April 09, 2020
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_h7183c1
CS/HB 7183

1
A bill to be entitled
2An act relating to the reorganization of the Department of
3Health; amending s. 20.43, F.S.; revising the mission and
4responsibilities of the department; providing duties of
5the State Surgeon General with respect to management of
6the department; abolishing responsibility to regulate
7health practitioners effective July 1, 2011; abolishing
8specified divisions of the department effective July 1,
92011, unless reviewed and reenacted by the Legislature;
10authorizing the department to establish multicounty
11service areas for county health departments; requiring the
12department to submit a reorganization plan to the
13Legislature by a specified date; prohibiting the
14department from establishing new programs or modifying
15current programs without legislative approval; requiring
16the department to seek approval from the Legislative
17Budget Commission for certain activities; providing that
18the request for approval is subject to certain notice,
19review, and objection procedures; amending s. 381.0011,
20F.S.; revising duties and powers of the department;
21requiring the department to manage emergency preparedness
22and disaster response functions; authorizing the
23department to issue health alerts or advisories under
24certain conditions; revising rulemaking authority of the
25department; amending s. 381.006, F.S.; revising the
26definition of the term "group care facility"; amending s.
27381.0072, F.S.; revising the definition of the term "food
28service establishment"; authorizing the department to
29advise and consult with other agencies relating to the
30provision of food services; revising entities that are
31exempt from rules relating to standards for food service
32establishment manager certification; amending s. 381.0101,
33F.S.; revising the definition of the term "primary
34environmental health program"; repealing s. 381.001, F.S.,
35relating to legislative intent with respect to the state's
36public health system; repealing s. 381.04015, F.S.,
37relating to the Women's Health Strategy; repealing s.
38401.243, F.S., relating to the department's injury
39prevention program; repealing ss. 411.23, 411.231, and
40411.232, F.S., relating to the Children's Early Investment
41Act; amending s. 381.4018, F.S.; providing definitions;
42revising the list of governmental stakeholders that the
43department is required to work with regarding the state
44strategic plan and in assessing the state's physician
45workforce; creating the Physician Workforce Advisory
46Council; providing for appointments, membership, terms,
47and duties of the council; providing that council members
48are not entitled to receive compensation or reimbursement
49for per diem or travel expenses; providing the duties of
50the council; amending s. 392.51, F.S.; revising
51legislative intent with respect to the delivery of
52tuberculosis control services; amending s. 392.69, F.S.;
53requiring the department to develop a plan to provide
54tuberculosis services; requiring the department to submit
55the plan to the Governor and Legislature; amending ss.
56411.01 and 411.224, F.S.; conforming cross-references;
57amending ss. 458.3192 and 459.0082, F.S.; requiring the
58department to determine by geographic area and specialty
59the number of physicians who plan to relocate outside the
60state, practice medicine in this state, and reduce or
61modify the scope of their practice; authorizing the
62department to include additional information in its report
63to the Governor and Legislature; amending s. 499.01, F.S.;
64creating an exemption from device manufacturer permits for
65certain persons; amending s. 499.01212, F.S.; exempting
66specified prescription drugs from pedigree paper
67requirements under certain circumstances; amending s.
68499.029, F.S.; renaming the Cancer Drug Donation Program
69as the Prescription Drug Donation Program; revising
70definitions; expanding the drugs and supplies that may be
71donated under the program; expanding the types of
72facilities and practitioners that may participate in the
73program; conforming provisions to changes in terminology;
74amending s. 509.013, F.S.; revising the definitions of the
75terms "public lodging establishment" and "public food
76establishment"; transferring and reassigning certain
77functions and responsibilities, including records,
78personnel, property, and unexpended balances of
79appropriations and other resources, from the Department of
80Health to the Department of Business and Professional
81Regulation by a type two transfer; providing for the
82continued validity of pending judicial or administrative
83actions to which the Department of Health is a party;
84providing for the continued validity of lawful orders
85issued by the Department of Health; transferring rules
86created by the Department of Health to the Department of
87Business and Professional Regulation; providing for the
88continued validity of permits and certifications issued by
89the Department of Health; providing effective dates.
90
91Be It Enacted by the Legislature of the State of Florida:
92
93     Section 1.  Section 20.43, Florida Statutes, is amended to
94read:
95     20.43  Department of Health.-There is created a Department
96of Health.
97     (1)(a)  The purpose of the Department of Health is
98responsible for to promote and protect the health of all
99residents and visitors in the state through organized state and
100community efforts, including cooperative agreements with
101counties. The department shall:
102     1.(a)  Identifying, diagnosing, investigating, and
103conducting surveillance of communicable diseases in the state
104Prevent to the fullest extent possible, the occurrence and
105progression of communicable and noncommunicable diseases and
106disabilities.
107     2.(b)  Maintaining Maintain a constant surveillance of
108disease occurrence and accumulating accumulate health statistics
109necessary to establish disease trends and to design health
110programs.
111     3.  Implementing interventions that prevent or limit the
112impact or spread of disease in the state.
113     4.(c)  Maintaining and coordinating preparedness for and
114responses to public health emergencies in the state Conduct
115special studies of the causes of diseases and formulate
116preventive strategies.
117     5.(d)  Regulating environmental activities that have a
118direct impact on public health in the state Promote the
119maintenance and improvement of the environment as it affects
120public health.
121     6.(e)  Administering and providing health and related
122services for targeted populations in the state Promote the
123maintenance and improvement of health in the residents of the
124state.
125     7.(f)  Collecting, managing, and analyzing vital statistics
126data in the state Provide leadership, in cooperation with the
127public and private sectors, in establishing statewide and
128community public health delivery systems.
129     (g)  Provide health care and early intervention services to
130infants, toddlers, children, adolescents, and high-risk
131perinatal patients who are at risk for disabling conditions or
132have chronic illnesses.
133     (h)  Provide services to abused and neglected children
134through child protection teams and sexual abuse treatment
135programs.
136     (i)  Develop working associations with all agencies and
137organizations involved and interested in health and health care
138delivery.
139     (j)  Analyze trends in the evolution of health systems, and
140identify and promote the use of innovative, cost-effective
141health delivery systems.
142     (k)  Serve as the statewide repository of all aggregate
143data accumulated by state agencies related to health care;
144analyze that data and issue periodic reports and policy
145statements, as appropriate; require that all aggregated data be
146kept in a manner that promotes easy utilization by the public,
147state agencies, and all other interested parties; provide
148technical assistance as required; and work cooperatively with
149the state's higher education programs to promote further study
150and analysis of health care systems and health care outcomes.
151     (l)  Include in the department's strategic plan developed
152under s. 186.021 an assessment of current health programs,
153systems, and costs; projections of future problems and
154opportunities; and recommended changes that are needed in the
155health care system to improve the public health.
156     8.(m)  Regulating Regulate health practitioners, to the
157extent authorized by the Legislature, as necessary for the
158preservation of the health, safety, and welfare of the public.
159This subparagraph expires on July 1, 2011.
160     (b)  By November 1, 2010, the department shall submit a
161proposal to the President of the Senate, the Speaker of the
162House of Representatives, and the appropriate substantive
163legislative committees for a new department structure based upon
164the responsibilities delegated under paragraph (a). The proposal
165shall include reductions in the number of departmental bureaus
166and divisions and limits on the number of executive positions in
167a manner that enables the department to fulfill the
168responsibilities delegated under paragraph (a). The department
169shall identify existing functions and activities that are
170inconsistent with the responsibilities delegated under paragraph
171(a) and shall provide a job description for each bureau chief
172and division director position proposed for retention.
173     (2)(a)  The head of the Department of Health is the State
174Surgeon General and State Health Officer. The State Surgeon
175General must be a physician licensed under chapter 458 or
176chapter 459 who has advanced training or extensive experience in
177public health administration. The State Surgeon General is
178appointed by the Governor subject to confirmation by the Senate.
179The State Surgeon General serves at the pleasure of the
180Governor. The State Surgeon General shall manage the department
181as it carries out the responsibilities delegated under paragraph
182(1)(a) serve as the leading voice on wellness and disease
183prevention efforts, including the promotion of healthful
184lifestyles, immunization practices, health literacy, and the
185assessment and promotion of the physician and health care
186workforce in order to meet the health care needs of the state.
187The State Surgeon General shall focus on advocating healthy
188lifestyles, developing public health policy, and building
189collaborative partnerships with schools, businesses, health care
190practitioners, community-based organizations, and public and
191private institutions in order to promote health literacy and
192optimum quality of life for all Floridians.
193     (b)  The Officer of Women's Health Strategy is established
194within the Department of Health and shall report directly to the
195State Surgeon General.
196     (3)  The following divisions of the Department of Health
197are established:
198     (a)  Division of Administration. This paragraph expires
199July 1, 2011, unless reviewed and reenacted by the Legislature
200before that date.
201     (b)  Division of Environmental Health. This paragraph
202expires July 1, 2011, unless reviewed and reenacted by the
203Legislature before that date.
204     (c)  Division of Disease Control. This paragraph expires
205July 1, 2011, unless reviewed and reenacted by the Legislature
206before that date.
207     (d)  Division of Family Health Services. This paragraph
208expires July 1, 2011, unless reviewed and reenacted by the
209Legislature before that date.
210     (e)  Division of Children's Medical Services Network. This
211paragraph expires July 1, 2011, unless reviewed and reenacted by
212the Legislature before that date.
213     (f)  Division of Emergency Medical Operations. This
214paragraph expires July 1, 2011, unless reviewed and reenacted by
215the Legislature before that date.
216     (g)  Division of Medical Quality Assurance, which is
217responsible for the following boards and professions established
218within the division:
219     1.  The Board of Acupuncture, created under chapter 457.
220     2.  The Board of Medicine, created under chapter 458.
221     3.  The Board of Osteopathic Medicine, created under
222chapter 459.
223     4.  The Board of Chiropractic Medicine, created under
224chapter 460.
225     5.  The Board of Podiatric Medicine, created under chapter
226461.
227     6.  Naturopathy, as provided under chapter 462.
228     7.  The Board of Optometry, created under chapter 463.
229     8.  The Board of Nursing, created under part I of chapter
230464.
231     9.  Nursing assistants, as provided under part II of
232chapter 464.
233     10.  The Board of Pharmacy, created under chapter 465.
234     11.  The Board of Dentistry, created under chapter 466.
235     12.  Midwifery, as provided under chapter 467.
236     13.  The Board of Speech-Language Pathology and Audiology,
237created under part I of chapter 468.
238     14.  The Board of Nursing Home Administrators, created
239under part II of chapter 468.
240     15.  The Board of Occupational Therapy, created under part
241III of chapter 468.
242     16.  Respiratory therapy, as provided under part V of
243chapter 468.
244     17.  Dietetics and nutrition practice, as provided under
245part X of chapter 468.
246     18.  The Board of Athletic Training, created under part
247XIII of chapter 468.
248     19.  The Board of Orthotists and Prosthetists, created
249under part XIV of chapter 468.
250     20.  Electrolysis, as provided under chapter 478.
251     21.  The Board of Massage Therapy, created under chapter
252480.
253     22.  The Board of Clinical Laboratory Personnel, created
254under part III of chapter 483.
255     23.  Medical physicists, as provided under part IV of
256chapter 483.
257     24.  The Board of Opticianry, created under part I of
258chapter 484.
259     25.  The Board of Hearing Aid Specialists, created under
260part II of chapter 484.
261     26.  The Board of Physical Therapy Practice, created under
262chapter 486.
263     27.  The Board of Psychology, created under chapter 490.
264     28.  School psychologists, as provided under chapter 490.
265     29.  The Board of Clinical Social Work, Marriage and Family
266Therapy, and Mental Health Counseling, created under chapter
267491.
268
269This paragraph expires July 1, 2011.
270     (h)  Division of Children's Medical Services Prevention and
271Intervention. This paragraph expires July 1, 2011, unless
272reviewed and reenacted by the Legislature before that date.
273     (i)  Division of Information Technology. This paragraph
274expires July 1, 2011, unless reviewed and reenacted by the
275Legislature before that date.
276     (j)  Division of Health Access and Tobacco. This paragraph
277expires July 1, 2011, unless reviewed and reenacted by the
278Legislature before that date.
279     (k)  Division of Disability Determinations. This paragraph
280expires July 1, 2011, unless reviewed and reenacted by the
281Legislature before that date.
282     (4)(a)  The members of each board within the department
283shall be appointed by the Governor, subject to confirmation by
284the Senate. Consumer members on the board shall be appointed
285pursuant to paragraph (b). Members shall be appointed for 4-year
286terms, and such terms shall expire on October 31. However, a
287term of less than 4 years may be used to ensure that:
288     1.  No more than two members' terms expire during the same
289calendar year for boards consisting of seven or eight members.
290     2.  No more than 3 members' terms expire during the same
291calendar year for boards consisting of 9 to 12 members.
292     3.  No more than 5 members' terms expire during the same
293calendar year for boards consisting of 13 or more members.
294
295A member whose term has expired shall continue to serve on the
296board until such time as a replacement is appointed. A vacancy
297on the board shall be filled for the unexpired portion of the
298term in the same manner as the original appointment. No member
299may serve for more than the remaining portion of a previous
300member's unexpired term, plus two consecutive 4-year terms of
301the member's own appointment thereafter.
302     (b)  Each board with five or more members shall have at
303least two consumer members who are not, and have never been,
304members or practitioners of the profession regulated by such
305board or of any closely related profession. Each board with
306fewer than five members shall have at least one consumer member
307who is not, and has never been, a member or practitioner of the
308profession regulated by such board or of any closely related
309profession.
310     (c)  Notwithstanding any other provision of law, the
311department is authorized to establish uniform application forms
312and certificates of licensure for use by the boards within the
313department. Nothing in this paragraph authorizes the department
314to vary any substantive requirements, duties, or eligibilities
315for licensure or certification as provided by law.
316     (5)  The department shall plan and administer authorized
317its public health programs through its county health departments
318and may, for administrative purposes and efficient service
319delivery, establish multicounty up to 15 service areas to carry
320out such duties as may be prescribed by the State Surgeon
321General. The boundaries of the service areas shall be the same
322as, or combinations of, the service districts of the Department
323of Children and Family Services established in s. 20.19 and, to
324the extent practicable, shall take into consideration the
325boundaries of the jobs and education regional boards.
326     (6)  The State Surgeon General may and division directors
327are authorized to appoint ad hoc advisory committees as
328necessary to address issues relating to the responsibilities
329delegated to the department under paragraph (1)(a). The issue or
330problem that the ad hoc committee shall address, and the
331timeframe within which the committee is to complete its work,
332shall be specified at the time the committee is appointed. Ad
333hoc advisory committees shall include representatives of groups
334or entities affected by the issue or problem that the committee
335is asked to examine. Members of ad hoc advisory committees shall
336receive no compensation, but may, within existing departmental
337resources, receive reimbursement for travel expenses as provided
338in s. 112.061.
339     (7)  To protect and improve the public health, the
340department may use state or federal funds to:
341     (a)  Provide incentives, including, but not limited to, the
342promotional items listed in paragraph (b), food and including
343food coupons, and payment for travel expenses, for encouraging
344healthy lifestyle and disease prevention behaviors and patient
345compliance with medical treatment, such as tuberculosis therapy
346and smoking cessation programs. Such incentives shall be
347intended to cause individuals to take action to improve their
348health. Any incentive for food, food coupons, or travel expenses
349may not exceed the limitations in s. 112.061.
350     (b)  Plan and conduct health education campaigns for the
351purpose of protecting or improving public health. The department
352may purchase promotional items, such as, but not limited to, t-
353shirts, hats, sports items such as water bottles and sweat
354bands, calendars, nutritional charts, baby bibs, growth charts,
355and other items printed with health promotion messages, and
356advertising, such as space on billboards or in publications or
357radio or television time, for health information and promotional
358messages that recognize that the following behaviors, among
359others, are detrimental to public health: unprotected sexual
360intercourse, other than with one's spouse; cigarette and cigar
361smoking, use of smokeless tobacco products, and exposure to
362environmental tobacco smoke; alcohol consumption or other
363substance abuse during pregnancy; alcohol abuse or other
364substance abuse; lack of exercise and poor diet and nutrition
365habits; and failure to recognize and address a genetic tendency
366to suffer from sickle-cell anemia, diabetes, high blood
367pressure, cardiovascular disease, or cancer. For purposes of
368activities under this paragraph, the Department of Health may
369establish requirements for local matching funds or in-kind
370contributions to create and distribute advertisements, in either
371print or electronic format, which are concerned with each of the
372targeted behaviors, establish an independent evaluation and
373feedback system for the public health communication campaign,
374and monitor and evaluate the efforts to determine which of the
375techniques and methodologies are most effective.
376     (c)  Plan and conduct promotional campaigns to recruit
377health professionals to be employed by the department or to
378recruit participants in departmental programs for health
379practitioners, such as scholarship, loan repayment, or volunteer
380programs. To this effect the department may purchase promotional
381items and advertising.
382     (8)  The department may hold copyrights, trademarks, and
383service marks and enforce its rights with respect thereto,
384except such authority does not extend to any public records
385relating to the department's responsibilities for health care
386practitioners regulated under part II of chapter 455.
387     (7)(9)  There is established within the Department of
388Health the Office of Minority Health.
389     (8)(a)  Beginning in fiscal year 2010-2011, the department
390shall initiate or commence new programs, including any new
391federally funded or grant-supported initiative, or make changes
392in current programs only when the Legislature expressly
393authorizes the department to do so.
394     (b)  Beginning in fiscal year 2010-2011, prior to applying
395for any continuation of federal or private grants, the
396department shall request the express approval of the Legislative
397Budget Commission. The request for approval shall provide
398detailed information about the purpose of the grant, the prior
399use of the grant, the reason for continuation, the intended use
400of the continuation funds, and the number of full-time permanent
401or temporary employees that participate in administering the
402program funded by the grant. This paragraph is subject to the
403notice, review, and objection procedures set forth in s.
404216.177.
405     Section 2.  Section 381.0011, Florida Statutes, is amended
406to read:
407     381.0011  Duties and powers of the Department of Health.-It
408is the duty of the Department of Health to:
409     (1)  Assess the public health status and needs of the state
410pursuant to the responsibilities delegated to the department
411under s. 20.43 through statewide data collection and other
412appropriate means, with special attention to future needs that
413may result from population growth, technological advancements,
414new societal priorities, or other changes.
415     (2)  Manage and coordinate emergency preparedness and
416disaster response functions to: investigate and control the
417spread of disease; coordinate the availability and staffing of
418special needs shelters; support patient evacuation; ensure the
419safety of food and drugs; provide critical incident stress
420debriefing; and provide surveillance and control of
421radiological, chemical, biological, and other environmental
422hazards Formulate general policies affecting the public health
423of the state.
424     (3)  Include in the department's strategic plan developed
425under s. 186.021 a summary of all aspects of the public health
426related to the responsibilities delegated to the department
427under s. 20.43(1) mission and health status objectives to direct
428the use of public health resources with an emphasis on
429prevention.
430     (4)  Administer and enforce laws and rules relating to
431sanitation, control of communicable diseases, and illnesses and
432hazards to health among humans and from animals to humans, and
433the general health of the people of the state.
434     (5)  Cooperate with and accept assistance from federal,
435state, and local officials for the prevention and suppression of
436communicable and other diseases, illnesses, injuries, and
437hazards to human health and cooperate with the Federal
438Government in enforcing public health laws and regulations.
439     (6)  Declare, enforce, modify, and abolish quarantine of
440persons, animals, and premises as the circumstances indicate for
441controlling communicable diseases or providing protection from
442unsafe conditions that pose a threat to public health, except as
443provided in ss. 384.28 and 392.545-392.60.
444     (a)  The department shall adopt rules to specify the
445conditions and procedures for imposing and releasing a
446quarantine. The rules must include provisions related to:
447     1.  The closure of premises.
448     2.  The movement of persons or animals exposed to or
449infected with a communicable disease.
450     3.  The tests or treatment, including vaccination, for
451communicable disease required prior to employment or admission
452to the premises or to comply with a quarantine.
453     4.  Testing or destruction of animals with or suspected of
454having a disease transmissible to humans.
455     5.  Access by the department to quarantined premises.
456     6.  The disinfection of quarantined animals, persons, or
457premises.
458     7.  Methods of quarantine.
459     (b)  Any health regulation that restricts travel or trade
460within the state may not be adopted or enforced in this state
461except by authority of the department.
462     (7)  Identify, diagnose, investigate, and conduct
463surveillance of communicable diseases in the state and promote
464and implement interventions that prevent or limit the impact and
465spread of disease in the state Provide for a thorough
466investigation and study of the incidence, causes, modes of
467propagation and transmission, and means of prevention, control,
468and cure of diseases, illnesses, and hazards to human health.
469     (8)  Issue, as necessary and in its discretion, health
470alerts or advisories Provide for the dissemination of
471information to the public relative to the prevention, control,
472and cure of diseases, illnesses, and hazards to human health.
473The department shall conduct a workshop before issuing any
474health alert or advisory relating to food-borne illness or
475communicable disease in public lodging or food service
476establishments in order to inform persons, trade associations,
477and businesses of the risk to public health and to seek the
478input of affected persons, trade associations, and businesses on
479the best methods of informing and protecting the public. The
480department shall conduct a workshop before issuing any such
481alert or advisory, except in an emergency, in which case the
482workshop must be held within 14 days after the issuance of the
483emergency alert or advisory.
484     (9)  Act as registrar of vital statistics.
485     (10)  Cooperate with and assist federal health officials in
486enforcing public health laws and regulations.
487     (11)  Cooperate with other departments, local officials,
488and private boards and organizations for the improvement and
489preservation of the public health.
490     (12)  Maintain a statewide injury-prevention program.
491     (10)(13)  Adopt rules pursuant to ss. 120.536(1) and 120.54
492to implement the provisions of law conferring duties upon it.
493This subsection does not authorize the department to require a
494permit or license or to inspect a building or facility, unless
495such requirement is specifically provided by law.
496     (11)(14)  Perform any other duties expressly assigned to
497the department prescribed by law.
498     Section 3.  Subsection (16) of section 381.006, Florida
499Statutes, is amended to read:
500     381.006  Environmental health.-The department shall conduct
501an environmental health program as part of fulfilling the
502state's public health mission. The purpose of this program is to
503detect and prevent disease caused by natural and manmade factors
504in the environment. The environmental health program shall
505include, but not be limited to:
506     (16)  A group-care-facilities function. As used in this
507subsection, the term, where a "group care facility" means any
508public or private school, assisted living facility, adult
509family-care home, adult day care center, short-term residential
510treatment center, residential treatment facility, home for
511special services, transitional living facility, crisis
512stabilization unit, hospice, prescribed pediatric extended care
513center, intermediate care facility for persons with
514developmental disabilities, or boarding school housing, building
515or buildings, section of a building, or distinct part of a
516building or other place, whether operated for profit or not,
517which undertakes, through its ownership or management, to
518provide one or more personal services, care, protection, and
519supervision to persons who require such services and who are not
520related to the owner or administrator. The department may adopt
521rules necessary to protect the health and safety of residents,
522staff, and patrons of group care facilities. Rules related to
523public and private schools shall be developed by, such as child
524care facilities, family day care homes, assisted living
525facilities, adult day care centers, adult family care homes,
526hospices, residential treatment facilities, crisis stabilization
527units, pediatric extended care centers, intermediate care
528facilities for the developmentally disabled, group care homes,
529and, jointly with the Department of Education in consultation
530with the department, private and public schools. These Rules
531adopted under this subsection may include definitions of terms;
532provisions relating to operation and maintenance of facilities,
533buildings, grounds, equipment, furnishings, and occupant-space
534requirements; lighting; heating, cooling, and ventilation; food
535service; water supply and plumbing; sewage; sanitary facilities;
536insect and rodent control; garbage; safety; personnel health,
537hygiene, and work practices; and other matters the department
538finds are appropriate or necessary to protect the safety and
539health of the residents, staff, students, faculty, or patrons.
540The department may not adopt rules that conflict with rules
541adopted by the licensing or certifying agency. The department
542may enter and inspect at reasonable hours to determine
543compliance with applicable statutes or rules. In addition to any
544sanctions that the department may impose for violations of rules
545adopted under this section, the department shall also report
546such violations to any agency responsible for licensing or
547certifying the group care facility. The licensing or certifying
548agency may also impose any sanction based solely on the findings
549of the department.
550
551The department may adopt rules to carry out the provisions of
552this section.
553     Section 4.  Subsections (1), (2), (3), and (6) of section
554381.0072, Florida Statutes, are amended to read:
555     381.0072  Food service protection.-It shall be the duty of
556the Department of Health to adopt and enforce sanitation rules
557consistent with law to ensure the protection of the public from
558food-borne illness. These rules shall provide the standards and
559requirements for the storage, preparation, serving, or display
560of food in food service establishments as defined in this
561section and which are not permitted or licensed under chapter
562500 or chapter 509.
563     (1)  DEFINITIONS.-As used in this section, the term:
564     (a)  "Department" means the Department of Health or its
565representative county health department.
566     (b)  "Food service establishment" means detention
567facilities, public or private schools, migrant labor camps,
568assisted living facilities, adult family-care homes, adult day
569care centers, short-term residential treatment centers,
570residential treatment facilities, homes for special services,
571transitional living facilities, crisis stabilization units,
572hospices, prescribed pediatric extended care centers,
573intermediate care facilities for persons with developmental
574disabilities, boarding schools, civic or fraternal
575organizations, bars and lounges, vending machines that dispense
576potentially hazardous foods at facilities expressly named in
577this paragraph, and facilities used as temporary food events or
578mobile food units at any facility expressly named any facility,
579as described in this paragraph, where food is prepared and
580intended for individual portion service, including and includes
581the site at which individual portions are provided,. The term
582includes any such facility regardless of whether consumption is
583on or off the premises and regardless of whether there is a
584charge for the food. The term includes detention facilities,
585child care facilities, schools, institutions, civic or fraternal
586organizations, bars and lounges and facilities used at temporary
587food events, mobile food units, and vending machines at any
588facility regulated under this section. The term does not include
589any entity not expressly named in this paragraph private homes
590where food is prepared or served for individual family
591consumption; nor does the term include churches, synagogues, or
592other not-for-profit religious organizations as long as these
593organizations serve only their members and guests and do not
594advertise food or drink for public consumption, or any facility
595or establishment permitted or licensed under chapter 500 or
596chapter 509; nor does the term include any theater, if the
597primary use is as a theater and if patron service is limited to
598food items customarily served to the admittees of theaters; nor
599does the term include a research and development test kitchen
600limited to the use of employees and which is not open to the
601general public.
602     (c)  "Operator" means the owner, operator, keeper,
603proprietor, lessee, manager, assistant manager, agent, or
604employee of a food service establishment.
605     (2)  DUTIES.-
606     (a)  The department may advise and consult with the Agency
607for Health Care Administration, the Department of Business and
608Professional Regulation, the Department of Agriculture and
609Consumer Services, and the Department of Children and Family
610Services concerning procedures related to the storage,
611preparation, serving, or display of food at any building,
612structure, or facility not expressly included in this section
613that is inspected, licensed, or regulated by those agencies.
614     (b)(a)  The department shall adopt rules, including
615definitions of terms which are consistent with law prescribing
616minimum sanitation standards and manager certification
617requirements as prescribed in s. 509.039, and which shall be
618enforced in food service establishments as defined in this
619section. The sanitation standards must address the construction,
620operation, and maintenance of the establishment; lighting,
621ventilation, laundry rooms, lockers, use and storage of toxic
622materials and cleaning compounds, and first-aid supplies; plan
623review; design, construction, installation, location,
624maintenance, sanitation, and storage of food equipment and
625utensils; employee training, health, hygiene, and work
626practices; food supplies, preparation, storage, transportation,
627and service, including access to the areas where food is stored
628or prepared; and sanitary facilities and controls, including
629water supply and sewage disposal; plumbing and toilet
630facilities; garbage and refuse collection, storage, and
631disposal; and vermin control. Public and private schools, if the
632food service is operated by school employees,; hospitals
633licensed under chapter 395; nursing homes licensed under part II
634of chapter 400; child care facilities as defined in s. 402.301;
635residential facilities colocated with a nursing home or
636hospital, if all food is prepared in a central kitchen that
637complies with nursing or hospital regulations; and bars and
638lounges, civic organizations, and any other facility that is not
639regulated under this section as defined by department rule, are
640exempt from the rules developed for manager certification. The
641department shall administer a comprehensive inspection,
642monitoring, and sampling program to ensure such standards are
643maintained. With respect to food service establishments
644permitted or licensed under chapter 500 or chapter 509, the
645department shall assist the Division of Hotels and Restaurants
646of the Department of Business and Professional Regulation and
647the Department of Agriculture and Consumer Services with
648rulemaking by providing technical information.
649     (c)(b)  The department shall carry out all provisions of
650this chapter and all other applicable laws and rules relating to
651the inspection or regulation of food service establishments as
652defined in this section, for the purpose of safeguarding the
653public's health, safety, and welfare.
654     (d)(c)  The department shall inspect each food service
655establishment as often as necessary to ensure compliance with
656applicable laws and rules. The department shall have the right
657of entry and access to these food service establishments at any
658reasonable time. In inspecting food service establishments as
659provided under this section, the department shall provide each
660inspected establishment with the food recovery brochure
661developed under s. 570.0725.
662     (e)(d)  The department or other appropriate regulatory
663entity may inspect theaters exempted in subsection (1) to ensure
664compliance with applicable laws and rules pertaining to minimum
665sanitation standards. A fee for inspection shall be prescribed
666by rule, but the aggregate amount charged per year per theater
667establishment shall not exceed $300, regardless of the entity
668providing the inspection.
669     (3)  LICENSES REQUIRED.-
670     (a)  Licenses; annual renewals.-Each food service
671establishment regulated under this section shall obtain a
672license from the department annually. Food service establishment
673licenses shall expire annually and are not transferable from one
674place or individual to another. However, those facilities
675licensed by the department's Office of Licensure and
676Certification, the Child Care Services Program Office, or the
677Agency for Persons with Disabilities are exempt from this
678subsection. It shall be a misdemeanor of the second degree,
679punishable as provided in s. 381.0061, s. 775.082, or s.
680775.083, for such an establishment to operate without this
681license. The department may refuse a license, or a renewal
682thereof, to any establishment that is not constructed or
683maintained in accordance with law and with the rules of the
684department. Annual application for renewal is not required.
685     (b)  Application for license.-Each person who plans to open
686a food service establishment regulated under this section and
687not regulated under chapter 500 or chapter 509 shall apply for
688and receive a license prior to the commencement of operation.
689     (6)  IMMINENT DANGERS; STOP-SALE ORDERS.-
690     (a)  In the course of epidemiological investigations or for
691those establishments regulated by the department under this
692chapter, the department, to protect the public from food that is
693unwholesome or otherwise unfit for human consumption, may
694examine, sample, seize, and stop the sale or use of food to
695determine its condition. The department may stop the sale and
696supervise the proper destruction of food when the State Health
697Officer or his or her designee determines that such food
698represents a threat to the public health.
699     (b)  The department may determine that a food service
700establishment regulated under this section is an imminent danger
701to the public health and require its immediate closure when such
702establishment fails to comply with applicable sanitary and
703safety standards and, because of such failure, presents an
704imminent threat to the public's health, safety, and welfare. The
705department may accept inspection results from state and local
706building and firesafety officials and other regulatory agencies
707as justification for such actions. Any facility so deemed and
708closed shall remain closed until allowed by the department or by
709judicial order to reopen.
710     Section 5.  Paragraph (g) of subsection (2) of section
711381.0101, Florida Statutes, is amended to read:
712     (2)  DEFINITIONS.-As used in this section:
713     (g)  "Primary environmental health program" means those
714programs determined by the department is expressly authorized by
715law to administer to be essential for providing basic
716environmental and sanitary protection to the public. At a
717minimum, These programs shall include food protection program
718work at food service establishments as defined in s. 381.0072
719and onsite sewage treatment and disposal system evaluations.
720     Section 6.  Sections 381.001, 381.04015, 401.243, 411.23,
721411.231, and 411.232, Florida Statutes, are repealed.
722     Section 7.  Section 381.4018, Florida Statutes, is amended
723to read:
724     381.4018  Physician workforce assessment and development.-
725     (1)  DEFINITIONS.-As used in this section, the term:
726     (a)  "Consortium" or "consortia" means a combination of
727statutory teaching hospitals, statutory rural hospitals, other
728hospitals, accredited medical schools, clinics operated by the
729department, clinics operated by the Department of Veterans'
730Affairs, area health education centers, community health
731centers, federally qualified health centers, prison clinics,
732local community clinics, or other programs. At least one member
733of the consortium shall be a sponsoring institution accredited
734or currently seeking accreditation by the Accreditation Council
735for Graduate Medical Education or the American Osteopathic
736Association.
737     (b)  "Council" means the Physician Workforce Advisory
738Council.
739     (c)  "Department" means the Department of Health.
740     (d)  "Graduate medical education program" means a program
741accredited by the Accreditation Council for Graduate Medical
742Education or the American Osteopathic Association.
743     (e)  "Primary care specialty" means emergency medicine,
744family practice, internal medicine, pediatrics, psychiatry,
745obstetrics and gynecology, or combined internal medicine and
746other primary care specialties as determined by the council or
747the department.
748     (2)(1)  LEGISLATIVE INTENT.- The Legislature recognizes
749that physician workforce planning is an essential component of
750ensuring that there is an adequate and appropriate supply of
751well-trained physicians to meet this state's future health care
752service needs as the general population and elderly population
753of the state increase. The Legislature finds that items to
754consider relative to assessing the physician workforce may
755include physician practice status; specialty mix; geographic
756distribution; demographic information, including, but not
757limited to, age, gender, race, and cultural considerations; and
758needs of current or projected medically underserved areas in the
759state. Long-term strategic planning is essential as the period
760from the time a medical student enters medical school to
761completion of graduate medical education may range from 7 to 10
762years or longer. The Legislature recognizes that strategies to
763provide for a well-trained supply of physicians must include
764ensuring the availability and capacity of quality graduate
765medical schools and graduate medical education programs in this
766state, as well as using new or existing state and federal
767programs providing incentives for physicians to practice in
768needed specialties and in underserved areas in a manner that
769addresses projected needs for physician manpower.
770     (3)(2)  PURPOSE.-The Department of Health shall serve as a
771coordinating and strategic planning body to actively assess the
772state's current and future physician workforce needs and work
773with multiple stakeholders to develop strategies and
774alternatives to address current and projected physician
775workforce needs.
776     (4)(3)  GENERAL FUNCTIONS.-The department shall maximize
777the use of existing programs under the jurisdiction of the
778department and other state agencies and coordinate governmental
779and nongovernmental stakeholders and resources in order to
780develop a state strategic plan and assess the implementation of
781such strategic plan. In developing the state strategic plan, the
782department shall:
783     (a)  Monitor, evaluate, and report on the supply and
784distribution of physicians licensed under chapter 458 or chapter
785459. The department shall maintain a database to serve as a
786statewide source of data concerning the physician workforce.
787     (b)  Develop a model and quantify, on an ongoing basis, the
788adequacy of the state's current and future physician workforce
789as reliable data becomes available. Such model must take into
790account demographics, physician practice status, place of
791education and training, generational changes, population growth,
792economic indicators, and issues concerning the "pipeline" into
793medical education.
794     (c)  Develop and recommend strategies to determine whether
795the number of qualified medical school applicants who might
796become competent, practicing physicians in this state will be
797sufficient to meet the capacity of the state's medical schools.
798If appropriate, the department shall, working with
799representatives of appropriate governmental and nongovernmental
800entities, develop strategies and recommendations and identify
801best practice programs that introduce health care as a
802profession and strengthen skills needed for medical school
803admission for elementary, middle, and high school students, and
804improve premedical education at the precollege and college level
805in order to increase this state's potential pool of medical
806students.
807     (d)  Develop strategies to ensure that the number of
808graduates from the state's public and private allopathic and
809osteopathic medical schools are adequate to meet physician
810workforce needs, based on the analysis of the physician
811workforce data, so as to provide a high-quality medical
812education to students in a manner that recognizes the uniqueness
813of each new and existing medical school in this state.
814     (e)  Pursue strategies and policies to create, expand, and
815maintain graduate medical education positions in the state based
816on the analysis of the physician workforce data. Such strategies
817and policies must take into account the effect of federal
818funding limitations on the expansion and creation of positions
819in graduate medical education. The department shall develop
820options to address such federal funding limitations. The
821department shall consider options to provide direct state
822funding for graduate medical education positions in a manner
823that addresses requirements and needs relative to accreditation
824of graduate medical education programs. The department shall
825consider funding residency positions as a means of addressing
826needed physician specialty areas, rural areas having a shortage
827of physicians, and areas of ongoing critical need, and as a
828means of addressing the state's physician workforce needs based
829on an ongoing analysis of physician workforce data.
830     (f)  Develop strategies to maximize federal and state
831programs that provide for the use of incentives to attract
832physicians to this state or retain physicians within the state.
833Such strategies should explore and maximize federal-state
834partnerships that provide incentives for physicians to practice
835in federally designated shortage areas. Strategies shall also
836consider the use of state programs, such as the Florida Health
837Service Corps established pursuant to s. 381.0302 and the
838Medical Education Reimbursement and Loan Repayment Program
839pursuant to s. 1009.65, which provide for education loan
840repayment or loan forgiveness and provide monetary incentives
841for physicians to relocate to underserved areas of the state.
842     (g)  Coordinate and enhance activities relative to
843physician workforce needs, undergraduate medical education, and
844graduate medical education provided by the Division of Medical
845Quality Assurance, the Community Hospital Education Program and
846the Graduate Medical Education Committee established pursuant to
847s. 381.0403, area health education center networks established
848pursuant to s. 381.0402, and other offices and programs within
849the Department of Health as designated by the State Surgeon
850General.
851     (h)  Work in conjunction with and act as a coordinating
852body for governmental and nongovernmental stakeholders to
853address matters relating to the state's physician workforce
854assessment and development for the purpose of ensuring an
855adequate supply of well-trained physicians to meet the state's
856future needs. Such governmental stakeholders shall include, but
857need not be limited to, the State Surgeon General or his or her
858designee, the Commissioner of Education or his or her designee,
859the Secretary of Health Care Administration or his or her
860designee, and the Chancellor of the State University System or
861his or her designee from the Board of Governors of the State
862University System, and, at the discretion of the department,
863other representatives of state and local agencies that are
864involved in assessing, educating, or training the state's
865current or future physicians. Other stakeholders shall include,
866but need not be limited to, organizations representing the
867state's public and private allopathic and osteopathic medical
868schools; organizations representing hospitals and other
869institutions providing health care, particularly those that have
870an interest in providing accredited medical education and
871graduate medical education to medical students and medical
872residents; organizations representing allopathic and osteopathic
873practicing physicians; and, at the discretion of the department,
874representatives of other organizations or entities involved in
875assessing, educating, or training the state's current or future
876physicians.
877     (i)  Serve as a liaison with other states and federal
878agencies and programs in order to enhance resources available to
879the state's physician workforce and medical education continuum.
880     (j)  Act as a clearinghouse for collecting and
881disseminating information concerning the physician workforce and
882medical education continuum in this state.
883     (5)  PHYSICIAN WORKFORCE ADVISORY COUNCIL.-There is created
884in the department the Physician Workforce Advisory Council, an
885advisory council as defined in s. 20.03. The council shall
886comply with the requirements of s. 20.052, except as otherwise
887provided in this section.
888     (a)  The council shall be composed of the following 23
889members:
890     1.  The following members appointed by the State Surgeon
891General:
892     a.  A designee from the department.
893     b.  An individual recommended by the Area Health Education
894Center Network.
895     c.  Two individuals recommended by the Council of Florida
896Medical School Deans, one representing a college of allopathic
897medicine and one representing a college of osteopathic medicine.
898     d.  Two individuals recommended by the Florida Hospital
899Association, one representing a statutory teaching hospital and
900one representing a hospital that is licensed under chapter 395,
901has an accredited graduate medical education program, and is not
902a statutory teaching hospital.
903     e.  Two individuals recommended by the Florida Medical
904Association, one representing a primary care specialty and one
905representing a nonprimary care specialty.
906     f.  Two individuals recommended by the Florida Osteopathic
907Medical Association, one representing a primary care specialty
908and one representing a nonprimary care specialty.
909     g.  Two individuals who are program directors of accredited
910graduate medical education programs, one representing a program
911that is accredited by the Accreditation Council for Graduate
912Medical Education and one representing a program that is
913accredited by the American Osteopathic Association.
914     h.  An individual recommended by the Florida Justice
915Association.
916     i.  An individual representing a profession in the field of
917health services administration.
918     j.  A layperson member.
919
920Each entity authorized to make recommendations under this
921subparagraph shall make at least two recommendations to the
922State Surgeon General for each appointment to the council. The
923State Surgeon General shall appoint one member for each position
924from among the recommendations made by each authorized entity.
925     2.  The following members or designees appointed by the
926respective agency head, legislative presiding officer, or
927congressional delegation:
928     a.  The Commissioner of Education or his or her designee.
929     b.  The Chancellor of the State University System or his or
930her designee.
931     c.  The Secretary of Health Care Administration or his or
932her designee.
933     d.  The executive director of the Department of Veterans'
934Affairs or his or her designee.
935     e.  The Secretary of Elderly Affairs or his or her
936designee.
937     f.  The President of the Senate or his or her designee.
938     g.  The Speaker of the House of Representatives or his or
939her designee.
940     h.  A designee of Florida's Congressional Delegation.
941     (b)  Each council member shall be appointed to a 4-year
942term. A member may not serve more than two full terms. Any
943council member may be removed from office for malfeasance,
944misfeasance, neglect of duty, incompetence, permanent inability
945to perform official duties, or pleading guilty or nolo
946contendere to, or being found guilty of, a felony. Any council
947member who meets the criteria for removal, or who is otherwise
948unwilling or unable to properly fulfill the duties of the
949office, shall be succeeded by an individual chosen by the State
950Surgeon General to serve out the remainder of the council
951member's term. If the remainder of the replaced council member's
952term is less than 18 months, notwithstanding the provisions of
953this paragraph, the succeeding council member may be reappointed
954twice by the State Surgeon General.
955     (c)  The chair of the council is the State Surgeon General,
956who shall designate a vice chair to serve in the absence of the
957State Surgeon General. A vacancy shall be filled for the
958remainder of the unexpired term in the same manner as the
959original appointment.
960     (d)  Council members are not entitled to receive
961compensation or reimbursement for per diem or travel expenses.
962     (e)  The council shall meet twice a year in person or by
963teleconference.
964     (f)  The council shall:
965     1.  Advise the State Surgeon General and the department on
966matters concerning current and future physician workforce needs
967in this state.
968     2.  Review survey materials and the compilation of survey
969information.
970     3.  Provide recommendations to the department for the
971development of additional items to be incorporated in the survey
972completed by physicians licensed under chapter 458 or chapter
973459.
974     4.  Assist the department in preparing the annual report to
975the Legislature pursuant to ss. 458.3192 and 459.0082.
976     5.  Assist the department in preparing an initial strategic
977plan, conducting ongoing strategic planning in accordance with
978this section, and providing ongoing advice on implementing the
979recommendations.
980     6.  Monitor the need for an increased number of primary
981care physicians to provide the necessary current and projected
982health and medical services for the state.
983     7.  Monitor the status of graduate medical education in
984this state, including, but not limited to, as considered
985appropriate:
986     a.  The role of residents and medical faculty in the
987provision of health care.
988     b.  The relationship of graduate medical education to the
989state's physician workforce.
990     c.  The availability and use of state and federal
991appropriated funds for graduate medical education.
992     Section 8.  Section 392.51, Florida Statutes, is amended to
993read:
994     392.51  Findings and intent.-The Legislature finds and
995declares that active tuberculosis is a highly contagious
996infection that is sometimes fatal and constitutes a serious
997threat to the public health. The Legislature finds that there is
998a significant reservoir of tuberculosis infection in this state
999and that there is a need to develop community programs to
1000identify tuberculosis and to respond quickly with appropriate
1001measures. The Legislature finds that some patients who have
1002active tuberculosis have complex medical, social, and economic
1003problems that make outpatient control of the disease difficult,
1004if not impossible, without posing a threat to the public health.
1005The Legislature finds that in order to protect the citizenry
1006from those few persons who pose a threat to the public, it is
1007necessary to establish a system of mandatory contact
1008identification, treatment to cure, hospitalization, and
1009isolation for contagious cases and to provide a system of
1010voluntary, community-oriented care and surveillance in all other
1011cases. The Legislature finds that the delivery of tuberculosis
1012control services is best accomplished by the coordinated efforts
1013of the respective county health departments, the A.G. Holley
1014State Hospital, and the private health care delivery system.
1015     Section 9.  Subsection (5) is added to section 392.69,
1016Florida Statutes, to read:
1017     392.69  Appropriation, sinking, and maintenance trust
1018funds; additional powers of the department.-
1019     (5)  The department shall develop a plan that exclusively
1020uses private and nonstate public hospitals to provide treatment
1021to cure, hospitalization, and isolation for persons with
1022contagious cases of tuberculosis who pose a threat to the
1023public. The department shall submit the plan to the Governor,
1024the President of the Senate, and the Speaker of the House of
1025Representatives by November 1, 2010. The plan shall include the
1026following elements:
1027     (a)  Identification of hospitals functionally capable of
1028caring for such patients.
1029     (b)  Reimbursement for hospital inpatient services at the
1030Medicaid rate and reimbursement for other medically necessary
1031services that are not hospital inpatient services at the
1032relevant Medicaid rate.
1033     (c)  Projected cost estimates.
1034     (d)  A transition plan for closing the A. G. Holley State
1035Hospital and transferring patients to private and nonstate
1036public hospitals over a 90-day period of time.
1037     Section 10.  Paragraph (d) of subsection (5) of section
1038411.01, Florida Statutes, is amended to read:
1039     411.01  School readiness programs; early learning
1040coalitions.-
1041     (5)  CREATION OF EARLY LEARNING COALITIONS.-
1042     (d)  Implementation.-
1043     1.  An early learning coalition may not implement the
1044school readiness program until the coalition is authorized
1045through approval of the coalition's school readiness plan by the
1046Agency for Workforce Innovation.
1047     2.  Each early learning coalition shall develop a plan for
1048implementing the school readiness program to meet the
1049requirements of this section and the performance standards and
1050outcome measures adopted by the Agency for Workforce Innovation.
1051The plan must demonstrate how the program will ensure that each
10523-year-old and 4-year-old child in a publicly funded school
1053readiness program receives scheduled activities and instruction
1054designed to enhance the age-appropriate progress of the children
1055in attaining the performance standards adopted by the Agency for
1056Workforce Innovation under subparagraph (4)(d)8. Before
1057implementing the school readiness program, the early learning
1058coalition must submit the plan to the Agency for Workforce
1059Innovation for approval. The Agency for Workforce Innovation may
1060approve the plan, reject the plan, or approve the plan with
1061conditions. The Agency for Workforce Innovation shall review
1062school readiness plans at least annually.
1063     3.  If the Agency for Workforce Innovation determines
1064during the annual review of school readiness plans, or through
1065monitoring and performance evaluations conducted under paragraph
1066(4)(l), that an early learning coalition has not substantially
1067implemented its plan, has not substantially met the performance
1068standards and outcome measures adopted by the agency, or has not
1069effectively administered the school readiness program or
1070Voluntary Prekindergarten Education Program, the Agency for
1071Workforce Innovation may dissolve the coalition and temporarily
1072contract with a qualified entity to continue school readiness
1073and prekindergarten services in the coalition's county or
1074multicounty region until the coalition is reestablished through
1075resubmission of a school readiness plan and approval by the
1076agency.
1077     4.  The Agency for Workforce Innovation shall adopt
1078criteria for the approval of school readiness plans. The
1079criteria must be consistent with the performance standards and
1080outcome measures adopted by the agency and must require each
1081approved plan to include the following minimum standards and
1082provisions:
1083     a.  A sliding fee scale establishing a copayment for
1084parents based upon their ability to pay, which is the same for
1085all program providers, to be implemented and reflected in each
1086program's budget.
1087     b.  A choice of settings and locations in licensed,
1088registered, religious-exempt, or school-based programs to be
1089provided to parents.
1090     c.  Instructional staff who have completed the training
1091course as required in s. 402.305(2)(d)1., as well as staff who
1092have additional training or credentials as required by the
1093Agency for Workforce Innovation. The plan must provide a method
1094for assuring the qualifications of all personnel in all program
1095settings.
1096     d.  Specific eligibility priorities for children within the
1097early learning coalition's county or multicounty region in
1098accordance with subsection (6).
1099     e.  Performance standards and outcome measures adopted by
1100the Agency for Workforce Innovation.
1101     f.  Payment rates adopted by the early learning coalition
1102and approved by the Agency for Workforce Innovation. Payment
1103rates may not have the effect of limiting parental choice or
1104creating standards or levels of services that have not been
1105authorized by the Legislature.
1106     g.  Systems support services, including a central agency,
1107child care resource and referral, eligibility determinations,
1108training of providers, and parent support and involvement.
1109     h.  Direct enhancement services to families and children.
1110System support and direct enhancement services shall be in
1111addition to payments for the placement of children in school
1112readiness programs.
1113     i.  The business organization of the early learning
1114coalition, which must include the coalition's articles of
1115incorporation and bylaws if the coalition is organized as a
1116corporation. If the coalition is not organized as a corporation
1117or other business entity, the plan must include the contract
1118with a fiscal agent. An early learning coalition may contract
1119with other coalitions to achieve efficiency in multicounty
1120services, and these contracts may be part of the coalition's
1121school readiness plan.
1122     j.  Strategies to meet the needs of unique populations,
1123such as migrant workers.
1124
1125As part of the school readiness plan, the early learning
1126coalition may request the Governor to apply for a waiver to
1127allow the coalition to administer the Head Start Program to
1128accomplish the purposes of the school readiness program. If a
1129school readiness plan demonstrates that specific statutory goals
1130can be achieved more effectively by using procedures that
1131require modification of existing rules, policies, or procedures,
1132a request for a waiver to the Agency for Workforce Innovation
1133may be submitted as part of the plan. Upon review, the Agency
1134for Workforce Innovation may grant the proposed modification.
1135     5.  Persons with an early childhood teaching certificate
1136may provide support and supervision to other staff in the school
1137readiness program.
1138     6.  An early learning coalition may not implement its
1139school readiness plan until it submits the plan to and receives
1140approval from the Agency for Workforce Innovation. Once the plan
1141is approved, the plan and the services provided under the plan
1142shall be controlled by the early learning coalition. The plan
1143shall be reviewed and revised as necessary, but at least
1144biennially. An early learning coalition may not implement the
1145revisions until the coalition submits the revised plan to and
1146receives approval from the Agency for Workforce Innovation. If
1147the Agency for Workforce Innovation rejects a revised plan, the
1148coalition must continue to operate under its prior approved
1149plan.
1150     7.  Sections 125.901(2)(a)3. and, 411.221, and 411.232 do
1151not apply to an early learning coalition with an approved school
1152readiness plan. To facilitate innovative practices and to allow
1153the regional establishment of school readiness programs, an
1154early learning coalition may apply to the Governor and Cabinet
1155for a waiver of, and the Governor and Cabinet may waive, any of
1156the provisions of ss. 411.223, 411.232, and 1003.54, if the
1157waiver is necessary for implementation of the coalition's school
1158readiness plan.
1159     8.  Two or more counties may join for purposes of planning
1160and implementing a school readiness program.
1161     9.  An early learning coalition may, subject to approval by
1162the Agency for Workforce Innovation as part of the coalition's
1163school readiness plan, receive subsidized child care funds for
1164all children eligible for any federal subsidized child care
1165program.
1166     10.  An early learning coalition may enter into multiparty
1167contracts with multicounty service providers in order to meet
1168the needs of unique populations such as migrant workers.
1169     Section 11.  Paragraphs (f) and (g) of subsection (2) of
1170section 411.224, Florida Statutes, are redesignated as
1171paragraphs (e) and (f), respectively, and present paragraph (e)
1172of that subsection is amended to read:
1173     411.224  Family support planning process.-The Legislature
1174establishes a family support planning process to be used by the
1175Department of Children and Family Services as the service
1176planning process for targeted individuals, children, and
1177families under its purview.
1178     (2)  To the extent possible within existing resources, the
1179following populations must be included in the family support
1180planning process:
1181     (e)  Participants who are served by the Children's Early
1182Investment Program established in s. 411.232.
1183     Section 12.  Section 458.3192, Florida Statutes, is amended
1184to read:
1185     458.3192  Analysis of survey results; report.-
1186     (1)  Each year, the Department of Health shall analyze the
1187results of the physician survey required by s. 458.3191 and
1188determine by geographic area and specialty the number of
1189physicians who:
1190     (a)  Perform deliveries of children in this state Florida.
1191     (b)  Read mammograms and perform breast-imaging-guided
1192procedures in this state Florida.
1193     (c)  Perform emergency care on an on-call basis for a
1194hospital emergency department.
1195     (d)  Plan to reduce or increase emergency on-call hours in
1196a hospital emergency department.
1197     (e)  Plan to relocate their allopathic or osteopathic
1198practice outside the state.
1199     (f)  Practice medicine in this state.
1200     (g)  Reduce or modify the scope of their practice.
1201     (2)  The Department of Health must report its findings to
1202the Governor, the President of the Senate, and the Speaker of
1203the House of Representatives by November 1 each year. The
1204department may also include in its report findings,
1205recommendations, or other information requested by the council.
1206     Section 13.  Section 459.0082, Florida Statutes, is amended
1207to read:
1208     459.0082  Analysis of survey results; report.-
1209     (1)  Each year, the Department of Health shall analyze the
1210results of the physician survey required by s. 459.0081 and
1211determine by geographic area and specialty the number of
1212physicians who:
1213     (a)  Perform deliveries of children in this state Florida.
1214     (b)  Read mammograms and perform breast-imaging-guided
1215procedures in this state Florida.
1216     (c)  Perform emergency care on an on-call basis for a
1217hospital emergency department.
1218     (d)  Plan to reduce or increase emergency on-call hours in
1219a hospital emergency department.
1220     (e)  Plan to relocate their allopathic or osteopathic
1221practice outside the state.
1222     (f)  Practice medicine in this state.
1223     (g)  Reduce or modify the scope of their practice.
1224     (2)  The Department of Health must report its findings to
1225the Governor, the President of the Senate, and the Speaker of
1226the House of Representatives by November 1 each year. The
1227department may also include in its report findings,
1228recommendations, or other information requested by the council.
1229     Section 14.  Paragraph (q) of subsection (2) of section
1230499.01, Florida Statutes, is amended to read:
1231     499.01  Permits.-
1232     (2)  The following permits are established:
1233     (q)  Device manufacturer permit.-
1234     1.  A device manufacturer permit is required for any person
1235that engages in the manufacture, repackaging, or assembly of
1236medical devices for human use in this state, except that a
1237permit is not required if:
1238     a.  The person is engaged only in manufacturing,
1239repackaging, or assembling a medical device pursuant to a
1240practitioner's order for a specific patient; or
1241     b.  The person does not manufacture, repackage, or assemble
1242any medical devices or components for such devices, except those
1243devices or components which are exempt from registration
1244pursuant to s. 499.015(8).
1245     2.1.  A manufacturer or repackager of medical devices in
1246this state must comply with all appropriate state and federal
1247good manufacturing practices and quality system rules.
1248     3.2.  The department shall adopt rules related to storage,
1249handling, and recordkeeping requirements for manufacturers of
1250medical devices for human use.
1251     Section 15.  Paragraph (i) is added to subsection (3) of
1252section 499.01212, Florida Statutes, to read:
1253     499.01212  Pedigree paper.-
1254     (3)  EXCEPTIONS.-A pedigree paper is not required for:
1255     (i)  The wholesale distribution of prescription drugs that
1256are contained within a sealed medical convenience kit provided
1257that:
1258     1.  The medical convenience kit is assembled in an
1259establishment that is registered as a medical device
1260manufacturer with the Food and Drug Administration; and
1261     2.  The medical convenience kit does not contain any
1262controlled substance that appears in any schedule contained in
1263or subject to chapter 893 or the federal Comprehensive Drug
1264Abuse Prevention and Control Act of 1970.
1265     Section 16.  Section 499.029, Florida Statutes, is amended
1266to read:
1267     499.029  Prescription Cancer Drug Donation Program.-
1268     (1)  This section may be cited as the Prescription "Cancer
1269Drug Donation Program Act."
1270     (2)  There is created a Prescription Cancer Drug Donation
1271Program within the department for the purpose of authorizing and
1272facilitating the donation of prescription cancer drugs and
1273supplies to eligible patients.
1274     (3)  As used in this section, the term:
1275     (a)  "Cancer drug" means a prescription drug that has been
1276approved under s. 505 of the federal Food, Drug, and Cosmetic
1277Act and is used to treat cancer or its side effects or is used
1278to treat the side effects of a prescription drug used to treat
1279cancer or its side effects. "Cancer drug" does not include a
1280substance listed in Schedule II, Schedule III, Schedule IV, or
1281Schedule V of s. 893.03.
1282     (a)(b)  "Closed drug delivery system" means a system in
1283which the actual control of the unit-dose medication package is
1284maintained by the facility rather than by the individual
1285patient.
1286     (b)  "Dispensing practitioner" means a practitioner
1287registered under s. 465.0276.
1288     (c)  "Donor" means a patient or patient representative who
1289donates prescription cancer drugs or supplies needed to
1290administer prescription cancer drugs that have been maintained
1291within a closed drug delivery system; health care facilities,
1292nursing homes, hospices, or hospitals with closed drug delivery
1293systems; or pharmacies, prescription drug manufacturers, medical
1294device manufacturers or suppliers, or wholesalers of
1295prescription drugs or supplies, in accordance with this section.
1296The term "donor" includes a physician licensed under chapter 458
1297or chapter 459 who receives prescription cancer drugs or
1298supplies directly from a drug manufacturer, wholesale
1299distributor, or pharmacy.
1300     (d)  "Eligible patient" means a person who the department
1301determines is eligible to receive prescription cancer drugs from
1302the program.
1303     (e)  "Participant facility" means a class II hospital
1304pharmacy or dispensing practitioner that has elected to
1305participate in the program and that accepts donated prescription
1306cancer drugs and supplies under the rules adopted by the
1307department for the program.
1308     (f)  "Prescribing practitioner" means a physician licensed
1309under chapter 458 or chapter 459 or any other medical
1310professional with authority under state law to prescribe drugs
1311cancer medication.
1312     (g)  "Prescription drug" does not include a substance
1313listed in Schedule II, Schedule III, Schedule IV, or Schedule V
1314of s. 893.03.
1315     (h)(g)  "Program" means the Prescription Cancer Drug
1316Donation Program created by this section.
1317     (i)(h)  "Supplies" means any supplies used in the
1318administration of a prescription cancer drug.
1319     (4)  Any donor may donate prescription cancer drugs or
1320supplies to a participant facility that elects to participate in
1321the program and meets criteria established by the department for
1322such participation. Prescription Cancer drugs or supplies may
1323not be donated to a specific cancer patient, and donated
1324prescription drugs or supplies may not be resold by the
1325participant program. Prescription Cancer drugs billed to and
1326paid for by Medicaid in long-term care facilities that are
1327eligible for return to stock under federal Medicaid regulations
1328shall be credited to Medicaid and are not eligible for donation
1329under the program. A participant facility may provide dispensing
1330and counseling consulting services to individuals who are not
1331patients of the participant hospital.
1332     (5)  The prescription cancer drugs or supplies donated to
1333the program may be prescribed only by a prescribing practitioner
1334for use by an eligible patient and may be dispensed only by a
1335pharmacist or a dispensing practitioner.
1336     (6)(a)  A prescription cancer drug may only be accepted or
1337dispensed under the program if the drug is in its original,
1338unopened, sealed container, or in a tamper-evident unit-dose
1339packaging, except that a prescription cancer drug packaged in
1340single-unit doses may be accepted and dispensed if the outside
1341packaging is opened but the single-unit-dose packaging is
1342unopened with tamper-resistant packaging intact.
1343     (b)  A prescription cancer drug may not be accepted or
1344dispensed under the program if the drug bears an expiration date
1345that is less than 6 months after the date the drug was donated
1346or if the drug appears to have been tampered with or mislabeled
1347as determined in paragraph (c).
1348     (c)  Before Prior to being dispensed to an eligible
1349patient, the prescription cancer drug or supplies donated under
1350the program shall be inspected by a pharmacist or dispensing
1351practitioner to determine that the drug and supplies do not
1352appear to have been tampered with or mislabeled.
1353     (d)  A dispenser of donated prescription cancer drugs or
1354supplies may not submit a claim or otherwise seek reimbursement
1355from any public or private third-party payor for donated
1356prescription cancer drugs or supplies dispensed to any patient
1357under the program, and a public or private third-party payor is
1358not required to provide reimbursement to a dispenser for donated
1359prescription cancer drugs or supplies dispensed to any patient
1360under the program.
1361     (7)(a)  A donation of prescription cancer drugs or supplies
1362shall be made only at a participant's participant facility. A
1363participant facility may decline to accept a donation. A
1364participant facility that accepts donated prescription cancer
1365drugs or supplies under the program shall comply with all
1366applicable provisions of state and federal law relating to the
1367storage and dispensing of the donated prescription cancer drugs
1368or supplies.
1369     (b)  A participant facility that voluntarily takes part in
1370the program may charge a handling fee sufficient to cover the
1371cost of preparation and dispensing of prescription cancer drugs
1372or supplies under the program. The fee shall be established in
1373rules adopted by the department.
1374     (8)  The department, upon the recommendation of the Board
1375of Pharmacy, shall adopt rules to carry out the provisions of
1376this section. Initial rules under this section shall be adopted
1377no later than 90 days after the effective date of this act. The
1378rules shall include, but not be limited to:
1379     (a)  Eligibility criteria, including a method to determine
1380priority of eligible patients under the program.
1381     (b)  Standards and procedures for participants participant
1382facilities that accept, store, distribute, or dispense donated
1383prescription cancer drugs or supplies.
1384     (c)  Necessary forms for administration of the program,
1385including, but not limited to, forms for use by entities that
1386donate, accept, distribute, or dispense prescription cancer
1387drugs or supplies under the program.
1388     (d)  The maximum handling fee that may be charged by a
1389participant facility that accepts and distributes or dispenses
1390donated prescription cancer drugs or supplies.
1391     (e)  Categories of prescription cancer drugs and supplies
1392that the program will accept for dispensing; however, the
1393department may exclude any drug based on its therapeutic
1394effectiveness or high potential for abuse or diversion.
1395     (f)  Maintenance and distribution of the participant
1396facility registry established in subsection (10).
1397     (9)  A person who is eligible to receive prescription
1398cancer drugs or supplies under the state Medicaid program or
1399under any other prescription drug program funded in whole or in
1400part by the state, by any other prescription drug program funded
1401in whole or in part by the Federal Government, or by any other
1402prescription drug program offered by a third-party insurer,
1403unless benefits have been exhausted, or a certain prescription
1404cancer drug or supply is not covered by the prescription drug
1405program, is ineligible to participate in the program created
1406under this section.
1407     (10)  The department shall establish and maintain a
1408participant facility registry for the program. The participant
1409facility registry shall include the participant's participant
1410facility's name, address, and telephone number. The department
1411shall make the participant facility registry available on the
1412department's website to any donor wishing to donate prescription
1413cancer drugs or supplies to the program. The department's
1414website shall also contain links to prescription cancer drug
1415manufacturers that offer drug assistance programs or free
1416medication.
1417     (11)  Any donor of prescription cancer drugs or supplies,
1418or any participant in the program, who exercises reasonable care
1419in donating, accepting, distributing, or dispensing prescription
1420cancer drugs or supplies under the program and the rules adopted
1421under this section shall be immune from civil or criminal
1422liability and from professional disciplinary action of any kind
1423for any injury, death, or loss to person or property relating to
1424such activities.
1425     (12)  A pharmaceutical manufacturer is not liable for any
1426claim or injury arising from the transfer of any prescription
1427cancer drug under this section, including, but not limited to,
1428liability for failure to transfer or communicate product or
1429consumer information regarding the transferred drug, as well as
1430the expiration date of the transferred drug.
1431     (13)  If any conflict exists between the provisions in this
1432section and the provisions in this chapter or chapter 465, the
1433provisions in this section shall control the operation of the
1434Cancer Drug Donation program.
1435     Section 17.  Subsections (4) and (5) of section 509.013,
1436Florida Statutes, are amended to read:
1437     509.013  Definitions.-As used in this chapter, the term:
1438     (4)(a)  "Public lodging establishment" includes a transient
1439public lodging establishment as defined in subparagraph 1. and a
1440nontransient public lodging establishment as defined in
1441subparagraph 2.
1442     1.  "Transient public lodging establishment" means any
1443unit, group of units, dwelling, building, or group of buildings
1444within a single complex of buildings which is rented to guests
1445more than three times in a calendar year for periods of less
1446than 30 days or 1 calendar month, whichever is less, or which is
1447advertised or held out to the public as a place regularly rented
1448to guests.
1449     2.  "Nontransient public lodging establishment" means any
1450unit, group of units, dwelling, building, or group of buildings
1451within a single complex of buildings which is rented to guests
1452for periods of at least 30 days or 1 calendar month, whichever
1453is less, or which is advertised or held out to the public as a
1454place regularly rented to guests for periods of at least 30 days
1455or 1 calendar month.
1456
1457License classifications of public lodging establishments, and
1458the definitions therefor, are set out in s. 509.242. For the
1459purpose of licensure, the term does not include condominium
1460common elements as defined in s. 718.103.
1461     (b)  The following are excluded from the definitions in
1462paragraph (a):
1463     1.  Any dormitory or other living or sleeping facility
1464maintained by a public or private school, college, or university
1465for the use of students, faculty, or visitors;
1466     2.  Any facility certified or licensed and regulated by the
1467Agency for Health Care Administration or the Department of
1468Children and Family Services hospital, nursing home, sanitarium,
1469assisted living facility, or other similar place regulated under
1470s. 381.0072;
1471     3.  Any place renting four rental units or less, unless the
1472rental units are advertised or held out to the public to be
1473places that are regularly rented to transients;
1474     4.  Any unit or group of units in a condominium,
1475cooperative, or timeshare plan and any individually or
1476collectively owned one-family, two-family, three-family, or
1477four-family dwelling house or dwelling unit that is rented for
1478periods of at least 30 days or 1 calendar month, whichever is
1479less, and that is not advertised or held out to the public as a
1480place regularly rented for periods of less than 1 calendar
1481month, provided that no more than four rental units within a
1482single complex of buildings are available for rent;
1483     5.  Any migrant labor camp or residential migrant housing
1484permitted by the Department of Health; under ss. 381.008-
1485381.00895; and
1486     6.  Any establishment inspected by the Department of Health
1487and regulated by chapter 513.
1488     (5)(a)  "Public food service establishment" means any
1489building, vehicle, place, or structure, or any room or division
1490in a building, vehicle, place, or structure where food is
1491prepared, served, or sold for immediate consumption on or in the
1492vicinity of the premises; called for or taken out by customers;
1493or prepared prior to being delivered to another location for
1494consumption.
1495     (b)  The following are excluded from the definition in
1496paragraph (a):
1497     1.  Any place maintained and operated by a public or
1498private school, college, or university:
1499     a.  For the use of students and faculty; or
1500     b.  Temporarily to serve such events as fairs, carnivals,
1501and athletic contests.
1502     2.  Any eating place maintained and operated by a church or
1503a religious, nonprofit fraternal, or nonprofit civic
1504organization:
1505     a.  For the use of members and associates; or
1506     b.  Temporarily to serve such events as fairs, carnivals,
1507or athletic contests.
1508     3.  Any eating place located on an airplane, train, bus, or
1509watercraft which is a common carrier.
1510     4.  Any eating place maintained by a facility certified or
1511licensed and regulated by the Agency for Health Care
1512Administration or the Department of Children and Family Services
1513hospital, nursing home, sanitarium, assisted living facility,
1514adult day care center, or other similar place that is regulated
1515under s. 381.0072.
1516     5.  Any place of business issued a permit or inspected by
1517the Department of Agriculture and Consumer Services under s.
1518500.12.
1519     6.  Any place of business where the food available for
1520consumption is limited to ice, beverages with or without
1521garnishment, popcorn, or prepackaged items sold without
1522additions or preparation.
1523     7.  Any theater, if the primary use is as a theater and if
1524patron service is limited to food items customarily served to
1525the admittees of theaters.
1526     8.  Any vending machine that dispenses any food or
1527beverages other than potentially hazardous foods, as defined by
1528division rule.
1529     9.  Any vending machine that dispenses potentially
1530hazardous food and which is located in a facility regulated
1531under s. 381.0072.
1532     10.  Any research and development test kitchen limited to
1533the use of employees and which is not open to the general
1534public.
1535     Section 18.  (1)  All of the statutory powers, duties, and
1536functions, records, personnel, property, and unexpended balances
1537of appropriations, allocations, or other funds for the
1538administration of part I of chapter 499, Florida Statutes,
1539relating to drugs, devices, cosmetics, and household products
1540shall be transferred by a type two transfer, as defined in s.
154120.06(2), Florida Statutes, from the Department of Health to the
1542Department of Business and Professional Regulation.
1543     (2)  The transfer of regulatory authority under part I of
1544chapter 499, Florida Statutes, provided by this section shall
1545not affect the validity of any judicial or administrative action
1546pending as of 11:59 p.m. on the day before the effective date of
1547this section to which the Department of Health is at that time a
1548party, and the Department of Business and Professional
1549Regulation shall be substituted as a party in interest in any
1550such action.
1551     (3)  All lawful orders issued by the Department of Health
1552implementing or enforcing or otherwise in regard to any
1553provision of part I of chapter 499, Florida Statutes, issued
1554prior to the effective date of this section shall remain in
1555effect and be enforceable after the effective date of this
1556section unless thereafter modified in accordance with law.
1557     (4)  The rules of the Department of Health relating to the
1558implementation of part I of chapter 499, Florida Statutes, that
1559were in effect at 11:59 p.m. on the day prior to the effective
1560date of this section shall become the rules of the Department of
1561Business and Professional Regulation and shall remain in effect
1562until amended or repealed in the manner provided by law.
1563     (5)  Notwithstanding the transfer of regulatory authority
1564under part I of chapter 499, Florida Statutes, provided by this
1565section, persons and entities holding in good standing any
1566permit under part I of chapter 499, Florida Statutes, as of
156711:59 p.m. on the day prior to the effective date of this
1568section shall, as of the effective date of this section, be
1569deemed to hold in good standing a permit in the same capacity as
1570that for which the permit was formerly issued.
1571     (6)  Notwithstanding the transfer of regulatory authority
1572under part I of chapter 499, Florida Statutes, provided by this
1573section, persons holding in good standing any certification
1574under part I of chapter 499, Florida Statutes, as of 11:59 p.m.
1575on the day prior to the effective date of this section shall, as
1576of the effective date of this section, be deemed to be certified
1577in the same capacity in which they were formerly certified.
1578     (7)  This section shall take effect July 1, 2011.
1579     Section 19.  (1)  All of the statutory powers, duties, and
1580functions, records, personnel, property, and unexpended balances
1581of appropriations, allocations, or other funds for the
1582administration of the boards and professions established within
1583the Division of Medical Quality Assurance as specified in s.
158420.43(3)(g), Florida Statutes, shall be transferred by a type
1585two transfer, as defined in s. 20.06(2), Florida Statutes, from
1586the Department of Health to the Department of Business and
1587Professional Regulation.
1588     (2)  The transfer of regulatory authority of the Division
1589of Medical Quality Assurance provided by this section shall not
1590affect the validity of any judicial or administrative action
1591pending as of 11:59 p.m. on the day before the effective date of
1592this section to which the Department of Health is at that time a
1593party, and the Department of Business and Professional
1594Regulation shall be substituted as a party in interest in any
1595such action.
1596     (3)  All lawful orders issued by the Department of Health
1597implementing or enforcing or otherwise in regard to any function
1598of the Division of Medical Quality Assurance issued prior to the
1599effective date of this section shall remain in effect and be
1600enforceable after the effective date of this section unless
1601thereafter modified in accordance with law.
1602     (4)  The rules of the Department of Health relating to the
1603implementation of statutory directives administered by the
1604Division of Medical Quality Assurance that were in effect at
160511:59 p.m. on the day prior to the effective date of this
1606section shall become the rules of the Department of Business and
1607Professional Regulation and shall remain in effect until amended
1608or repealed in the manner provided by law.
1609     (5)  Notwithstanding the transfer of regulatory authority
1610of the Division of Medical Quality Assurance provided by this
1611section, persons and entities holding in good standing any
1612license or permit issued by the Division of Medical Quality
1613Assurance as of 11:59 p.m. on the day prior to the effective
1614date of this section shall, as of the effective date of this
1615section, be deemed to hold in good standing a permit in the same
1616capacity as that for which the permit was formerly issued.
1617     (6)  Notwithstanding the transfer of regulatory authority
1618of the Division of Medical Quality Assurance provided by this
1619section, persons holding in good standing any certification
1620issued by the Division of Medical Quality Assurance as of 11:59
1621p.m. on the day prior to the effective date of this section
1622shall, as of the effective date of this section, be deemed to be
1623certified in the same capacity in which they were formerly
1624certified.
1625     (7)  This section shall take effect July 1, 2011.
1626     Section 20.  Except as otherwise expressly provided in this
1627act, this act shall take effect July 1, 2010.


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