January 19, 2020
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_h0593__
HB 593

1
A bill to be entitled
2An act relating to the health care; amending s. 20.43,
3F.S.; establishing the Office of Public Health Nutrition
4within the Department of Health; amending ss. 20.435,
5154.503, and 215.5602, F.S.; conforming cross-references;
6repealing s. 381.0053, F.S., relating to the comprehensive
7nutrition program; repealing s. 381.0054, F.S., relating
8to the promotion of healthy lifestyles; repealing ss.
9381.732 and 381.733, F.S., relating to the Healthy
10Communities, Healthy People Act; repealing s. 381.734,
11F.S., relating to the Healthy Communities, Healthy People
12Program; repealing s. 381.912, F.S., relating to the
13Cervical Cancer Elimination Task Force; repealing s.
14385.103, F.S., relating to community intervention
15programs; renumbering s. 381.91, F.S., relating to the
16Jessie Trice Cancer Prevention Program; renumbering and
17amending s. 381.911, F.S., relating to the Prostate Cancer
18Awareness Program; revising the criteria for members of
19the prostate cancer advisory committee; renumbering s.
20381.92, F.S., relating to the Florida Cancer Council;
21renumbering s. 381.921, F.S., relating to the mission and
22duties of the Florida Cancer Council; renumbering and
23amending s. 381.922, F.S., relating to the William G.
24"Bill" Bankhead, Jr., and David Coley Cancer Research
25Program; conforming cross-references; renumbering s.
26381.93, F.S., relating to a breast and cervical cancer
27early detection program; renumbering and amending s.
28381.931, F.S., relating to an annual report on Medicaid
29expenditures; removing a provision limiting the number of
30breast and cervical cancer screenings based on projected
31Medicaid expenditures; renumbering s. 381.932, F.S.,
32relating to the breast cancer early detection and
33treatment referral program; renaming ch. 385, F.S., as the
34"Healthy and Fit Florida Act"; amending s. 385.101, F.S.;
35revising the short title; amending s. 385.102, F.S.;
36revising legislative intent with regard to chronic
37diseases and health promotion; creating s. 385.1021, F.S.;
38providing definitions; creating s. 385.1022, F.S.;
39requiring the Department of Health to support the creation
40of public health programs at the state and community
41levels to reduce the incidence of mortality and morbidity
42from chronic diseases; authorizing the department to
43advance funds for program startup and contracted services
44under certain conditions; creating s. 385.1023, F.S.;
45requiring the department to create state-level programs to
46address the preventable risk factors associated with
47chronic diseases; requiring the program to perform certain
48activities; requiring a biennial report to the Governor
49and Legislature; creating s. 385.1035, F.S.; providing for
50community-level programs for the prevention of chronic
51diseases and the promotion of health; requiring the
52department to develop and implement a community-level
53chronic disease prevention and health promotion program;
54providing the purpose of the program; providing
55requirements for the program; creating s. 385.104, F.S.;
56creating the State Employee Wellness Interagency Council;
57providing for purpose, membership, and duties of the
58council; creating s. 385.105, F.S.; requiring the
59department to develop programs to promote physical
60fitness, healthy lifestyles, and weight control; requiring
61the Office of Public Health Nutrition to promote optimal
62nutritional status in the state's population; requiring
63the department to promote personal responsibility and
64regular health visits; authorizing state agencies to
65conduct employee wellness programs; requiring the
66department to serve as a model for the development and
67implementation of wellness programs; requiring the
68department to assist state agencies in developing and
69implementing wellness programs; providing equal access to
70the programs by agency employees; requiring the department
71to coordinate efforts with the Department of Management
72Services and other state agencies; authorizing each state
73agency to establish an employee wellness workgroup to
74design the agency's wellness program; requiring the
75department to adopt rules to provide requirements for
76participation fees, collaboration with businesses, and
77procurement of equipment and incentives; amending s.
78385.202, F.S.; requiring licensed laboratories and
79practitioners to report certain information to the
80department; authorizing the department to adopt rules
81regarding reporting requirements for the statewide cancer
82registry; removing a provision that provides for
83registration or licensure suspension or revocation for
84failure to comply with such requirements; providing
85immunity from liability for facilities, laboratories, and
86practitioners reporting certain information; authorizing
87the department to adopt rules regarding the establishment
88and operation of a statewide cancer registry program;
89permitting the department or contractual designee
90operating the statewide cancer registry program to use or
91publish information contained in the registry for the
92purpose of public health surveillance under certain
93circumstances; authorizing the department to exchange
94personal data with an agency or contractual designee for
95the purpose of public health surveillance under certain
96circumstances; authorizing additional uses for funds
97appropriated for the program; clarifying that the
98department may adopt rules regarding the classifications
99of facilities, laboratories, and practitioners related to
100reports made to the statewide cancer registry; removing an
101exemption from reporting requirements for certain
102facilities; requiring each facility, laboratory, and
103practitioner that reports cancer cases to the department
104to make their records available for onsite review;
105amending s. 385.203, F.S.; increasing the membership of
106the Diabetes Advisory Council; amending s. 385.206, F.S.;
107renaming the "Hematology-oncology care center program" as
108the "Pediatric Hematology-oncology Center Program";
109revising the definition of the term "patient"; authorizing
110the department to designate centers and provide funding to
111maintain programs for the care of patients with
112hematologic and oncologic disorders; providing
113requirements for contracts that provide funding for the
114program; deleting a requirement for the establishment of
115district programs and annual review thereof; revising
116procedure for evaluation of services provided by the
117centers; requiring data from the centers and other sources
118relating to pediatric cancer to be available to the
119department for program planning and quality assurance
120initiatives; amending s. 385.207, F.S.; revising
121provisions that require the department to collect
122information regarding the number of clients served,
123outcomes reached, expenses incurred, and fees collected by
124providers of epilepsy services; deleting a provision that
125requires the department to limit administrative expenses
126from the Epilepsy Services Trust Fund to a certain
127percentage of annual receipts; amending s. 385.210, F.S.;
128revising legislative findings regarding the economic costs
129of treating arthritis and its complications; authorizing
130the State Surgeon General to seek any federal waivers
131necessary to maximize funds from the Federal Government to
132implement an arthritis prevention and education program;
133creating s. 385.301, F.S.; authorizing the department to
134adopt rules to administer ch. 385, F.S.; creating s.
135385.401, F.S.; authorizing the department, with the
136approval of the State Surgeon General, to establish a
137direct-support organization; specifying duties; providing
138for appointment and terms of members of the board of
139directors; providing for the use of department and county
140health department property and facilities by the direct-
141support organization under certain conditions; requiring
142the direct-support organization to comply with directives
143and requirements established by funding sources; requiring
144the direct-support organization to submit certain forms to
145the department and reports to the Governor and
146Legislature; requiring an annual audit; amending s.
147409.904, F.S.; conforming a cross-reference; providing an
148effective date.
149
150     WHEREAS, chronic diseases account for 70 percent of all
151deaths in the United States, and
152     WHEREAS, heart disease and stroke have remained the first
153and third leading causes of death in the United States for over
154seven decades and are responsible for approximately one-third of
155total deaths each year in this state, and
156     WHEREAS, cancer is the second leading cause of death and is
157responsible for one in every four deaths in this state, and
158     WHEREAS, lung disease is the fourth leading cause of death
159and is responsible for one in every six deaths in this state,
160and
161     WHEREAS, diabetes is the sixth leading cause of death in
162this state, and
163     WHEREAS, oral disease, specifically dental caries, commonly
164known as tooth decay, is the single most common chronic disease
165in children. Dental caries is the most prevalent chronic disease
166experienced by children that is not self-limiting or amenable to
167a short-term course of antibiotics, despite the fact that dental
168caries is usually preventable, and
169     WHEREAS, arthritis is the leading cause of disability in
170the United States, limiting the daily activities of more than 19
171million people across the country and more than 1 million people
172in this state alone, NOW, THEREFORE,
173
174Be It Enacted by the Legislature of the State of Florida:
175
176     Section 1.  Subsection (10) is added to section 20.43,
177Florida Statutes, to read:
178     20.43  Department of Health.-There is created a Department
179of Health.
180     (10)  There is established within the Department of Health
181the Office of Public Health Nutrition.
182     Section 2.  Paragraph (a) of subsection (8) of section
18320.435, Florida Statutes, is amended to read:
184     20.435  Department of Health; trust funds.-The following
185trust funds shall be administered by the Department of Health:
186     (8)  Biomedical Research Trust Fund.
187     (a)  Funds to be credited to the trust fund shall consist
188of funds deposited pursuant to s. 215.5601 and any other funds
189appropriated by the Legislature. Funds shall be used for the
190purposes of the James and Esther King Biomedical Research
191Program and the William G. "Bill" Bankhead, Jr., and David Coley
192Cancer Research Program as specified in ss. 215.5602, 288.955,
193and 385.20252 381.922. The trust fund is exempt from the service
194charges imposed by s. 215.20.
195     Section 3.  Paragraph (e) of subsection (2) of section
196154.503, Florida Statutes, is amended to read:
197     154.503  Primary Care for Children and Families Challenge
198Grant Program; creation; administration.-
199     (2)  The department shall:
200     (e)  Coordinate with the primary care program developed
201pursuant to s. 154.011, the Florida Healthy Kids Corporation
202program created in s. 624.91, the school health services program
203created in ss. 381.0056 and 381.0057, the Healthy Communities,
204Healthy People Program created in s. 381.734, and the volunteer
205health care provider program developed pursuant to s. 766.1115.
206     Section 4.  Subsection (11) of section 215.5602, Florida
207Statutes, is amended to read:
208     215.5602  James and Esther King Biomedical Research
209Program.-
210     (11)  The council shall award grants for cancer research
211through the William G. "Bill" Bankhead, Jr., and David Coley
212Cancer Research Program created in s. 385.20252 s. 381.922.
213     Section 5.  Sections 381.0053, 381.0054, 381.732, 381.733,
214381.734, 381.912, and 385.103, Florida Statutes, are repealed.
215     Section 6.  Section 381.91, Florida Statutes, is renumbered
216as section 385.2023, Florida Statutes, to read:
217     385.2023 381.91  Jessie Trice Cancer Prevention Program.-
218     (1)  It is the intent of the Legislature to:
219     (a)  Reduce the rates of illness and death from lung cancer
220and other cancers and improve the quality of life among low-
221income African-American and Hispanic populations through
222increased access to early, effective screening and diagnosis,
223education, and treatment programs.
224     (b)  Create a community faith-based disease-prevention
225program in conjunction with the Health Choice Network and other
226community health centers to build upon the natural referral and
227education networks in place within minority communities and to
228increase access to health service delivery in Florida.
229     (c)  Establish a funding source to build upon local private
230participation to sustain the operation of the program.
231     (2)(a)  There is created the Jessie Trice Cancer Prevention
232Program, to be located, for administrative purposes, within the
233Department of Health, and operated from the community health
234centers within the Health Choice Network in Florida.
235     (b)  Funding may be provided to develop contracts with
236community health centers and local community faith-based
237education programs to provide cancer screening, diagnosis,
238education, and treatment services to low-income populations
239throughout the state.
240     Section 7.  Section 381.911, Florida Statutes, is
241renumbered as section 385.2024, Florida Statutes, and amended to
242read:
243     385.2024 381.911  Prostate Cancer Awareness Program.-
244     (1)  To the extent that funds are specifically made
245available for this purpose, the Prostate Cancer Awareness
246Program is established within the Department of Health. The
247purpose of this program is to implement the recommendations of
248January 2000 of the Florida Prostate Cancer Task Force to
249provide for statewide outreach and health education activities
250to ensure that men are aware of and appropriately seek medical
251counseling for prostate cancer as an early-detection health care
252measure.
253     (2)  For purposes of implementing the program, the
254Department of Health and the Florida Public Health Institute,
255Inc., may:
256     (a)  Conduct activities directly or enter into a contract
257with a qualified nonprofit community education entity.
258     (b)  Seek any available gifts, grants, or funds from the
259state, the Federal Government, philanthropic foundations, and
260industry or business groups.
261     (3)  A prostate cancer advisory committee is created to
262advise and assist the Department of Health and the Florida
263Public Health Institute, Inc., in implementing the program.
264     (a)  The State Surgeon General shall appoint the advisory
265committee members, who shall consist of:
266     1.  Three persons from prostate cancer survivor groups or
267cancer-related advocacy groups.
268     2.  Three persons who are scientists or clinicians from
269public or nonpublic universities or research organizations.
270     3.  Three persons who are engaged in the practice of a
271cancer-related medical specialty from health organizations
272committed to cancer research and control.
273     (b)  Members shall serve without compensation but are
274entitled to reimbursement, pursuant to s. 112.061, for per diem
275and travel expenses incurred in the performance of their
276official duties.
277     (4)  The program shall coordinate its efforts with those of
278the Florida Public Health Institute, Inc.
279     Section 8.  Section 381.92, Florida Statutes, is renumbered
280as section 385.2025, Florida Statutes, to read:
281     385.2025 381.92  Florida Cancer Council.-
282     (1)  Effective July 1, 2004, the Florida Cancer Council
283within the Department of Health is established for the purpose
284of making the state a center of excellence for cancer research.
285     (2)(a)  The council shall be representative of the state's
286cancer centers, hospitals, and patient groups and shall be
287organized and shall operate in accordance with this act.
288     (b)  The Florida Cancer Council may create not-for-profit
289corporate subsidiaries to fulfill its mission. The council and
290its subsidiaries are authorized to receive, hold, invest, and
291administer property and any moneys acquired from private, local,
292state, and federal sources, as well as technical and
293professional income generated or derived from the mission-
294related activities of the council.
295     (c)  The members of the council shall consist of:
296     1.  The chair of the Florida Dialogue on Cancer, who shall
297serve as the chair of the council;
298     2.  The State Surgeon General or his or her designee;
299     3.  The chief executive officer of the H. Lee Moffitt
300Cancer Center or his or her designee;
301     4.  The director of the University of Florida Shands Cancer
302Center or his or her designee;
303     5.  The chief executive officer of the University of Miami
304Sylvester Comprehensive Cancer Center or his or her designee;
305     6.  The chief executive officer of the Mayo Clinic,
306Jacksonville, or his or her designee;
307     7.  The chief executive officer of the American Cancer
308Society, Florida Division, Inc., or his or her designee;
309     8.  The president of the American Cancer Society, Florida
310Division, Inc., Board of Directors or his or her designee;
311     9.  The president of the Florida Society of Clinical
312Oncology or his or her designee;
313     10.  The president of the American College of Surgeons,
314Florida Chapter, or his or her designee;
315     11.  The chief executive officer of Enterprise Florida,
316Inc., or his or her designee;
317     12.  Five representatives from cancer programs approved by
318the American College of Surgeons. Three shall be appointed by
319the Governor, one shall be appointed by the Speaker of the House
320of Representatives, and one shall be appointed by the President
321of the Senate;
322     13.  One member of the House of Representatives, to be
323appointed by the Speaker of the House of Representatives; and
324     14.  One member of the Senate, to be appointed by the
325President of the Senate.
326     (d)  Appointments made by the Speaker of the House of
327Representatives and the President of the Senate pursuant to
328paragraph (c) shall be for 2-year terms, concurrent with the
329bienniums in which they serve as presiding officers.
330     (e)  Appointments made by the Governor pursuant to
331paragraph (c) shall be for 2-year terms, although the Governor
332may reappoint members.
333     (f)  Members of the council or any subsidiaries shall serve
334without compensation, and each organization represented on the
335council shall cover the expenses of its representatives.
336     (3)  The council shall issue an annual report to the Center
337for Universal Research to Eradicate Disease, the Governor, the
338Speaker of the House of Representatives, and the President of
339the Senate by December 15 of each year, with policy and funding
340recommendations regarding cancer research capacity in Florida
341and related issues.
342     Section 9.  Section 381.921, Florida Statutes, is
343renumbered as section 385.20251, Florida Statutes, to read:
344     385.20251 381.921  Florida Cancer Council mission and
345duties.-The council, which shall work in concert with the
346Florida Center for Universal Research to Eradicate Disease to
347ensure that the goals of the center are advanced, shall endeavor
348to dramatically improve cancer research and treatment in this
349state through:
350     (1)  Efforts to significantly expand cancer research
351capacity in the state by:
352     (a)  Identifying ways to attract new research talent and
353attendant national grant-producing researchers to cancer
354research facilities in this state;
355     (b)  Implementing a peer-reviewed, competitive process to
356identify and fund the best proposals to expand cancer research
357institutes in this state;
358     (c)  Funding through available resources for those
359proposals that demonstrate the greatest opportunity to attract
360federal research grants and private financial support;
361     (d)  Encouraging the employment of bioinformatics in order
362to create a cancer informatics infrastructure that enhances
363information and resource exchange and integration through
364researchers working in diverse disciplines, to facilitate the
365full spectrum of cancer investigations;
366     (e)  Facilitating the technical coordination, business
367development, and support of intellectual property as it relates
368to the advancement of cancer research; and
369     (f)  Aiding in other multidisciplinary research-support
370activities as they inure to the advancement of cancer research.
371     (2)  Efforts to improve both research and treatment through
372greater participation in clinical trials networks by:
373     (a)  Identifying ways to increase adult enrollment in
374cancer clinical trials;
375     (b)  Supporting public and private professional education
376programs designed to increase the awareness and knowledge about
377cancer clinical trials;
378     (c)  Providing tools to cancer patients and community-based
379oncologists to aid in the identification of cancer clinical
380trials available in the state; and
381     (d)  Creating opportunities for the state's academic cancer
382centers to collaborate with community-based oncologists in
383cancer clinical trials networks.
384     (3)  Efforts to reduce the impact of cancer on disparate
385groups by:
386     (a)  Identifying those cancers that disproportionately
387impact certain demographic groups; and
388     (b)  Building collaborations designed to reduce health
389disparities as they relate to cancer.
390     Section 10.  Section 381.922, Florida Statutes, is
391renumbered as section 385.20252, Florida Statutes, and amended,
392to read:
393     385.20252 381.922  William G. "Bill" Bankhead, Jr., and
394David Coley Cancer Research Program.-
395     (1)  The William G. "Bill" Bankhead, Jr., and David Coley
396Cancer Research Program, which may be otherwise cited as the
397"Bankhead-Coley Program," is created within the Department of
398Health. The purpose of the program shall be to advance progress
399towards cures for cancer through grants awarded through a peer-
400reviewed, competitive process.
401     (2)  The program shall provide grants for cancer research
402to further the search for cures for cancer.
403     (a)  Emphasis shall be given to the goals enumerated in s.
404385.20251 s. 381.921, as those goals support the advancement of
405such cures.
406     (b)  Preference may be given to grant proposals that foster
407collaborations among institutions, researchers, and community
408practitioners, as such proposals support the advancement of
409cures through basic or applied research, including clinical
410trials involving cancer patients and related networks.
411     (3)(a)  Applications for funding for cancer research may be
412submitted by any university or established research institute in
413the state. All qualified investigators in the state, regardless
414of institutional affiliation, shall have equal access and
415opportunity to compete for the research funding. Collaborative
416proposals, including those that advance the program's goals
417enumerated in subsection (2), may be given preference. Grants
418shall be awarded by the State Surgeon General, after
419consultation with the Biomedical Research Advisory Council, on
420the basis of scientific merit, as determined by an open,
421competitive peer review process that ensures objectivity,
422consistency, and high quality. The following types of
423applications shall be considered for funding:
424     1.  Investigator-initiated research grants.
425     2.  Institutional research grants.
426     3.  Collaborative research grants, including those that
427advance the finding of cures through basic or applied research.
428     (b)  In order to ensure that all proposals for research
429funding are appropriate and are evaluated fairly on the basis of
430scientific merit, the State Surgeon General, in consultation
431with the council, shall appoint a peer review panel of
432independent, scientifically qualified individuals to review the
433scientific content of each proposal and establish its priority
434score. The priority scores shall be forwarded to the council and
435must be considered in determining which proposals shall be
436recommended for funding.
437     (c)  The council and the peer review panel shall establish
438and follow rigorous guidelines for ethical conduct and adhere to
439a strict policy with regard to conflicts of interest. A member
440of the council or panel may not participate in any discussion or
441decision with respect to a research proposal by any firm,
442entity, or agency with which the member is associated as a
443member of the governing body or as an employee or with which the
444member has entered into a contractual arrangement. Meetings of
445the council and the peer review panels are subject to chapter
446119, s. 286.011, and s. 24, Art. I of the State Constitution.
447     (4)  By December 15 of each year, the Department of Health
448shall submit to the Governor, the President of the Senate, and
449the Speaker of the House of Representatives a report indicating
450progress towards the program's mission and making
451recommendations that further its purpose.
452     (5)  Funds appropriated for the William G. "Bill" Bankhead,
453Jr., and David Coley Cancer Research Program shall be
454distributed pursuant to this section to provide grants to
455researchers seeking cures for cancer and cancer-related
456illnesses, with emphasis given to the goals enumerated in s.
457385.20251 s. 381.921. From the total funds appropriated, an
458amount of up to 10 percent may be used for administrative
459expenses. In the 2009-2010 fiscal year, 2.5 percent, not to
460exceed $25 million, of the revenue deposited into the Health
461Care Trust Fund pursuant to s. 215.5602(12)(a) shall be
462transferred to the Biomedical Research Trust Fund within the
463Department of Health for the William G. "Bill" Bankhead, Jr.,
464and David Coley Cancer Research Program.
465     (6)  By June 1, 2009, the Division of Statutory Revision of
466the Office of Legislative Services shall certify to the
467President of the Senate and the Speaker of the House of
468Representatives the language and statutory citation of this
469section, which is scheduled to expire January 1, 2011.
470     (7)  The Legislature shall review the performance, the
471outcomes, and the financial management of the William G. "Bill"
472Bankhead, Jr., and David Coley Cancer Research Program during
473the 2010 Regular Session of the Legislature and shall determine
474the most appropriate funding source and means of funding the
475program based on its review.
476     (8)  This section expires January 1, 2011, unless reviewed
477and reenacted by the Legislature before that date.
478     Section 11.  Section 381.93, Florida Statutes, is
479renumbered as section 385.20253, Florida Statutes, to read:
480     385.20253 381.93  Breast and cervical cancer early
481detection program.-This section may be cited as the "Mary Brogan
482Breast and Cervical Cancer Early Detection Program Act."
483     (1)  It is the intent of the Legislature to reduce the
484rates of death due to breast and cervical cancer through early
485diagnosis and increased access to early screening, diagnosis,
486and treatment programs.
487     (2)  The Department of Health, using available federal
488funds and state funds appropriated for that purpose, is
489authorized to establish the Mary Brogan Breast and Cervical
490Cancer Screening and Early Detection Program to provide
491screening, diagnosis, evaluation, treatment, case management,
492and followup and referral to the Agency for Health Care
493Administration for coverage of treatment services.
494     (3)  The Mary Brogan Breast and Cervical Cancer Early
495Detection Program shall be funded through grants for such
496screening and early detection purposes from the federal Centers
497for Disease Control and Prevention under Title XV of the Public
498Health Service Act, 42 U.S.C. ss. 300k et seq.
499     (4)  The department shall limit enrollment in the program
500to persons with incomes up to and including 200 percent of the
501federal poverty level. The department shall establish an
502eligibility process that includes an income-verification process
503to ensure that persons served under the program meet income
504guidelines.
505     (5)  The department may provide other breast and cervical
506cancer screening and diagnostic services; however, such services
507shall be funded separately through other sources than this act.
508     Section 12.  Section 381.931, Florida Statutes, is
509renumbered as section 385.20254, Florida Statutes, and amended
510to read:
511     385.20254 381.931  Annual report on Medicaid expenditures.-
512The Department of Health and the Agency for Health Care
513Administration shall monitor the total Medicaid expenditures for
514services made under this act. If Medicaid expenditures are
515projected to exceed the amount appropriated by the Legislature,
516the Department of Health shall limit the number of screenings to
517ensure Medicaid expenditures do not exceed the amount
518appropriated. The Department of Health, in cooperation with the
519Agency for Health Care Administration, shall prepare an annual
520report that must include the number of women screened; the
521percentage of positive and negative outcomes; the number of
522referrals to Medicaid and other providers for treatment
523services; the estimated number of women who are not screened or
524not served by Medicaid due to funding limitations, if any; the
525cost of Medicaid treatment services; and the estimated cost of
526treatment services for women who were not screened or referred
527for treatment due to funding limitations. The report shall be
528submitted to the President of the Senate, the Speaker of the
529House of Representatives, and the Executive Office of the
530Governor by March 1 of each year.
531     Section 13.  Section 381.932, Florida Statutes, is
532renumbered as section 385.20255, Florida Statutes, to read:
533     385.20255 381.932  Breast cancer early detection and
534treatment referral program.-
535     (1)  For purposes of this section, the term:
536     (a)  "Breast cancer screening and referral services" means
537necessary breast cancer screening and referral services for a
538procedure intended to treat cancer of the human breast,
539including, but not limited to, surgery, radiation therapy,
540chemotherapy, hormonal therapy, and related medical followup
541services.
542     (b)  "Unserved or underserved populations" means women who
543are:
544     1.  At or below 200 percent of the federal poverty level
545for individuals;
546     2.  Without health insurance that covers breast cancer
547screenings; and
548     3.  Nineteen to 64 years of age, inclusive.
549     (2)  There is established, within existing or specific
550appropriations, a breast cancer early detection and treatment
551referral program within the Department of Health. The purposes
552of the program are to:
553     (a)  Promote referrals for the screening, detection, and
554treatment of breast cancer among unserved or underserved
555populations.
556     (b)  Educate the public regarding breast cancer and the
557benefits of early detection.
558     (c)  Provide referral services for persons seeking
559treatment.
560     (3)  The program shall include, but is not be limited to,
561the:
562     (a)  Establishment of a public education and outreach
563initiative to publicize breast cancer early detection services,
564the benefits of early detection of breast cancer, and the
565recommended frequency for receiving screening services,
566including clinical breast examinations and mammography
567guidelines established by the United States Preventive Services
568Task Force.
569     (b)  Development of professional education programs that
570include information regarding the benefits of the early
571detection of breast cancer and the recommended frequency for
572receiving a mammogram, as recommended in the most current breast
573cancer screening guidelines established by the United States
574Preventive Services Task Force.
575     (c)  Establishment of a system to track and monitor all
576women screened for breast cancer in the program. The system
577shall include, but is not be limited to, monitoring abnormal
578screening tests, referring women for treatment when needed, and
579tracking women to be screened at recommended screening
580intervals.
581     (4)  The State Surgeon General shall submit an annual
582report to the appropriate substantive committees of the
583Legislature. The report shall include, but is not be limited to,
584a description of the rate of breast cancer morbidity and
585mortality in the state and the extent to which women are
586participating in breast cancer screening as reported by the
587Behavioral Risk Factor Surveillance System.
588     Section 14.  Chapter 385, Florida Statutes, entitled
589"Chronic Diseases," is renamed the "Healthy and Fit Florida
590Act."
591     Section 15.  Section 385.101, Florida Statutes, is amended
592to read:
593     385.101  Short title.-This chapter Sections 385.101-385.103
594may be cited as the "Healthy and Fit Florida Chronic Diseases
595Act."
596     Section 16.  Section 385.102, Florida Statutes, is amended
597to read:
598     385.102  Legislative intent.-It is the finding of the
599Legislature that:
600     (1)  Chronic diseases continue to be the leading cause of
601death and disability in the state and the nation exist in high
602proportions among the people of this state. These Chronic
603diseases include, but are not limited to, arthritis,
604cardiovascular disease heart disease, hypertension, diabetes,
605renal disease, oral diseases, cancer, and chronic obstructive
606lung disease, including chronic obstructive pulmonary disease
607and asthma. These diseases are often have the same preventable
608risk factors and interrelated, and they directly and indirectly
609account for a high rate of death and disability, which results
610in higher costs to the state's health care system illness.
611     (2)  Chronic diseases have a significant impact on quality
612of life, not only for the individuals who experience the painful
613symptoms and resulting disabilities, but also for family members
614and caregivers.
615     (3)  Racial and ethnic minorities and other underserved
616populations are disproportionately affected by chronic diseases.
617     (4)  Chronic diseases and the complications associated with
618these diseases result in increased medical costs and lost wages.
619     (5)(2)  Advances in medical knowledge and technology assist
620have assisted in the prevention, detection, and management of
621chronic diseases. Comprehensive approaches that stress the
622stressing application of current medical treatment, continuing
623research, professional training, and patient education, and
624state and local policy and environmental changes should be
625implemented encouraged.
626     (6)(3)  A comprehensive program dealing with the early
627detection and prevention of chronic diseases is required to make
628knowledge and therapy available to all people of this state. The
629mobilization of scientific, medical, and educational resources
630and the implementation of state and local policies relating to
631chronic diseases under one comprehensive law chronic disease act
632will facilitate the prevention, early intervention, and
633management of chronic and treatment of these diseases and their
634symptoms. This integration of resources and policy will and
635result in a decline in death and disability illness among the
636people of this state.
637     (7)  The department shall establish, promote, and maintain
638programs at the state and community levels for chronic disease
639prevention and health promotion as described in this chapter to
640the extent that funds are specifically made available for this
641purpose.
642     Section 17.  Section 385.1021, Florida Statutes, is created
643to read:
644     385.1021  Definitions.-As used in this chapter, the term:
645     (1)  "Best and promising practices" means specific
646activities used to effect change, which may include guidelines
647developed by organizations, volunteer scientists, and health
648care professionals who have published medical or scientific
649articles on topics relating to chronic diseases in a generally
650available scientific journal that has a rigorous review and
651approval process.
652     (2)  "CDC" means the United States Centers for Disease
653Control and Prevention.
654     (3)  "Chronic disease" means an illness that is prolonged,
655does not resolve spontaneously, and is rarely cured completely.
656     (4)  "Department" means the Department of Health.
657     (5)  "Environmental changes" means changes to the economic,
658social, or physical natural or built environment that encourage
659or enable healthy behavior.
660     (6)  "Policy change" means altering an informal or formal
661agreement between the public or private sector to identify
662values, behaviors, or resource allocation in order to improve
663health.
664     (7)  "Primary prevention" means an intervention that is
665directed toward healthy populations and focuses on preventing a
666disease before it occurs.
667     (8)  "Risk factor" means a characteristic or condition
668identified during the course of an epidemiological study of a
669disease that appears to be statistically associated with a high
670incidence of that disease.
671     (9)  "Secondary prevention" means an intervention that is
672designed to promote the early detection and management of
673diseases and reduce the risks experienced by at-risk
674populations.
675     (10)  "System changes" means altering standard activities,
676protocols, policies, processes, and structures carried out in
677population-based settings, such as schools, worksites, health
678care facilities, faith-based organizations, and the overall
679community, which promote and support new behaviors.
680     (11)  "Tertiary prevention" means an intervention that is
681directed at rehabilitating and minimizing the effects of disease
682in a chronically ill population.
683     (12)  "Wellness program" means a structured program that is
684designed or approved by the department to offer intervention
685activities on or off the worksite which help state and local
686government employees change certain behaviors or adopt healthy
687lifestyles.
688     Section 18.  Section 385.1022, Florida Statutes, is created
689to read:
690     385.1022  Chronic disease prevention and health promotion
691program.-
692     (1)  The department shall support the creation of public
693health programs at the state and community levels to reduce the
694incidence of mortality and morbidity from chronic diseases for
695which risk factors can be identified. Such risk factors include,
696but are not limited to, being overweight or obese, physical
697inactivity, poor diet and nutrition habits, sun exposure, poor
698oral hygiene, and other practices that are detrimental to
699health.
700     (2)  For any contracts or grants awarded pursuant to this
701chapter, the department may make advances in total or
702periodically for program startup or contracted services to other
703governmental entities and not-for-profit corporations. The
704amount advanced may not exceed the expected financial needs of
705the contractor or recipient during the initial 3 months of the
706contract. Any agreement that provides for advancements may
707contain a clause that permits the contractor or recipient to
708temporarily invest the proceeds, provided that any interest
709income shall be returned to the agency or applied against the
710agency's obligation to pay the contract amount.
711     Section 19.  Section 385.1023, Florida Statutes, is created
712to read:
713     385.1023  State-level programs for chronic disease
714prevention.-
715     (1)  The department shall create state-level programs that
716address preventable chronic disease risk factors, such as being
717overweight or obese, physical inactivity, poor diet and
718nutrition habits, sun exposure, poor oral hygiene, and other
719practices that are detrimental to health, in order to decrease
720the incidence of arthritis, cancer, diabetes, heart disease,
721lung disease, including chronic obstructive pulmonary disease
722and asthma, stroke, and other chronic diseases.
723     (2)  State-level programs shall include, but not be limited
724to:
725     (a)  Monitoring specific causal and behavioral risk factors
726that affect the health of residents of this state.
727     (b)  Analyzing data regarding chronic disease mortality and
728morbidity to track changes.
729     (c)  Promoting public awareness and increasing knowledge
730concerning the causes of chronic diseases, including the
731importance of early detection, diagnosis, and appropriate
732evidence-based prevention, management, and treatment strategies.
733     (d)  Disseminating educational materials and information
734concerning evidence-based results, available services, and
735pertinent new research findings and prevention strategies to
736patients, health insurers, health professionals, and the public.
737     (e)  Providing technical assistance using educational and
738training resources and services developed by organizations with
739the appropriate expertise and knowledge of chronic diseases.
740     (f)  Evaluating the quality and accessibility of existing
741community-based services for persons with chronic diseases.
742     (g)  Increasing awareness among state and local officials
743involved in health and human services, health professionals and
744providers, and policymakers regarding evidence-based chronic
745disease prevention, treatment strategies, and benefits for
746persons with chronic diseases.
747     (h)  Developing a partnership with state and local
748governments, voluntary health organizations, hospitals, health
749insurers, universities, medical centers, faith-based
750organizations, employer groups, private companies, and health
751care providers to address the issue of chronic diseases in this
752state.
753     (i)  Implementing and coordinating state-level policies in
754order to reduce the impact of chronic diseases.
755     (j)  Providing lasting improvements in the delivery of
756health care for individuals who have chronic diseases and their
757families, thus improving their quality of life while also
758containing health care costs.
759     (3)  The department shall prepare a biennial report on the
760status of chronic diseases, including current data regarding
761incidences of chronic disease in the state. The report shall be
762submitted to the Governor, the President of the Senate, and the
763Speaker of the House of Representatives by March 1 and shall
764include:
765     (a)  An analysis reviewing and forecasting the correlation
766of chronic diseases and emerging related issues, as determined
767by the state chronic disease report, to the direct and indirect
768financial costs to the state, which may include costs relating
769to health care, lost productivity, and a reduced quality of
770life.
771     (b)  The reporting of health disparities regarding
772incidences of chronic diseases among different segments of the
773population.
774     (c)  Recommendations supported by the data provided in the
775state chronic disease report.
776     Section 20.  Section 385.1035, Florida Statutes, is created
777to read:
778     385.1035  Community-level programs for chronic disease
779prevention and health promotion.-The department shall develop
780and implement a comprehensive, community-level program for
781chronic disease prevention and health promotion. The program
782shall be designed to reduce major behavioral risk factors
783associated with chronic diseases by enhancing knowledge, skills,
784motivation, and opportunities to enable individuals,
785organizations, health care providers, small businesses, health
786insurers, and communities to develop and maintain healthy
787lifestyles. A community-level chronic disease prevention and
788health promotion program shall include, but not be limited to:
789     (1)  The employment of skilled staff who are trained in
790public health, community health, or school health education to
791facilitate the operation of the program.
792     (2)  A process for soliciting community input into the
793planning, implementation, and evaluation processes.
794     (3)  The use of local and statewide data as a basis for
795decisionmaking and the development and prioritization of
796community-based interventions focused on the risk factors
797associated with chronic diseases.
798     (4)  The development and implementation of interventions
799and activities through community organizations, schools,
800worksites, faith-based organizations, and health-care settings.
801     (5)  The use of evidence-based interventions as well as
802best and promising practices.
803     (6)  The use of policies, systems, and environmental
804changes that support healthy behaviors in order to affect large
805segments of the population and encourage healthy choices.
806     (7)  The provision of counseling in nutrition, physical
807activity, the effects of tobacco use, hypertension, blood
808pressure control, and diabetes control, and other clinical
809prevention services.
810     Section 21.  Section 385.104, Florida Statutes, is created
811to read:
812     385.104  State Employee Wellness Interagency Council.-
813     (1)  The State Employee Wellness Interagency Council is
814created within the Department of Health for the purpose of
815developing policies to enhance the full implementation of
816employee wellness in state agencies. The council shall operate
817as a workgroup under the State Surgeon General.
818     (2)  The council shall be composed of representatives of no
819fewer than six agencies, including, but not limited to, the
820Departments of Health, Revenue, Education, and Management
821Services. The council shall include state agency representatives
822in leadership positions in the areas of human resources, risk
823assessment, or existing employee wellness programs. Council
824members shall be appointed in such a manner as to equitably
825represent the state agencies on the council. Not more than two
826members of the council may be from any one state agency.
827     (3)  Council members shall be nominated by the agency head
828and appointed by the State Surgeon General to 4-year terms,
829except that the initial terms shall be staggered, with three
830members appointed to 3-year terms and three members appointed to
8314-year terms.
832     (4)  A member's absence from three consecutive meetings
833shall result in his or her automatic removal from the council. A
834vacancy on the council shall be filled for the remainder of the
835unexpired term.
836     (5)  The council shall annually elect from its membership
837one member to serve as chair of the council and one member to
838serve as vice chair. The State Surgeon General shall serve as
839chair until an election is held.
840     (6)  The first meeting of the council shall be called by
841the chair not more than 60 days after the council members are
842appointed by the State Surgeon General. The council shall
843thereafter meet at least once quarterly and may meet more often
844as necessary. The department shall provide staff assistance to
845the council which shall include, but is not limited to, keeping
846records of the proceedings of the council and serving as
847custodian of all books, documents, and papers filed with the
848council.
849     (7)  A majority of the members of the council constitutes a
850quorum.
851     (8)  Service on the council shall be considered a part of a
852member's job duties and responsibilities.
853     (9)  The council shall:
854     (a)  Work to develop and implement policies that offer
855evidence-based wellness programs to employees of state agencies.
856     (b)  Work to encourage state employees to participate in
857wellness programs. The council may prepare informational
858programs and brochures for state agencies and employees.
859     (c)  In consultation with the department, develop standards
860and criteria for age-based and gender-based wellness programs.
861     (d)  Define employee wellness and establish the minimum
862elements of any employee wellness program and specify those
863activities that are prohibited.
864     Section 22.  Section 385.105, Florida Statutes, is created
865to read:
866     385.105  Physical activity, obesity prevention, nutrition,
867and other health-promotion services and wellness programs.-
868     (1)  PHYSICAL ACTIVITY.-The department shall:
869     (a)  Promote programs for people at every stage of their
870lives to increase physical fitness and encourage healthy
871behavior changes.
872     (b)  Work with school health advisory committees in each
873school district as established in s. 381.0056 to encourage the
874physical activity of students, staff, and teachers.
875     (c)  Develop public and private partnerships that allow the
876public to easily access recreational facilities and public land
877areas that are suitable for physical activity.
878     (d)  Work in collaboration with the Executive Office of the
879Governor and Volunteer Florida, Inc., to promote school
880initiatives, such as the Governor's Fitness Challenge.
881     (e)  Collaborate with the Department of Education in
882recognizing nationally accepted best practices for improving
883physical education in schools.
884     (2)  OBESITY PREVENTION.-The department shall promote
885healthy lifestyles to reduce the rate of obesity and encourage
886weight control and weight reduction through programs that are
887directed towards all residents of this state by:
888     (a)  Using all appropriate media to promote maximum public
889awareness of the latest research on healthy lifestyles and
890chronic diseases and disseminating relevant information relating
891to wellness, physical activity, and nutrition and the effect of
892these factors on chronic diseases and disabling conditions
893through a statewide clearinghouse.
894     (b)  Providing technical assistance, training, and
895resources on healthy lifestyles and chronic diseases to the
896public, health care providers, school districts, and other
897persons or entities, including faith-based organizations, that
898request such assistance to promote physical activity, nutrition,
899and healthy lifestyle programs.
900     (c)  Developing, implementing, and using all available
901research methods to collect data, including, but not limited to,
902population-specific data, and tracking the incidence and effects
903of weight gain, obesity, and related chronic diseases. All
904research conducted under this paragraph is subject to review and
905approval as required by the department's Institutional Review
906Board under s. 381.86.
907     (d)  Entering into partnerships with the Department of
908Education, local communities, school districts, and other
909entities to encourage schools in the state to promote activities
910during and after school to help students meet a minimum goal of
91130 minutes of physical fitness activities per day.
912     (e)  Entering into partnerships with the Department of
913Education, school districts, and the Florida Sports Foundation
914to develop programs recognizing the schools at which students
915demonstrate excellent physical fitness or fitness improvement.
916     (f)  Collaborating with other state agencies to develop
917policies and strategies for preventing and treating obesity,
918which shall be incorporated into programs administered by each
919agency and shall include promoting healthy lifestyles among the
920employees of each agency.
921     (g)  Advising, in accordance with s. 456.081, health care
922practitioners about the morbidity, mortality, and costs
923associated with being overweight or obese; informing
924practitioners of promising clinical practices for preventing and
925treating obesity; and encouraging practitioners to counsel their
926patients regarding the adoption of healthy lifestyles.
927     (h)  Maximizing all local, state, and federal funding
928sources, including seeking grants, public-private partnerships,
929and other mechanisms, to strengthen the department's programs
930that promote physical activity and nutrition.
931     (3)  NUTRITION.-The Office of Public Health Nutrition
932shall:
933     (a)  Promote the maintenance of optimal nutritional status
934in the state's population through activities, including, but not
935limited to:
936     1.  Nutrition screening and assessment and nutrition
937counseling, including nutrition therapy, followup, case
938management, and referrals, for persons who have medical
939conditions or nutrition risk factors and who receive health
940services through public health programs or through referrals
941from private health care providers or facilities.
942     2.  Nutrition education to assist residents of the state in
943achieving optimal health and preventing chronic disease.
944     3.  Consultative nutrition services to group facilities
945which promote the provision of safe and nutritionally adequate
946diets.
947     (b)  Monitor and conduct surveillance of the nutritional
948status of the state's population.
949     (c)  Conduct or support research or evaluations related to
950public health nutrition. All research conducted under this
951paragraph is subject to review and approval as required by the
952department's Institutional Review Board under s. 381.86.
953     (d)  Establish policies and standards for public health
954nutrition practices.
955     (e)  Promote interagency cooperation, professional
956education, and consultation.
957     (f)  Provide technical assistance and advise state
958agencies, private institutions, and local organizations
959regarding public health nutrition standards.
960     (g)  Work with the Department of Agriculture and Consumer
961Services, the Department of Education, and the Department of
962Management Services to further the use of the state's fresh
963produce in schools and encourage the development of community
964gardens. Nutritional services shall be available to eligible
965persons in accordance with eligibility criteria adopted by the
966department. The department shall provide by rule requirements
967for the service fees, when applicable, which may not exceed the
968department's actual costs.
969
970The department may adopt rules to administer this subsection.
971     (4)  OTHER HEALTH PROMOTION SERVICES.-The department shall:
972     (a)  Promote personal responsibility by encouraging
973residents of this state to be informed, follow health
974recommendations, seek medical consultations and health
975assessments, and comply with medical guidelines, including those
976that lead to earlier detection of chronic diseases, in order to
977prevent chronic diseases or slow the progression of established
978chronic diseases.
979     (b)  Promote regular health visits during a person's
980lifetime, including annual physical examinations that include
981measuring body mass index and vital signs, blood work,
982immunizations, screenings, and dental examinations, in order to
983reduce the financial, social, and personal burden of chronic
984disease.
985     (5)  WELLNESS PROGRAMS.-
986     (a)  Each state agency may conduct employee wellness
987programs in buildings and on lands owned or leased by the state.
988The department shall serve as a model for the development and
989implementation of employee wellness programs that may include
990physical fitness, healthy nutrition, self-management of disease,
991wellness and fitness education, and behavioral change elements.
992The department shall assist other state agencies in developing
993and implementing employee wellness programs. These programs
994shall use existing resources, facilities, and programs or
995resources procured through grant funding and donations that are
996obtained in accordance with state ethics and procurement
997policies, and shall provide equal access to any such programs,
998resources, and facilities to all state employees.
999     (b)  The department shall coordinate its efforts with the
1000Department of Management Services and other state agencies.
1001     (c)  Each state agency may establish an employee wellness
1002workgroup to design the agency's wellness program. The
1003department shall provide policy guidance and assist in
1004identifying effective wellness program strategies.
1005     (d)  The department shall provide by rule requirements for
1006nominal participation fees, when applicable, which may not
1007exceed the department's actual costs, collaboration with
1008businesses, and the procurement of equipment and incentives.
1009     Section 23.  Section 385.202, Florida Statutes, is amended
1010to read:
1011     385.202  Statewide cancer registry.-
1012     (1)  Each facility, laboratory, or practitioner licensed
1013under chapter 395, chapter 458, chapter 459, chapter 464,
1014chapter 483, or chapter 485, and each freestanding radiation
1015therapy center as defined in s. 408.07, shall report to the
1016department of Health such information, specified by the
1017department, by rule. The department may adopt rules regarding
1018reporting requirements for the statewide cancer registry, which
1019shall include the data required, the timeframe for reporting,
1020and those professionals who are responsible for ensuring
1021compliance with reporting requirements, which indicates
1022diagnosis, stage of disease, medical history, laboratory data,
1023tissue diagnosis, and radiation, surgical, or other methods of
1024diagnosis or treatment for each cancer diagnosed or treated by
1025the facility or center. Failure to comply with this requirement
1026may be cause for registration or licensure suspension or
1027revocation.
1028     (2)  The department shall establish, or cause to have
1029established, by contract with a recognized medical organization
1030in this state and its affiliated institutions, a statewide
1031cancer registry program to ensure that cancer reports required
1032under this section shall be maintained and available for use in
1033the course of public health surveillance and any study for the
1034purpose of reducing morbidity or mortality; and no liability of
1035any kind or character for damages or other relief shall arise or
1036be enforced against any facility, laboratory, or practitioner
1037hospital by reason of having provided such information or
1038material to the department.
1039     (3)  The department may adopt rules regarding the
1040establishment and operation of a statewide cancer registry
1041program.
1042     (4)(3)  The department or a contractual designee operating
1043the statewide cancer registry program required by this section
1044shall use or publish such said material only for the purpose of
1045public health surveillance and advancing medical research or
1046medical education in the interest of reducing morbidity or
1047mortality, except that a summary of such studies may be released
1048for general publication. Information which discloses or could
1049lead to the disclosure of the identity of any person whose
1050condition or treatment has been reported and studied shall be
1051confidential and exempt from the provisions of s. 119.07(1),
1052except that:
1053     (a)  Release may be made with the written consent of all
1054persons to whom the information applies;
1055     (b)  The department or a contractual designee may contact
1056individuals for the purpose of epidemiologic investigation and
1057monitoring, provided information that is confidential under this
1058section is not further disclosed; or
1059     (c)  The department may exchange personal data with any
1060other governmental agency or a contractual designee for the
1061purpose of public health surveillance and medical or scientific
1062research, if provided such governmental agency or contractual
1063designee does shall not further disclose information that is
1064confidential under this section.
1065     (5)(4)  Funds appropriated for this section shall be used
1066for establishing, administering, compiling, processing, and
1067providing biometric and statistical analyses to the reporting
1068facilities, laboratories, and practitioners. Funds may also be
1069used to ensure the quality and accuracy of the information
1070reported and to provide management information to the reporting
1071facilities, laboratories, and practitioners.
1072     (6)(5)  The department may adopt rules regarding the
1073classifications of, by rule, classify facilities, laboratories,
1074and practitioners that are responsible for making reports to the
1075statewide cancer registry, the content and frequency of the
1076reports, and the penalty for failure to comply with these
1077requirements for purposes of reports made to the cancer registry
1078and specify the content and frequency of the reports. In
1079classifying facilities, the department shall exempt certain
1080facilities from reporting cancer information that was previously
1081reported to the department or retrieved from existing state
1082reports made to the department or the Agency for Health Care
1083Administration. The provisions of this section shall not apply
1084to any facility whose primary function is to provide psychiatric
1085care to its patients.
1086     (7)  Notwithstanding subsection (1), each facility,
1087laboratory, and practitioner that reports cancer cases to the
1088department shall make their records available for onsite review
1089by the department or its authorized representative.
1090     Section 24.  Subsection (3) of section 385.203, Florida
1091Statutes, is amended to read:
1092     385.203  Diabetes Advisory Council; creation; function;
1093membership.-
1094     (3)  The council shall be composed of 26 25 citizens of the
1095state who have knowledge of, or work in, the area of diabetes
1096mellitus as follows:
1097     (a)  Five interested citizens, three of whom are affected
1098by diabetes.
1099     (b)  Twenty-one Twenty members, who must include one
1100representative from each of the following areas: nursing with
1101diabetes-educator certification; dietary with diabetes educator
1102certification; podiatry; ophthalmology or optometry; psychology;
1103pharmacy; adult endocrinology; pediatric endocrinology; the
1104American Diabetes Association (ADA); the Juvenile Diabetes
1105Foundation (JDF); the Florida Academy of Family Physicians; a
1106community health center; a county health department; an American
1107Diabetes Association recognized community education program;
1108each medical school in the state; an osteopathic medical school;
1109the insurance industry; a Children's Medical Services diabetes
1110regional program; and an employer.
1111     (c)  One or more representatives from the Department of
1112Health, who shall serve on the council as ex officio members.
1113     Section 25.  Section 385.206, Florida Statutes, is amended
1114to read:
1115     385.206  Pediatric Hematology-oncology care Center
1116Program.-
1117     (1)  DEFINITIONS.-As used in this section, the term:
1118     (a)  "Department" means the Department of Health.
1119     (b)  "Hematology" means the study, diagnosis, and treatment
1120of blood and blood-forming tissues.
1121     (c)  "Oncology" means the study, diagnosis, and treatment
1122of malignant neoplasms or cancer.
1123     (d)  "Hemophilia" or "other hemostatic disorder" means a
1124bleeding disorder resulting from a genetic abnormality of
1125mechanisms related to the control of bleeding.
1126     (e)  "Sickle-cell anemia or other hemoglobinopathy" means
1127an hereditary, chronic disease caused by an abnormal type of
1128hemoglobin.
1129     (f)  "Patient" means a person under the age of 21 who is in
1130need of hematologic-oncologic services and who is enrolled in
1131the Children's Medical Services Network declared medically and
1132financially eligible by the department; or a person who received
1133such services prior to age 21 and who requires long-term
1134monitoring and evaluation to ascertain the sequelae and the
1135effectiveness of treatment.
1136     (g)  "Center" means a facility designated by the department
1137as having a program specifically designed to provide a full
1138range of medical and specialty services to patients with
1139hematologic and oncologic disorders.
1140     (2)  PEDIATRIC HEMATOLOGY-ONCOLOGY CARE CENTER PROGRAM;
1141AUTHORITY.-The department may designate is authorized to make
1142grants and reimbursements to designated centers and provide
1143funding to establish and maintain programs for the care of
1144patients with hematologic and oncologic disorders. Program
1145administration costs shall be paid by the department from funds
1146appropriated for this purpose.
1147     (3)  FUNDING; CONTRACT REQUIREMENTS GRANT AGREEMENTS;
1148CONDITIONS.-
1149     (a)  Funding provided A grant made under this section shall
1150be pursuant to a contract contractual agreement made between a
1151center and the department. Each contract agreement shall provide
1152that patients will receive services specified types of treatment
1153and care from the center without additional charge to the
1154patients or their parents or guardians. Grants shall be
1155disbursed in accordance with conditions set forth in the
1156disbursement guidelines.
1157     (4)  GRANT DISBURSEMENTS AND SPECIAL DISBURSEMENTS FOR
1158LOCAL PROGRAMS.-
1159     (b)(a)  Funding may be provided Grant disbursements may be
1160made to centers that which meet the following criteria:
1161     1.  The personnel shall include at least one board-
1162certified pediatric hematologist-oncologist, at least one board-
1163certified pediatric surgeon, at least one board-certified
1164radiotherapist, and at least one board-certified pathologist.
1165     2.  As approved by the department, The center shall
1166actively participate in a national children's cancer study
1167group, maintain a pediatric tumor registry, have a
1168multidisciplinary pediatric tumor board, and meet other
1169guidelines for development, including, but not limited to,
1170guidelines from such organizations as the American Academy of
1171Pediatrics and the American Pediatric Surgical Association.
1172     (b)  Programs shall also be established to provide care to
1173hematology-oncology patients within each district of the
1174department. The guidelines for local programs shall be
1175formulated by the department. Special disbursements may be made
1176by the program office to centers for educational programs
1177designed for the districts of the department. These programs may
1178include teaching total supportive care of the dying patient and
1179his or her family, home therapy to hemophiliacs and patients
1180with other hemostatic disorders, and screening and counseling
1181for patients with sickle-cell anemia or other
1182hemoglobinopathies.
1183     (4)(5)  PROGRAM AND PEER REVIEW.-The department shall
1184evaluate at least annually during the grant period the services
1185rendered by the centers and the districts of the department.
1186Data from the centers and other sources relating to pediatric
1187cancer shall be reviewed annually by the Florida Association of
1188Pediatric Tumor Programs, Inc.; and a written report with
1189recommendations shall be made to the department. This database
1190will be available to the department for program planning and
1191quality assurance initiatives formulation of its annual program
1192and financial evaluation report. A portion of the funds
1193appropriated for this section may be used to provide statewide
1194consultation, supervision, and evaluation of the programs of the
1195centers, as well as central program office support personnel.
1196     Section 26.  Paragraph (g) of subsection (2) and subsection
1197(7) of section 385.207, Florida Statutes, are amended to read:
1198     385.207  Care and assistance of persons with epilepsy;
1199establishment of programs in epilepsy control.-
1200     (2)  The Department of Health shall:
1201     (g)  Continue current programs and develop cooperative
1202programs and services designed to enhance the vocational
1203rehabilitation of epilepsy clients, including the current jobs
1204programs. The department shall, as part of its contract with a
1205provider of epilepsy services, collect information regarding the
1206number of clients served, the outcomes reached, the expenses
1207incurred, and the fees collected by such providers for the
1208provision of services keep and make this information available
1209to the Governor and the Legislature upon request information
1210regarding the number of clients served, the outcome reached, and
1211the expense incurred by such programs and services.
1212     (7)  The department shall limit total administrative
1213expenditures from the Epilepsy Services Trust Fund to 5 percent
1214of annual receipts.
1215     Section 27.  Paragraphs (b), (d), and (g) of subsection (2)
1216and paragraph (b) of subsection (5) of section 385.210, Florida
1217Statutes, are amended to read:
1218     385.210  Arthritis prevention and education.-
1219     (2)  LEGISLATIVE FINDINGS.-The Legislature finds the
1220following:
1221     (b)  Arthritis is the leading cause of disability in the
1222United States, limiting daily activities for more than 7 million
1223citizens.
1224     (d)  There are enormous economic and social costs
1225associated with treating arthritis and its complications; the
1226economic costs are estimated at over $116 billion (1997)
1227annually in the United States.
1228     (g)  The National Arthritis Foundation, the CDC Centers for
1229Disease Control and Prevention, and the Association of State and
1230Territorial Health Officials have led the development of a
1231public health strategy, the National Arthritis Action Plan, to
1232respond to this challenge.
1233     (5)  FUNDING.-
1234     (b)  The State Surgeon General may shall seek any federal
1235waiver or waivers that may be necessary to maximize funds from
1236the Federal Government to implement this program.
1237     Section 28.  Section 385.301, Florida Statutes, is created
1238to read:
1239     385.301  Rulemaking authority.-The department may adopt
1240rules pursuant to ss. 120.536(1) and 120.54 to implement the
1241provisions of this chapter.
1242     Section 29.  Section 385.401, Florida Statutes, is created
1243to read:
1244     385.401  Direct-support organization.-
1245     (1)  DIRECT-SUPPORT ORGANIZATION ESTABLISHED.-The
1246Department of Health may establish a direct-support organization
1247to provide assistance, funding, and support for the department
1248in carrying out the specific mission of promoting a range of
1249collaborations to prevent and alleviate the effects of chronic
1250disease upon written approval by the State Surgeon General. This
1251section governs the creation, use, powers, and duties of the
1252direct-support organization. Such direct-support organization is
1253an organization that is:
1254     (a)  A Florida corporation, not for profit, incorporated
1255under chapter 617, exempted from filing fees, and approved by
1256the Department of State.
1257     (b)  Organized and operated to conduct programs and
1258activities; to initiate developmental projects; to raise funds;
1259to request and receive grants, gifts, and bequests of moneys; to
1260acquire, receive, hold, invest, and administer in its own name
1261securities, funds, or property; and to make expenditures to or
1262for the direct or indirect benefit of the state public health
1263system for promoting a range of collaborations to prevent and
1264alleviate the effects of chronic disease through the department
1265or its individual county health departments and the health care
1266system.
1267     (c)  Determined by the department to be operating in a
1268manner consistent with the priority issues and objectives of the
1269department and in the best interest of the state.
1270     (d)  Approved in writing by the State Surgeon General to
1271operate for the direct or indirect benefit of the department or
1272its individual county health departments. This approval shall be
1273in a form determined by the department.
1274     (2)  BOARD OF DIRECTORS.-The direct-support organization
1275shall be governed by a board of directors.
1276     (a)  The board of directors shall consist of at least seven
1277members, five of whom shall be appointed by the State Surgeon
1278General, one of whom shall be appointed by the President of the
1279Senate, and one of whom shall be appointed by the Speaker of the
1280House of Representatives. Networks and partnerships in the state
1281that are involved in issues related to chronic disease may
1282recommend nominees to the State Surgeon General.
1283     (b)  The term of office of the board members shall be 3
1284years, except that the terms of the initial appointees shall be
1285for 1 year, 2 years, or 3 years in order to achieve staggered
1286terms. A member may be reappointed when his or her term expires.
1287The State Surgeon General or his or her designee shall serve as
1288an ex officio member of the board.
1289     (c)  Members must be current residents of this state. A
1290majority of the board members must be highly knowledgeable about
1291the department, its service personnel, and its missions. The
1292board shall include representatives of county government, the
1293health care industry, the medical community, and other
1294components of the public health system. The State Surgeon
1295General may remove any member of the board for cause and with
1296the approval of a majority of the members. The State Surgeon
1297General shall appoint a replacement for any vacancy that occurs.
1298     (3)  USE OF PROPERTY.-
1299     (a)  The department and each county health department may
1300allow, without charge, the use of the department's fixed
1301property and facilities within the state public health system by
1302the direct-support organization, subject to this section. Use of
1303the fixed property and facilities by the direct-support
1304organization may not interfere with use of the fixed property
1305and facilities by the department's clients or staff.
1306     (b)  The department may not allow the use of its fixed
1307property and facilities by a direct-support organization that is
1308organized under this section and does not provide equal
1309employment opportunities to all persons regardless of race,
1310color, national origin, gender, age, or religion.
1311     (4)  DIRECTIVES.-The direct-support organization must
1312comply with directives and requirements established by the
1313sources of its funding.
1314     (5)  ANNUAL BUDGETS AND REPORTS.-
1315     (a)  The fiscal year of the direct-support organization
1316shall begin on July 1 of each year and end on June 30 of the
1317following year.
1318     (b)  The direct-support organization shall submit to the
1319department its federal Internal Revenue Service Application for
1320Recognition of Exemption form and its federal Internal Revenue
1321Service Return of Organization Exempt from Income Tax form.
1322     (c)  By January 15th of each year, the direct-support
1323organization shall submit to the Governor, the President of the
1324Senate, and the Speaker of the House of Representative a report
1325describing the progress of the organization in meeting the goals
1326of its mission, making recommendations that further its purpose,
1327and providing an audit of its expenditures.
1328     (6)  ANNUAL AUDIT.-The direct-support organization shall
1329provide for an annual financial audit in accordance with s.
1330215.981.
1331     Section 30.  Subsection (9) of section 409.904, Florida
1332Statutes, is amended to read:
1333     409.904  Optional payments for eligible persons.-The agency
1334may make payments for medical assistance and related services on
1335behalf of the following persons who are determined to be
1336eligible subject to the income, assets, and categorical
1337eligibility tests set forth in federal and state law. Payment on
1338behalf of these Medicaid eligible persons is subject to the
1339availability of moneys and any limitations established by the
1340General Appropriations Act or chapter 216.
1341     (9)  Eligible women with incomes at or below 200 percent of
1342the federal poverty level and under age 65, for cancer treatment
1343pursuant to the federal Breast and Cervical Cancer Prevention
1344and Treatment Act of 2000, screened through the Mary Brogan
1345Breast and Cervical Cancer Early Detection Program established
1346under s. 385.20253 s. 381.93.
1347     Section 31.  This act shall take effect July 1, 2010.


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