from private, local,
  635  state, and federal sources, as well as technical and
  636  professional income generated or derived from the mission
  637  related activities of the council.
  638         (c) The members of the council shall consist of:
  639         1. The chair of the Florida Dialogue on Cancer, who shall
  640  serve as the chair of the council;
  641         2. The State Surgeon General or his or her designee;
  642         3. The chief executive officer of the H. Lee Moffitt Cancer
  643  Center or his or her designee;
  644         4. The director of the University of Florida Shands Cancer
  645  Center or his or her designee;
  646         5. The chief executive officer of the University of Miami
  647  Sylvester Comprehensive Cancer Center or his or her designee;
  648         6. The chief executive officer of the Mayo Clinic,
  649  Jacksonville, or his or her designee;
  650         7. The chief executive officer of the American Cancer
  651  Society, Florida Division, Inc., or his or her designee;
  652         8. The president of the American Cancer Society, Florida
  653  Division, Inc., Board of Directors or his or her designee;
  654         9. The president of the Florida Society of Clinical
  655  Oncology or his or her designee;
  656         10. The president of the American College of Surgeons,
  657  Florida Chapter, or his or her designee;
  658         11. The chief executive officer of Enterprise Florida,
  659  Inc., or his or her designee;
  660         12. Five representatives from cancer programs approved by
  661  the American College of Surgeons. Three shall be appointed by
  662  the Governor, one shall be appointed by the Speaker of the House
  663  of Representatives, and one shall be appointed by the President
  664  of the Senate;
  665         13. One member of the House of Representatives, to be
  666  appointed by the Speaker of the House of Representatives; and
  667         14. One member of the Senate, to be appointed by the
  668  President of the Senate.
  669         (d) Appointments made by the Speaker of the House of
  670  Representatives and the President of the Senate pursuant to
  671  paragraph (c) shall be for 2-year terms, concurrent with the
  672  bienniums in which they serve as presiding officers.
  673         (e) Appointments made by the Governor pursuant to paragraph
  674  (c) shall be for 2-year terms, although the Governor may
  675  reappoint members.
  676         (f) Members of the council or any subsidiaries shall serve
  677  without compensation, and each organization represented on the
  678  council shall cover the expenses of its representatives.
  679         (3) The council shall issue an annual report to the Center
  680  for Universal Research to Eradicate Disease, the Governor, the
  681  Speaker of the House of Representatives, and the President of
  682  the Senate by December 15 of each year, with policy and funding
  683  recommendations regarding cancer research capacity in Florida
  684  and related issues.
  685         Section 12. Section 381.921, Florida Statutes, is
  686  transferred and renumbered as section 385.20251, Florida
  687  Statutes, to read:
  688         385.20251 381.921 Florida Cancer Council mission and
  689  duties.—The council, which shall work in concert with the
  690  Florida Center for Universal Research to Eradicate Disease to
  691  ensure that the goals of the center are advanced, shall endeavor
  692  to dramatically improve cancer research and treatment in this
  693  state through:
  694         (1) Efforts to significantly expand cancer research
  695  capacity in the state by:
  696         (a) Identifying ways to attract new research talent and
  697  attendant national grant-producing researchers to cancer
  698  research facilities in this state;
  699         (b) Implementing a peer-reviewed, competitive process to
  700  identify and fund the best proposals to expand cancer research
  701  institutes in this state;
  702         (c) Funding through available resources for those proposals
  703  that demonstrate the greatest opportunity to attract federal
  704  research grants and private financial support;
  705         (d) Encouraging the employment of bioinformatics in order
  706  to create a cancer informatics infrastructure that enhances
  707  information and resource exchange and integration through
  708  researchers working in diverse disciplines, to facilitate the
  709  full spectrum of cancer investigations;
  710         (e) Facilitating the technical coordination, business
  711  development, and support of intellectual property as it relates
  712  to the advancement of cancer research; and
  713         (f) Aiding in other multidisciplinary research-support
  714  activities as they inure to the advancement of cancer research.
  715         (2) Efforts to improve both research and treatment through
  716  greater participation in clinical trials networks by:
  717         (a) Identifying ways to increase adult enrollment in cancer
  718  clinical trials;
  719         (b) Supporting public and private professional education
  720  programs designed to increase the awareness and knowledge about
  721  cancer clinical trials;
  722         (c) Providing tools to cancer patients and community-based
  723  oncologists to aid in the identification of cancer clinical
  724  trials available in the state; and
  725         (d) Creating opportunities for the state’s academic cancer
  726  centers to collaborate with community-based oncologists in
  727  cancer clinical trials networks.
  728         (3) Efforts to reduce the impact of cancer on disparate
  729  groups by:
  730         (a) Identifying those cancers that disproportionately
  731  impact certain demographic groups; and
  732         (b) Building collaborations designed to reduce health
  733  disparities as they relate to cancer.
  734         Section 13. Paragraph (a) of subsection (2) and subsection
  735  (5) of section 381.922, Florida Statutes, as amended by section
  736  2 of chapter 2009-5, Law of Florida, is amended to read:
  737         381.922 William G. “Bill” Bankhead, Jr., and David Coley
  738  Cancer Research Program.—
  739         (2) The program shall provide grants for cancer research to
  740  further the search for cures for cancer.
  741         (a) Emphasis shall be given to the goals enumerated in s.
  742  385.20251 s. 381.921, as those goals support the advancement of
  743  such cures.
  744         (5) For the 2008-2009 fiscal year and each fiscal year
  745  thereafter, the sum of $6.75 million is appropriated annually
  746  from recurring funds in the General Revenue Fund to the
  747  Biomedical Research Trust Fund within the Department of Health
  748  for purposes of the William G. “Bill” Bankhead, Jr., and David
  749  Coley Cancer Research Program and shall be distributed pursuant
  750  to this section to provide grants to researchers seeking cures
  751  for cancer, with emphasis given to the goals enumerated in s.
  752  385.20251 s. 381.921. From the total funds appropriated, an
  753  amount of up to 10 percent may be used for administrative
  754  expenses.
  755         Section 14. Section 381.93, Florida Statutes, is
  756  transferred and renumbered as section 385.2021, Florida
  757  Statutes, to read:
  758         385.2021 381.93 Breast and cervical cancer early detection
  759  program.—This section may be cited as the “Mary Brogan Breast
  760  and Cervical Cancer Early Detection Program Act.”
  761         (1) It is the intent of the Legislature to reduce the rates
  762  of death due to breast and cervical cancer through early
  763  diagnosis and increased access to early screening, diagnosis,
  764  and treatment programs.
  765         (2) The Department of Health, using available federal funds
  766  and state funds appropriated for that purpose, is authorized to
  767  establish the Mary Brogan Breast and Cervical Cancer Screening
  768  and Early Detection Program to provide screening, diagnosis,
  769  evaluation, treatment, case management, and followup and
  770  referral to the Agency for Health Care Administration for
  771  coverage of treatment services.
  772         (3) The Mary Brogan Breast and Cervical Cancer Early
  773  Detection Program shall be funded through grants for such
  774  screening and early detection purposes from the federal Centers
  775  for Disease Control and Prevention under Title XV of the Public
  776  Health Service Act, 42 U.S.C. ss. 300k et seq.
  777         (4) The department shall limit enrollment in the program to
  778  persons with incomes up to and including 200 percent of the
  779  federal poverty level. The department shall establish an
  780  eligibility process that includes an income-verification process
  781  to ensure that persons served under the program meet income
  782  guidelines.
  783         (5) The department may provide other breast and cervical
  784  cancer screening and diagnostic services; however, such services
  785  shall be funded separately through other sources than this act.
  786         Section 15. Section 381.931, Florida Statutes, is
  787  transferred and renumbered as section 385.20211, Florida
  788  Statutes, to read:
  789         385.20211 381.931 Annual report on Medicaid expenditures.
  790  The Department of Health and the Agency for Health Care
  791  Administration shall monitor the total Medicaid expenditures for
  792  services made under this act. If Medicaid expenditures are
  793  projected to exceed the amount appropriated by the Legislature,
  794  the Department of Health shall limit the number of screenings to
  795  ensure Medicaid expenditures do not exceed the amount
  796  appropriated. The Department of Health, in cooperation with the
  797  Agency for Health Care Administration, shall prepare an annual
  798  report that must include the number of women screened; the
  799  percentage of positive and negative outcomes; the number of
  800  referrals to Medicaid and other providers for treatment
  801  services; the estimated number of women who are not screened or
  802  not served by Medicaid due to funding limitations, if any; the
  803  cost of Medicaid treatment services; and the estimated cost of
  804  treatment services for women who were not screened or referred
  805  for treatment due to funding limitations. The report shall be
  806  submitted to the President of the Senate, the Speaker of the
  807  House of Representatives, and the Executive Office of the
  808  Governor by March 1 of each year.
  809         Section 16. Chapter 385, Florida Statutes, entitled
  810  “Chronic Diseases,” is renamed the “Healthy and Fit Florida
  811  Act.”
  812         Section 17. Section 385.101, Florida Statutes, is amended
  813  to read:
  814         385.101 Short title.—This chapter Sections 385.101-385.103
  815  may be cited as the “Healthy and Fit Florida Chronic Diseases
  816  Act.”
  817         Section 18. Section 385.102, Florida Statutes, is amended
  818  to read:
  819         385.102 Legislative intent.—It is the finding of the
  820  Legislature that:
  821         (1) Chronic diseases continue to be the leading cause of
  822  death and disability in this state and the country exist in high
  823  proportions among the people of this state. These Chronic
  824  diseases include, but are not limited to, arthritis,
  825  cardiovascular disease heart disease, hypertension, diabetes,
  826  renal disease, cancer, and chronic obstructive lung disease,
  827  including chronic obstructive pulmonary disease. These diseases
  828  are often have the same preventable risk factors interrelated,
  829  and they directly and indirectly account for a high rate of
  830  death, disability, and underlying costs to the state’s health
  831  care system illness.
  832         (2)Chronic diseases have a significant impact on quality
  833  of life, not only for the individuals who experience their
  834  painful symptoms and resulting disabilities, but also for family
  835  members and caregivers.
  836         (3)Racial and ethnic minorities and other underserved
  837  populations are disproportionately affected by chronic diseases.
  838         (4)There are enormous medical costs and lost wages
  839  associated with chronic diseases and their complications.
  840         (5)(2) Advances in medical knowledge and technology assist
  841  have assisted in the prevention, detection, and management of
  842  chronic diseases. Comprehensive approaches that stress the
  843  stressing application of current medical treatment, continuing
  844  research, professional training, and patient education, and
  845  community-level policy and environmental changes should be
  846  implemented encouraged.
  847         (6)(3)A comprehensive program dealing with the early
  848  detection and prevention of chronic diseases is required to make
  849  knowledge and therapy available to all people of this state. The
  850  mobilization of scientific, medical, and educational resources,
  851  along with the implementation of community-based policy under
  852  one comprehensive chronic disease law, act will facilitate the
  853  prevention, early intervention, and management treatment of
  854  chronic these diseases and their symptoms. This integration of
  855  resources and policy will and result in a decline in death and
  856  disability illness among the people of this state.
  857         (7)Chronic diseases account for 70 percent of all deaths
  858  in the United States. The following chronic diseases are the
  859  leading causes of death and disability:
  860         (a)Heart disease and stroke, which have remained the first
  861  and third leading causes of death for both men and women in the
  862  United States for over seven decades and account for
  863  approximately one-third of total deaths each year in this state.
  864         (b)Cancer, which is the second leading cause of death and
  865  is responsible for one in four deaths in this state.
  866         (c)Lung disease, which is the third leading cause of death
  867  and accounts for one in every six deaths in this state.
  868         (d)Diabetes, which is the sixth leading cause of death in
  869  this state.
  870         (e)Arthritis, which is the leading cause of disability in
  871  the United States, limiting daily activities for more than 19
  872  million citizens. In this state, arthritis limits daily
  873  activities for an estimated 1.3 million people.
  874         (8)The department shall establish, promote, and maintain
  875  state-level and local-level programs for chronic disease
  876  prevention and health promotion to the extent that funds are
  877  specifically made available for this purpose.
  878         Section 19. Section 385.1021, Florida Statutes, is created
  879  to read:
  880         385.1021Definitions.—As used in this chapter, the term:
  881         (1)“CDC” means the United States Centers for Disease
  882  Control and Prevention.
  883         (2)“Chronic disease” means an illness that is prolonged,
  884  does not resolve spontaneously, and is rarely cured completely.
  885         (3)“Department” means the Department of Health.
  886         (4)“Environmental changes” means changes to the economic,
  887  social, or physical natural or built environments which
  888  encourage or enable behaviors.
  889         (5)“Policy change” means altering an informal or formal
  890  agreement between public or private sectors which sets forth
  891  values, behaviors, or resource allocation in order to improve
  892  health.
  893         (6)“Primary prevention” means an intervention that is
  894  directed toward healthy populations and focuses on avoiding
  895  disease before it occurs.
  896         (7)“Risk factor” means a characteristic or condition
  897  identified during the course of an epidemiological study of a
  898  disease that appears to be statistically associated with a high
  899  incidence of that disease.
  900         (8)“Secondary prevention” means an intervention that is
  901  designed to promote the early detection and management of
  902  diseases and reduce the risks experienced by at-risk
  903  populations.
  904         (9)“System changes” means altering standard activities,
  905  protocols, policies, processes, and structures carried out in
  906  population-based settings, such as schools, worksites, health
  907  care facilities, faith-based organizations, and the overall
  908  community, which promote and support new behaviors.
  909         (10)“Tertiary prevention” means an intervention that is
  910  directed at rehabilitating and minimizing the effects of disease
  911  in a chronically ill population.
  912         (11)“Tobacco” means, without limitation, tobacco itself
  913  and tobacco products that include tobacco and are intended or
  914  expected for human use or consumption, including, but not
  915  limited to, cigarettes, cigars, pipe tobacco, and smokeless
  916  tobacco.
  917         (12)“Wellness program” means a structured program that is
  918  designed or approved by the department to offer intervention
  919  activities on or off the worksite which help state employees
  920  change certain behaviors or adopt healthy lifestyles.
  921         (13)“Youth” means children and young adults, up through 24
  922  years of age, inclusive.
  923         Section 20. Section 385.1022, Florida Statutes, is created
  924  to read:
  925         385.1022Chronic disease prevention program.—The department
  926  shall support public health programs to reduce the incidence of
  927  mortality and morbidity from diseases for which risk factors can
  928  be identified. Such risk factors include, but are not limited
  929  to, being overweight or obese, physical inactivity, poor
  930  nutrition and diet, tobacco use, sun exposure, and other
  931  practices that are detrimental to health. The programs shall
  932  educate and screen the general public as well as groups at
  933  particularly high risk of chronic diseases.
  934         Section 21. Section 385.1023, Florida Statutes, is created
  935  to read:
  936         385.1023State-level prevention programs for chronic
  937  disease.—
  938         (1)The department shall create state-level programs that
  939  address the leading, preventable chronic disease risk factors of
  940  poor nutrition and obesity, tobacco use, sun exposure, and
  941  physical inactivity in order to decrease the incidence of
  942  arthritis, cancer, diabetes, heart disease, lung disease,
  943  stroke, and other chronic diseases.
  944         (2)State-level programs shall address, but need not be
  945  limited to, the following activities:
  946         (a)Monitoring specific causal and behavioral risk factors
  947  that affect the health of residents in the state.
  948         (b)Analyzing data regarding chronic disease mortality and
  949  morbidity to track changes over time.
  950         (c)Promoting public awareness and increasing knowledge
  951  concerning the causes of chronic diseases, the importance of
  952  early detection, diagnosis, and appropriate evidence-based
  953  prevention, management, and treatment strategies.
  954         (d)Disseminating educational materials and information
  955  concerning evidence-based results, available services, and
  956  pertinent new research findings and prevention strategies to
  957  patients, health insurers, health professionals, and the public.
  958         (e)Using education and training resources and services
  959  developed by organizations having appropriate expertise and
  960  knowledge of chronic diseases for technical assistance.
  961         (f)Evaluating the quality and accessibility of existing
  962  community-based services for chronic disease.
  963         (g)Increasing awareness among state and local officials
  964  involved in health and human services, health professionals and
  965  providers, and policymakers about evidence-based chronic-disease
  966  prevention, tobacco cessation, and treatment strategies and
  967  their benefits for people who have chronic diseases.
  968         (h)Developing a partnership with state and local
  969  governments, voluntary health organizations, hospitals, health
  970  insurers, universities, medical centers, employer groups,
  971  private companies, and health care providers to address the
  972  burden of chronic disease in this state.
  973         (i)Implementing and coordinating state-level policies in
  974  order to reduce the burden of chronic disease.
  975         (j)Providing lasting improvements in the delivery of
  976  health care for individuals who have chronic disease and their
  977  families, thus improving their quality of life while also
  978  containing health care costs.
  979         Section 22. Section 385.103, Florida Statutes, is amended
  980  to read:
  981         385.103 Community-level Community intervention programs for
  982  chronic disease prevention and health promotion.—
  983         (1) DEFINITIONS.—As used in this section, the term:
  984         (a) “Chronic disease prevention and health promotion
  985  control program” means a program that may include, but is not
  986  limited to, including a combination of the following elements:
  987         1. Staff who are sufficiently trained and skilled in public
  988  health, community health, or school health education to
  989  facilitate the operation of the program Health screening;
  990         2. Community input into the planning, implementation, and
  991  evaluation processes Risk factor detection;
  992         3. Use of public health data to make decisions and to
  993  develop and prioritize community-based interventions focusing on
  994  chronic diseases and their risk factors; Appropriate
  995  intervention to enable and encourage changes in behaviors that
  996  create health risks; and
  997         4. Adherence to a population-based approach by using a
  998  socioecological model that addresses the influence on individual
  999  behavior, interpersonal behavior, organizational behavior, the
 1000  community, and public policy; Counseling in nutrition, physical
 1001  activity, the effects of tobacco use, hypertension, blood
 1002  pressure control, and diabetes control and the provision of
 1003  other clinical prevention services.
 1004         5.Focus on at least the common preventable risk factors
 1005  for chronic disease, such as physical inactivity, obesity, poor
 1006  nutrition, and tobacco use;
 1007         6.Focus on developing and implementing interventions and
 1008  activities through communities, schools, worksites, faith-based
 1009  organizations, and health-care settings;
 1010         7.Use of evidence-based interventions as well as best and
 1011  promising practices to guide specific activities and effect
 1012  change, which may include guidelines developed by organizations,
 1013  volunteer scientists, and health care professionals who write
 1014  published medical, scientific statements on various chronic
 1015  disease topics. The statements shall be supported by scientific
 1016  studies published in recognized journals that have a rigorous
 1017  review and approval process. Scientific statements generally
 1018  include a review of data available on a specific subject and an
 1019  evaluation of its relationship to overall chronic disease
 1020  science;
 1021         8.Use of policy, system, and environmental changes that
 1022  support healthy behaviors so as to affect large segments of the
 1023  population and encourage healthy choices;
 1024         9.Development of extensive and comprehensive evaluation
 1025  that is linked to program planning at the state level and the
 1026  community level in order to determine the program’s
 1027  effectiveness or necessary program modifications; and
 1028         10.Reduction of duplication of efforts through
 1029  coordination among appropriate entities for the efficient use of
 1030  resources.
 1031         (b) “Community Health education program” means a program
 1032  that follows involving the planned and coordinated use of the
 1033  educational standards and teaching methods resources available
 1034  in a community in an effort to provide:
 1035         1.Appropriate medical, research-based interventions to
 1036  enable and encourage changes in behaviors which reduce or
 1037  eliminate health risks;
 1038         2.Counseling in nutrition, weight management, physical
 1039  inactivity, and tobacco-use prevention and cessation strategies;
 1040  hypertension, blood pressure, high cholesterol, and diabetes
 1041  control; and other clinical prevention services;
 1042         3.1.Motivation and assistance to individuals or groups in
 1043  adopting and maintaining Motivate and assist citizens to adopt
 1044  and maintain healthful practices and lifestyles; and
 1045         4.2.Make available Learning opportunities that which will
 1046  increase the ability of people to make informed decisions
 1047  affecting their personal, family, and community well-being and
 1048  that which are designed to facilitate voluntary adoption of
 1049  behavior that which will improve or maintain health.;
 1050         3.Reduce, through coordination among appropriate agencies,
 1051  duplication of health education efforts; and
 1052         4.Facilitate collaboration among appropriate agencies for
 1053  efficient use of scarce resources.
 1054         (c) “Community intervention program” means a program
 1055  combining the required elements of a chronic disease prevention
 1056  and health promotion control program and the principles of a
 1057  community health education program that addresses system,
 1058  policy, and environmental changes that ensure that communities
 1059  provide support for healthy lifestyles into a unified program
 1060  over which a single administrative entity has authority and
 1061  responsibility.
 1062         (d)“Department” means the Department of Health.
 1063         (e)“Risk factor” means a factor identified during the
 1064  course of an epidemiological study of a disease, which factor
 1065  appears to be statistically associated with a high incidence of
 1066  that disease.
 1067         (2) OPERATION OF COMMUNITY-LEVEL COMMUNITY INTERVENTION
 1068  PROGRAMS FOR CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION.—
 1069         (a) The department shall develop and implement a
 1070  comprehensive, community-based program for chronic disease
 1071  prevention and health promotion. The program shall be designed
 1072  to reduce major behavioral risk factors that are associated with
 1073  chronic diseases by enhancing the knowledge, skills, motivation,
 1074  and opportunities for individuals, organizations, health care
 1075  providers, small businesses, health insurers, and communities to
 1076  develop and maintain healthy lifestyles. The department shall
 1077  assist the county health departments in developing and operating
 1078  community intervention programs throughout the state. At a
 1079  minimum, the community intervention programs shall address one
 1080  to three of the following chronic diseases: cancer, diabetes,
 1081  heart disease, stroke, hypertension, renal disease, and chronic
 1082  obstructive lung disease.
 1083         (b) The program shall include:
 1084         1.Countywide assessments of specific, causal, and
 1085  behavioral risk factors that affect the health of residents;
 1086         2.The development of community-based programs for chronic
 1087  disease prevention and health promotion which incorporate health
 1088  promotion and preventive care practices that are supported in
 1089  scientific and medical literature;
 1090         3.The development and implementation of statewide age
 1091  specific, disease-specific, and community-specific health
 1092  promotion and preventive care strategies using primary,
 1093  secondary, and tertiary prevention interventions;
 1094         4.The promotion of community, research-based health
 1095  promotion model programs that meet specific criteria, address
 1096  major risk factors, and motivate individuals to permanently
 1097  adopt healthy behaviors and increase social and personal
 1098  responsibilities;
 1099         5.The development of policies that encourage the use of
 1100  alternative community delivery sites for health promotion,
 1101  disease prevention, and preventive care programs and promote the
 1102  use of neighborhood delivery sites that are close to work, home,
 1103  and school; and
 1104         6.An emphasis on the importance of healthy and physically
 1105  active lifestyles to build self-esteem and reduce morbidity and
 1106  mortality associated with chronic disease and being overweight
 1107  or obese. Existing community resources, when available, shall be
 1108  used to support the programs. The department shall seek funding
 1109  for the programs from federal and state financial assistance
 1110  programs which presently exist or which may be hereafter
 1111  created. Additional services, as appropriate, may be
 1112  incorporated into a program to the extent that resources are
 1113  available. The department may accept gifts and grants in order
 1114  to carry out a program.
 1115         (c)Volunteers shall be used to the maximum extent possible
 1116  in carrying out the programs. The department shall contract for
 1117  the necessary insurance coverage to protect volunteers from
 1118  personal liability while acting within the scope of their
 1119  volunteer assignments under a program.
 1120         (d)The department may contract for the provision of all or
 1121  any portion of the services required by a program, and shall so
 1122  contract whenever the services so provided are more cost
 1123  efficient than those provided by the department.
 1124         (e)If the department determines that it is necessary for
 1125  clients to help pay for services provided by a program, the
 1126  department may require clients to make contribution therefor in
 1127  either money or personal services. The amount of money or value
 1128  of the personal services shall be fixed according to a fee
 1129  schedule established by the department or by the entity
 1130  developing the program. In establishing the fee schedule, the
 1131  department or the entity developing the program shall take into
 1132  account the expenses and resources of a client and his or her
 1133  overall ability to pay for the services.
 1134         Section 23. Section 385.105, Florida Statutes, is created
 1135  to read:
 1136         385.105Physical activity, obesity prevention, nutrition,
 1137  other health-promotion services, and wellness programs.—
 1138         (1)PHYSICAL ACTIVITY—.
 1139         (a)The department shall develop programs for people at
 1140  every stage of their lives to increase physical fitness and
 1141  promote behavior changes.
 1142         (b)The department shall work with school health advisory
 1143  or wellness committees in each school district as established in
 1144  s. 381.0056.
 1145         (c)The department shall develop public and private
 1146  partnerships that allow the public to easily access recreational
 1147  facilities and public land areas that are suitable for physical
 1148  activity.
 1149         (d)The department shall work in collaboration with the
 1150  Executive Office of the Governor and Volunteer Florida, Inc., to
 1151  promote school initiatives, such as the Governor’s Fitness
 1152  Challenge.
 1153         (e)The department shall collaborate with the Department of
 1154  Education in recognizing nationally accepted best practices for
 1155  improving physical education in schools.
 1156         (2)OBESITY PREVENTION.—The department shall promote
 1157  healthy lifestyles to reduce the prevalence of excess weight
 1158  gain and being overweight or obese through programs that are
 1159  directed towards all residents of this state by:
 1160         (a)Using all appropriate media to promote maximum public
 1161  awareness of the latest research on healthy lifestyles and
 1162  chronic diseases and disseminating relevant information through
 1163  a statewide clearinghouse relating to wellness, physical
 1164  activity, and nutrition and the effect of these factors on
 1165  chronic diseases and disabling conditions.
 1166         (b)Providing technical assistance, training, and resources
 1167  on healthy lifestyles and chronic diseases to the public, health
 1168  care providers, school districts, and other persons or entities,
 1169  including faith-based organizations that request such assistance
 1170  to promote physical activity, nutrition, and healthy lifestyle
 1171  programs.
 1172         (c)Developing, implementing, and using all available
 1173  research methods to collect data, including, but not limited to,
 1174  population-specific data, and tracking the incidence and effects
 1175  of weight gain, obesity, and related chronic diseases. The
 1176  department shall include an evaluation and data-collection
 1177  component in all programs as appropriate. All research conducted
 1178  under this paragraph is subject to review and approval as
 1179  required by the department’s institutional review board under s.
 1180  381.86.
 1181         (d)Entering into partnerships with the Department of
 1182  Education, local communities, school districts, and other
 1183  entities to encourage schools in this state to promote
 1184  activities during and after school to help students meet a
 1185  minimum goal of 30 minutes of physical activity or physical
 1186  fitness per day.
 1187         (e)Entering into partnerships with the Department of
 1188  Education, school districts, and the Florida Sports Foundation
 1189  to develop a programs recognizing the schools at which students
 1190  demonstrate excellent physical fitness or fitness improvement.
 1191         (f)Collaborating with other state agencies to develop
 1192  policies and strategies for preventing and treating obesity,
 1193  which shall be incorporated into programs administered by each
 1194  agency and shall include promoting healthy lifestyles of
 1195  employees of each agency.
 1196         (g)Advising, in accordance with s. 456.081, health care
 1197  practitioners about the morbidity, mortality, and costs
 1198  associated with being overweight or obese, informing such
 1199  practitioners of promising clinical practices for preventing and
 1200  treating obesity, and encouraging practitioners to counsel their
 1201  patients regarding the adoption of healthy lifestyles.
 1202         (h)Maximizing all local, state, and federal funding
 1203  sources, including grants, public-private partnerships, and
 1204  other mechanisms to strengthen the department’s programs
 1205  promoting physical activity and nutrition.
 1206         (3)NUTRITION.—The department shall promote optimal
 1207  nutritional status in all stages of people’s lives by developing
 1208  strategies to:
 1209         (a)Promote and maintain optimal nutritional status in the
 1210  population through activities, including, but not limited to:
 1211         1.Nutrition screening and assessment and nutrition
 1212  counseling, including nutrition therapy, followup, case
 1213  management, and referrals for persons who have medical
 1214  conditions or nutrition-risk factors and who are provided health
 1215  services through public health programs or through referrals
 1216  from private health care providers or facilities;
 1217         2.Nutrition education to assist residents of the state in
 1218  achieving optimal health and preventing chronic disease; and
 1219         3.Consultative nutrition services to group facilities
 1220  which promote the provision of safe and nutritionally adequate
 1221  diets.
 1222         (b)Monitor and conduct surveillance of the nutritional
 1223  status of this state’s population.
 1224         (c)Conduct or support research or evaluations related to
 1225  public health nutrition. All research conducted under this
 1226  paragraph is subject to review and approval as required by the
 1227  department’s institutional review board under s. 381.86.
 1228         (d)Establish policies and standards for public health
 1229  nutrition practices.
 1230         (e)Promote interagency cooperation, professional
 1231  education, and consultation.
 1232         (f)Provide technical assistance and advise state agencies,
 1233  private institutions, and local organizations regarding public
 1234  health nutrition standards.
 1235         (g)Work with the Department of Agriculture and Consumer
 1236  Services, the Department of Education, and the Department of
 1237  Management Services to further the use of fresh produce from
 1238  this state in schools and encourage the development of community
 1239  gardens. Nutritional services shall be available to eligible
 1240  persons in accordance with eligibility criteria adopted by the
 1241  department. The department shall provide by rule requirements
 1242  for the service fees, when applicable, which may not exceed the
 1243  department’s actual costs.
 1244  
 1245  The department may adopt rules to administer this subsection.
 1246         (4)OTHER HEALTH-PROMOTION SERVICES.—
 1247         (a)The department shall promote personal responsibility by
 1248  encouraging residents of this state to be informed, follow
 1249  health recommendations, seek medical consultations and health
 1250  assessments, take healthy precautions, and comply with medical
 1251  guidelines, including those that lead to earlier detection of
 1252  chronic diseases in order to prevent chronic diseases or slow
 1253  the progression of established chronic diseases.
 1254         (b)The department shall promote regular health visits
 1255  during a person’s lifetime, including annual physical
 1256  examinations that include measuring body mass index and vital
 1257  signs, blood work, immunizations, screenings, and dental
 1258  examinations in order to reduce the financial, social, and
 1259  personal burden of chronic disease.
 1260         (5)WELLNESS PROGRAMS.—
 1261         (a)Each state agency may conduct employee wellness
 1262  programs in buildings and lands owned or leased by the state.
 1263  The department shall serve as a model to develop and implement
 1264  employee wellness programs that may include physical fitness,
 1265  healthy nutrition, self-management of disease, education, and
 1266  behavioral change. The department shall assist other state
 1267  agencies to develop and implement employee wellness programs.
 1268  These programs shall use existing resources, facilities, and
 1269  programs or resources procured through grant funding and
 1270  donations that are obtained in accordance with state ethics and
 1271  procurement policies, and shall provide equal access to any such
 1272  programs, resources, and facilities to all state employees.
 1273         (b)The department shall coordinate its efforts with the
 1274  Department of Management Services and other state agencies.
 1275         (c)Each agency may establish an employee wellness work
 1276  group to design the program. The department shall be available
 1277  to provide policy guidance and assist in identifying effective
 1278  wellness program strategies.
 1279         (d)The department shall provide by rule requirements for
 1280  nominal participation fees, when applicable, which may not
 1281  exceed the department’s actual costs; collaborations with
 1282  businesses; and the procurement of equipment and incentives.
 1283         Section 24. Section 385.202, Florida Statutes, is amended
 1284  to read:
 1285         385.202 Statewide cancer registry.—
 1286         (1) Each facility, laboratory, or practitioner licensed
 1287  under chapter 395, chapter 458, chapter 459, chapter 464,
 1288  chapter 483, and each freestanding radiation therapy center as
 1289  defined in s. 408.07, shall report to the department of Health
 1290  such information, specified by the department, by rule. The
 1291  department may adopt rules regarding reporting requirements for
 1292  the cancer registry, which shall include the data required, the
 1293  timeframe for reporting, and those professionals who are
 1294  responsible for ensuring compliance with reporting requirements,
 1295  which indicates diagnosis, stage of disease, medical history,
 1296  laboratory data, tissue diagnosis, and radiation, surgical, or
 1297  other methods of diagnosis or treatment for each cancer
 1298  diagnosed or treated by the facility or center. Failure to
 1299  comply with this requirement may be cause for registration or
 1300  licensure suspension or revocation.
 1301         (2) The department shall establish, or cause to have
 1302  established, by contract with a recognized medical organization
 1303  in this state and its affiliated institutions, a statewide
 1304  cancer registry program to ensure that cancer reports required
 1305  under this section shall be maintained and available for use in
 1306  the course of public health surveillance and any study for the
 1307  purpose of reducing morbidity or mortality; and no liability of
 1308  any kind or character for damages or other relief shall arise or
 1309  be enforced against any facility or practitioner hospital by
 1310  reason of having provided such information or material to the
 1311  department.
 1312         (3)The department may adopt rules regarding the
 1313  establishment and operation of a statewide cancer registry
 1314  program.
 1315         (4)(3) The department or a contractual designee operating
 1316  the statewide cancer registry program required by this section
 1317  shall use or publish said material only for the purpose of
 1318  public health surveillance and advancing medical research or
 1319  medical education in the interest of reducing morbidity or
 1320  mortality, except that a summary of such studies may be released
 1321  for general publication. Information which discloses or could
 1322  lead to the disclosure of the identity of any person whose
 1323  condition or treatment has been reported and studied shall be
 1324  confidential and exempt from the provisions of s. 119.07(1),
 1325  except that:
 1326         (a) Release may be made with the written consent of all
 1327  persons to whom the information applies;
 1328         (b) The department or a contractual designee may contact
 1329  individuals for the purpose of epidemiologic investigation and
 1330  monitoring, provided information that is confidential under this
 1331  section is not further disclosed; or
 1332         (c) The department may exchange personal data with any
 1333  other governmental agency or a contractual designee for the
 1334  purpose of public health surveillance and medical or scientific
 1335  research, if provided such governmental agency or contractual
 1336  designee does shall not further disclose information that is
 1337  confidential under this section.
 1338         (5)(4) Funds appropriated for this section shall be used
 1339  for establishing, administering, compiling, processing, and
 1340  providing biometric and statistical analyses to the reporting
 1341  facilities and practitioners. Funds may also be used to ensure
 1342  the quality and accuracy of the information reported and to
 1343  provide management information to the reporting facilities and
 1344  practitioners.
 1345         (6)(5) The department may adopt rules regarding the
 1346  classifications of, by rule, classify facilities that are
 1347  responsible for making reports to the cancer registry, the
 1348  content and frequency of the reports, and the penalty for
 1349  failure to comply with these requirements for purposes of
 1350  reports made to the cancer registry and specify the content and
 1351  frequency of the reports. In classifying facilities, the
 1352  department shall exempt certain facilities from reporting cancer
 1353  information that was previously reported to the department or
 1354  retrieved from existing state reports made to the department or
 1355  the Agency for Health Care Administration. The provisions of
 1356  This section does shall not apply to any facility whose primary
 1357  function is to provide psychiatric care to its patients.
 1358         (7)Notwithstanding subsection (1), each facility and
 1359  practitioner that reports cancer cases to the department shall
 1360  make their records available for onsite review by the department
 1361  or its authorized representative.
 1362         Section 25. Subsection (3) of section 385.203, Florida
 1363  Statutes, is amended to read:
 1364         385.203 Diabetes Advisory Council; creation; function;
 1365  membership.—
 1366         (3) The council shall be composed of 26 25 citizens of the
 1367  state who have knowledge of, or work in, the area of diabetes
 1368  mellitus as follows:
 1369         (a) Five interested citizens, three of whom are affected by
 1370  diabetes.
 1371         (b) Twenty-one Twenty members, who must include one
 1372  representative from each of the following areas: nursing with
 1373  diabetes-educator certification; dietary with diabetes educator
 1374  certification; podiatry; ophthalmology or optometry; psychology;
 1375  pharmacy; adult endocrinology; pediatric endocrinology; the
 1376  American Diabetes Association (ADA); the Juvenile Diabetes
 1377  Foundation (JDF); the Florida Academy of Family Physicians; a
 1378  community health center; a county health department; an American
 1379  Diabetes Association recognized community education program;
 1380  each medical school in the state; an osteopathic medical school;
 1381  the insurance industry; a Children’s Medical Services diabetes
 1382  regional program; and an employer.
 1383         (c) One or more representatives from the Department of
 1384  Health, who shall serve on the council as ex officio members.
 1385         Section 26. Section 385.206, Florida Statutes, is amended
 1386  to read:
 1387         385.206 Pediatric Hematology-Oncology care Center Program.—
 1388         (1) DEFINITIONS.—As used in this section, the term:
 1389         (a) “Department” means the Department of Health.
 1390         (b) “Hematology” means the study, diagnosis, and treatment
 1391  of blood and blood-forming tissues.
 1392         (c) “Oncology” means the study, diagnosis, and treatment of
 1393  malignant neoplasms or cancer.
 1394         (d) “Hemophilia” or “other hemostatic disorder” means a
 1395  bleeding disorder resulting from a genetic abnormality of
 1396  mechanisms related to the control of bleeding.
 1397         (e) “Sickle-cell anemia or other hemoglobinopathy” means an
 1398  hereditary, chronic disease caused by an abnormal type of
 1399  hemoglobin.
 1400         (f) “Patient” means a person under the age of 21 who is in
 1401  need of hematologic-oncologic services and who is enrolled in
 1402  the Children’s Medical Services Network declared medically and
 1403  financially eligible by the department; or a person who received
 1404  such services prior to age 21 and who requires long-term
 1405  monitoring and evaluation to ascertain the sequelae and the
 1406  effectiveness of treatment.
 1407         (g) “Center” means a facility designated by the department
 1408  as having a program specifically designed to provide a full
 1409  range of medical and specialty services to patients with
 1410  hematologic and oncologic disorders.
 1411         (2) PEDIATRIC HEMATOLOGY-ONCOLOGY CARE CENTER PROGRAM;
 1412  AUTHORITY.—The department may designate is authorized to make
 1413  grants and reimbursements to designated centers and provide
 1414  funding to establish and maintain programs for the care of
 1415  patients with hematologic and oncologic disorders. Program
 1416  administration costs shall be paid by the department from funds
 1417  appropriated for this purpose.
 1418         (3) GRANT FUNDING CONTRACTS GRANT AGREEMENTS; CONDITIONS.—
 1419         (a)Funding provided A grant made under this section shall
 1420  be pursuant to a contract contractual agreement made between a
 1421  center and the department. Each contract agreement shall provide
 1422  that patients will receive services specified types of treatment
 1423  and care from the center without additional charge to the
 1424  patients or their parents or guardians. Grants shall be
 1425  disbursed in accordance with conditions set forth in the
 1426  disbursement guidelines.
 1427         (4)GRANT DISBURSEMENTS AND SPECIAL DISBURSEMENTS FOR LOCAL
 1428  PROGRAMS.—
 1429         (b)(a)Funding may be provided Grant disbursements may be
 1430  made to centers that which meet the following criteria:
 1431         1. The personnel shall include at least one board-certified
 1432  pediatric hematologist-oncologist, at least one board-certified
 1433  pediatric surgeon, at least one board-certified radiotherapist,
 1434  and at least one board-certified pathologist.
 1435         2. As approved by the department, The center shall actively
 1436  participate in a national children’s cancer study group,
 1437  maintain a pediatric tumor registry, have a multidisciplinary
 1438  pediatric tumor board, and meet other guidelines for
 1439  development, including, but not limited to, guidelines from such
 1440  organizations as the American Academy of Pediatrics and the
 1441  American Pediatric Surgical Association.
 1442         (b)Programs shall also be established to provide care to
 1443  hematology-oncology patients within each district of the
 1444  department. The guidelines for local programs shall be
 1445  formulated by the department. Special disbursements may be made
 1446  by the program office to centers for educational programs
 1447  designed for the districts of the department. These programs may
 1448  include teaching total supportive care of the dying patient and
 1449  his or her family, home therapy to hemophiliacs and patients
 1450  with other hemostatic disorders, and screening and counseling
 1451  for patients with sickle-cell anemia or other
 1452  hemoglobinopathies.
 1453         (4)(5) PROGRAM AND PEER REVIEW.—The department shall
 1454  evaluate at least annually during the grant period the services
 1455  rendered by the centers and the districts of the department.
 1456  Data from the centers and other sources relating to pediatric
 1457  cancer shall be reviewed annually by the Florida Association of
 1458  Pediatric Tumor Programs, Inc.; and a written report with
 1459  recommendations shall be made to the department. This database
 1460  will be available to the department for program planning and
 1461  quality assurance initiatives formulation of its annual program
 1462  and financial evaluation report. A portion of the funds
 1463  appropriated for this section may be used to provide statewide
 1464  consultation, supervision, and evaluation of the programs of the
 1465  centers, as well as central program office support personnel.
 1466         Section 27. Paragraph (g) of subsection (2) and subsection
 1467  (7) of section 385.207, Florida Statutes, are amended to read:
 1468         385.207 Care and assistance of persons with epilepsy;
 1469  establishment of programs in epilepsy control.—
 1470         (2) The Department of Health shall:
 1471         (g) Continue current programs and develop cooperative
 1472  programs and services designed to enhance the vocational
 1473  rehabilitation of epilepsy clients, including the current jobs
 1474  programs. The department shall, as part of its contract with a
 1475  provider of epilepsy services, collect information regarding the
 1476  number of clients served, the outcomes reached, the expenses
 1477  incurred, and the fees collected by such providers for the
 1478  provision of services keep and make this information available
 1479  to the Governor and the Legislature upon request information
 1480  regarding the number of clients served, the outcome reached, and
 1481  the expense incurred by such programs and services.
 1482         (7)The department shall limit total administrative
 1483  expenditures from the Epilepsy Services Trust Fund to 5 percent
 1484  of annual receipts.
 1485         Section 28. Paragraphs (b), (d), and (g) of subsection (2)
 1486  and paragraph (b) of subsection (5) of section 385.210, Florida
 1487  Statutes, are amended to read:
 1488         385.210 Arthritis prevention and education.—
 1489         (2) LEGISLATIVE FINDINGS.—The Legislature finds the
 1490  following:
 1491         (b) Arthritis is the leading cause of disability in the
 1492  United States, limiting daily activities for more than 19 7
 1493  million citizens.
 1494         (d) There are enormous economic and social costs associated
 1495  with treating arthritis and its complications; the economic
 1496  costs are estimated at over $128 billion (2003) $116 billion
 1497  (1997) annually in the United States.
 1498         (g) The National Arthritis Foundation, the CDC Centers for
 1499  Disease Control and Prevention, and the Association of State and
 1500  Territorial Health Officials have led the development of a
 1501  public health strategy, the National Arthritis Action Plan, to
 1502  respond to this challenge.
 1503         (5) FUNDING.—
 1504         (b) The State Surgeon General may shall seek any federal
 1505  waiver or waivers that may be necessary to maximize funds from
 1506  the Federal Government to implement this program.
 1507         Section 29. Section 385.301, Florida Statutes, is created
 1508  to read:
 1509         385.301Rulemaking authority.—The department may adopt
 1510  rules pursuant to chapter 120 to administer this chapter.
 1511         Section 30. Paragraph (l) of subsection (4) of section
 1512  400.9905, Florida Statutes, is amended to read:
 1513         400.9905 Definitions.—
 1514         (4) “Clinic” means an entity at which health care services
 1515  are provided to individuals and which tenders charges for
 1516  reimbursement for such services, including a mobile clinic and a
 1517  portable equipment provider. For purposes of this part, the term
 1518  does not include and the licensure requirements of this part do
 1519  not apply to:
 1520         (l) Orthotic, or prosthetic, pediatric cardiological, or
 1521  perinatological clinical facilities that are a publicly traded
 1522  corporation or that are wholly owned, directly or indirectly, by
 1523  a publicly traded corporation. As used in this paragraph, a
 1524  publicly traded corporation is a corporation that issues
 1525  securities traded on an exchange registered with the United
 1526  States Securities and Exchange Commission as a national
 1527  securities exchange.
 1528         Section 31. Subsection (9) of section 409.904, Florida
 1529  Statutes, is amended to read:
 1530         409.904 Optional payments for eligible persons.—The agency
 1531  may make payments for medical assistance and related services on
 1532  behalf of the following persons who are determined to be
 1533  eligible subject to the income, assets, and categorical
 1534  eligibility tests set forth in federal and state law. Payment on
 1535  behalf of these Medicaid eligible persons is subject to the
 1536  availability of moneys and any limitations established by the
 1537  General Appropriations Act or chapter 216.
 1538         (9) Eligible women with incomes at or below 200 percent of
 1539  the federal poverty level and under age 65, for cancer treatment
 1540  pursuant to the federal Breast and Cervical Cancer Prevention
 1541  and Treatment Act of 2000, screened through the Mary Brogan
 1542  Breast and Cervical Cancer Early Detection Program established
 1543  under s. 385.2021 s. 381.93.
 1544         Section 32. The amendment to s. 409.912(17), Florida
 1545  Statutes, contained in CS/CS/CS/SB 1986, as enacted by the 2009
 1546  Regular Session of the Legislature, shall not take effect if
 1547  that act becomes law.
 1548         Section 33. The repeal of s. 429.26(9), Florida Statutes,
 1549  contained in CS/CS/CS/SB 1986, as enacted by the 2009 Regular
 1550  Session of the Legislature, shall not take effect if that act
 1551  becomes law.
 1552         Section 34. The Pharmacy and Therapeutic Advisory Council.—
 1553         (1)The Pharmacy and Therapeutic Advisory Council is
 1554  created within the Executive Office of the Governor to serve in
 1555  an advisory capacity to the Department of Health and other
 1556  governmental agencies. The council may not interfere with
 1557  existing mandated Medicaid services and may not develop or
 1558  implement new ones. Specifically, the council may not interfere
 1559  with the work of the Agency for Health Care Administration as it
 1560  complies with federal and state statutory obligations to develop
 1561  a preferred drug list, to negotiate rebate agreements for
 1562  medications included in the preferred drug list, and to protect
 1563  the confidentiality of rebate agreements. The council may not
 1564  interfere with the Medicaid Pharmacy and Therapeutics Committee
 1565  or the Drug Utilization Review Board, which oversee clinical
 1566  activities within the Bureau of Pharmacy Services if such
 1567  interference would violate any federal or state statutory
 1568  obligations.
 1569         (2)The Pharmacy and Therapeutic Advisory Council shall use
 1570  Medicaid processes within the existing Medicaid structure of the
 1571  Agency for Health Care Administration as a guide for assisting
 1572  state agencies in:
 1573         (a)Developing an unbiased clinical perspective on drug
 1574  evaluations and utilization protocols that are relevant to
 1575  patient care provided through programs administered by state
 1576  agencies.
 1577         (b)Developing drug-utilization-review processes that are
 1578  relevant to the agencies and those receiving care through
 1579  programs administered by the agencies.
 1580         (c)Building a formulary structure that enforces formulary
 1581  compliance or adherence within each agency.
 1582         (d)Performing pharmacoeconomic analyses on formulary
 1583  management so that the state maximizes the cost-effectiveness of
 1584  its pharmaceutical purchasing.
 1585         (e)Reviewing new and existing therapies using criteria
 1586  established for efficacy, safety, and quality in order to
 1587  maximize cost-effective purchasing.
 1588         (f)Reviewing state agency proposals to maximize the cost
 1589  effectiveness of pharmaceutical purchasing in compliance with s.
 1590  381.0203.
 1591         (3) The council shall verify the cost-effectiveness and
 1592  clinical efficacy of any state contracts under s. 381.0203(1),
 1593  Florida Statutes, no less than once every 2 years.
 1594         (4)The members of the council and the chair shall be
 1595  appointed by the Governor to 4-year staggered terms or until
 1596  their successors are appointed. Members may be appointed to more
 1597  than one term. The Governor shall fill any vacancies for the
 1598  remainder of the unexpired term in the same manner as the
 1599  original appointment.
 1600         (5)The council shall include voting and nonvoting members,
 1601  and the chair, who is a voting member, must be a pharmacist
 1602  employed by a state agency.
 1603         (a)The voting members shall represent:
 1604         1.The Agency for Health Care Administration.
 1605         2.The Agency for Persons with Disabilities.
 1606         3.The Department of Children and Family Services.
 1607         4.The Department of Corrections.
 1608         5.The Department of Elderly Affairs.
 1609         6.The Department of Health.
 1610         7.The Department of Juvenile Justice.
 1611         8.The Bureau of Pharmacy Services within the Agency for
 1612  Health Care Administration, which shall be represented by the
 1613  bureau chief.
 1614         9.The Bureau of Statewide Pharmaceutical Services within
 1615  the Department of Health, which shall be represented by the
 1616  bureau chief.
 1617         (b)The nonvoting members shall be:
 1618         1.A representative from the Agency for Health Care
 1619  Administration’s drug contracting program.
 1620         2.The contracting officer for the Department of Health’s
 1621  drug procurement program.
 1622         3.A clinical pharmacy program manager from the Agency for
 1623  Health Care Administration.
 1624         4.The chair of the Department of Health’s Pharmacy and
 1625  Therapeutics Committee.
 1626         5.The general counsel for the Agency for Health Care
 1627  Administration or his or her designee.
 1628         6.The general counsel for a state agency in the executive
 1629  branch of state government, or his or her designee.
 1630         7.A representative from the Executive Office of the
 1631  Governor.
 1632         8.The statewide pharmacy director of the Department of
 1633  Corrections’ Office of Health Services.
 1634         (6)Members of the council shall consist of at least one
 1635  physician licensed under chapter 458 or chapter 459, Florida
 1636  Statutes, at least one pharmacist licensed under chapter 465,
 1637  Florida Statutes, and at least one registered nurse licensed
 1638  under chapter 464, Florida Statutes. Each member designated in
 1639  this subsection must have an active license in his or her
 1640  profession and may not have been the subject of any agency
 1641  disciplinary action.
 1642         (7)Members, who must be residents of this state, shall be
 1643  selected on the basis of specialty, board certification, prior
 1644  pharmacy and therapeutic experience, experience treating medical
 1645  assistance recipients, ability to represent a broad base of
 1646  constituents, and number of years of practice. Members must not
 1647  have any conflicts of interest due to their service on the
 1648  council.
 1649         (8)The council may request the participation of additional
 1650  subject-matter experts to address specific drug, therapeutic, or
 1651  drug-procurement issues under review by the council.
 1652         (9)A majority of the members of the council constitutes a
 1653  quorum, and an affirmative vote of a majority of the voting
 1654  members is necessary to take action.
 1655         (10)The council shall meet quarterly or at the call of the
 1656  chair.
 1657         (11)The council shall be staffed by the chair’s department
 1658  or agency.
 1659         (12)The council members shall serve without compensation,
 1660  but are entitled to reimbursement for travel and per diem
 1661  expenses incurred in the performance of their duties in
 1662  accordance with s. 112.061, Florida Statutes.
 1663         Section 35. Subsections (1) and (3) of section 430.80,
 1664  Florida Statutes, are amended to read:
 1665         430.80 Implementation of a teaching nursing home pilot
 1666  project.—
 1667         (1) As used in this section, the term “teaching nursing
 1668  home” means a nursing home facility licensed under chapter 400
 1669  which contains a minimum of 275 400 licensed nursing home beds;
 1670  has access to a resident senior population of sufficient size to
 1671  support education, training, and research relating to geriatric
 1672  care; and has a contractual relationship with a federally funded
 1673  accredited geriatric research center in this state or operates
 1674  in its own right a geriatric research center.
 1675         (3) To be designated as a teaching nursing home, a nursing
 1676  home licensee must, at a minimum:
 1677         (a) Provide a comprehensive program of integrated senior
 1678  services that include institutional services and community-based
 1679  services;
 1680         (b) Participate in a nationally recognized accreditation
 1681  program and hold a valid accreditation, such as the
 1682  accreditation awarded by the Joint Commission on Accreditation
 1683  of Healthcare Organizations, or possess a Gold Seal Award as
 1684  conferred by the Agency for Health Care Administration on its
 1685  licensed nursing home;
 1686         (c) Have been in business in this state for a minimum of 10
 1687  consecutive years;
 1688         (d) Demonstrate an active program in multidisciplinary
 1689  education and research that relates to gerontology;
 1690         (e) Have a formalized contractual relationship with at
 1691  least one accredited health profession education program located
 1692  in this state;
 1693         (f) Have a formalized contractual relationship with an
 1694  accredited hospital that is designated by law as a teaching
 1695  hospital; and
 1696         (f)(g) Have senior staff members who hold formal faculty
 1697  appointments at universities, which must include at least one
 1698  accredited health profession education program; and.
 1699         (g)(h) Maintain insurance coverage pursuant to s.
 1700  400.141(20) or proof of financial responsibility in a minimum
 1701  amount of $750,000. Such proof of financial responsibility may
 1702  include:
 1703         1. Maintaining an escrow account consisting of cash or
 1704  assets eligible for deposit in accordance with s. 625.52; or
 1705         2. Obtaining and maintaining pursuant to chapter 675 an
 1706  unexpired, irrevocable, nontransferable and nonassignable letter
 1707  of credit issued by any bank or savings association organized
 1708  and existing under the laws of this state or any bank or savings
 1709  association organized under the laws of the United States that
 1710  has its principal place of business in this state or has a
 1711  branch office which is authorized to receive deposits in this
 1712  state. The letter of credit shall be used to satisfy the
 1713  obligation of the facility to the claimant upon presentment of a
 1714  final judgment indicating liability and awarding damages to be
 1715  paid by the facility or upon presentment of a settlement
 1716  agreement signed by all parties to the agreement when such final
 1717  judgment or settlement is a result of a liability claim against
 1718  the facility.
 1719         Section 36. Paragraph (g) is added to subsection (53) of
 1720  section 499.003, Florida Statutes, to read:
 1721         499.003 Definitions of terms used in this part.—As used in
 1722  this part, the term:
 1723         (53) “Wholesale distribution” means distribution of
 1724  prescription drugs to persons other than a consumer or patient,
 1725  but does not include:
 1726         (g)The sale, purchase, trade, or transfer of a
 1727  prescription drug among agencies and health care entities of the
 1728  state to complete the dispensing of the prescription drug to a
 1729  patient under the care of a state agency or health care entity,
 1730  or to a patient for whom the state is responsible for providing
 1731  or arranging health care services. The agency or health care
 1732  entity that received the prescription drug on behalf of the
 1733  patient is deemed the patient’s agent under s. 465.003(6).
 1734         Section 37. Subsection (1) of section 651.105, Florida
 1735  Statutes, is amended to read:
 1736         651.105 Examination and inspections.—
 1737         (1) The office may at any time, and shall at least once
 1738  every 5 3 years, examine the business of any applicant for a
 1739  certificate of authority and any provider engaged in the
 1740  execution of care contracts or engaged in the performance of
 1741  obligations under such contracts, in the same manner as is
 1742  provided for examination of insurance companies pursuant to s.
 1743  624.316. Such examinations shall be made by a representative or
 1744  examiner designated by the office, whose compensation will be
 1745  fixed by the office pursuant to s. 624.320. Routine examinations
 1746  may be made by having the necessary documents submitted to the
 1747  office; and, for this purpose, financial documents and records
 1748  conforming to commonly accepted accounting principles and
 1749  practices, as required under s. 651.026, will be deemed
 1750  adequate. The final written report of each such examination
 1751  shall be filed with the office and, when so filed, will
 1752  constitute a public record. Any provider being examined shall,
 1753  upon request, give reasonable and timely access to all of its
 1754  records. The representative or examiner designated by the office
 1755  may at any time examine the records and affairs and inspect the
 1756  physical property of any provider, whether in connection with a
 1757  formal examination or not.
 1758         Section 38. Effective upon this act becoming a law,
 1759  paragraphs (d) and (g) of subsection (5) of section 627.6692,
 1760  Florida Statutes, are amended to read:
 1761         627.6692 Florida Health Insurance Coverage Continuation
 1762  Act.—
 1763         (5) CONTINUATION OF COVERAGE UNDER GROUP HEALTH PLANS.—
 1764         (d)1. A qualified beneficiary must give written notice to
 1765  the insurance carrier within 63 days after the occurrence of a
 1766  qualifying event. Unless otherwise specified in the notice, a
 1767  notice by any qualified beneficiary constitutes notice on behalf
 1768  of all qualified beneficiaries. The written notice must inform
 1769  the insurance carrier of the occurrence and type of the
 1770  qualifying event giving rise to the potential election by a
 1771  qualified beneficiary of continuation of coverage under the
 1772  group health plan issued by that insurance carrier, except that
 1773  in cases where the covered employee has been involuntarily
 1774  discharged, the nature of such discharge need not be disclosed.
 1775  The written notice must, at a minimum, identify the employer,
 1776  the group health plan number, the name and address of all
 1777  qualified beneficiaries, and such other information required by
 1778  the insurance carrier under the terms of the group health plan
 1779  or the commission by rule, to the extent that such information
 1780  is known by the qualified beneficiary.
 1781         2. A special election period shall be provided for
 1782  qualified beneficiaries whose qualifying event was involuntary
 1783  termination of employment during the period from September 1,
 1784  2008, through February 16, 2009, who did not elect continuation
 1785  coverage when it was first offered, or who did elect
 1786  continuation coverage but are no longer enrolled. The carrier
 1787  that issued the small employer’s group health plan shall provide
 1788  notice to individuals eligible for this special continuation
 1789  coverage election period informing them of this opportunity. The
 1790  notice must be provided by June 15, 2009.
 1791         a. Individuals have 30 days after notice is provided to
 1792  elect continuation coverage by written notice to the insurer.
 1793  The written notice must, at a minimum, identify the employer,
 1794  the group health plan number, the name and address of all
 1795  qualified beneficiaries, and such other information required by
 1796  the insurance carrier under the terms of the group health plan
 1797  or the commission by rule, to the extent that such information
 1798  is known by the qualified beneficiary.
 1799         b. Coverage shall be effective with the first period of
 1800  coverage on or after February 17, 2009.
 1801         c. For individuals electing continuation coverage during
 1802  this election period, the period between the loss of coverage
 1803  and beginning of coverage under this election is to be
 1804  disregarded for purposes of determining the 63-day periods
 1805  referred to in s. 627.6561(6).
 1806         3.2. Within 14 days after the receipt of written notice
 1807  under subparagraphs subparagraph 1. and 2., the insurance
 1808  carrier shall send each qualified beneficiary by certified mail
 1809  an election and premium notice form, approved by the office,
 1810  which form must provide for the qualified beneficiary’s election
 1811  or nonelection of continuation of coverage under the group
 1812  health plan and the applicable premium amount due after the
 1813  election to continue coverage. This subparagraph does not
 1814  require separate mailing of notices to qualified beneficiaries
 1815  residing in the same household, but requires a separate mailing
 1816  for each separate household.
 1817         (g) If an insurance carrier fails to comply with the notice
 1818  requirements of subparagraph (d)3.2. and such noncompliance
 1819  results in the failure of an eligible qualified beneficiary to
 1820  elect continuation under the group health plan, the qualified
 1821  beneficiary shall be deemed to have timely elected continuation
 1822  of coverage within the election period and shall be covered
 1823  under the group health plan at the expense of the noncomplying
 1824  insurance carrier. The liability exposure of a noncomplying
 1825  insurance carrier under this paragraph shall be limited to that
 1826  period which includes the effective date of coverage pursuant to
 1827  an affirmative election through the date on which the qualified
 1828  beneficiary receives actual notice. This paragraph does not
 1829  apply to the extent that the failure of the insurance carrier to
 1830  comply with applicable notice requirements was due to
 1831  noncompliance by the qualified beneficiary with notice
 1832  requirements applicable to the qualified beneficiary.
 1833         Section 39. Paragraph (l) is added to subsection (13) of
 1834  section 627.6699, Florida Statutes, to read:
 1835         627.6699 Employee Health Care Access Act.—
 1836         (13) STANDARDS TO ASSURE FAIR MARKETING.—
 1837         (l)1. In order to improve the ability of small employers to
 1838  obtain information including premium rates for small employer
 1839  health benefit plans and to facilitate the application process,
 1840  all small employer carriers shall use a uniform employee health
 1841  status form. The commission shall adopt rules specifying such
 1842  form. The form shall be designed by the Office of Insurance
 1843  Regulation, in consultation with small employer carriers, to
 1844  permit its use as a written document and through electronic or
 1845  other and alternative delivery formats. The form shall include
 1846  the following health data elements for all persons to be covered
 1847  under the policy that occurred in the 2 years before the date of
 1848  completion of the form:
 1849         a. Any treatment or diagnosis by any licensed medical
 1850  practitioner.
 1851         b. Any procedure or treatment in a hospital, rehabilitation
 1852  program, or surgical center.
 1853         c. All current medications prescribed by a licensed
 1854  practitioner.
 1855         d. Current diagnosis of pregnancy.
 1856         e. Current use of any tobacco products.
 1857         f. Pending test results.
 1858         g. Workers’ compensation injury or illness.
 1859         h. Tests or treatments recommended but not completed.
 1860         2.The form shall require the signature of the employee
 1861  completing the form. Use of a standardized form does not prevent
 1862  a small employer carrier from obtaining information from other
 1863  sources in order to determine the appropriate premium rate for a
 1864  small employer.
 1865         Section 40. Subsection (1) of section 641.407, Florida
 1866  Statutes, is amended to read:
 1867         641.407 Minimum surplus.—
 1868         (1) Each prepaid health clinic that is licensed before July
 1869  1, 2009, shall have and maintain minimum surplus in accordance
 1870  with the following schedule: On January 1, 2010 1996, $225,000
 1871  $150,000 or 10 percent of total liabilities, whichever is
 1872  greater; on January 1, 2011, $300,000 or 10 percent of total
 1873  liabilities, whichever is greater. A prepaid health clinic that
 1874  is licensed on or after July 1, 2009, shall have and maintain a
 1875  surplus of $300,000 or 10 percent of total liabilities,
 1876  whichever is greater. A prepaid health clinic that is licensed
 1877  on or before January 1, 2004, and that has an active membership
 1878  on July 1, 2009, shall have and maintain a minimum surplus of
 1879  $150,000 or 10 percent of total liabilities, whichever is
 1880  greater.
 1881         Section 41. Except as otherwise expressly provided in this
 1882  act, and except for this section, which shall take effect upon
 1883  becoming a law, this act shall take effect July 1, 2009.
 1884  
 1885  ================= T I T L E  A M E N D M E N T ================
 1886         And the title is amended as follows:
 1887         Delete everything before the enacting clause
 1888  and insert:
 1889                        A bill to be entitled                      
 1890         An act relating to health care; amending s. 154.503,
 1891         F.S.; conforming a cross-reference; repealing s.
 1892         381.0053, F.S., relating to a comprehensive nutrition
 1893         program; repealing s. 381.0054, F.S., relating to
 1894         healthy lifestyles promotion; repealing ss. 381.732,
 1895         381.733, and 381.734, F.S., relating to the Healthy
 1896         Communities, Healthy People Act; amending s. 381.006,
 1897         F.S.; requiring the Department of Health, when
 1898         conducting an environmental health program inspection
 1899         of a certified domestic violence center and certain
 1900         residential child-caring agencies to limit the
 1901         inspection of the domestic violence center or
 1902         residential child-caring agency to the requirements
 1903         set forth in the department’s rules applicable to
 1904         community-based residential facilities with five or
 1905         fewer residents; requiring the Department of Health to
 1906         include in its environmental health program the
 1907         testing of the air in enclosed ice rinks; authorizing
 1908         the department to adopt rules relating to air quality
 1909         standards, monitoring, testing, record keeping, the
 1910         maintenance and operation of equipment that affects
 1911         air quality, and assessment of fees; authorizing the
 1912         department to enter and inspect an enclosed ice
 1913         skating rink at reasonable hours to determine
 1914         compliance with applicable air quality statutes or
 1915         rules; authorizing the department to assess a fee for
 1916         a specified purpose; requiring the air quality
 1917         standards be consistent with federal risk values or
 1918         exposure guidelines; amending s. 381.0061, F.S.;
 1919         providing that the department may impose a fine, which
 1920         may not exceed a specified amount for a violation of
 1921         the ice rink air quality standards; amending s.
 1922         381.0072, F.S.; requiring the Department of Health,
 1923         when conducting a food service inspection of a
 1924         certified domestic violence center to limit the
 1925         inspection of the domestic violence center to the
 1926         requirements set forth in the department’s rules
 1927         applicable to community-based residential facilities
 1928         with five or fewer residents; amending s. 381.0203,
 1929         F.S.; requiring certain state agencies to purchase
 1930         drugs through the statewide purchasing contract
 1931         administered by the Department of Health; providing an
 1932         exception; requiring the department to establish and
 1933         maintain certain pharmacy services program;
 1934         transferring, renumbering, and amending s. 381.84,
 1935         F.S., relating to the Comprehensive Statewide Tobacco
 1936         Education and Use Prevention Program; revising
 1937         definitions; revising program components; requiring
 1938         program components to include efforts to educate youth
 1939         and their parents about tobacco use; requiring a
 1940         youth-directed focus in each program component;
 1941         requiring the Tobacco Education and Use Prevention
 1942         Advisory Council to adhere to state ethics laws;
 1943         providing that meetings of the council are subject to
 1944         public-records and public-meetings requirements;
 1945         revising the duties of the council; deleting a
 1946         provision that prohibits a member of the council from
 1947         participating in a discussion or decision with respect
 1948         to a research proposal by a firm, entity, or agency
 1949         with which the member is associated as a member of the
 1950         governing body or as an employee or with which the
 1951         member has entered into a contractual arrangement;
 1952         revising the submission date of an annual report;
 1953         deleting an expired provision relating to rulemaking
 1954         authority of the department; transferring and
 1955         renumbering s. 381.91, F.S., relating to the Jessie
 1956         Trice Cancer Prevention Program; transferring,
 1957         renumbering, and amending s. 381.911, F.S., relating
 1958         to the Prostate Cancer Awareness Program; revising the
 1959         criteria for members of the prostate cancer advisory
 1960         committee; repealing s. 381.912, F.S., relating to the
 1961         Cervical Cancer Elimination Task Force; transferring
 1962         and renumbering s. 381.92, F.S., relating to the
 1963         Florida Cancer Council; transferring and renumbering
 1964         s. 381.921, F.S., relating to the mission and duties
 1965         of the Florida Cancer Council; amending s. 381.922,
 1966         F.S.; conforming cross-references; transferring and
 1967         renumbering s. 381.93, F.S., relating to a breast and
 1968         cervical cancer early detection program; transferring
 1969         and renumbering s. 381.931, F.S., relating to an
 1970         annual report on Medicaid expenditures; renaming ch.
 1971         385, F.S., as the “Healthy and Fit Florida Act”;
 1972         amending s. 385.101, F.S.; renaming the “Chronic
 1973         Diseases Act” as the “Healthy and Fit Florida Act”;
 1974         amending s. 385.102, F.S.; revising legislative
 1975         intent; creating s. 385.1021, F.S.; providing
 1976         definitions; creating s. 385.1022, F.S.; requiring the
 1977         Department of Health to support public health programs
 1978         to reduce the incidence of mortality and morbidity
 1979         from chronic diseases; creating s. 385.1023, F.S.;
 1980         requiring the department to create state-level
 1981         programs that address the risk factors of certain
 1982         chronic diseases; providing required activities of the
 1983         state-level programs; amending s. 385.103, F.S.;
 1984         providing for community-level programs for the
 1985         prevention of chronic diseases; revising definitions;
 1986         requiring the department to develop and implement a
 1987         community-based chronic disease prevention and health
 1988         promotion program; providing the purpose of the
 1989         program; providing requirements for the program;
 1990         creating s. 385.105, F.S.; requiring the department to
 1991         develop programs to increase physical fitness, to work
 1992         with school districts, to develop partnerships that
 1993         allow the public to access recreational facilities and
 1994         public land areas suitable for physical activity, to
 1995         work with the Executive Office of the Governor and
 1996         Volunteer Florida, Inc., to promote school
 1997         initiatives, and to collaborate with the Department of
 1998         Education in recognizing nationally accepted best
 1999         practices for improving physical education in schools;
 2000         requiring the Department of Health to promote healthy
 2001         lifestyles to reduce obesity; requiring the department
 2002         to promote optimal nutritional status in all stages of
 2003         people’s lives, personal responsibility to prevent
 2004         chronic disease or slow its progression, and regular
 2005         health visits during a person’s life span; authorizing
 2006         state agencies to conduct employee wellness programs;
 2007         requiring the department to serve as a model to
 2008         develop and implement employee wellness programs;
 2009         requiring the department to assist state agencies to
 2010         develop the employee wellness programs; providing
 2011         equal access to the programs by agency employees;
 2012         requiring the department to coordinate efforts with
 2013         the Department of Management Services and other state
 2014         agencies; authorizing each state agency to establish
 2015         an employee wellness work group to design the wellness
 2016         program; requiring the department to provide
 2017         requirements for participation fees, collaborations
 2018         with businesses, and procurement of equipment and
 2019         incentives; amending s. 385.202, F.S.; requiring
 2020         facilities, laboratories, and practitioners to report
 2021         information; authorizing the department to adopt rules
 2022         regarding reporting requirements for the cancer
 2023         registry; providing immunity from liability for
 2024         facilities and practitioners reporting certain
 2025         information; requiring the department to adopt rules
 2026         regarding the establishment and operation of a
 2027         statewide cancer registry program; requiring the
 2028         department or contractual designee operating the
 2029         statewide cancer registry program to use or publish
 2030         material only for the purpose of public health
 2031         surveillance and advancing medical research or medical
 2032         education in the interest of reducing morbidity or
 2033         mortality; authorizing the department to exchange
 2034         personal data with any agency or contractual designee
 2035         for the purpose of public health surveillance and
 2036         medical or scientific research under certain
 2037         circumstances; clarifying that the department may
 2038         adopt rules regarding the classifications of
 2039         facilities related to reports made to the cancer
 2040         registry; requiring each facility and practitioner
 2041         that reports cancer cases to the department to make
 2042         their records available for onsite review; amending s.
 2043         385.203, F.S.; increasing the size of the Diabetes
 2044         Advisory Council to include one representative of the
 2045         Florida Academy of Family Physicians; amending s.
 2046         385.206, F.S.; renaming the “hematology-oncology care
 2047         center program” as the “Pediatric Hematology-Oncology
 2048         Center Program”; revising definitions; authorizing the
 2049         department to designate centers and provide funding to
 2050         maintain programs for the care of patients with
 2051         hematologic and oncologic disorders; clarifying
 2052         provisions related to grant-funding agreements and
 2053         grant disbursements; revising the department’s
 2054         requirement to evaluate services rendered by the
 2055         centers; requiring data from the centers and other
 2056         sources relating to pediatric cancer to be available
 2057         to the department for program planning and quality
 2058         assurance initiatives; amending s. 385.207, F.S.;
 2059         clarifying provisions that require the department to
 2060         collect information regarding the number of clients
 2061         served, the outcomes reached, the expense incurred,
 2062         and fees collected by providers of epilepsy services;
 2063         deleting the provision that requires the department to
 2064         limit administrative expenses from the Epilepsy
 2065         Services Trust Fund to a certain percentage of annual
 2066         receipts; amending s. 385.210, F.S.; revising
 2067         legislative findings regarding the economic costs of
 2068         treating arthritis and its complications; authorizing
 2069         the State Surgeon General to seek any federal waivers
 2070         that may be necessary to maximize funds from the
 2071         Federal Government to implement the Arthritis
 2072         Prevention and Education Program; creating s. 385.301,
 2073         F.S.; authorizing the department to adopt rules to
 2074         administer the act; amending s. 400.9905, F.S.;
 2075         revising the definition of the term “clinic” as it
 2076         relates to the Health Care Clinic Act; amending s.
 2077         409.904, F.S.; conforming a cross-reference;
 2078         abrogating an amendment to s. 409.912(17), F.S.,
 2079         relating to a requirement that entities providing
 2080         services under the Medicaid program maintain certain
 2081         surplus funds; abrogating the repeal of 429.26(9),
 2082         F.S., relating to assisted living facility resident
 2083         examinations and evaluations in certain circumstances;
 2084         creating the Pharmacy and Therapeutic Advisory Council
 2085         within the Executive Office of the Governor; providing
 2086         duties of the council; providing for the appointment
 2087         and qualification of members; providing for the use of
 2088         subject-matter experts when necessary; providing
 2089         requirements for voting and a quorum; providing for
 2090         quarterly meetings of the council; providing for
 2091         staffing; providing for reimbursement of per diem and
 2092         travel expenses for members of the council; amending
 2093         s. 430.80, F.S.; redefining the term “teaching nursing
 2094         home” as it relates to the implementation of a
 2095         teaching nursing home pilot project; revising the
 2096         requirements to be designated as a teaching nursing
 2097         home; amending s. 499.003, F.S.; excluding from the
 2098         definition of “wholesale distribution” certain
 2099         activities of state agencies; amending s. 651.105,
 2100         F.S.; revising the time period in which the Office of
 2101         Insurance Regulation is required to examine the
 2102         business of an applicant for a certificate of
 2103         authority and a provider engaged in the execution of
 2104         continuing care contracts; amending s. 627.6692, F.S.;
 2105         providing for a special election period for
 2106         continuation of coverage under group health plans for
 2107         certain qualified beneficiaries; providing carrier
 2108         notification requirements; providing for effectiveness
 2109         of such coverage; providing for disregarding certain
 2110         periods for which coverage is not provided; amending
 2111         s. 627.6699, F.S.; requiring small employer carriers
 2112         to use a uniform employee health status form;
 2113         requiring the Financial Service Commission to adopt
 2114         rules; requiring the Office of Insurance Regulation to
 2115         design the form in consultation with small employer
 2116         carriers; providing form delivery formats; specifying
 2117         form requirements; amending s. 641.407, F.S.; revising
 2118         the minimum surplus that a prepaid health clinic is
 2119         required to maintain; providing a schedule for
 2120         compliance; providing effective dates.