HB 0913CS


1The Committee on Health Care recommends the following:
3     Committee Substitute
4     Remove the entire bill and insert:
A bill to be entitled
6An act relating to public health care; amending s.
7381.0012, F.S.; expanding the environmental health
8enforcement authority of the Department of Health;
9authorizing the department to issue citations or order
10payment of fines; providing requirements and limitations;
11providing a criminal penalty; providing for deposit and
12use of fines; amending s. 381.004, F.S.; providing
13additional criteria for release of HIV preliminary test
14results; amending s. 381.006, F.S.; establishing
15permitting procedures for group care facilities; providing
16requirements and limitations; providing for fees;
17providing fee exemptions for foster homes and certain
18homes for persons with developmental disabilities;
19providing fee limitations; providing authority to the
20department to take adverse action on permits under certain
21circumstances; amending s. 381.0065, F.S.; modifying
22standards for rulemaking applicable to regulation of
23onsite sewage treatment and disposal systems; revising
24research award qualifications; providing for an extended
25right of entry; amending s. 381.0101, F.S.; revising
26definitions; revising environmental health professional
27certification requirements; clarifying exemptions;
28creating s. 381.104, F.S.; creating an employee health and
29wellness program; providing requirements; authorizing
30state agencies to undertake certain activities relating to
31agency resources for program purposes; requiring each
32participating agency to make an annual report; providing
33duties of the department; amending s. 384.25, F.S.;
34revising reporting requirements for sexually transmissible
35diseases; authorizing the department to adopt rules;
36amending s. 384.31, F.S.; revising sexually transmissible
37disease testing requirements for pregnant women; providing
38notice requirements; creating s. 385.104, F.S.;
39establishing the Health Promotion and Health Education
40Statewide Initiative for certain purposes; providing
41requirements; authorizing the department to award funding
42to county health departments for certain purposes;
43providing funding requirements; providing participation
44requirements for county health departments; creating s.
45458.3215, F.S.; providing for reactivation of licenses of
46certain physicians for certain limited purposes; providing
47for a reactivation fee; amending s. 945.601, F.S.;
48revising a cross reference, to conform; creating s.
49945.6038, F.S.; authorizing the State of Florida
50Correctional Medical Authority to enter into agreements
51with other state agencies to provide additional medical
52services; providing a limitation; providing an effective
55Be It Enacted by the Legislature of the State of Florida:
57     Section 1.  Subsections (6) and (7) are added to section
58381.0012, Florida Statutes, to read:
59     381.0012  Enforcement authority.--
60     (6)  When a violation of s. 386.01, s. 386.041, or
61environmental health rules adopted under this chapter occurs,
62and such violation is enforceable by administrative or civil
63remedy or is a second degree misdemeanor, the department may
64issue a citation that contains an order of correction, an order
65to pay a fine, or both. A citation issued under this subsection
66constitutes a notice of proposed agency action.
67     (a)  Citations must be in writing and must describe the
68particular nature of the violation, including specific reference
69to the provision of statute or rule allegedly violated.
70     (b)  The fines imposed may not exceed $500 for each
71violation. Each day constitutes a separate violation for which a
72citation may be issued.
73     (c)  The citing official shall inform the recipient, by
74written notice pursuant to ss. 120.569 and 120.57, of the right
75to an administrative hearing. The citation must contain a
76conspicuous statement that failure to pay the fine within the
77allotted time, or failure to appear to contest the citation
78after having requested a hearing, constitutes a waiver of the
79right to contest the citation.
80     (d)  The department may reduce or waive the fine imposed by
81the citation after giving due consideration to such factors as
82the gravity of the violation, the good faith of the person who
83has allegedly committed the violation, and the person's history
84of previous violations, including violations for which
85enforcement actions were taken under this section or other
86provisions of law.
87     (e)  Any person who willfully refuses to sign and accept a
88citation issued by the department commits a misdemeanor of the
89second degree, punishable as provided in s. 775.082 or s.
91     (f)  The department shall deposit all fines collected under
92the authority of this subsection in the County Health Department
93Trust Fund for use in the environmental health program under
94which the fine was issued and shall use such fines to improve
95the respective programs or to provide training to the regulated
96industry and department staff working in such programs.
97     (g)  The provisions of this subsection are an alternative
98means of enforcing environmental health requirements which does
99not prohibit the department from using other means of
100enforcement. However, the department shall use only one method
101of enforcement for a single violation.
102     (7)  The department may use positive means of enforcement
103to ensure compliance with environmental health requirements
104specified in this chapter, ss. 386.01 and 386.041, or
105environmental health rules adopted under the authority of this
106chapter. Such means of enforcement may include requiring
107attendance at training courses applicable to the violations
108committed and requiring the use of best management practices
109currently used or recognized by the appropriate regulated
110industry or governmental agency.
111     Section 2.  Paragraph (d) of subsection (3) of section
112381.004, Florida Statutes, is amended to read:
113     381.004  HIV testing.--
116     (d)  No test result shall be determined as positive, and no
117positive test result shall be revealed to any person, without
118corroborating or confirmatory tests being conducted except in
119the following situations:
120     1.  Preliminary test results may be released to licensed
121physicians or the medical or nonmedical personnel subject to the
122significant exposure for purposes of subparagraphs (h)10., 11.,
123and 12.
124     2.  Preliminary test results may be released to health care
125providers and to the person tested when decisions about medical
126care or treatment of, or recommendation to, the person tested
127and, in the case of an intrapartum or postpartum woman, when
128care, treatment, or recommendations regarding her newborn,
129cannot await the results of confirmatory testing. Positive
130preliminary HIV test results shall not be characterized to the
131patient as a diagnosis of HIV infection. Justification for the
132use of preliminary test results must be documented in the
133medical record by the health care provider who ordered the test.
134This subparagraph does not authorize the release of preliminary
135test results for the purpose of routine identification of HIV-
136infected individuals or when HIV testing is incidental to the
137preliminary diagnosis or care of a patient. Corroborating or
138confirmatory testing must be conducted as followup to a positive
139preliminary test. Results shall be communicated to the patient
140according to statute regardless of the outcome. Except as
141provided in this section, test results are confidential and
142exempt from the provisions of s. 119.07(1).
143     3.  Positive rapid test results are considered preliminary
144and may be released in accordance with the manufacturer's
145instructions as approved by the United States Food and Drug
146Administration. Positive rapid test results require confirmatory
147testing for diagnosis and reporting of HIV infection.
148     Section 3.  Subsection (16) of section 381.006, Florida
149Statutes, is amended to read:
150     381.006  Environmental health.--The department shall
151conduct an environmental health program as part of fulfilling
152the state's public health mission. The purpose of this program
153is to detect and prevent disease caused by natural and manmade
154factors in the environment. The environmental health program
155shall include, but not be limited to:
156     (16)  A group care facilities group-care-facilities
157function, where a group care group-care facility means any
158public or private school, housing, building or buildings,
159section of a building, or distinct part of a building or other
160place, whether operated for profit or not, which undertakes,
161through its ownership or management, to provide one or more
162personal services, care, protection, and supervision to persons
163who require such services and who are not related to the owner
164or administrator. The department may adopt rules necessary to
165protect the health and safety of residents, staff, and patrons
166of group care group-care facilities, such as child care
167facilities, family day care day-care homes, assisted living
168assisted-living facilities, adult day care day-care centers,
169adult family-care homes, hospices, residential treatment
170facilities, crisis stabilization crisis-stabilization units,
171pediatric extended care extended-care centers, intermediate care
172intermediate-care facilities for the developmentally disabled,
173group care group-care homes, and, jointly with the Department of
174Education, private and public schools. These rules may include
175definitions of terms; provisions relating to operation and
176maintenance of facilities, buildings, grounds, equipment,
177furnishings, and occupant-space requirements; lighting; heating,
178cooling, and ventilation; food service; water supply and
179plumbing; sewage; sanitary facilities; insect and rodent
180control; garbage; safety; personnel health, hygiene, and work
181practices; permits and fees; and other matters the department
182finds are appropriate or necessary to protect the safety and
183health of the residents, staff, or patrons. The department may
184not adopt rules that conflict with rules adopted by the
185licensing or certifying agency. The department may enter and
186inspect at reasonable hours to determine compliance with
187applicable statutes or rules. In addition to any sanctions that
188the department may impose for violations of rules adopted under
189this section, the department shall also report such violations
190to any agency responsible for licensing or certifying the group
191care group-care facility. The licensing or certifying agency may
192also impose any sanction based solely on the findings of the
194     (a)  Each group care facility regulated under this section
195shall obtain a permit from the department annually. Group care
196facility permits shall expire annually and shall not be
197transferable from one place or individual to another. An annual
198application for permit renewal shall not be required. In new
199facilities, or when the ownership, control, address, or name of
200a group care facility is changed, the owner, or the owner's
201designee, shall apply to the department for issuance of a permit
202in the manner prescribed by the department.
203     (b)  The department shall establish procedures for the
204issuance and annual renewal of permits and shall establish
205annual permit and renewal fees by rule in an amount necessary to
206cover the expenses of administering this section. Effective
207October 1, 2004, and until such fees are established by rule,
208the annual permit fee shall be as follows:
209     1.  Nonresidential facilities, including, but not limited
210to, child care centers, public schools, and private schools,
211shall pay an annual fee based on a rate of $3.50 per student for
212the maximum authorized capacity. The total permit fee shall not
213be less than $110 nor more than $300.
214     2.  Residential facilities, including, but not limited to,
215assisted living facilities, group homes, residential treatment
216facilities, and other residential facilities, shall pay an
217annual fee based on a rate of $15.50 per bed for the maximum
218authorized capacity. The total permit fee shall not be less than
219$110 nor more than $600, except for adult family care homes,
220which shall pay a flat fee of $60. Foster homes and homes of
221three or fewer beds for persons with developmental disabilities
222shall be exempt from payment of such fees.
223     (c)  The annual permit and renewal fees established and
224adopted by rule shall not be less than $60 nor more than $600
225per group care facility. Foster homes and homes of three or
226fewer beds for persons with developmental disabilities shall be
227exempt from payment of such fees.
228     (d)  Permit fees shall be prorated quarterly to reflect the
229actual number of quarters per calendar year the permit is valid.
230     (e)  The department may refuse to issue a permit to or
231renew a permit for any facility that is not constructed or
232maintained in accordance with the rules of the department. The
233department may cancel, revoke, or suspend a permit to operate a
234group care facility if the permittee:
235     1.  Fails to pay any fee required by this section;
236     2.  Obtains or attempts to obtain a permit by fraud; or
237     3.  Violates a provision of this section.
239The department may adopt rules to carry out the provisions of
240this section.
241     Section 4.  Paragraphs (a) and (j) of subsection (3) of
242section 381.0065, Florida Statutes, are amended, and paragraph
243(c) is added to subsection (5) of said section, to read:
244     381.0065  Onsite sewage treatment and disposal systems;
247department shall:
248     (a)  Adopt rules to administer ss. 381.0065-381.0067,
249including definitions that are consistent with the definitions
250in this section, decreases to setback requirements where no
251health hazard exists, increases for the lot-flow allowance for
252performance-based systems, requirements for separation from
253water table elevation during the wettest season, requirements
254for the design and construction of any component part of an
255onsite sewage treatment and disposal system, application and
256permit requirements for persons who maintain an onsite sewage
257treatment and disposal system, requirements for maintenance and
258service agreements for aerobic treatment units and performance-
259based treatment systems, and recommended standards, including
260disclosure requirements, for voluntary system inspections to be
261performed by individuals who are authorized by law to perform
262such inspections and who shall inform a person having ownership,
263control, or use of an onsite sewage treatment and disposal
264system of the inspection standards and of that person's
265authority to request an inspection based on all or part of the
266standards, and requirements for implementation of the United
267States Environmental Protection Agency's voluntary national
268guidelines for management of onsite and clustered or
269decentralized wastewater treatment systems.
270     (j)  Supervise research on, demonstration of, and training
271on the performance, environmental impact, and public health
272impact of onsite sewage treatment and disposal systems within
273this state. Research fees collected under s. 381.0066(2)(k) must
274be used to develop and fund hands-on training centers designed
275to provide practical information about onsite sewage treatment
276and disposal systems to septic tank contractors, master septic
277tank contractors, contractors, inspectors, engineers, and the
278public and must also be used to fund research projects which
279focus on improvements of onsite sewage treatment and disposal
280systems, including use of performance-based standards and
281reduction of environmental impact. Research projects shall be
282initially approved by the technical advisory panel and shall be
283applicable to and reflect the soil conditions specific to
284Florida. Such projects shall be awarded through competitive
285negotiation, using the procedures provided in s. 287.055, to
286public or private entities that have experience in onsite sewage
287treatment and disposal systems in Florida and that are
288principally located in Florida. Research projects shall not be
289awarded to firms or entities that employ or are associated with
290persons who serve on either the technical advisory panel or the
291research review and advisory committee.
293     (c)  Department personnel may enter the premises of others
294when necessary to conduct site evaluations and inspections
295relating to the permitting of onsite sewage treatment and
296disposal systems. Such entry does not constitute trespass, and
297department personnel making such entry are not subject to arrest
298or to a civil action by reason of such entry. This paragraph
299does not authorize a department employee to destroy, injure,
300damage, or move anything on premises of another without the
301written permission of the landowner.
302     Section 5.  Subsections (1), (2), (3), and (6) and
303paragraph (a) of subsection (5) of section 381.0101, Florida
304Statutes, are amended to read:
305     381.0101  Environmental health professionals.--
306     (1)  LEGISLATIVE INTENT.--Persons responsible for providing
307technical and scientific evaluations of environmental health and
308sanitary conditions in business establishments and communities
309throughout the state may create a danger to the public health if
310they are not skilled or competent to perform such evaluations.
311The public relies on the judgment of environmental health
312professionals employed by both government agencies and private
313industries to assure them that environmental hazards are
314identified and removed before they endanger the health or safety
315of the public. The purpose of this section is to assure the
316public that persons specifically responsible for performing
317environmental health and sanitary evaluations have been
318certified by examination as competent to perform such work.
319     (2)  DEFINITIONS.--As used in this section:
320     (a)  "Accredited" means recognized by the American Council
321on Education as meeting acceptable levels of quality and
323     (b)(a)  "Board" means the Environmental Health
324Professionals Advisory Board.
325     (c)(b)  "Department" means the Department of Health.
326     (d)(c)  "Environmental health" means that segment of public
327health work which deals with the examination of those factors in
328the human environment which may impact adversely on the health
329status of an individual or the public.
330     (e)(d)  "Environmental health professional" means a person
331who is employed or assigned the responsibility for assessing the
332environmental health or sanitary conditions, as defined by the
333department, within a building, on an individual's property, or
334within the community at large, and who has the knowledge,
335skills, and abilities to carry out these tasks. Environmental
336health professionals may be either field, supervisory, or
337administrative staff members.
338     (f)(e)  "Certified" means a person who has displayed
339competency to perform evaluations of environmental or sanitary
340conditions through examination.
341     (g)(f)  "Registered sanitarian," "R.S.," "Registered
342Environmental Health Specialist," or "R.E.H.S." means a person
343who has been certified by either the National Environmental
344Health Association or the Florida Environmental Health
345Association as knowledgeable in the environmental health
347     (h)(g)  "Primary environmental health program" means those
348programs determined by the department to be essential for
349providing basic environmental and sanitary protection to the
350public. These programs shall be established by rule and, at a
351minimum, these programs shall include food protection program
352work and onsite sewage treatment and disposal systems program
353work system evaluations.
354     (3)  CERTIFICATION REQUIRED.--No person shall perform
355environmental health or sanitary evaluations in any primary
356program area of environmental health without being certified by
357the department as competent to perform such evaluations. The
358requirements of this section shall not be mandatory for persons
359performing inspections of public or retail food service
360establishments licensed under chapter 500 or chapter 509.
361     (5)  STANDARDS FOR CERTIFICATION.--The department shall
362adopt rules that establish definitions of terms and minimum
363standards of education, training, or experience for those
364persons subject to this section. The rules must also address the
365process for application, examination, issuance, expiration, and
366renewal of certification and ethical standards of practice for
367the profession.
368     (a)  Persons employed as environmental health professionals
369shall exhibit a knowledge of rules and principles of
370environmental and public health law in Florida through
371examination. A person may not conduct environmental health
372evaluations in a primary program area unless he or she is
373currently certified in that program area or works under the
374direct supervision, during his or her initial probationary
375period for that position, of a certified environmental health
377     1.  All persons who begin employment in a primary
378environmental health program on or after September 21, 1994,
379must be certified in that program within the initial
380probationary period for that position 6 months after employment.
381     2.  Persons employed in the primary environmental health
382programs program of a food protection program or an onsite
383sewage treatment and disposal systems system prior to September
38421, 1994, shall be considered certified while employed in that
385position and shall be required to adhere to any professional
386standards established by the department pursuant to paragraph
387(b), complete any continuing education requirements imposed
388under paragraph (d), and pay the certificate renewal fee imposed
389under subsection (7).
390     3.  Persons employed in the primary environmental health
391programs program of a food protection program or an onsite
392sewage treatment and disposal systems system prior to September
39321, 1994, who change positions or program areas and transfer
394into another primary environmental health program area on or
395after September 21, 1994, must be certified by examination in
396that program within 6 months after such transfer, except that
397they will not be required to possess the college degree required
398under paragraph (e).
399     4.  Registered sanitarians shall be considered certified
400and shall be required to adhere to any professional standards
401established by the department pursuant to paragraph (b).
402     (6)  EXEMPTIONS.--A person who conducts primary
403environmental evaluation activities and maintains a current
404registration or certification from another state agency which
405examined the person's knowledge of the primary program area and
406requires comparable continuing education to maintain the
407certificate shall not be required to be certified by this
408section. Examples of persons not subject to certification are
409physicians, registered dietitians, certified laboratory
410personnel, and nurses.
411     Section 6.  Section 381.104, Florida Statutes, is created
412to read:
413     381.104  Employee health and wellness program.--
414     (1)  Each state agency may allocate, from existing
415resources, the necessary funding and facilities for the
416development and maintenance of an employee health and wellness
417program and may seek additional funding from other sources to
418support the program for the benefit of the agency's employees.
419     (2)  Each state agency may dedicate resources to develop
420and coordinate an employee health and wellness program or
421arrange to cooperate with other agencies within such agency's
422geographic proximity for program coordination, including
423providers of state employee benefits.
424     (3)  Each state agency electing to participate shall
425establish an employee health and wellness coordinator and
426advisory committee to guide the development of an operational
427plan, including the collection of data and development of goals
428and objectives, and to oversee program evaluation and use of any
429agency-allocated funds.
430     (4)  Each state agency may conduct and dedicate resources
431toward an employee needs assessment to ascertain the health-and-
432wellness-related needs of its employees.
433     (5)  Each state agency may establish policies that allow
434employees no more than 30 minutes of work time three times each
435week, as individual workload allows, to use for the purpose of
436engaging in health and wellness activities which may include
437physical activity, stress reduction, tobacco cessation, personal
438training, nutrition counseling, or weight reduction and control.
439Such 30-minute periods may be used to modify the start or end of
440the workday or to extend the lunch hour.
441     (6)  Each state agency shall use an employee health and
442wellness activity agreement form, developed by the Department of
443Health, to be completed by the employee, signed by both the
444employee and the employee's immediate supervisor, and kept in
445the employee's personnel file prior to the employee's
446participation in any activity. It is the responsibility of the
447employee to complete the form and submit it to the personnel
448office. Any change to the employee's activities requires
449submission of a revised form. An employee found to be in
450violation of the submitted agreement form is not allowed further
451participation in the program.
452     (7)  Each state agency may designate up to 1 hour each
453month for the purpose of providing inservice health and wellness
454training for its employees.
455     (8)  Each state agency may use electronic mail and other
456communication systems to promote the agency's employee health
457and wellness activities.
458     (9)  Each state agency may, and is encouraged to:
459     (a)  Enter into an agreement or contract with other public
460or private entities to collaborate or participate jointly in
461health or wellness education or activity programs.
462     (b)  Implement health education activities that focus on
463skill development and lifestyle behavior change along with
464information dissemination and awareness building, preferably
465tailored to the employees' interests and needs.
466     (c)  Review and offer recommendations to agency leadership
467on environmental and social support policies that pertain to
468improving the health of employees.
469     (d)  Link the employee health and wellness program to other
470programs such as the employee assistance program and other
471related programs to help employees balance work and family.
472     (e)  Offer free, low-cost, or employee-fee-based programs
473on site, including the designation of rooms for the express
474purpose of physical activity, nutrition, stress reduction, and
475weight control activities. Participating agencies with
476established employee health and wellness programs may purchase
477exercise equipment to be used in the room designated for this
479     (10)  Each state agency that develops and implements an
480employee health and wellness program shall include and document
481an evaluation and improvement process in an annual report to
482help enhance the program's efficiency and effectiveness. The
483annual report shall be submitted to the Department of Health on
484July 1 of each year. Agencies shall use an annual report
485template provided by the Department of Health to ensure
486consistency in the presentation of data and other evaluation
488     (11)  The Department of Health shall provide employee
489health and wellness model program guidelines and ongoing
490technical assistance to other state agencies to assist in the
491development of each agency's employee health and wellness
493     Section 7.  Section 384.25, Florida Statutes, is amended to
495     384.25  Reporting required.--
496     (1)  Each person who makes a diagnosis of or treats a
497person with a sexually transmissible disease, including, but not
498limited to, HIV and AIDS, and each laboratory that performs a
499test for a sexually transmissible disease, including, but not
500limited to, HIV, which concludes with a positive result shall
501report such facts as may be required by the department by rule,
502within a time period as specified by rule of the department, but
503in no case to exceed 2 weeks.
504     (a)(2)  The department shall adopt rules specifying the
505information required in and a maximum minimum time period for
506reporting a sexually transmissible disease, including, but not
507limited to, HIV and AIDS. In adopting such rules, the department
508shall consider the need for information, protections for the
509privacy and confidentiality of the patient, and the practical
510ability of persons and laboratories to report in a reasonable
511fashion. To ensure the confidentiality of persons infected with
512HIV the human immunodeficiency virus (HIV), reporting of HIV
513infection and AIDS acquired immune deficiency syndrome (AIDS)
514must be conducted using a system the HIV/AIDS Reporting System
515(HARS) developed by the Centers for Disease Control and
516Prevention of the United States Public Health Service or an
517equivalent system.
518     (3)  The department shall require reporting of physician
519diagnosed cases of AIDS based upon diagnostic criteria from the
520Centers for Disease Control and Prevention.
521     (b)(4)  The department may require physician and laboratory
522reporting of HIV infection. However, only reports of HIV
523infection identified on or after the effective date of the rule
524developed by the department pursuant to this subsection shall be
525accepted. The Reporting may not affect or relate to anonymous
526HIV testing programs conducted pursuant to s. 381.004(4) or to
527university-based medical research protocols as determined by the
529     (2)(5)  After notification of the test subject under
530subsection (4), the department may, with the consent of the test
531subject, notify school superintendents of students and school
532personnel whose HIV tests are positive.
533     (3)  The department shall adopt rules requiring each
534physician and laboratory to report any newborn or infant up to
53518 months of age who has been exposed to HIV. The rules may
536include the method and time period for reporting, information to
537be included in the report, requirements for enforcement, and
538followup activities by the department.
539     (4)(6)  The department shall by February 1 of each year
540submit to the Legislature an annual report relating to all
541information obtained pursuant to this section.
542     (5)(7)  Each person who violates the provisions of this
543section or the rules adopted hereunder may be fined by the
544department up to $500 for each offense. The department shall
545report each violation of this section to the regulatory agency
546responsible for licensing each health care professional and each
547laboratory to which these provisions apply.
548     Section 8.  Section 384.31, Florida Statutes, is amended to
550     384.31  Serological Testing of pregnant women; duty of the
552     (1)  Every person, including every physician licensed under
553chapter 458 or chapter 459 or midwife licensed under part I of
554chapter 464 or chapter 467, attending a pregnant woman for
555conditions relating to pregnancy during the period of gestation
556and delivery shall take or cause the woman to be tested for
557sexually transmissible diseases, including, but not limited to,
558HIV, as required by rule of the department, notwithstanding s.
559381.004(3)(a), taken a sample of venous blood at a time or times
560specified by the department. The tests Each sample of blood
561shall be performed tested by a laboratory approved for such
562purposes under part I of chapter 483 for sexually transmissible
563diseases as required by rule of the department. Pregnant women
564shall be notified of the tests that will be conducted and of
565their right to refuse testing. If a woman objects to testing, a
566written statement of objection, signed by the patient, shall be
567placed in the patient's medical record and no testing shall
569     (2)  At the time the venous blood sample is taken, testing
570for human immunodeficiency virus (HIV) infection shall be
571offered to each pregnant woman. The prevailing professional
572standard of care in this state requires each health care
573provider and midwife who attends a pregnant woman to counsel the
574woman to be tested for human immunodeficiency virus (HIV).
575Counseling shall include a discussion of the availability of
576treatment if the pregnant woman tests HIV positive. If a
577pregnant woman objects to HIV testing, reasonable steps shall be
578taken to obtain a written statement of such objection, signed by
579the patient, which shall be placed in the patient's medical
580record. Every person, including every physician licensed under
581chapter 458 or chapter 459 or midwife licensed under part I of
582chapter 464 or chapter 467, who attends a pregnant woman who has
583been offered and objects to HIV testing shall be immune from
584liability arising out of or related to the contracting of HIV
585infection or acquired immune deficiency syndrome (AIDS) by the
586child from the mother.
587     Section 9.  Section 385.104, Florida Statutes, is created
588to read:
589     385.104  Health Promotion and Health Education Statewide
591     (1)  The Department of Health shall establish the Health
592Promotion and Health Education Statewide Initiative to provide a
593comprehensive and community-based health promotion and education
594program. The program is designed to provide funding to counties
595in this state to improve individual and community health, aimed
596specifically at preventing and reducing the impact of chronic
597diseases and promoting healthy lifestyles.
598     (2)  The program's targeted diseases include, but are not
599limited to, diabetes, heart disease, stroke, asthma, and cancer,
600with a focus on the preventable risk factors of tobacco use,
601physical inactivity, and poor nutrition.
602     (3)  The implementation of these activities shall be
603coordinated with and linked to existing state plans and national
604priorities, focusing on evidence-based programs and population-
605based efforts that specifically address social and environmental
606policy strategies.
607     (4)  Subject to the availability of funds, the Department
608of Health may award funding to county health departments for
609purposes of improving individual and community health by
610expanding and improving the health infrastructure through
611environmental and policy changes aimed specifically at
612preventing and reducing the impact of chronic diseases and
613promoting healthy lifestyles.
614     (5)  To be eligible to receive funding under this section,
615a county health department shall submit an application to the
616secretary of the Department of Health containing information as
617required, including:
618     (a)  A description of the proposed activities and how they
619promote tobacco cessation, healthy eating, or physical fitness
620and address the health and social consequences to residents of
621this state that have chronic diseases.
622     (b)  Information describing how health promotion and
623education activities are to be coordinated at the local level
624with other health activities conducted by other education,
625health, and agricultural agencies.
626     (c)  Information describing how local health promotion and
627education activities reflect state and national objectives for
629     (d)  A description of the collaborative process that the
630county health department employed in the development of the
631health promotion and education program, including consultations
632with individuals and organizations with expertise in promoting
633public health, nutrition, or physical activity.
634     (e)  A description of how the county health department will
635evaluate the effectiveness of its program.
636     (6)  Subject to the availability of funds, a county health
637department receiving funds under this section shall, pending
638successful implementation or evaluation as determined by
639department headquarters staff, conduct the project for at least
640a period of 3 consecutive years.
641     (7)  A county health department that receives funds under
642this section may use the funds to carry out one or more of the
643following activities:
644     (a)  Collect, analyze, and disseminate data related to
645diabetes, heart disease, stroke, asthma, and cancer, with a
646focus on the preventable risk factors of tobacco use, physical
647inactivity, and poor nutrition.
648     (b)  Develop and implement activities to create a
649comprehensive, coordinated nutrition and physical fitness
650awareness and chronic disease prevention program.
651     (c)  Develop and implement programs in schools and
652worksites to increase physical fitness and to enhance the
653nutritional status of residents of this state.
654     (d)  Develop and implement policy and environmental changes
655related to the cessation of tobacco, healthful nutrition, and
656physical education.
657     (e)  Collaborate with community-based organizations,
658volunteer organizations, state medical associations, and public
659health groups to develop and implement health education and
660promotion activities.
661     (f)  Collaborate with public and private organizations that
662have a mission to increase public awareness of the importance of
663a balanced diet and an active lifestyle.
664     Section 10.  Section 458.3215, Florida Statutes, is created
665to read:
666     458.3215  Reactivation of license for clinical research
668     (1)  Any person who left the practice of medicine for
669purposes of retirement and who, at the time of retirement, was
670in good standing with the board may apply to have his or her
671license reactivated, without examination, for purposes of seeing
672patients solely in a clinical research setting. Such person must
673not have been out of the practice of medicine for more than 10
674years at the time of application under this section.
675     (2)  The board shall by rule set the reactivation fee, not
676to exceed $300, and develop criteria for reactivation of a
677license under this section, including appropriate continuing
678education requirements, not to exceed those prescribed in s.
679458.321 for reactivation of a license.
680     Section 11.  Section 945.601, Florida Statutes, is amended
681to read:
682     945.601  Correctional Medical Authority; ss. 945.601-
683945.6038; 945.601-945.6035, definitions.--As used in this act:
684     (1)  "Authority" means the State of Florida Correctional
685Medical Authority created in this act.
686     (2)  "Health care provider" means:
687     (a)  A regional research hospital or research center which
688is authorized by law to provide hospital services in accordance
689with chapter 395, which has a contractual or operating
690arrangement with a regional school of medicine, and which is
691located at that regional school of medicine;
692     (b)  Any entity which has agreed to provide hospital
693services to inmates in the Department of Corrections; or
694     (c)  Any entity licensed to provide hospital services in
695accordance with chapter 395.
696     (3)  "Project" means any structure, facility, machinery,
697equipment, or other property suitable for use by a health
698facility in connection with its operations or proposed
699operations, including, without limitation, real property
700therefor; a clinic, computer facility, dining hall, firefighting
701facility, fire prevention facility, long-term care facility,
702hospital, interns' residence, laboratory, laundry, maintenance
703facility, nurses' residence, office, parking area, pharmacy,
704recreational facility, research facility, storage facility,
705utility, or X-ray facility, or any combination of the foregoing;
706and other structure or facility related thereto or required or
707useful for health care purposes, the conducting of research, or
708the operation of a health facility, including a facility or
709structure essential or convenient for the orderly conduct of the
710health facility and other similar items necessary or convenient
711for the operation of a particular facility or structure in the
712manner for which its use is intended. "Project" does not include
713such items as fuel, supplies, or other items which are
714customarily deemed to result in a current operating charge.
715     (4)  "Quality management program" means to monitor and
716evaluate inmate health care and includes the following
718     (a)  Assuring that all inmates receive appropriate and
719timely services in a safe environment.
720     (b)  Assuring systematic monitoring of the treatment
722     (c)  Assisting in the reduction of professional and general
723liability risks.
724     (d)  Enhancing efficient utilization of resources.
725     (e)  Assisting in credential review and privilege
727     (f)  Enhancing the identification of continuing educational
729     (g)  Facilitating the identification of strengths,
730weaknesses, and opportunities for improvement.
731     (h)  Facilitating the coordination and integration of
732information systems.
733     (i)  Assuring the resolution of identified problems.
734     (5)  "Real property" includes all lands, including
735buildings, structures, improvements, and fixtures thereon; any
736property of any nature appurtenant thereto or used in connection
737therewith; and every estate, interest, and right, legal or
738equitable, therein, including any such interest for a term of
740     Section 12.  Section 945.6038, Florida Statutes, is created
741to read:
742     945.6038  Additional services.--The authority is authorized
743to enter into an agreement or may contract with the Department
744of Children and Family Services, subject to the availability of
745funding, to conduct surveys of medical services and to provide
746medical quality assurance and improvement assistance at secure
747confinement and treatment facilities for persons confined under
748part V of chapter 394. The authority may enter into similar
749agreements with other state agencies, subject to the
750availability of funds. The authority may not enter into any such
751agreement if doing so would impair the authority's ability to
752fulfill its obligations with regard to the Department of
753Corrections as set forth in this chapter.
754     Section 13.  This act shall take effect upon becoming a

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

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