Amendment
Bill No. CS/HB 1471

Amendment No. 905379

CHAMBER ACTION
Senate		House
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1	Representative Adams offered the following:
2
3	Amendment (with title amendment)
4	Remove everything after the enacting clause and insert:
5
6	Section 1.  Paragraph (e) of subsection (2) of section
7	154.503, Florida Statutes, is amended to read:
8	154.503  Primary Care for Children and Families Challenge
9	Grant Program; creation; administration.--
10	(2)  The department shall:
11	(e)  Coordinate with the primary care program developed
12	pursuant to s. 154.011, the Florida Healthy Kids Corporation
13	program created in s. 624.91, the school health services program
14	created in ss. 381.0056 and 381.0057, the Healthy Communities,
15	Healthy People Program created in s. 381.734, and the volunteer
16	health care provider program developed pursuant to s. 766.1115.
17	Section 2.  Sections 381.0053, 381.0054, 381.732, 381.733,
18	and 381.734, Florida Statutes, are repealed.
19	Section 3.  Subsection (16) of section 381.006, Florida
20	Statutes, is amended to read:
21	381.006  Environmental health.--The department shall
22	conduct an environmental health program as part of fulfilling
23	the state's public health mission. The purpose of this program
24	is to detect and prevent disease caused by natural and manmade
25	factors in the environment. The environmental health program
26	shall 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 shall be
57	limited to the requirements set forth in the department's rules
58	applicable to community-based residential facilities with five
59	or fewer residents. In addition to any sanctions that the
60	department may impose for violations of rules adopted under this
61	section, the department shall also report such violations to any
62	agency responsible for licensing or certifying the group care
63	facility. The licensing or certifying agency may also impose any
64	sanction based solely on the findings of the department.
65	(17)  Upon completion of the department's study to develop
66	passive strategies for nitrogen reduction that complement use of
67	conventional onsite wastewater treatment systems, the department
68	shall submit a final report to the Executive Office of the
69	Governor, the President of the Senate, and the Speaker of the
70	House of Representatives prior to proceeding with any nitrogen
71	reduction activities.
72
73	The department may adopt rules to carry out the provisions of
74	this section.
75	Section 4.  Paragraph (a) of subsection (2) of section
76	381.0072, Florida Statutes, is amended to read:
77	381.0072  Food service protection.--It shall be the duty of
78	the Department of Health to adopt and enforce sanitation rules
79	consistent with law to ensure the protection of the public from
80	food-borne illness. These rules shall provide the standards and
81	requirements for the storage, preparation, serving, or display
82	of food in food service establishments as defined in this
83	section and which are not permitted or licensed under chapter
84	500 or chapter 509.
85	(2)  DUTIES.--
86	(a)  The department shall adopt rules, including
87	definitions of terms which are consistent with law prescribing
88	minimum sanitation standards and manager certification
89	requirements as prescribed in s. 509.039, and which shall be
90	enforced in food service establishments as defined in this
91	section. The sanitation standards must address the construction,
92	operation, and maintenance of the establishment; lighting,
93	ventilation, laundry rooms, lockers, use and storage of toxic
94	materials and cleaning compounds, and first-aid supplies; plan
95	review; design, construction, installation, location,
96	maintenance, sanitation, and storage of food equipment and
97	utensils; employee training, health, hygiene, and work
98	practices; food supplies, preparation, storage, transportation,
99	and service, including access to the areas where food is stored
100	or prepared; and sanitary facilities and controls, including
101	water supply and sewage disposal; plumbing and toilet
102	facilities; garbage and refuse collection, storage, and
103	disposal; and vermin control. Public and private schools, if the
104	food service is operated by school employees; hospitals licensed
105	under chapter 395; nursing homes licensed under part II of
106	chapter 400; child care facilities as defined in s. 402.301;
107	residential facilities colocated with a nursing home or
108	hospital, if all food is prepared in a central kitchen that
109	complies with nursing or hospital regulations; and bars and
110	lounges, as defined by department rule, are exempt from the
111	rules developed for manager certification. The department shall
112	administer a comprehensive inspection, monitoring, and sampling
113	program to ensure such standards are maintained. With respect to
114	food service establishments permitted or licensed under chapter
115	500 or chapter 509, the department shall assist the Division of
116	Hotels and Restaurants of the Department of Business and
117	Professional Regulation and the Department of Agriculture and
118	Consumer Services with rulemaking by providing technical
119	information. Food service inspections of a certified domestic
120	violence center shall be limited to the requirements set forth
121	in the department's rules applicable to community-based
122	residential facilities with five or fewer residents.
123	Section 5.  Subsection (1) and paragraph (a) of subsection
124	(2) of section 381.0203, Florida Statutes, are amended to read:
125	381.0203  Pharmacy services.--
126	(1)  The department must may contract on a statewide basis
127	for the purchase of drugs, as defined in s. 499.003, to be used
128	by state agencies and political subdivisions, and may adopt
129	rules to administer this section. Effective January 1, 2010, all
130	state agencies, except the Agency for Health Care
131	Administration, the Department of Veterans' Affairs, and the
132	Department of Management Services, must purchase drugs through
133	the statewide contract unless:
134	(a)  The Pharmacy and Therapeutic Advisory Council approves
135	a more cost-effective purchasing plan; or
136	(b)  The drugs required are not available through the
137	statewide purchasing contract.
138	(2)  The department must may establish and maintain a
139	pharmacy services program that includes, including, but is not
140	limited to:
141	(a)  A central pharmacy to support pharmaceutical services
142	provided by the county health departments, including
143	pharmaceutical repackaging, dispensing, and the purchase and
144	distribution of immunizations and other pharmaceuticals. Such
145	services shall be provided to other state agencies and political
146	subdivisions of the state upon written agreement. Cost savings
147	realized by the state through utilization of the central
148	pharmacy may be used by the department to offset additional
149	costs.
150	Section 6.  Section 381.84, Florida Statutes, is
151	transferred, renumbered as section 385.106, Florida Statutes,
152	and amended to read:
153	385.106 381.84  Comprehensive Statewide Tobacco Education
154	and Use Prevention Program.--
155	(1)  DEFINITIONS.--As used in this section and for purposes
156	of the provisions of s. 27, Art. X of the State Constitution,
157	the term:
158	(a)  "AHEC network" means an area health education center
159	network established under s. 381.0402.
160	(b)  "Best practices" means the Best Practices for
161	Comprehensive Tobacco Control Programs as established by the
162	CDC, as amended.
163	(c)(b)  "CDC" means the United States Centers for Disease
164	Control and Prevention.
165	(d)(c)  "Council" means the Tobacco Education and Use
166	Prevention Advisory Council.
167	(d)  "Department" means the Department of Health.
168	(e)  "Tobacco" means, without limitation, tobacco itself
169	and tobacco products that include tobacco and are intended or
170	expected for human use or consumption, including, but not
171	limited to, cigarettes, cigars, pipe tobacco, and smokeless
172	tobacco.
173	(f)  "Youth" means minors and young adults.
174	(2)  PURPOSE, FINDINGS, AND INTENT.--It is the purpose of
175	this section to implement s. 27, Art. X of the State
176	Constitution. The Legislature finds that s. 27, Art. X of the
177	State Constitution requires the funding of a statewide tobacco
178	education and use prevention program that focuses on tobacco use
179	by youth. The Legislature further finds that the primary goals
180	of the program are to reduce the prevalence of tobacco use among
181	youth, adults, and pregnant women; reduce per capita tobacco
182	consumption; and reduce exposure to environmental tobacco smoke.
183	Further, it is the intent of the Legislature to base increases
184	in funding for individual components of the program on the
185	results of assessments and evaluations. Recognizing that some
186	components will need to grow faster than inflation, it is the
187	intent of the Legislature to fund portions of the program on a
188	nonrecurring basis in the early years so that those components
189	that are most effective can be supported as the program matures.
190	(3)  PROGRAM COMPONENTS AND REQUIREMENTS.--The department
191	shall conduct a comprehensive, statewide tobacco education and
192	use prevention program consistent with the recommendations for
193	effective program components contained in the 1999 Best
194	Practices for Comprehensive Tobacco Control Programs of the CDC,
195	as amended by the CDC. The program shall include the following
196	components, each of which shall focus on educating people,
197	particularly youth and their parents, about the health hazards
198	of tobacco and discouraging the use of tobacco. All program
199	components shall include efforts to educate youth and their
200	parents about tobacco use, and a youth-directed focus shall
201	exist in all components outlined in this subsection.:
202	(a)  State and community interventions.--These
203	interventions shall include, but not be limited to, a statewide
204	tobacco control program that combines and coordinates community-
205	based interventions that focus on preventing initiation of
206	tobacco use among youth and young adults; promoting quitting
207	among adults, youth, and pregnant women; eliminating exposure to
208	secondhand smoke; identifying and eliminating tobacco-related
209	disparities among population groups; and promoting a range of
210	collaborations to prevent and alleviate the effects of chronic
211	diseases. Counter-marketing and advertising; cyberspace resource
212	center.--The counter-marketing and advertising campaign shall
213	include, at a minimum, Internet, print, radio, and television
214	advertising and shall be funded with a minimum of one-third of
215	the total annual appropriation required by s. 27, Art. X of the
216	State Constitution. A cyberspace resource center for copyrighted
217	materials and information concerning tobacco education and use
218	prevention, including cessation, shall be maintained by the
219	program. Such resource center must be accessible to the public,
220	including parents, teachers, and students, at each level of
221	public and private schools, universities, and colleges in the
222	state and shall provide links to other relevant resources. The
223	Internet address for the resource center must be incorporated in
224	all advertising. The information maintained in the resource
225	center shall be used by the other components of the program.
226	(b)  Health communication interventions.--Effective media
227	and health communication intervention efforts include, but are
228	not limited to, audience research to define themes and execute
229	messages for influential, high impact, and specifically targeted
230	campaigns; market research to identify the target market and the
231	behavioral theory motivating change; counter-marketing
232	surveillance; community tie-ins to support and reinforce the
233	statewide campaign; technologies such as viral marketing, social
234	networks, personal web pages, and web logs; traditional media;
235	process and outcome evaluation of the communication efforts; and
236	promotion of available services, including the state telephone
237	cessation quitline. Cessation programs, counseling, and
238	treatment.--This program component shall include two
239	subcomponents:
240	1.  A statewide toll-free cessation service, which may
241	include counseling, referrals to other local resources and
242	support services, and treatment to the extent funds are
243	available for treatment services; and
244	2.  A local community-based program to disseminate
245	information about smoking cessation, how smoking cessation
246	relates to prenatal care and obesity prevention, and other
247	chronic tobacco-related diseases.
248	(c)  Cessation interventions.--Cessation interventions
249	include, but are not limited to, sustaining, expanding, and
250	promoting the service through population-based counseling and
251	treatment programs; encouraging public and private insurance
252	coverage for counseling and FDA-approved medication treatments
253	for tobacco-use cessation; eliminating cost and other barriers
254	to treatment for underserved populations; and making health care
255	system changes. Youth interventions to prevent tobacco-use
256	initiation and encourage cessation among young people are needed
257	in order to reshape the environment so that it supports tobacco-
258	free norms. Because most people who start smoking are younger
259	than 18 years of age, intervening during adolescence is
260	critical. Community programs and school-based policies and
261	interventions should be a part of a comprehensive effort that is
262	implemented in coordination with community and school
263	environments and in conjunction with increasing the unit price
264	of tobacco products, sustaining anti-tobacco media campaigns,
265	making environments tobacco free, and engaging in other efforts
266	to create tobacco-free social norms. Surveillance and
267	evaluation.--The program shall conduct ongoing epidemiological
268	surveillance and shall contract for annual independent
269	evaluations of the effectiveness of the various components of
270	the program in meeting the goals as set forth in subsection (2).
271	(d)  Surveillance and evaluation.--The surveillance and
272	evaluation of all program components shall monitor and document
273	short-term, intermediate, and long-term intervention outcomes to
274	inform program and policy direction and ensure accountability.
275	The surveillance and evaluation must be conducted objectively
276	through scientifically sound methodology. Youth school
277	programs.--School and after-school programs shall use current
278	evidence-based curricula and programs that involve youth to
279	educate youth about the health hazards of tobacco, help youth
280	develop skills to refuse tobacco, and demonstrate to youth how
281	to stop using tobacco.
282	(e)  Administration and management.--Administration and
283	management activities include, but are not limited to, strategic
284	planning to guide program efforts and resources in order to
285	accomplish goals; recruiting and developing qualified and
286	diverse technical, program, and administrative staff; awarding
287	and monitoring program contracts and grants to coordinate
288	implementation across program areas; developing and maintaining
289	a fiscal-management system to track allocations and the
290	expenditure of funds; increasing capacity at the community level
291	through ongoing training and technical assistance; creating
292	effective communications internally among chronic disease
293	prevention programs and local coalitions and partners; and
294	educating the public and decisionmakers on the health effects of
295	tobacco and evidence-based effective program and policy
296	interventions. Community programs and chronic disease
297	prevention.--The department shall promote and support local
298	community-based partnerships that emphasize programs involving
299	youth, including programs for the prevention, detection, and
300	early intervention of smoking-related chronic diseases.
301	(f)  Training.--The program shall include the training of
302	health care practitioners, smoking-cessation counselors, and
303	teachers by health professional students and other tobacco-use
304	prevention specialists who are trained in preventing tobacco use
305	and health education. Smoking-cessation counselors shall be
306	trained by specialists who are certified in tobacco-use
307	cessation.
308	(g)  County health departments Administration, statewide
309	programs, and county health departments.--Each county health
310	department is eligible to receive a portion of the annual
311	appropriation, on a per capita basis, for coordinating tobacco
312	education and use prevention programs within that county.
313	Appropriated funds may be used to improve the infrastructure of
314	the county health department to implement the comprehensive,
315	statewide tobacco education and use prevention program. Each
316	county health department shall prominently display in all
317	treatment rooms and waiting rooms, counter-marketing and
318	advertisement materials in the form of wall posters, brochures,
319	television advertising if televisions are used in the lobby or
320	waiting room, and screensavers and Internet advertising if
321	computer kiosks are available for use or viewing by people at
322	the county health department.
323	(h)  Enforcement and awareness of related laws.--In
324	coordination with the Department of Business and Professional
325	Regulation, the program shall monitor the enforcement of laws,
326	rules, and policies prohibiting the sale or other provision of
327	tobacco to minors, as well as the continued enforcement of the
328	Clean Indoor Air Act prescribed in chapter 386. The
329	advertisements produced in accordance with paragraph (b)
330	paragraph (a) may also include information designed to make the
331	public aware of these related laws and rules. The departments
332	may enter into interagency agreements to carry out this program
333	component.
334	(i)  AHEC smoking-cessation initiative.--For the 2007-2008
335	and 2008-2009 fiscal years only, The AHEC network shall expand
336	the AHEC smoking-cessation initiative to each county within the
337	state and perform other activities as determined by the
338	department.
339	(4)  ADVISORY COUNCIL; MEMBERS, APPOINTMENTS, AND
340	MEETINGS.--The Tobacco Education and Use Prevention Advisory
341	Council is created within the department.
342	(a)  The council shall consist of 23 members, including:
343	1.  The State Surgeon General, who shall serve as the
344	chairperson.
345	2.  One county health department director, appointed by the
346	State Surgeon General.
347	3.  Two members appointed by the Commissioner of Education,
348	of whom one must be a school district superintendent.
349	4.  The chief executive officer of the Florida Division of
350	the American Cancer Society, or his or her designee.
351	5.  The chief executive officer of the Greater Southeast
352	Affiliate of the American Heart Association, or his or her
353	designee.
354	6.  The chief executive officer of the American Lung
355	Association of Florida, or his or her designee.
356	7.  The dean of the University of Miami School of Medicine,
357	or his or her designee.
358	8.  The dean of the University of Florida College of
359	Medicine, or his or her designee.
360	9.  The dean of the University of South Florida College of
361	Medicine, or his or her designee.
362	10.  The dean of the Florida State University College of
363	Medicine, or his or her designee.
364	11.  The dean of Nova Southeastern College of Osteopathic
365	Medicine, or his or her designee.
366	12.  The dean of the Lake Erie College of Osteopathic
367	Medicine in Bradenton, Florida, or his or her designee.
368	13.  The chief executive officer of the Campaign for
369	Tobacco Free Kids, or his or her designee.
370	14.  The chief executive officer of the Legacy Foundation,
371	or his or her designee.
372	15.  Four members appointed by the Governor, of whom two
373	must have expertise in the field of tobacco-use prevention and
374	education or smoking cessation and one individual who shall be
375	between the ages of 16 and 21 at the time of his or her
376	appointment.
377	16.  Two members appointed by the President of the Senate,
378	of whom one must have expertise in the field of tobacco-use
379	prevention and education or smoking cessation.
380	17.  Two members appointed by the Speaker of the House of
381	Representatives, of whom one must have expertise in the field of
382	tobacco-use prevention and education or smoking cessation.
383	(b)  The appointments shall be for 3-year terms and shall
384	reflect the diversity of the state's population. A vacancy shall
385	be filled by appointment by the original appointing authority
386	for the unexpired portion of the term.
387	(c)  An appointed member may not serve more than two
388	consecutive terms.
389	(d)  The council shall meet at least quarterly and upon the
390	call of the chairperson. Meetings may be held via teleconference
391	or other electronic means.
392	(e)  Members of the council shall serve without
393	compensation, but are entitled to reimbursement for per diem and
394	travel expenses pursuant to s. 112.061. Members who are state
395	officers or employees or who are appointed by state officers or
396	employees shall be reimbursed for per diem and travel expenses
397	pursuant to s. 112.061 from the state agency through which they
398	serve.
399	(f)  The council shall adhere to all state ethics laws.
400	Meetings of the council and the review panels are subject to
401	chapter 119, s. 286.011, and s. 24, Art. I of the State
402	Constitution. The department shall provide council members with
403	information and other assistance as is reasonably necessary to
404	assist the council in carrying out its responsibilities.
405	(5)  COUNCIL DUTIES AND RESPONSIBILITIES.--The council
406	shall advise the State Surgeon General as to the direction and
407	scope of the Comprehensive Statewide Tobacco Education and Use
408	Prevention Program. The responsibilities of the council may
409	include, but are not limited to:
410	(a)  Providing advice on program priorities and emphases.
411	(b)  Providing advice on the overall program budget.
412	(c)  Providing advice on copyrighted material, trademark,
413	and future transactions as they pertain to the tobacco education
414	and use prevention program.
415	(d)  Reviewing, as requested by the department, broadcast
416	material prepared for the Internet, portable media players,
417	radio, and television advertisement as it relates to the
418	advertising component of the tobacco education and use
419	prevention program.
420	(e)  Participating in periodic program evaluation, as
421	requested by the department.
422	(f)  Assisting the department in developing the development
423	of guidelines to ensure fairness, neutrality, and adherence to
424	the principles of merit and quality in the conduct of the
425	program.
426	(g)  Assisting the department in developing the development
427	of administrative procedures relating to solicitation, review,
428	and award of contracts and grants in order to ensure an
429	impartial, high-quality peer review system.
430	(h)  Assisting the department in developing panels to
431	review and evaluate potential fund recipients the development
432	and supervision of peer review panels.
433	(i)  Assisting the department in reviewing reports of peer
434	review panels and making recommendations for funding allocations
435	contracts and grants.
436	(j)  Assisting the department in reviewing the activities
437	and evaluating the performance of the AHEC network to avoid
438	duplicative efforts using state funds.
439	(k)  Recommending specific measureable outcomes meaningful
440	outcome measures through a regular review of evidence-based and
441	promising tobacco-use prevention and education strategies and
442	programs of other states and the Federal Government.
443	(l)  Recommending policies to encourage a coordinated
444	response to tobacco use in this state, focusing specifically on
445	creating partnerships within and between the public and private
446	sectors.
447	(6)  CONTRACT REQUIREMENTS.--Contracts or grants for the
448	program components or subcomponents described in paragraphs
449	(3)(a)-(f) shall be awarded by the State Surgeon General, after
450	consultation with the council, on the basis of merit, as
451	determined by an open, competitive, peer-reviewed process that
452	ensures objectivity, consistency, and high quality. The
453	department shall award such grants or contracts no later than
454	October 1 for each fiscal year. A recipient of a contract or
455	grant for the program component described in paragraph (3)(d)
456	(3)(c) is not eligible for a contract or grant award for any
457	other program component described in subsection (3) in the same
458	state fiscal year. A school or college of medicine that is
459	represented on the council is not eligible to receive a contract
460	or grant under this section. For the 2007-2008 and 2008-2009
461	fiscal years only, The department shall award a contract or
462	grant in the amount of $11 $10 million to the AHEC network for
463	the purpose of developing the components described in paragraph
464	(3)(i). The AHEC network may apply for a competitive contract or
465	grant after the 2008-2009 fiscal year.
466	(a)  In order to ensure that all proposals for funding are
467	appropriate and are evaluated fairly on the basis of merit, the
468	State Surgeon General, in consultation with the council, shall
469	appoint a peer review panel of independent, qualified experts in
470	the field of tobacco control to review the content of each
471	proposal and establish its priority score. The priority scores
472	shall be forwarded to the council and must be considered in
473	determining which proposals will be recommended for funding.
474	(b)  The council and the peer review panel shall establish
475	and follow rigorous guidelines for ethical conduct and adhere to
476	a strict policy with regard to conflicts of interest. Council
477	members are subject to the applicable provisions of chapter 112.
478	A member of the council or panel may not participate in any
479	discussion or decision with respect to a research proposal by
480	any firm, entity, or agency with which the member is associated
481	as a member of the governing body or as an employee or with
482	which the member has entered into a contractual arrangement.
483	Meetings of the council and the peer review panels are subject
484	to chapter 119, s. 286.011, and s. 24, Art. I of the State
485	Constitution.
486	(c)  In each contract or grant agreement, the department
487	shall limit the use of food and promotional items to no more
488	than 2.5 percent of the total amount of the contract or grant
489	and limit overhead or indirect costs to no more than 7.5 percent
490	of the total amount of the contract or grant. The department, in
491	consultation with the Department of Financial Services, shall
492	publish guidelines for appropriate food and promotional items.
493	(d)  In each advertising contract, the department shall
494	limit the total of production fees, buyer commissions, and
495	related costs to no more than 10 percent of the total contract
496	amount.
497	(e)  Notwithstanding the competitive process for contracts
498	prescribed in this subsection, each county health department is
499	eligible for core funding, on a per capita basis, to implement
500	tobacco education and use prevention activities within that
501	county.
502	(7)  ANNUAL REPORT REQUIRED.--By February 28 January 31 of
503	each year, the department shall provide to the Governor, the
504	President of the Senate, and the Speaker of the House of
505	Representatives a report that evaluates the program's
506	effectiveness in reducing and preventing tobacco use and that
507	recommends improvements to enhance the program's effectiveness.
508	The report must contain, at a minimum, an annual survey of youth
509	attitudes and behavior toward tobacco, as well as a description
510	of the progress in reducing the prevalence of tobacco use among
511	youth, adults, and pregnant women; reducing per capita tobacco
512	consumption; and reducing exposure to environmental tobacco
513	smoke.
514	(8)  LIMITATION ON ADMINISTRATIVE EXPENSES.--From the total
515	funds appropriated for the Comprehensive Statewide Tobacco
516	Education and Use Prevention Program in the General
517	Appropriations Act, an amount of up to 5 percent may be used by
518	the department for administrative expenses.
519	(9)  RULEMAKING AUTHORIZED.--By January 1, 2008, the
520	department shall adopt rules pursuant to ss. 120.536(1) and
521	120.54 to administer this section.
522	Section 7.  Section 381.91, Florida Statutes, is
523	transferred and renumbered as section 385.2024, Florida
524	Statutes, to read:
525	385.2024 381.91  Jessie Trice Cancer Prevention Program.--
526	(1)  It is the intent of the Legislature to:
527	(a)  Reduce the rates of illness and death from lung cancer
528	and other cancers and improve the quality of life among low-
529	income African-American and Hispanic populations through
530	increased access to early, effective screening and diagnosis,
531	education, and treatment programs.
532	(b)  Create a community faith-based disease-prevention
533	program in conjunction with the Health Choice Network and other
534	community health centers to build upon the natural referral and
535	education networks in place within minority communities and to
536	increase access to health service delivery in Florida.
537	(c)  Establish a funding source to build upon local private
538	participation to sustain the operation of the program.
539	(2)(a)  There is created the Jessie Trice Cancer Prevention
540	Program, to be located, for administrative purposes, within the
541	Department of Health, and operated from the community health
542	centers within the Health Choice Network in Florida.
543	(b)  Funding may be provided to develop contracts with
544	community health centers and local community faith-based
545	education programs to provide cancer screening, diagnosis,
546	education, and treatment services to low-income populations
547	throughout the state.
548	Section 8.  Section 381.911, Florida Statutes, is
549	transferred, renumbered as section 385.2023, Florida Statutes,
550	and amended to read:
551	385.2023 381.911  Prostate Cancer Awareness Program.--
552	(1)  To the extent that funds are specifically made
553	available for this purpose, the Prostate Cancer Awareness
554	Program is established within the Department of Health. The
555	purpose of this program is to implement the recommendations of
556	January 2000 of the Florida Prostate Cancer Task Force to
557	provide for statewide outreach and health education activities
558	to ensure that men are aware of and appropriately seek medical
559	counseling for prostate cancer as an early-detection health care
560	measure.
561	(2)  For purposes of implementing the program, the
562	Department of Health and the Florida Public Health Foundation,
563	Inc., may:
564	(a)  Conduct activities directly or enter into a contract
565	with a qualified nonprofit community education entity.
566	(b)  Seek any available gifts, grants, or funds from the
567	state, the Federal Government, philanthropic foundations, and
568	industry or business groups.
569	(3)  A prostate cancer advisory committee is created to
570	advise and assist the Department of Health and the Florida
571	Public Health Foundation, Inc., in implementing the program.
572	(a)  The State Surgeon General shall appoint the advisory
573	committee members, who shall consist of:
574	1.  Three persons from prostate cancer survivor groups or
575	cancer-related advocacy groups.
576	2.  Three persons who are scientists or clinicians from
577	public or nonpublic universities or research organizations.
578	3.  Three persons who are engaged in the practice of a
579	cancer-related medical specialty from health organizations
580	committed to cancer research and control.
581	(b)  Members shall serve without compensation but are
582	entitled to reimbursement, pursuant to s. 112.061, for per diem
583	and travel expenses incurred in the performance of their
584	official duties.
585	(4)  The program shall coordinate its efforts with those of
586	the Florida Public Health Foundation, Inc.
587	Section 9.  Section 381.912, Florida Statutes, is repealed.
588	Section 10.  Section 381.92, Florida Statutes, is
589	transferred and renumbered as section 385.2025, Florida
590	Statutes, to read:
591	385.2025 381.92  Florida Cancer Council.--
592	(1)  Effective July 1, 2004, the Florida Cancer Council
593	within the Department of Health is established for the purpose
594	of making the state a center of excellence for cancer research.
595	(2)(a)  The council shall be representative of the state's
596	cancer centers, hospitals, and patient groups and shall be
597	organized and shall operate in accordance with this act.
598	(b)  The Florida Cancer Council may create not-for-profit
599	corporate subsidiaries to fulfill its mission. The council and
600	its subsidiaries are authorized to receive, hold, invest, and
601	administer property and any moneys acquired from private, local,
602	state, and federal sources, as well as technical and
603	professional income generated or derived from the mission-
604	related activities of the council.
605	(c)  The members of the council shall consist of:
606	1.  The chair of the Florida Dialogue on Cancer, who shall
607	serve as the chair of the council;
608	2.  The State Surgeon General or his or her designee;
609	3.  The chief executive officer of the H. Lee Moffitt
610	Cancer Center or his or her designee;
611	4.  The director of the University of Florida Shands Cancer
612	Center or his or her designee;
613	5.  The chief executive officer of the University of Miami
614	Sylvester Comprehensive Cancer Center or his or her designee;
615	6.  The chief executive officer of the Mayo Clinic,
616	Jacksonville, or his or her designee;
617	7.  The chief executive officer of the American Cancer
618	Society, Florida Division, Inc., or his or her designee;
619	8.  The president of the American Cancer Society, Florida
620	Division, Inc., Board of Directors or his or her designee;
621	9.  The president of the Florida Society of Clinical
622	Oncology or his or her designee;
623	10.  The president of the American College of Surgeons,
624	Florida Chapter, or his or her designee;
625	11.  The chief executive officer of Enterprise Florida,
626	Inc., or his or her designee;
627	12.  Five representatives from cancer programs approved by
628	the American College of Surgeons. Three shall be appointed by
629	the Governor, one shall be appointed by the Speaker of the House
630	of Representatives, and one shall be appointed by the President
631	of the Senate;
632	13.  One member of the House of Representatives, to be
633	appointed by the Speaker of the House of Representatives; and
634	14.  One member of the Senate, to be appointed by the
635	President of the Senate.
636	(d)  Appointments made by the Speaker of the House of
637	Representatives and the President of the Senate pursuant to
638	paragraph (c) shall be for 2-year terms, concurrent with the
639	bienniums in which they serve as presiding officers.
640	(e)  Appointments made by the Governor pursuant to
641	paragraph (c) shall be for 2-year terms, although the Governor
642	may reappoint members.
643	(f)  Members of the council or any subsidiaries shall serve
644	without compensation, and each organization represented on the
645	council shall cover the expenses of its representatives.
646	(3)  The council shall issue an annual report to the Center
647	for Universal Research to Eradicate Disease, the Governor, the
648	Speaker of the House of Representatives, and the President of
649	the Senate by December 15 of each year, with policy and funding
650	recommendations regarding cancer research capacity in Florida
651	and related issues.
652	Section 11.  Section 381.921, Florida Statutes, is
653	transferred and renumbered as section 385.20251, Florida
654	Statutes, to read:
655	385.20251 381.921  Florida Cancer Council mission and
656	duties.--The council, which shall work in concert with the
657	Florida Center for Universal Research to Eradicate Disease to
658	ensure that the goals of the center are advanced, shall endeavor
659	to dramatically improve cancer research and treatment in this
660	state through:
661	(1)  Efforts to significantly expand cancer research
662	capacity in the state by:
663	(a)  Identifying ways to attract new research talent and
664	attendant national grant-producing researchers to cancer
665	research facilities in this state;
666	(b)  Implementing a peer-reviewed, competitive process to
667	identify and fund the best proposals to expand cancer research
668	institutes in this state;
669	(c)  Funding through available resources for those
670	proposals that demonstrate the greatest opportunity to attract
671	federal research grants and private financial support;
672	(d)  Encouraging the employment of bioinformatics in order
673	to create a cancer informatics infrastructure that enhances
674	information and resource exchange and integration through
675	researchers working in diverse disciplines, to facilitate the
676	full spectrum of cancer investigations;
677	(e)  Facilitating the technical coordination, business
678	development, and support of intellectual property as it relates
679	to the advancement of cancer research; and
680	(f)  Aiding in other multidisciplinary research-support
681	activities as they inure to the advancement of cancer research.
682	(2)  Efforts to improve both research and treatment through
683	greater participation in clinical trials networks by:
684	(a)  Identifying ways to increase adult enrollment in
685	cancer clinical trials;
686	(b)  Supporting public and private professional education
687	programs designed to increase the awareness and knowledge about
688	cancer clinical trials;
689	(c)  Providing tools to cancer patients and community-based
690	oncologists to aid in the identification of cancer clinical
691	trials available in the state; and
692	(d)  Creating opportunities for the state's academic cancer
693	centers to collaborate with community-based oncologists in
694	cancer clinical trials networks.
695	(3)  Efforts to reduce the impact of cancer on disparate
696	groups by:
697	(a)  Identifying those cancers that disproportionately
698	impact certain demographic groups; and
699	(b)  Building collaborations designed to reduce health
700	disparities as they relate to cancer.
701	Section 12.  Paragraph (a) of subsection (2) and subsection
702	(5) of section 381.922, Florida Statutes, as amended by section
703	2 of chapter 2009-5, Laws of Florida, is amended to read:
704	381.922  William G. "Bill" Bankhead, Jr., and David Coley
705	Cancer Research Program.--
706	(2)  The program shall provide grants for cancer research
707	to further the search for cures for cancer.
708	(a)  Emphasis shall be given to the goals enumerated in s.
709	385.20251 s. 381.921, as those goals support the advancement of
710	such cures.
711	(5)  For the 2008-2009 fiscal year and each fiscal year
712	thereafter, the sum of $6.75 million is appropriated annually
713	from recurring funds in the General Revenue Fund to the
714	Biomedical Research Trust Fund within the Department of Health
715	for purposes of the William G. "Bill" Bankhead, Jr., and David
716	Coley Cancer Research Program and shall be distributed pursuant
717	to this section to provide grants to researchers seeking cures
718	for cancer, with emphasis given to the goals enumerated in s.
719	385.20251 s. 381.921. From the total funds appropriated, an
720	amount of up to 10 percent may be used for administrative
721	expenses.
722	Section 13.  Section 381.93, Florida Statutes, is
723	transferred and renumbered as section 385.2021, Florida
724	Statutes, to read:
725	385.2021 381.93  Breast and cervical cancer early detection
726	program.--This section may be cited as the "Mary Brogan Breast
727	and Cervical Cancer Early Detection Program Act."
728	(1)  It is the intent of the Legislature to reduce the
729	rates of death due to breast and cervical cancer through early
730	diagnosis and increased access to early screening, diagnosis,
731	and treatment programs.
732	(2)  The Department of Health, using available federal
733	funds and state funds appropriated for that purpose, is
734	authorized to establish the Mary Brogan Breast and Cervical
735	Cancer Screening and Early Detection Program to provide
736	screening, diagnosis, evaluation, treatment, case management,
737	and followup and referral to the Agency for Health Care
738	Administration for coverage of treatment services.
739	(3)  The Mary Brogan Breast and Cervical Cancer Early
740	Detection Program shall be funded through grants for such
741	screening and early detection purposes from the federal Centers
742	for Disease Control and Prevention under Title XV of the Public
743	Health Service Act, 42 U.S.C. ss. 300k et seq.
744	(4)  The department shall limit enrollment in the program
745	to persons with incomes up to and including 200 percent of the
746	federal poverty level. The department shall establish an
747	eligibility process that includes an income-verification process
748	to ensure that persons served under the program meet income
749	guidelines.
750	(5)  The department may provide other breast and cervical
751	cancer screening and diagnostic services; however, such services
752	shall be funded separately through other sources than this act.
753	Section 14.  Section 381.931, Florida Statutes, is
754	transferred and renumbered as section 385.20211, Florida
755	Statutes, to read:
756	385.20211 381.931  Annual report on Medicaid
757	expenditures.--The Department of Health and the Agency for
758	Health Care Administration shall monitor the total Medicaid
759	expenditures for services made under this act. If Medicaid
760	expenditures are projected to exceed the amount appropriated by
761	the Legislature, the Department of Health shall limit the number
762	of screenings to ensure Medicaid expenditures do not exceed the
763	amount appropriated. The Department of Health, in cooperation
764	with the Agency for Health Care Administration, shall prepare an
765	annual report that must include the number of women screened;
766	the percentage of positive and negative outcomes; the number of
767	referrals to Medicaid and other providers for treatment
768	services; the estimated number of women who are not screened or
769	not served by Medicaid due to funding limitations, if any; the
770	cost of Medicaid treatment services; and the estimated cost of
771	treatment services for women who were not screened or referred
772	for treatment due to funding limitations. The report shall be
773	submitted to the President of the Senate, the Speaker of the
774	House of Representatives, and the Executive Office of the
775	Governor by March 1 of each year.
776	Section 15.  Chapter 385, Florida Statutes, entitled
777	"Chronic Diseases," is renamed the "Healthy and Fit Florida
778	Act."
779	Section 16.  Section 385.101, Florida Statutes, is amended
780	to read:
781	385.101  Short title.--This chapter Sections 385.101-
782	385.103 may be cited as the "Healthy and Fit Florida Chronic
783	Diseases Act."
784	Section 17.  Section 385.102, Florida Statutes, is amended
785	to read:
786	385.102  Legislative intent.--It is the finding of the
787	Legislature that:
788	(1)  Chronic diseases continue to be the leading cause of
789	death and disability in this state and the country exist in high
790	proportions among the people of this state. These Chronic
791	diseases include, but are not limited to, arthritis,
792	cardiovascular disease heart disease, hypertension, diabetes,
793	renal disease, cancer, and chronic obstructive lung disease.
794	These diseases are often have the same preventable risk factors
795	interrelated, and they directly and indirectly account for a
796	high rate of death, disability, and underlying costs to the
797	state's health care system illness.
798	(2)  Chronic diseases have a significant impact on quality
799	of life, not only for the individuals who experience their
800	painful symptoms and resulting disabilities, but also for family
801	members and caregivers.
802	(3)  Racial and ethnic minorities and other underserved
803	populations are disproportionately affected by chronic diseases.
804	(4)  There are enormous medical costs and lost wages
805	associated with chronic diseases and their complications.
806	(5)(2)  Advances in medical knowledge and technology assist
807	have assisted in the prevention, detection, and management of
808	chronic diseases. Comprehensive approaches that stress the
809	stressing application of current medical treatment, continuing
810	research, professional training, and patient education, and
811	community-level policy and environmental changes should be
812	implemented encouraged.
813	(6)(3)  A comprehensive program dealing with the early
814	detection and prevention of chronic diseases is required to make
815	knowledge and therapy available to all people of this state. The
816	mobilization of scientific, medical, and educational resources,
817	along with the implementation of community-based policy under
818	one comprehensive chronic disease law, act will facilitate the
819	prevention, early intervention, and management treatment of
820	chronic these diseases and their symptoms. This integration of
821	resources and policy will and result in a decline in death and
822	disability illness among the people of this state.
823	(7)  Chronic diseases account for 70 percent of all deaths
824	in the United States. The following chronic diseases are the
825	leading causes of death and disability:
826	(a)  Heart disease and stroke, which have remained the
827	first and third leading causes of death for both men and women
828	in the United States for over seven decades and account for
829	approximately one-third of total deaths each year in this state.
830	(b)  Cancer, which is the second leading cause of death and
831	is responsible for one in four deaths in this state.
832	(c)  Lung disease, which is the third leading cause of
833	death and accounts for one in every six deaths in this state.
834	(d)  Diabetes, which is the sixth leading cause of death in
835	this state.
836	(e)  Arthritis, which is the leading cause of disability in
837	the United States, limiting daily activities for more than 19
838	million citizens. In this state, arthritis limits daily
839	activities for an estimated 1.3 million people.
840	(8)  The department shall establish, promote, and maintain
841	state-level and local-level programs for chronic disease
842	prevention and health promotion to the extent that funds are
843	specifically made available for this purpose.
844	Section 18.  Section 385.1021, Florida Statutes, is created
845	to read:
846	385.1021  Definitions.--As used in this chapter, the term:
847	(1)  "CDC" means the United States Centers for Disease
848	Control and Prevention.
849	(2)  "Chronic disease" means an illness that is prolonged,
850	does not resolve spontaneously, and is rarely cured completely.
851	(3)  "Department" means the Department of Health.
852	(4)  "Environmental changes" means changes to the economic,
853	social, or physical natural or built environments which
854	encourage or enable behaviors.
855	(5)  "Policy change" means altering an informal or formal
856	agreement between public or private sectors which sets forth
857	values, behaviors, or resource allocation in order to improve
858	health.
859	(6)  "Primary prevention" means an intervention that is
860	directed toward healthy populations and focuses on avoiding
861	disease before it occurs.
862	(7)  "Risk factor" means a characteristic or condition
863	identified during the course of an epidemiological study of a
864	disease that appears to be statistically associated with a high
865	incidence of that disease.
866	(8)  "Secondary prevention" means an intervention that is
867	designed to promote the early detection and management of
868	diseases and reduce the risks experienced by at-risk
869	populations.
870	(9)  "System changes" means altering standard activities,
871	protocols, policies, processes, and structures carried out in
872	population-based settings, such as schools, worksites, health
873	care facilities, faith-based organizations, and the overall
874	community, which promote and support new behaviors.
875	(10)  "Tertiary prevention" means an intervention that is
876	directed at rehabilitating and minimizing the effects of disease
877	in a chronically ill population.
878	(11)  "Tobacco" means, without limitation, tobacco itself
879	and tobacco products that include tobacco and are intended or
880	expected for human use or consumption, including, but not
881	limited to, cigarettes, cigars, pipe tobacco, and smokeless
882	tobacco.
883	(12)  "Wellness program" means a structured program that is
884	designed or approved by the department to offer intervention
885	activities on or off the worksite which help state employees
886	change certain behaviors or adopt healthy lifestyles.
887	(13)  "Youth" means children and young adults, up through
888	24 years of age, inclusive.
889	Section 19.  Section 385.1022, Florida Statutes, is created
890	to read:
891	385.1022  Chronic disease prevention program.--The
892	department shall support public health programs to reduce the
893	incidence of mortality and morbidity from diseases for which
894	risk factors can be identified. Such risk factors include, but
895	are not limited to, being overweight or obese, physical
896	inactivity, poor nutrition and diet, tobacco use, sun exposure,
897	and other practices that are detrimental to health. The programs
898	shall educate and screen the general public as well as groups at
899	particularly high risk of chronic diseases.
900	Section 20.  Section 385.1023, Florida Statutes, is created
901	to read:
902	385.1023  State-level prevention programs for chronic
903	disease.--
904	(1)  The department shall create state-level programs that
905	address the leading, preventable chronic disease risk factors of
906	poor nutrition and obesity, tobacco use, sun exposure, and
907	physical inactivity in order to decrease the incidence of
908	arthritis, cancer, diabetes, heart disease, lung disease,
909	stroke, and other chronic diseases.
910	(2)  State-level programs shall address, but need not be
911	limited to, the following activities:
912	(a)  Monitoring specific causal and behavioral risk factors
913	that affect the health of residents in the state.
914	(b)  Analyzing data regarding chronic disease mortality and
915	morbidity to track changes over time.
916	(c)  Promoting public awareness and increasing knowledge
917	concerning the causes of chronic diseases, the importance of
918	early detection, diagnosis, and appropriate evidence-based
919	prevention, management, and treatment strategies.
920	(d)  Disseminating educational materials and information
921	concerning evidence-based results, available services, and
922	pertinent new research findings and prevention strategies to
923	patients, health insurers, health professionals, and the public.
924	(e)  Using education and training resources and services
925	developed by organizations having appropriate expertise and
926	knowledge of chronic diseases for technical assistance.
927	(f)  Evaluating the quality and accessibility of existing
928	community-based services for chronic disease.
929	(g)  Increasing awareness among state and local officials
930	involved in health and human services, health professionals and
931	providers, and policymakers about evidence-based chronic-disease
932	prevention, tobacco cessation, and treatment strategies and
933	their benefits for people who have chronic diseases.
934	(h)  Developing a partnership with state and local
935	governments, voluntary health organizations, hospitals, health
936	insurers, universities, medical centers, employer groups,
937	private companies, and health care providers to address the
938	burden of chronic disease in this state.
939	(i)  Implementing and coordinating state-level policies in
940	order to reduce the burden of chronic disease.
941	(j)  Providing lasting improvements in the delivery of
942	health care for individuals who have chronic disease and their
943	families, thus improving their quality of life while also
944	containing health care costs.
945	Section 21.  Section 385.103, Florida Statutes, is amended
946	to read:
947	385.103  Community-level Community intervention programs
948	for chronic disease prevention and health promotion.--
949	(1)  DEFINITIONS.--As used in this section, the term:
950	(a)  "Chronic disease prevention and health promotion
951	control program" means a program that may include, but is not
952	limited to, including a combination of the following elements:
953	1.  Staff who are sufficiently trained and skilled in
954	public health, community health, or school health education to
955	facilitate the operation of the program Health screening;
956	2.  Community input into the planning, implementation, and
957	evaluation processes Risk factor detection;
958	3.  Use of public health data to make decisions and to
959	develop and prioritize community-based interventions focusing on
960	chronic diseases and their risk factors; Appropriate
961	intervention to enable and encourage changes in behaviors that
962	create health risks; and
963	4.  Adherence to a population-based approach by using a
964	socioecological model that addresses the influence on individual
965	behavior, interpersonal behavior, organizational behavior, the
966	community, and public policy; Counseling in nutrition, physical
967	activity, the effects of tobacco use, hypertension, blood
968	pressure control, and diabetes control and the provision of
969	other clinical prevention services.
970	5.  Focus on at least the common preventable risk factors
971	for chronic disease, such as physical inactivity, obesity, poor
972	nutrition, and tobacco use;
973	6.  Focus on developing and implementing interventions and
974	activities through communities, schools, worksites, faith-based
975	organizations, and health-care settings;
976	7.  Use of evidence-based interventions as well as best and
977	promising practices to guide specific activities and effect
978	change, which may include guidelines developed by organizations,
979	volunteer scientists, and health care professionals who write
980	published medical, scientific statements on various chronic
981	disease topics. The statements shall be supported by scientific
982	studies published in recognized journals that have a rigorous
983	review and approval process. Scientific statements generally
984	include a review of data available on a specific subject and an
985	evaluation of its relationship to overall chronic disease
986	science;
987	8.  Use of policy, system, and environmental changes that
988	support healthy behaviors so as to affect large segments of the
989	population and encourage healthy choices;
990	9.  Development of extensive and comprehensive evaluation
991	that is linked to program planning at the state level and the
992	community level in order to determine the program's
993	effectiveness or necessary program modifications; and
994	10.  Reduction of duplication of efforts through
995	coordination among appropriate entities for the efficient use of
996	resources.
997	(b)  "Community Health education program" means a program
998	that follows involving the planned and coordinated use of the
999	educational standards and teaching methods resources available
1000	in a community in an effort to provide:
1001	1.  Appropriate medical, research-based interventions to
1002	enable and encourage changes in behaviors which reduce or
1003	eliminate health risks;
1004	2.  Counseling in nutrition, weight management, physical
1005	inactivity, and tobacco-use prevention and cessation strategies;
1006	hypertension, blood pressure, high cholesterol, and diabetes
1007	control; and other clinical prevention services;
1008	3.1.  Motivation and assistance to individuals or groups in
1009	adopting and maintaining Motivate and assist citizens to adopt
1010	and maintain healthful practices and lifestyles; and
1011	4.2.  Make available Learning opportunities that which will
1012	increase the ability of people to make informed decisions
1013	affecting their personal, family, and community well-being and
1014	that which are designed to facilitate voluntary adoption of
1015	behavior that which will improve or maintain health.;
1016	3.  Reduce, through coordination among appropriate
1017	agencies, duplication of health education efforts; and
1018	4.  Facilitate collaboration among appropriate agencies for
1019	efficient use of scarce resources.
1020	(c)  "Community intervention program" means a program
1021	combining the required elements of a chronic disease prevention
1022	and health promotion control program and the principles of a
1023	community health education program that addresses system,
1024	policy, and environmental changes that ensure that communities
1025	provide support for healthy lifestyles into a unified program
1026	over which a single administrative entity has authority and
1027	responsibility.
1028	(d)  "Department" means the Department of Health.
1029	(e)  "Risk factor" means a factor identified during the
1030	course of an epidemiological study of a disease, which factor
1031	appears to be statistically associated with a high incidence of
1032	that disease.
1033	(2)  OPERATION OF COMMUNITY-LEVEL COMMUNITY INTERVENTION
1034	PROGRAMS FOR CHRONIC DISEASE PREVENTION AND HEALTH PROMOTION.--
1035	(a)  The department shall develop and implement a
1036	comprehensive, community-based program for chronic disease
1037	prevention and health promotion. The program shall be designed
1038	to reduce major behavioral risk factors that are associated with
1039	chronic diseases by enhancing the knowledge, skills, motivation,
1040	and opportunities for individuals, organizations, health care
1041	providers, small businesses, health insurers, and communities to
1042	develop and maintain healthy lifestyles. The department shall
1043	assist the county health departments in developing and operating
1044	community intervention programs throughout the state. At a
1045	minimum, the community intervention programs shall address one
1046	to three of the following chronic diseases: cancer, diabetes,
1047	heart disease, stroke, hypertension, renal disease, and chronic
1048	obstructive lung disease.
1049	(b)  The program shall include:
1050	1.  Countywide assessments of specific, causal, and
1051	behavioral risk factors that affect the health of residents;
1052	2.  The development of community-based programs for chronic
1053	disease prevention and health promotion which incorporate health
1054	promotion and preventive care practices that are supported in
1055	scientific and medical literature;
1056	3.  The development and implementation of statewide age-
1057	specific, disease-specific, and community-specific health
1058	promotion and preventive care strategies using primary,
1059	secondary, and tertiary prevention interventions;
1060	4.  The promotion of community, research-based health-
1061	promotion model programs that meet specific criteria, address
1062	major risk factors, and motivate individuals to permanently
1063	adopt healthy behaviors and increase social and personal
1064	responsibilities;
1065	5.  The development of policies that encourage the use of
1066	alternative community delivery sites for health promotion,
1067	disease prevention, and preventive care programs and promote the
1068	use of neighborhood delivery sites that are close to work, home,
1069	and school; and
1070	6.  An emphasis on the importance of healthy and physically
1071	active lifestyles to build self-esteem and reduce morbidity and
1072	mortality associated with chronic disease and being overweight
1073	or obese. Existing community resources, when available, shall be
1074	used to support the programs. The department shall seek funding
1075	for the programs from federal and state financial assistance
1076	programs which presently exist or which may be hereafter
1077	created. Additional services, as appropriate, may be
1078	incorporated into a program to the extent that resources are
1079	available. The department may accept gifts and grants in order
1080	to carry out a program.
1081	(c)  Volunteers shall be used to the maximum extent
1082	possible in carrying out the programs. The department shall
1083	contract for the necessary insurance coverage to protect
1084	volunteers from personal liability while acting within the scope
1085	of their volunteer assignments under a program.
1086	(d)  The department may contract for the provision of all
1087	or any portion of the services required by a program, and shall
1088	so contract whenever the services so provided are more cost-
1089	efficient than those provided by the department.
1090	(e)  If the department determines that it is necessary for
1091	clients to help pay for services provided by a program, the
1092	department may require clients to make contribution therefor in
1093	either money or personal services. The amount of money or value
1094	of the personal services shall be fixed according to a fee
1095	schedule established by the department or by the entity
1096	developing the program. In establishing the fee schedule, the
1097	department or the entity developing the program shall take into
1098	account the expenses and resources of a client and his or her
1099	overall ability to pay for the services.
1100	Section 22.  Section 385.105, Florida Statutes, is created
1101	to read:
1102	385.105  Physical activity, obesity prevention, nutrition,
1103	other health-promotion services, and wellness programs.--
1104	(1)  PHYSICAL ACTIVITY--.
1105	(a)  The department shall develop programs for people at
1106	every stage of their lives to increase physical fitness and
1107	promote behavior changes.
1108	(b)  The department shall work with school health advisory
1109	or wellness committees in each school district as established in
1110	s. 381.0056.
1111	(c)  The department shall develop public and private
1112	partnerships that allow the public to easily access recreational
1113	facilities and public land areas that are suitable for physical
1114	activity.
1115	(d)  The department shall work in collaboration with the
1116	Executive Office of the Governor and Volunteer Florida, Inc., to
1117	promote school initiatives, such as the Governor's Fitness
1118	Challenge.
1119	(e)  The department shall collaborate with the Department
1120	of Education in recognizing nationally accepted best practices
1121	for improving physical education in schools.
1122	(2)  OBESITY PREVENTION.--The department shall promote
1123	healthy lifestyles to reduce the prevalence of excess weight
1124	gain and being overweight or obese through programs that are
1125	directed towards all residents of this state by:
1126	(a)  Using all appropriate media to promote maximum public
1127	awareness of the latest research on healthy lifestyles and
1128	chronic diseases and disseminating relevant information through
1129	a statewide clearinghouse relating to wellness, physical
1130	activity, and nutrition and the effect of these factors on
1131	chronic diseases and disabling conditions.
1132	(b)  Providing technical assistance, training, and
1133	resources on healthy lifestyles and chronic diseases to the
1134	public, health care providers, school districts, and other
1135	persons or entities, including faith-based organizations that
1136	request such assistance to promote physical activity, nutrition,
1137	and healthy lifestyle programs.
1138	(c)  Developing, implementing, and using all available
1139	research methods to collect data, including, but not limited to,
1140	population-specific data, and tracking the incidence and effects
1141	of weight gain, obesity, and related chronic diseases. The
1142	department shall include an evaluation and data-collection
1143	component in all programs as appropriate. All research conducted
1144	under this paragraph is subject to review and approval as
1145	required by the department's institutional review board under s.
1146	381.86.
1147	(d)  Entering into partnerships with the Department of
1148	Education, local communities, school districts, and other
1149	entities to encourage schools in this state to promote
1150	activities during and after school to help students meet a
1151	minimum goal of 30 minutes of physical activity or physical
1152	fitness per day.
1153	(e)  Entering into partnerships with the Department of
1154	Education, school districts, and the Florida Sports Foundation
1155	to develop a programs recognizing the schools at which students
1156	demonstrate excellent physical fitness or fitness improvement.
1157	(f)  Collaborating with other state agencies to develop
1158	policies and strategies for preventing and treating obesity,
1159	which shall be incorporated into programs administered by each
1160	agency and shall include promoting healthy lifestyles of
1161	employees of each agency.
1162	(g)  Advising, in accordance with s. 456.081, health care
1163	practitioners about the morbidity, mortality, and costs
1164	associated with being overweight or obese, informing such
1165	practitioners of promising clinical practices for preventing and
1166	treating obesity, and encouraging practitioners to counsel their
1167	patients regarding the adoption of healthy lifestyles.
1168	(h)  Maximizing all local, state, and federal funding
1169	sources, including grants, public-private partnerships, and
1170	other mechanisms to strengthen the department's programs
1171	promoting physical activity and nutrition.
1172	(3)  NUTRITION.--The department shall promote optimal
1173	nutritional status in all stages of people's lives by developing
1174	strategies to:
1175	(a)  Promote and maintain optimal nutritional status in the
1176	population through activities, including, but not limited to:
1177	1.  Nutrition screening and assessment and nutrition
1178	counseling, including nutrition therapy, followup, case
1179	management, and referrals for persons who have medical
1180	conditions or nutrition-risk factors and who are provided health
1181	services through public health programs or through referrals
1182	from private health care providers or facilities;
1183	2.  Nutrition education to assist residents of the state in
1184	achieving optimal health and preventing chronic disease; and
1185	3.  Consultative nutrition services to group facilities
1186	which promote the provision of safe and nutritionally adequate
1187	diets.
1188	(b)  Monitor and conduct surveillance of the nutritional
1189	status of this state's population.
1190	(c)  Conduct or support research or evaluations related to
1191	public health nutrition. All research conducted under this
1192	paragraph is subject to review and approval as required by the
1193	department's institutional review board under s. 381.86.
1194	(d)  Establish policies and standards for public health
1195	nutrition practices.
1196	(e)  Promote interagency cooperation, professional
1197	education, and consultation.
1198	(f)  Provide technical assistance and advise state
1199	agencies, private institutions, and local organizations
1200	regarding public health nutrition standards.
1201	(g)  Work with the Department of Agriculture and Consumer
1202	Services, the Department of Education, and the Department of
1203	Management Services to further the use of fresh produce from
1204	this state in schools and encourage the development of community
1205	gardens. Nutritional services shall be available to eligible
1206	persons in accordance with eligibility criteria adopted by the
1207	department. The department shall provide by rule requirements
1208	for the service fees, when applicable, which may not exceed the
1209	department's actual costs.
1210
1211	The department may adopt rules to administer this subsection.
1212	(4)  OTHER HEALTH-PROMOTION SERVICES.--
1213	(a)  The department shall promote personal responsibility
1214	by encouraging residents of this state to be informed, follow
1215	health recommendations, seek medical consultations and health
1216	assessments, take healthy precautions, and comply with medical
1217	guidelines, including those that lead to earlier detection of
1218	chronic diseases in order to prevent chronic diseases or slow
1219	the progression of established chronic diseases.
1220	(b)  The department shall promote regular health visits
1221	during a person's lifetime, including annual physical
1222	examinations that include measuring body mass index and vital
1223	signs, blood work, immunizations, screenings, and dental
1224	examinations in order to reduce the financial, social, and
1225	personal burden of chronic disease.
1226	(5)  WELLNESS PROGRAMS.--
1227	(a)  Each state agency may conduct employee wellness
1228	programs in buildings and lands owned or leased by the state.
1229	The department shall serve as a model to develop and implement
1230	employee wellness programs that may include physical fitness,
1231	healthy nutrition, self-management of disease, education, and
1232	behavioral change. The department shall assist other state
1233	agencies to develop and implement employee wellness programs.
1234	These programs shall use existing resources, facilities, and
1235	programs or resources procured through grant funding and
1236	donations that are obtained in accordance with state ethics and
1237	procurement policies, and shall provide equal access to any such
1238	programs, resources, and facilities to all state employees.
1239	(b)  The department shall coordinate its efforts with the
1240	Department of Management Services and other state agencies.
1241	(c)  Each agency may establish an employee wellness work
1242	group to design the program. The department shall be available
1243	to provide policy guidance and assist in identifying effective
1244	wellness program strategies.
1245	(d)  The department shall provide by rule requirements for
1246	nominal participation fees, when applicable, which may not
1247	exceed the department's actual costs; collaborations with
1248	businesses; and the procurement of equipment and incentives.
1249	Section 23.  Section 385.202, Florida Statutes, is amended
1250	to read:
1251	385.202  Statewide cancer registry.--
1252	(1)  Each facility, laboratory, or practitioner licensed
1253	under chapter 395, chapter 458, chapter 459, chapter 464,
1254	chapter 483, and each freestanding radiation therapy center as
1255	defined in s. 408.07, shall report to the department of Health
1256	such information, specified by the department, by rule. The
1257	department may adopt rules regarding reporting requirements for
1258	the cancer registry, which shall include the data required, the
1259	timeframe for reporting, and those professionals who are
1260	responsible for ensuring compliance with reporting requirements,
1261	which indicates diagnosis, stage of disease, medical history,
1262	laboratory data, tissue diagnosis, and radiation, surgical, or
1263	other methods of diagnosis or treatment for each cancer
1264	diagnosed or treated by the facility or center. Failure to
1265	comply with this requirement may be cause for registration or
1266	licensure suspension or revocation.
1267	(2)  The department shall establish, or cause to have
1268	established, by contract with a recognized medical organization
1269	in this state and its affiliated institutions, a statewide
1270	cancer registry program to ensure that cancer reports required
1271	under this section shall be maintained and available for use in
1272	the course of public health surveillance and any study for the
1273	purpose of reducing morbidity or mortality; and no liability of
1274	any kind or character for damages or other relief shall arise or
1275	be enforced against any facility or practitioner hospital by
1276	reason of having provided such information or material to the
1277	department.
1278	(3)  The department may adopt rules regarding the
1279	establishment and operation of a statewide cancer registry
1280	program.
1281	(4)(3)  The department or a contractual designee operating
1282	the statewide cancer registry program required by this section
1283	shall use or publish said material only for the purpose of
1284	public health surveillance and advancing medical research or
1285	medical education in the interest of reducing morbidity or
1286	mortality, except that a summary of such studies may be released
1287	for general publication. Information which discloses or could
1288	lead to the disclosure of the identity of any person whose
1289	condition or treatment has been reported and studied shall be
1290	confidential and exempt from the provisions of s. 119.07(1),
1291	except that:
1292	(a)  Release may be made with the written consent of all
1293	persons to whom the information applies;
1294	(b)  The department or a contractual designee may contact
1295	individuals for the purpose of epidemiologic investigation and
1296	monitoring, provided information that is confidential under this
1297	section is not further disclosed; or
1298	(c)  The department may exchange personal data with any
1299	other governmental agency or a contractual designee for the
1300	purpose of public health surveillance and medical or scientific
1301	research, if provided such governmental agency or contractual
1302	designee does shall not further disclose information that is
1303	confidential under this section.
1304	(5)(4)  Funds appropriated for this section shall be used
1305	for establishing, administering, compiling, processing, and
1306	providing biometric and statistical analyses to the reporting
1307	facilities and practitioners. Funds may also be used to ensure
1308	the quality and accuracy of the information reported and to
1309	provide management information to the reporting facilities and
1310	practitioners.
1311	(6)(5)  The department may adopt rules regarding the
1312	classifications of, by rule, classify facilities that are
1313	responsible for making reports to the cancer registry, the
1314	content and frequency of the reports, and the penalty for
1315	failure to comply with these requirements for purposes of
1316	reports made to the cancer registry and specify the content and
1317	frequency of the reports. In classifying facilities, the
1318	department shall exempt certain facilities from reporting cancer
1319	information that was previously reported to the department or
1320	retrieved from existing state reports made to the department or
1321	the Agency for Health Care Administration. The provisions of
1322	This section does shall not apply to any facility whose primary
1323	function is to provide psychiatric care to its patients.
1324	(7)  Notwithstanding subsection (1), each facility and
1325	practitioner that reports cancer cases to the department shall
1326	make their records available for onsite review by the department
1327	or its authorized representative.
1328	Section 24.  Subsection (3) of section 385.203, Florida
1329	Statutes, is amended to read:
1330	385.203  Diabetes Advisory Council; creation; function;
1331	membership.--
1332	(3)  The council shall be composed of 26 25 citizens of the
1333	state who have knowledge of, or work in, the area of diabetes
1334	mellitus as follows:
1335	(a)  Five interested citizens, three of whom are affected
1336	by diabetes.
1337	(b)  Twenty-one Twenty members, who must include one
1338	representative from each of the following areas: nursing with
1339	diabetes-educator certification; dietary with diabetes educator
1340	certification; podiatry; ophthalmology or optometry; psychology;
1341	pharmacy; adult endocrinology; pediatric endocrinology; the
1342	American Diabetes Association (ADA); the Juvenile Diabetes
1343	Foundation (JDF); the Florida Academy of Family Physicians; a
1344	community health center; a county health department; an American
1345	Diabetes Association recognized community education program;
1346	each medical school in the state; an osteopathic medical school;
1347	the insurance industry; a Children's Medical Services diabetes
1348	regional program; and an employer.
1349	(c)  One or more representatives from the Department of
1350	Health, who shall serve on the council as ex officio members.
1351	Section 25.  Section 385.206, Florida Statutes, is amended
1352	to read:
1353	385.206  Pediatric Hematology-Oncology care Center
1354	Program.--
1355	(1)  DEFINITIONS.--As used in this section, the term:
1356	(a)  "Department" means the Department of Health.
1357	(b)  "Hematology" means the study, diagnosis, and treatment
1358	of blood and blood-forming tissues.
1359	(c)  "Oncology" means the study, diagnosis, and treatment
1360	of malignant neoplasms or cancer.
1361	(d)  "Hemophilia" or "other hemostatic disorder" means a
1362	bleeding disorder resulting from a genetic abnormality of
1363	mechanisms related to the control of bleeding.
1364	(e)  "Sickle-cell anemia or other hemoglobinopathy" means
1365	an hereditary, chronic disease caused by an abnormal type of
1366	hemoglobin.
1367	(f)  "Patient" means a person under the age of 21 who is in
1368	need of hematologic-oncologic services and who is enrolled in
1369	the Children's Medical Services Network declared medically and
1370	financially eligible by the department; or a person who received
1371	such services prior to age 21 and who requires long-term
1372	monitoring and evaluation to ascertain the sequelae and the
1373	effectiveness of treatment.
1374	(g)  "Center" means a facility designated by the department
1375	as having a program specifically designed to provide a full
1376	range of medical and specialty services to patients with
1377	hematologic and oncologic disorders.
1378	(2)  PEDIATRIC HEMATOLOGY-ONCOLOGY CARE CENTER PROGRAM;
1379	AUTHORITY.--The department may designate is authorized to make
1380	grants and reimbursements to designated centers and provide
1381	funding to establish and maintain programs for the care of
1382	patients with hematologic and oncologic disorders. Program
1383	administration costs shall be paid by the department from funds
1384	appropriated for this purpose.
1385	(3)  GRANT FUNDING CONTRACTS GRANT AGREEMENTS;
1386	CONDITIONS.--
1387	(a)  Funding provided A grant made under this section shall
1388	be pursuant to a contract contractual agreement made between a
1389	center and the department. Each contract agreement shall provide
1390	that patients will receive services specified types of treatment
1391	and care from the center without additional charge to the
1392	patients or their parents or guardians. Grants shall be
1393	disbursed in accordance with conditions set forth in the
1394	disbursement guidelines.
1395	(4)  GRANT DISBURSEMENTS AND SPECIAL DISBURSEMENTS FOR
1396	LOCAL PROGRAMS.--
1397	(b)(a)  Funding may be provided Grant disbursements may be
1398	made to centers that which meet the following criteria:
1399	1.  The personnel shall include at least one board-
1400	certified pediatric hematologist-oncologist, at least one board-
1401	certified pediatric surgeon, at least one board-certified
1402	radiotherapist, and at least one board-certified pathologist.
1403	2.  As approved by the department, The center shall
1404	actively participate in a national children's cancer study
1405	group, maintain a pediatric tumor registry, have a
1406	multidisciplinary pediatric tumor board, and meet other
1407	guidelines for development, including, but not limited to,
1408	guidelines from such organizations as the American Academy of
1409	Pediatrics and the American Pediatric Surgical Association.
1410	(b)  Programs shall also be established to provide care to
1411	hematology-oncology patients within each district of the
1412	department. The guidelines for local programs shall be
1413	formulated by the department. Special disbursements may be made
1414	by the program office to centers for educational programs
1415	designed for the districts of the department. These programs may
1416	include teaching total supportive care of the dying patient and
1417	his or her family, home therapy to hemophiliacs and patients
1418	with other hemostatic disorders, and screening and counseling
1419	for patients with sickle-cell anemia or other
1420	hemoglobinopathies.
1421	(4)(5)  PROGRAM AND PEER REVIEW.--The department shall
1422	evaluate at least annually during the grant period the services
1423	rendered by the centers and the districts of the department.
1424	Data from the centers and other sources relating to pediatric
1425	cancer shall be reviewed annually by the Florida Association of
1426	Pediatric Tumor Programs, Inc.; and a written report with
1427	recommendations shall be made to the department. This database
1428	will be available to the department for program planning and
1429	quality assurance initiatives formulation of its annual program
1430	and financial evaluation report. A portion of the funds
1431	appropriated for this section may be used to provide statewide
1432	consultation, supervision, and evaluation of the programs of the
1433	centers, as well as central program office support personnel.
1434	Section 26.  Paragraph (g) of subsection (2) and subsection
1435	(7) of section 385.207, Florida Statutes, are amended to read:
1436	385.207  Care and assistance of persons with epilepsy;
1437	establishment of programs in epilepsy control.--
1438	(2)  The Department of Health shall:
1439	(g)  Continue current programs and develop cooperative
1440	programs and services designed to enhance the vocational
1441	rehabilitation of epilepsy clients, including the current jobs
1442	programs. The department shall, as part of its contract with a
1443	provider of epilepsy services, collect information regarding the
1444	number of clients served, the outcomes reached, the expenses
1445	incurred, and the fees collected by such providers for the
1446	provision of services keep and make this information available
1447	to the Governor and the Legislature upon request information
1448	regarding the number of clients served, the outcome reached, and
1449	the expense incurred by such programs and services.
1450	(7)  The department shall limit total administrative
1451	expenditures from the Epilepsy Services Trust Fund to 5 percent
1452	of annual receipts.
1453	Section 27.  Paragraphs (b), (d), and (g) of subsection (2)
1454	and paragraph (b) of subsection (5) of section 385.210, Florida
1455	Statutes, are amended to read:
1456	385.210  Arthritis prevention and education.--
1457	(2)  LEGISLATIVE FINDINGS.--The Legislature finds the
1458	following:
1459	(b)  Arthritis is the leading cause of disability in the
1460	United States, limiting daily activities for more than 19 7
1461	million citizens.
1462	(d)  There are enormous economic and social costs
1463	associated with treating arthritis and its complications; the
1464	economic costs are estimated at over $128 billion (2003) $116
1465	billion (1997) annually in the United States.
1466	(g)  The National Arthritis Foundation, the CDC Centers for
1467	Disease Control and Prevention, and the Association of State and
1468	Territorial Health Officials have led the development of a
1469	public health strategy, the National Arthritis Action Plan, to
1470	respond to this challenge.
1471	(5)  FUNDING.--
1472	(b)  The State Surgeon General may shall seek any federal
1473	waiver or waivers that may be necessary to maximize funds from
1474	the Federal Government to implement this program.
1475	Section 28.  Section 385.301, Florida Statutes, is created
1476	to read:
1477	385.301  Rulemaking authority.--The department may adopt
1478	rules pursuant to chapter 120 to administer this chapter.
1479	Section 29.  Section 385.401, Florida Statutes, is created
1480	to read:
1481	385.401  Direct-support organization.--
1482	(1)  DIRECT-SUPPORT ORGANIZATION ESTABLISHED.--The
1483	Department of Health may establish a direct-support organization
1484	to provide assistance, funding, and support for the department
1485	in carrying out its mission upon written approval by the State
1486	Surgeon General. This section governs the creation, use, powers,
1487	and duties of the direct-support organization.
1488	(2)  DEFINITIONS.--As used in this section, the term:
1489	(a)  "Department" means the Department of Health.
1490	(b)  "Direct-support organization" means an organization
1491	that is:
1492	1.  A Florida corporation, not for profit, incorporated
1493	under chapter 617, exempted from filing fees, and approved by
1494	the Department of State;
1495	2.  Organized and operated to conduct programs and
1496	activities; to initiate developmental projects; to raise funds;
1497	to request and receive grants, gifts, and bequests of moneys; to
1498	acquire, receive, hold, invest, and administer in its own name
1499	securities, funds, or property; and to make expenditures to or
1500	for the direct or indirect benefit of the state public health
1501	system through the department or its individual county health
1502	departments;
1503	3.  Determined by the department to be operating in a
1504	manner consistent with the priority issues and objectives of the
1505	department and in the best interest of the state; and
1506	4.  Approved in writing by the State Surgeon General to
1507	operate for the direct or indirect benefit of the department or
1508	its individual county health departments. This approval shall be
1509	in a form determined by the department.
1510	(3)  BOARD OF DIRECTORS.--The direct-support organization
1511	shall be governed by a board of directors.
1512	(a)  The board of directors shall consist of no fewer than
1513	seven members appointed by the State Surgeon General. Networks
1514	and partnerships in this state which are involved in issues
1515	related to public health may recommend nominees to the State
1516	Surgeon General.
1517	(b)  The term of office of the board members shall be 3
1518	years, except that the terms of the initial appointees shall be
1519	for 1 year, 2 years, or 3 years in order to achieve staggered
1520	terms. A member may be reappointed when his or her term expires.
1521	The State Surgeon General or his or her designee shall serve as
1522	an ex officio member of the board of directors.
1523	(c)  Members must be current residents of this state. A
1524	majority of the members must be highly knowledgeable about the
1525	department, its service personnel, and its missions. The board
1526	must include members from county government, the health care
1527	industry, the medical community, and other components of the
1528	public health system. The State Surgeon General may remove any
1529	member of the board for cause and with the approval of a
1530	majority of the members of the board of directors. The State
1531	Surgeon General shall appoint a replacement for any vacancy that
1532	occurs.
1533	(4)  USE OF PROPERTY.--
1534	(a)  The department and each county health department in
1535	the state may allow, without charge, the use of the department's
1536	fixed property and facilities within the state public health
1537	system by the direct-support organization, subject to this
1538	section. Use of the fixed property and facilities by the direct
1539	support organization may not interfere with use of the fixed
1540	property and facilities by the department's clients or staff.
1541	(b)  The department may not allow the use of its fixed
1542	property and facilities by any direct-support organization that
1543	is organized under this section and does not provide equal
1544	employment opportunities to all persons regardless of race,
1545	color, national origin, gender, age, or religion.
1546	(5)  DIRECTIVES.--The direct-support organization that is
1547	organized under this section shall comply with directives and
1548	requirements established by the sources of its funding.
1549	(6)  ANNUAL BUDGETS AND REPORTS.--
1550	(a)  The fiscal year of the direct-support organization
1551	shall begin on July 1 of each year and end on June 30 of the
1552	following year.
1553	(b)  The direct-support organization shall submit to the
1554	department its federal Internal Revenue Service Application for
1555	Recognition of Exemption form and its federal Internal Revenue
1556	Service Return of Organization Exempt from Income Tax form.
1557	(7)  ANNUAL AUDIT.--The direct-support organization shall
1558	provide for an annual financial audit in accordance with s.
1559	215.981.
1560	Section 30.  Subsection (9) of section 409.904, Florida
1561	Statutes, is amended to read:
1562	409.904  Optional payments for eligible persons.--The
1563	agency may make payments for medical assistance and related
1564	services on behalf of the following persons who are determined
1565	to be eligible subject to the income, assets, and categorical
1566	eligibility tests set forth in federal and state law. Payment on
1567	behalf of these Medicaid eligible persons is subject to the
1568	availability of moneys and any limitations established by the
1569	General Appropriations Act or chapter 216.
1570	(9)  Eligible women with incomes at or below 200 percent of
1571	the federal poverty level and under age 65, for cancer treatment
1572	pursuant to the federal Breast and Cervical Cancer Prevention
1573	and Treatment Act of 2000, screened through the Mary Brogan
1574	Breast and Cervical Cancer Early Detection Program established
1575	under s. 385.2021 s. 381.93.
1576	Section 31.  The Pharmacy and Therapeutic Advisory
1577	Council.--
1578	(1)  The Pharmacy and Therapeutic Advisory Council is
1579	created within the Executive Office of the Governor to serve in
1580	an advisory capacity to the Department of Health and other
1581	governmental agencies. The council may not interfere with
1582	existing mandated Medicaid services and may not develop or
1583	implement new ones. Specifically, the council may not interfere
1584	with the work of the Agency for Health Care Administration as it
1585	complies with federal and state statutory obligations to develop
1586	a preferred drug list, to negotiate rebate agreements for
1587	medications included in the preferred drug list, and to protect
1588	the confidentiality of rebate agreements. The council may not
1589	interfere with the Medicaid Pharmacy and Therapeutics Committee
1590	or the Drug Utilization Review Board, which oversee clinical
1591	activities within the Bureau of Pharmacy Services if such
1592	interference would violate any federal or state statutory
1593	obligations.
1594	(2)  The Pharmacy and Therapeutic Advisory Council shall
1595	use Medicaid processes within the existing Medicaid structure of
1596	the Agency for Health Care Administration as a guide for
1597	assisting state agencies in:
1598	(a)  Developing an unbiased clinical perspective on drug
1599	evaluations and utilization protocols that are relevant to
1600	patient care provided through programs administered by state
1601	agencies.
1602	(b)  Developing drug-utilization-review processes that are
1603	relevant to the agencies and those receiving care through
1604	programs administered by the agencies.
1605	(c)  Building a formulary structure that enforces formulary
1606	compliance or adherence within each agency.
1607	(d)  Performing pharmacoeconomic analyses on formulary
1608	management so that the state maximizes the cost-effectiveness of
1609	its pharmaceutical purchasing.
1610	(e)  Reviewing new and existing therapies using criteria
1611	established for efficacy, safety, and quality in order to
1612	maximize cost-effective purchasing.
1613	(f)  Reviewing state agency proposals to maximize the cost-
1614	effectiveness of pharmaceutical purchasing in compliance with s.
1615	381.0203.
1616	(3) The council shall verify the cost-effectiveness and
1617	clinical efficacy of any state contracts under s. 381.0203(1),
1618	Florida Statutes, no less than once every 2 years.
1619	(4)  The members of the council and the chair shall be
1620	appointed by the Governor to 4-year staggered terms or until
1621	their successors are appointed. Members may be appointed to more
1622	than one term. The Governor shall fill any vacancies for the
1623	remainder of the unexpired term in the same manner as the
1624	original appointment.
1625	(5)  The council shall include voting and nonvoting
1626	members, and the chair, who is a voting member, must be a
1627	pharmacist employed by a state agency.
1628	(a)  The voting members shall represent:
1629	1.  The Agency for Health Care Administration.
1630	2.  The Agency for Persons with Disabilities.
1631	3.  The Department of Children and Family Services.
1632	4.  The Department of Corrections.
1633	5.  The Department of Elderly Affairs.
1634	6.  The Department of Health.
1635	7.  The Department of Juvenile Justice.
1636	8.  The Bureau of Pharmacy Services within the Agency for
1637	Health Care Administration, which shall be represented by the
1638	bureau chief.
1639	9.  The Bureau of Statewide Pharmaceutical Services within
1640	the Department of Health, which shall be represented by the
1641	bureau chief.
1642	(b)  The nonvoting members shall be:
1643	1.  A representative from the Agency for Health Care
1644	Administration's drug contracting program.
1645	2.  The contracting officer for the Department of Health's
1646	drug procurement program.
1647	3.  A clinical pharmacy program manager from the Agency for
1648	Health Care Administration.
1649	4.  The chair of the Department of Health's Pharmacy and
1650	Therapeutics Committee.
1651	5.  The general counsel for the Agency for Health Care
1652	Administration or his or her designee.
1653	6.  The general counsel for a state agency in the executive
1654	branch of state government, or his or her designee.
1655	7.  A representative from the Executive Office of the
1656	Governor.
1657	8.  The statewide pharmacy director of the Department of
1658	Corrections' Office of Health Services.
1659	(6)  Members of the council shall consist of at least one
1660	physician licensed under chapter 458 or chapter 459, Florida
1661	Statutes, at least one pharmacist licensed under chapter 465,
1662	Florida Statutes, and at least one registered nurse licensed
1663	under chapter 464, Florida Statutes. Each member designated in
1664	this subsection must have an active license in his or her
1665	profession and may not have been the subject of any agency
1666	disciplinary action.
1667	(7)  Members, who must be residents of this state, shall be
1668	selected on the basis of specialty, board certification, prior
1669	pharmacy and therapeutic experience, experience treating medical
1670	assistance recipients, ability to represent a broad base of
1671	constituents, and number of years of practice. Members must not
1672	have any conflicts of interest due to their service on the
1673	council.
1674	(8)  The council may request the participation of
1675	additional subject-matter experts to address specific drug,
1676	therapeutic, or drug-procurement issues under review by the
1677	council.
1678	(9)  A majority of the members of the council constitutes a
1679	quorum, and an affirmative vote of a majority of the voting
1680	members is necessary to take action.
1681	(10)  The council shall meet quarterly or at the call of
1682	the chair.
1683	(11)  The council shall be staffed by the chair's
1684	department or agency.
1685	(12)  The council members shall serve without compensation,
1686	but are entitled to reimbursement for travel and per diem
1687	expenses incurred in the performance of their duties in
1688	accordance with s. 112.061, Florida Statutes.
1689	Section 32.  Paragraph (g) is added to subsection (53) of
1690	section 499.003, Florida Statutes, to read:
1691	499.003  Definitions of terms used in this part.--As used
1692	in this part, the term:
1693	(53)  "Wholesale distribution" means distribution of
1694	prescription drugs to persons other than a consumer or patient,
1695	but does not include:
1696	(g)  The sale, purchase, trade, or transfer of a
1697	prescription drug among agencies and health care entities of the
1698	state to complete the dispensing of the prescription drug to a
1699	patient under the care of a state agency or health care entity,
1700	or to a patient for whom the state is responsible for providing
1701	or arranging health care services. The agency or health care
1702	entity that received the prescription drug on behalf of the
1703	patient is deemed the patient's agent under s. 465.003(6).
1704	Section 33.  This act shall take effect July 1, 2009.
1705
1706
1707	-----------------------------------------------------
1708	T I T L E  A M E N D M E N T
1709	Remove the entire title and insert:
1710	A bill to be entitled
1711	An act relating to health care; amending s. 154.503, F.S.;
1712	conforming a cross-reference; repealing s. 381.0053, F.S.,
1713	relating to a comprehensive nutrition program; repealing
1714	s. 381.0054, F.S., relating to healthy lifestyles
1715	promotion; repealing ss. 381.732, 381.733, and 381.734,
1716	F.S., relating to the Healthy Communities, Healthy People
1717	Act; amending s. 381.006, F.S.; requiring the Department
1718	of Health, when conducting an environmental health program
1719	inspection of a certified domestic violence center to
1720	limit the inspection of the domestic violence center to
1721	the requirements set forth in the department's rules
1722	applicable to community-based residential facilities with
1723	five or fewer residents; requiring a report to the
1724	Governor and Legislature prior to proceeding with nitrogen
1725	reduction activities; ; amending s. 381.0072, F.S.;
1726	requiring the Department of Health, when conducting a food
1727	service inspection of a certified domestic violence center
1728	to limit the inspection of the domestic violence center to
1729	the requirements set forth in the department's rules
1730	applicable to community-based residential facilities with
1731	five or fewer residents; amending s. 381.0203, F.S.;
1732	requiring certain state agencies to purchase drugs through
1733	the statewide purchasing contract administered by the
1734	Department of Health; providing an exception; requiring
1735	the department to establish and maintain certain pharmacy
1736	services program; transferring, renumbering, and amending
1737	s. 381.84, F.S., relating to the Comprehensive Statewide
1738	Tobacco Education and Use Prevention Program; revising
1739	definitions; revising program components; requiring
1740	program components to include efforts to educate youth and
1741	their parents about tobacco use; requiring a youth-
1742	directed focus in each program component; requiring the
1743	Tobacco Education and Use Prevention Advisory Council to
1744	adhere to state ethics laws; providing that meetings of
1745	the council are subject to public-records and public-
1746	meetings requirements; revising the duties of the council;
1747	deleting a provision that prohibits a member of the
1748	council from participating in a discussion or decision
1749	with respect to a research proposal by a firm, entity, or
1750	agency with which the member is associated as a member of
1751	the governing body or as an employee or with which the
1752	member has entered into a contractual arrangement;
1753	revising the submission date of an annual report; deleting
1754	an expired provision relating to rulemaking authority of
1755	the department; transferring and renumbering s. 381.91,
1756	F.S., relating to the Jessie Trice Cancer Prevention
1757	Program; transferring, renumbering, and amending s.
1758	381.911, F.S., relating to the Prostate Cancer Awareness
1759	Program; revising the criteria for members of the prostate
1760	cancer advisory committee; repealing s. 381.912, F.S.,
1761	relating to the Cervical Cancer Elimination Task Force;
1762	transferring and renumbering s. 381.92, F.S., relating to
1763	the Florida Cancer Council; transferring and renumbering
1764	s. 381.921, F.S., relating to the mission and duties of
1765	the Florida Cancer Council; amending s. 381.922, F.S.;
1766	conforming cross-references; transferring and renumbering
1767	s. 381.93, F.S., relating to a breast and cervical cancer
1768	early detection program; transferring and renumbering s.
1769	381.931, F.S., relating to an annual report on Medicaid
1770	expenditures; renaming ch. 385, F.S., as the "Healthy and
1771	Fit Florida Act"; amending s. 385.101, F.S.; renaming the
1772	"Chronic Diseases Act" as the "Healthy and Fit Florida
1773	Act"; amending s. 385.102, F.S.; revising legislative
1774	intent; creating s. 385.1021, F.S.; providing definitions;
1775	creating s. 385.1022, F.S.; requiring the Department of
1776	Health to support public health programs to reduce the
1777	incidence of mortality and morbidity from chronic
1778	diseases; creating s. 385.1023, F.S.; requiring the
1779	department to create state-level programs that address the
1780	risk factors of certain chronic diseases; providing
1781	required activities of the state-level programs; amending
1782	s. 385.103, F.S.; providing for community-level programs
1783	for the prevention of chronic diseases; revising
1784	definitions; requiring the department to develop and
1785	implement a community-based chronic disease prevention and
1786	health promotion program; providing the purpose of the
1787	program; providing requirements for the program; creating
1788	s. 385.105, F.S.; requiring the department to develop
1789	programs to increase physical fitness, to work with school
1790	districts, to develop partnerships that allow the public
1791	to access recreational facilities and public land areas
1792	suitable for physical activity, to work with the Executive
1793	Office of the Governor and Volunteer Florida, Inc., to
1794	promote school initiatives, and to collaborate with the
1795	Department of Education in recognizing nationally accepted
1796	best practices for improving physical education in
1797	schools; requiring the Department of Health to promote
1798	healthy lifestyles to reduce obesity; requiring the
1799	department to promote optimal nutritional status in all
1800	stages of people's lives, personal responsibility to
1801	prevent chronic disease or slow its progression, and
1802	regular health visits during a person's life span;
1803	authorizing state agencies to conduct employee wellness
1804	programs; requiring the department to serve as a model to
1805	develop and implement employee wellness programs;
1806	requiring the department to assist state agencies to
1807	develop the employee wellness programs; providing equal
1808	access to the programs by agency employees; requiring the
1809	department to coordinate efforts with the Department of
1810	Management Services and other state agencies; authorizing
1811	each state agency to establish an employee wellness work
1812	group to design the wellness program; requiring the
1813	department to provide requirements for participation fees,
1814	collaborations with businesses, and procurement of
1815	equipment and incentives; amending s. 385.202, F.S.;
1816	requiring facilities, laboratories, and practitioners to
1817	report information; authorizing the department to adopt
1818	rules regarding reporting requirements for the cancer
1819	registry; providing immunity from liability for facilities
1820	and practitioners reporting certain information; requiring
1821	the department to adopt rules regarding the establishment
1822	and operation of a statewide cancer registry program;
1823	requiring the department or contractual designee operating
1824	the statewide cancer registry program to use or publish
1825	material only for the purpose of public health
1826	surveillance and advancing medical research or medical
1827	education in the interest of reducing morbidity or
1828	mortality; authorizing the department to exchange personal
1829	data with any agency or contractual designee for the
1830	purpose of public health surveillance and medical or
1831	scientific research under certain circumstances;
1832	clarifying that the department may adopt rules regarding
1833	the classifications of facilities related to reports made
1834	to the cancer registry; requiring each facility and
1835	practitioner that reports cancer cases to the department
1836	to make their records available for onsite review;
1837	amending s. 385.203, F.S.; increasing the size of the
1838	Diabetes Advisory Council to include one representative of
1839	the Florida Academy of Family Physicians; amending s.
1840	385.206, F.S.; renaming the "hematology-oncology care
1841	center program" as the "Pediatric Hematology-Oncology
1842	Center Program"; revising definitions; authorizing the
1843	department to designate centers and provide funding to
1844	maintain programs for the care of patients with
1845	hematologic and oncologic disorders; clarifying provisions
1846	related to grant-funding agreements and grant
1847	disbursements; revising the department's requirement to
1848	evaluate services rendered by the centers; requiring data
1849	from the centers and other sources relating to pediatric
1850	cancer to be available to the department for program
1851	planning and quality assurance initiatives; amending s.
1852	385.207, F.S.; clarifying provisions that require the
1853	department to collect information regarding the number of
1854	clients served, the outcomes reached, the expense
1855	incurred, and fees collected by providers of epilepsy
1856	services; deleting the provision that requires the
1857	department to limit administrative expenses from the
1858	Epilepsy Services Trust Fund to a certain percentage of
1859	annual receipts; amending s. 385.210, F.S.; revising
1860	legislative findings regarding the economic costs of
1861	treating arthritis and its complications; authorizing the
1862	State Surgeon General to seek any federal waivers that may
1863	be necessary to maximize funds from the Federal Government
1864	to implement the Arthritis Prevention and Education
1865	Program; creating s. 385.301, F.S.; authorizing the
1866	department to adopt rules to administer the act; creating
1867	s. 385.401, F.S.; authorizing the department to establish
1868	a direct-support organization; providing definitions;
1869	providing for a board of directors; providing terms;
1870	providing for membership; authorizing the department to
1871	allow the direct-support organization to use the
1872	department's fixed property and facilities within the
1873	state public health system; providing an exception;
1874	requiring that the direct-support organization submit
1875	certain federal forms to the department; requiring that
1876	the direct-support organization provide an annual
1877	financial audit; amending s. 409.904, F.S.; conforming a
1878	cross-reference; creating the Pharmacy and Therapeutic
1879	Advisory Council within the Executive Office of the
1880	Governor; providing duties of the council; providing for
1881	the appointment and qualification of members; providing
1882	for the use of subject-matter experts when necessary;
1883	providing requirements for voting and a quorum; providing
1884	for quarterly meetings of the council; providing for
1885	staffing; providing for reimbursement of per diem and
1886	travel expenses for members of the council; amending s.
1887	499.003, F.S.; excluding from the definition of "wholesale
1888	distribution" certain activities of state agencies;
1889	providing an effective date.

CODING: Words stricken are deletions; words underlined are additions.