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Senate Bill 2216

Senate Bill sb2216

CODING: Words stricken are deletions; words underlined are additions.
    Florida Senate - 2004                                  SB 2216

    By Senator Jones

    13-1285-04                                          See HB 913

  1                      A bill to be entitled

  2         An act relating to public health care; amending

  3         s. 381.0012, F.S.; expanding the environmental

  4         health enforcement authority of the Department

  5         of Health; authorizing the department to issue

  6         citations or order payment of fines; providing

  7         requirements and limitations; providing a

  8         criminal penalty; providing for deposit and use

  9         of fines; amending s. 381.004, F.S.; providing

10         additional criteria for release of HIV

11         preliminary test results; amending s. 381.006,

12         F.S.; establishing permitting procedures for

13         group care facilities; providing requirements

14         and limitations; providing for fees; providing

15         fee limitations; providing authority to the

16         department to take adverse action on permits

17         under certain circumstances; amending s.

18         381.0065, F.S.; modifying standards for

19         rulemaking applicable to regulation of onsite

20         sewage treatment and disposal systems; revising

21         research award qualifications; providing for an

22         extended right of entry; amending s. 381.0101,

23         F.S.; revising definitions; revising

24         environmental health professional certification

25         requirements; clarifying exemptions; creating

26         s. 381.104, F.S.; creating an employee health

27         and wellness program; providing requirements;

28         authorizing state agencies to undertake certain

29         activities relating to agency resources for

30         program purposes; requiring each participating

31         agency to make an annual report; providing


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    Florida Senate - 2004                                  SB 2216
    13-1285-04                                          See HB 913

 1         duties of the department; amending s. 384.25,

 2         F.S.; revising reporting requirements for

 3         sexually transmissible diseases; authorizing

 4         the department to adopt rules; amending s.

 5         384.31, F.S.; revising sexually transmissible

 6         disease testing requirements for pregnant

 7         women; providing notice requirements; creating

 8         s. 385.104, F.S.; establishing the Health

 9         Promotion and Health Education Statewide

10         Initiative for certain purposes; providing

11         requirements; authorizing the department to

12         award funding to county health departments for

13         certain purposes; providing funding

14         requirements; providing participation

15         requirements for county health departments;

16         creating s. 458.3215, F.S.; providing for

17         reactivation of licenses of certain physicians

18         for certain limited purposes; providing for a

19         reactivation fee; amending s. 945.601, F.S.;

20         revising a cross-reference, to conform;

21         creating s. 945.6038, F.S.; authorizing the

22         State of Florida Correctional Medical Authority

23         to enter into agreements with other state

24         agencies to provide additional medical

25         services; providing a limitation; providing an

26         effective date.


28  Be It Enacted by the Legislature of the State of Florida:


30         Section 1.  Subsections (6) and (7) are added to

31  section 381.0012, Florida Statutes, to read:


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    Florida Senate - 2004                                  SB 2216
    13-1285-04                                          See HB 913

 1         381.0012  Enforcement authority.--

 2         (6)  When a violation of s. 386.01, s. 386.041, or

 3  environmental health rules adopted under this chapter occurs,

 4  and such violation is enforceable by administrative or civil

 5  remedy or is a second-degree misdemeanor, the department may

 6  issue a citation that contains an order of correction, an

 7  order to pay a fine, or both. A citation issued under this

 8  subsection constitutes a notice of proposed agency action.

 9         (a)  Citations must be in writing and must describe the

10  particular nature of the violation, including specific

11  reference to the provision of statute or rule allegedly

12  violated.

13         (b)  The fines imposed may not exceed $500 for each

14  violation. Each day constitutes a separate violation for which

15  a citation may be issued.

16         (c)  The citing official shall inform the recipient, by

17  written notice pursuant to ss. 120.569 and 120.57, of the

18  right to an administrative hearing. The citation must contain

19  a conspicuous statement that failure to pay the fine within

20  the allotted time, or failure to appear to contest the

21  citation after having requested a hearing, constitutes a

22  waiver of the right to contest the citation.

23         (d)  The department may reduce or waive the fine

24  imposed by the citation after giving due consideration to such

25  factors as the gravity of the violation, the good faith of the

26  person who has allegedly committed the violation, and the

27  person's history of previous violations, including violations

28  for which enforcement actions were taken under this section or

29  other provisions of law.

30         (e)  Any person who willfully refuses to sign and

31  accept a citation issued by the department commits a


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    Florida Senate - 2004                                  SB 2216
    13-1285-04                                          See HB 913

 1  misdemeanor of the second degree, punishable as provided in s.

 2  775.082 or s. 775.083.

 3         (f)  The department shall deposit all fines collected

 4  under the authority of this subsection in the County Health

 5  Department Trust Fund for use in the environmental health

 6  program under which the fine was issued and shall use such

 7  fines to improve the respective programs or to provide

 8  training to the regulated industry and department staff

 9  working in such programs.

10         (g)  The provisions of this subsection are an

11  alternative means of enforcing environmental health

12  requirements which does not prohibit the department from using

13  other means of enforcement. However, the department shall use

14  only one method of enforcement for a single violation.

15         (7)  The department may use positive means of

16  enforcement to ensure compliance with environmental health

17  requirements specified in this chapter, ss. 386.01 and

18  386.041, or environmental health rules adopted under the

19  authority of this chapter. Such means of enforcement may

20  include requiring attendance at training courses applicable to

21  the violations committed and requiring the use of best

22  management practices currently used or recognized by the

23  appropriate regulated industry or governmental agency.

24         Section 2.  Paragraph (d) of subsection (3) of section

25  381.004, Florida Statutes, is amended to read:

26         381.004  HIV testing.--



29         (d)  No test result shall be determined as positive,

30  and no positive test result shall be revealed to any person,



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    Florida Senate - 2004                                  SB 2216
    13-1285-04                                          See HB 913

 1  without corroborating or confirmatory tests being conducted

 2  except in the following situations:

 3         1.  Preliminary test results may be released to

 4  licensed physicians or the medical or nonmedical personnel

 5  subject to the significant exposure for purposes of

 6  subparagraphs (h)10., 11., and 12.

 7         2.  Preliminary test results may be released to health

 8  care providers and to the person tested when decisions about

 9  medical care or treatment of, or recommendation to, the person

10  tested and, in the case of an intrapartum or postpartum woman,

11  when care, treatment, or recommendations regarding her

12  newborn, cannot await the results of confirmatory testing.

13  Positive preliminary HIV test results shall not be

14  characterized to the patient as a diagnosis of HIV infection.

15  Justification for the use of preliminary test results must be

16  documented in the medical record by the health care provider

17  who ordered the test. This subparagraph does not authorize the

18  release of preliminary test results for the purpose of routine

19  identification of HIV-infected individuals or when HIV testing

20  is incidental to the preliminary diagnosis or care of a

21  patient. Corroborating or confirmatory testing must be

22  conducted as followup to a positive preliminary test. Results

23  shall be communicated to the patient according to statute

24  regardless of the outcome. Except as provided in this section,

25  test results are confidential and exempt from the provisions

26  of s. 119.07(1).

27         3.  Positive rapid test results are considered

28  preliminary and may be released in accordance with the

29  manufacturer's instructions as approved by the United States

30  Food and Drug Administration. Positive rapid test results



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    Florida Senate - 2004                                  SB 2216
    13-1285-04                                          See HB 913

 1  require confirmatory testing for diagnosis and reporting of

 2  HIV infection.

 3         Section 3.  Subsection (16) of section 381.006, Florida

 4  Statutes, is amended to read:

 5         381.006  Environmental health.--The department shall

 6  conduct an environmental health program as part of fulfilling

 7  the state's public health mission. The purpose of this program

 8  is to detect and prevent disease caused by natural and manmade

 9  factors in the environment. The environmental health program

10  shall include, but not be limited to:

11         (16)  A group care facilities group-care-facilities

12  function, where a group care group-care facility means any

13  public or private school, housing, building or buildings,

14  section of a building, or distinct part of a building or other

15  place, whether operated for profit or not, which undertakes,

16  through its ownership or management, to provide one or more

17  personal services, care, protection, and supervision to

18  persons who require such services and who are not related to

19  the owner or administrator. The department may adopt rules

20  necessary to protect the health and safety of residents,

21  staff, and patrons of group care group-care facilities, such

22  as child care facilities, family day care day-care homes,

23  assisted living assisted-living facilities, adult day care

24  day-care centers, adult family-care homes, hospices,

25  residential treatment facilities, crisis stabilization

26  crisis-stabilization units, pediatric extended care

27  extended-care centers, intermediate care intermediate-care

28  facilities for the developmentally disabled, group care

29  group-care homes, and, jointly with the Department of

30  Education, private and public schools. These rules may include

31  definitions of terms; provisions relating to operation and


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    Florida Senate - 2004                                  SB 2216
    13-1285-04                                          See HB 913

 1  maintenance of facilities, buildings, grounds, equipment,

 2  furnishings, and occupant-space requirements; lighting;

 3  heating, cooling, and ventilation; food service; water supply

 4  and plumbing; sewage; sanitary facilities; insect and rodent

 5  control; garbage; safety; personnel health, hygiene, and work

 6  practices; permits and fees; and other matters the department

 7  finds are appropriate or necessary to protect the safety and

 8  health of the residents, staff, or patrons. The department may

 9  not adopt rules that conflict with rules adopted by the

10  licensing or certifying agency. The department may enter and

11  inspect at reasonable hours to determine compliance with

12  applicable statutes or rules. In addition to any sanctions

13  that the department may impose for violations of rules adopted

14  under this section, the department shall also report such

15  violations to any agency responsible for licensing or

16  certifying the group care group-care facility. The licensing

17  or certifying agency may also impose any sanction based solely

18  on the findings of the department.

19         (a)  Each group care facility regulated under this

20  section shall obtain a permit from the department annually.

21  Group care facility permits shall expire annually and shall

22  not be transferable from one place or individual to another.

23  An annual application for permit renewal shall not be

24  required. In new facilities, or when the ownership, control,

25  address, or name of a group care facility is changed, the

26  owner, or the owner's designee, shall apply to the department

27  for issuance of a permit in the manner prescribed by the

28  department.

29         (b)  The department shall establish procedures for the

30  issuance and annual renewal of permits and shall establish

31  annual permit and renewal fees by rule in an amount necessary


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    Florida Senate - 2004                                  SB 2216
    13-1285-04                                          See HB 913

 1  to cover the expenses of administering this section. Effective

 2  October 1, 2004, and until such fees are established by rule,

 3  the annual permit fee shall be as follows:

 4         1.  Nonresidential facilities, including, but not

 5  limited to, child care centers, public schools, and private

 6  schools, shall pay an annual fee based on a rate of $3.50 per

 7  student for the maximum authorized capacity. The total permit

 8  fee shall not be less than $110 nor more than $300.

 9         2.  Residential facilities, including, but not limited

10  to, assisted living facilities, group homes, residential

11  treatment facilities, and other residential facilities, shall

12  pay an annual fee based on a rate of $15.50 per bed for the

13  maximum authorized capacity. The total permit fee shall not be

14  less than $110 nor more than $600, except for foster homes and

15  adult family care homes, which shall pay a flat fee of $60.

16         (c)  The annual permit and renewal fees established and

17  adopted by rule shall not be less than $60 nor more than $600

18  per group care facility.

19         (d)  Permit fees shall be prorated quarterly to reflect

20  the actual number of quarters per calendar year the permit is

21  valid.

22         (e)  The department may refuse to issue a permit to or

23  renew a permit for any facility that is not constructed or

24  maintained in accordance with the rules of the department. The

25  department may cancel, revoke, or suspend a permit to operate

26  a group care facility if the permittee:

27         1.  Fails to pay any fee required by this section;

28         2.  Obtains or attempts to obtain a permit by fraud; or

29         3.  Violates a provision of this section.




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    Florida Senate - 2004                                  SB 2216
    13-1285-04                                          See HB 913

 1  The department may adopt rules to carry out the provisions of

 2  this section.

 3         Section 4.  Paragraphs (a) and (j) of subsection (3) of

 4  section 381.0065, Florida Statutes, are amended, and paragraph

 5  (c) is added to subsection (5) of that section, to read:

 6         381.0065  Onsite sewage treatment and disposal systems;

 7  regulation.--


 9  HEALTH.--The department shall:

10         (a)  Adopt rules to administer ss. 381.0065-381.0067,

11  including definitions that are consistent with the definitions

12  in this section, decreases to setback requirements where no

13  health hazard exists, increases for the lot-flow allowance for

14  performance-based systems, requirements for separation from

15  water table elevation during the wettest season, requirements

16  for the design and construction of any component part of an

17  onsite sewage treatment and disposal system, application and

18  permit requirements for persons who maintain an onsite sewage

19  treatment and disposal system, requirements for maintenance

20  and service agreements for aerobic treatment units and

21  performance-based treatment systems, and recommended

22  standards, including disclosure requirements, for voluntary

23  system inspections to be performed by individuals who are

24  authorized by law to perform such inspections and who shall

25  inform a person having ownership, control, or use of an onsite

26  sewage treatment and disposal system of the inspection

27  standards and of that person's authority to request an

28  inspection based on all or part of the standards, and

29  requirements for implementation of the United States

30  Environmental Protection Agency's voluntary national



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    Florida Senate - 2004                                  SB 2216
    13-1285-04                                          See HB 913

 1  guidelines for management of onsite and clustered or

 2  decentralized wastewater treatment systems.

 3         (j)  Supervise research on, demonstration of, and

 4  training on the performance, environmental impact, and public

 5  health impact of onsite sewage treatment and disposal systems

 6  within this state. Research fees collected under s.

 7  381.0066(2)(k) must be used to develop and fund hands-on

 8  training centers designed to provide practical information

 9  about onsite sewage treatment and disposal systems to septic

10  tank contractors, master septic tank contractors, contractors,

11  inspectors, engineers, and the public and must also be used to

12  fund research projects which focus on improvements of onsite

13  sewage treatment and disposal systems, including use of

14  performance-based standards and reduction of environmental

15  impact. Research projects shall be initially approved by the

16  technical advisory panel and shall be applicable to and

17  reflect the soil conditions specific to Florida. Such projects

18  shall be awarded through competitive negotiation, using the

19  procedures provided in s. 287.055, to public or private

20  entities that have experience in onsite sewage treatment and

21  disposal systems in Florida and that are principally located

22  in Florida. Research projects shall not be awarded to firms or

23  entities that employ or are associated with persons who serve

24  on either the technical advisory panel or the research review

25  and advisory committee.


27         (c)  Department personnel may enter the premises of

28  others when necessary to conduct site evaluations and

29  inspections relating to the permitting of onsite sewage

30  treatment and disposal systems. Such entry does not constitute

31  trespass, and department personnel making such entry are not


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    Florida Senate - 2004                                  SB 2216
    13-1285-04                                          See HB 913

 1  subject to arrest or to a civil action by reason of such

 2  entry. This paragraph does not authorize a department employee

 3  to destroy, injure, damage, or move anything on the premises

 4  of another without the written permission of the landowner.

 5         Section 5.  Subsections (1), (2), (3), and (6) and

 6  paragraph (a) of subsection (5) of section 381.0101, Florida

 7  Statutes, are amended to read:

 8         381.0101  Environmental health professionals.--

 9         (1)  LEGISLATIVE INTENT.--Persons responsible for

10  providing technical and scientific evaluations of

11  environmental health and sanitary conditions in business

12  establishments and communities throughout the state may create

13  a danger to the public health if they are not skilled or

14  competent to perform such evaluations. The public relies on

15  the judgment of environmental health professionals employed by

16  both government agencies and private industries to assure them

17  that environmental hazards are identified and removed before

18  they endanger the health or safety of the public. The purpose

19  of this section is to assure the public that persons

20  specifically responsible for performing environmental health

21  and sanitary evaluations have been certified by examination as

22  competent to perform such work.

23         (2)  DEFINITIONS.--As used in this section:

24         (a)  "Accredited" means recognized by the American

25  Council on Education as meeting acceptable levels of quality

26  and performance.

27         (b)(a)  "Board" means the Environmental Health

28  Professionals Advisory Board.

29         (c)(b)  "Department" means the Department of Health.

30         (d)(c)  "Environmental health" means that segment of

31  public health work which deals with the examination of those


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    Florida Senate - 2004                                  SB 2216
    13-1285-04                                          See HB 913

 1  factors in the human environment which may impact adversely on

 2  the health status of an individual or the public.

 3         (e)(d)  "Environmental health professional" means a

 4  person who is employed or assigned the responsibility for

 5  assessing the environmental health or sanitary conditions, as

 6  defined by the department, within a building, on an

 7  individual's property, or within the community at large, and

 8  who has the knowledge, skills, and abilities to carry out

 9  these tasks. Environmental health professionals may be either

10  field, supervisory, or administrative staff members.

11         (f)(e)  "Certified" means a person who has displayed

12  competency to perform evaluations of environmental or sanitary

13  conditions through examination.

14         (g)(f)  "Registered sanitarian," "R.S.," "Registered

15  Environmental Health Specialist," or "R.E.H.S." means a person

16  who has been certified by either the National Environmental

17  Health Association or the Florida Environmental Health

18  Association as knowledgeable in the environmental health

19  profession.

20         (h)(g)  "Primary environmental health program" means

21  those programs determined by the department to be essential

22  for providing basic environmental and sanitary protection to

23  the public. These programs shall be established by rule and,

24  at a minimum, these programs shall include food protection

25  program work and onsite sewage treatment and disposal systems

26  program work system evaluations.

27         (3)  CERTIFICATION REQUIRED.--No person shall perform

28  environmental health or sanitary evaluations in any primary

29  program area of environmental health without being certified

30  by the department as competent to perform such evaluations.

31  The requirements of this section shall not be mandatory for


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    Florida Senate - 2004                                  SB 2216
    13-1285-04                                          See HB 913

 1  persons performing inspections of public or retail food

 2  service establishments licensed under chapter 500 or chapter

 3  509.

 4         (5)  STANDARDS FOR CERTIFICATION.--The department shall

 5  adopt rules that establish definitions of terms and minimum

 6  standards of education, training, or experience for those

 7  persons subject to this section. The rules must also address

 8  the process for application, examination, issuance,

 9  expiration, and renewal of certification and ethical standards

10  of practice for the profession.

11         (a)  Persons employed as environmental health

12  professionals shall exhibit a knowledge of rules and

13  principles of environmental and public health law in Florida

14  through examination. A person may not conduct environmental

15  health evaluations in a primary program area unless he or she

16  is currently certified in that program area or works under the

17  direct supervision, during his or her initial probationary

18  period for that position, of a certified environmental health

19  professional.

20         1.  All persons who begin employment in a primary

21  environmental health program on or after September 21, 1994,

22  must be certified in that program within the initial

23  probationary period for that position 6 months after

24  employment.

25         2.  Persons employed in the primary environmental

26  health programs program of a food protection program or an

27  onsite sewage treatment and disposal systems system prior to

28  September 21, 1994, shall be considered certified while

29  employed in that position and shall be required to adhere to

30  any professional standards established by the department

31  pursuant to paragraph (b), complete any continuing education


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    Florida Senate - 2004                                  SB 2216
    13-1285-04                                          See HB 913

 1  requirements imposed under paragraph (d), and pay the

 2  certificate renewal fee imposed under subsection (7).

 3         3.  Persons employed in the primary environmental

 4  health programs program of a food protection program or an

 5  onsite sewage treatment and disposal systems system prior to

 6  September 21, 1994, who change positions or program areas and

 7  transfer into another primary environmental health program

 8  area on or after September 21, 1994, must be certified by

 9  examination in that program within 6 months after such

10  transfer, except that they will not be required to possess the

11  college degree required under paragraph (e).

12         4.  Registered sanitarians shall be considered

13  certified and shall be required to adhere to any professional

14  standards established by the department pursuant to paragraph

15  (b).

16         (6)  EXEMPTIONS.--A person who conducts primary

17  environmental evaluation activities and maintains a current

18  registration or certification from another state agency which

19  examined the person's knowledge of the primary program area

20  and requires comparable continuing education to maintain the

21  certificate shall not be required to be certified by this

22  section. Examples of persons not subject to certification are

23  physicians, registered dietitians, certified laboratory

24  personnel, and nurses.

25         Section 6.  Section 381.104, Florida Statutes, is

26  created to read:

27         381.104  Employee health and wellness program.--

28         (1)  Each state agency may allocate, from existing

29  resources, the necessary funding and facilities for the

30  development and maintenance of an employee health and wellness



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    Florida Senate - 2004                                  SB 2216
    13-1285-04                                          See HB 913

 1  program and may seek additional funding from other sources to

 2  support the program for the benefit of the agency's employees.

 3         (2)  Each state agency may dedicate resources to

 4  develop and coordinate an employee health and wellness program

 5  or arrange to cooperate with other agencies within such

 6  agency's geographic proximity for program coordination,

 7  including providers of state employee benefits.

 8         (3)  Each state agency electing to participate shall

 9  establish an employee health and wellness coordinator and

10  advisory committee to guide the development of an operational

11  plan, including the collection of data and development of

12  goals and objectives, and to oversee program evaluation and

13  use of any agency-allocated funds.

14         (4)  Each state agency may conduct and dedicate

15  resources toward an employee needs assessment to ascertain the

16  health-and-wellness-related needs of its employees.

17         (5)  Each state agency may establish policies that

18  allow employees no more than 30 minutes of work time three

19  times each week, as individual workload allows, to use for the

20  purpose of engaging in health and wellness activities which

21  may include physical activity, stress reduction, tobacco

22  cessation, personal training, nutrition counseling, or weight

23  reduction and control. Such 30-minute periods may be used to

24  modify the start or end of the workday or to extend the lunch

25  hour.

26         (6)  Each state agency shall use an employee health and

27  wellness activity agreement form, developed by the Department

28  of Health, to be completed by the employee, signed by both the

29  employee and the employee's immediate supervisor, and kept in

30  the employee's personnel file prior to the employee's

31  participation in any activity. It is the responsibility of the


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    Florida Senate - 2004                                  SB 2216
    13-1285-04                                          See HB 913

 1  employee to complete the form and submit it to the personnel

 2  office. Any change to the employee's activities requires

 3  submission of a revised form. An employee found to be in

 4  violation of the submitted agreement form is not allowed

 5  further participation in the program.

 6         (7)  Each state agency may designate up to 1 hour each

 7  month for the purpose of providing inservice health and

 8  wellness training for its employees.

 9         (8)  Each state agency may use electronic mail and

10  other communication systems to promote the agency's employee

11  health and wellness activities.

12         (9)  Each state agency may, and is encouraged to:

13         (a)  Enter into an agreement or contract with other

14  public or private entities to collaborate or participate

15  jointly in health or wellness education or activity programs.

16         (b)  Implement health education activities that focus

17  on skill development and lifestyle behavior change along with

18  information dissemination and awareness building, preferably

19  tailored to the employees' interests and needs.

20         (c)  Review and offer recommendations to agency

21  leadership on environmental and social support policies that

22  pertain to improving the health of employees.

23         (d)  Link the employee health and wellness program to

24  other programs such as the employee assistance program and

25  other related programs to help employees balance work and

26  family.

27         (e)  Offer free, low-cost, or employee-fee-based

28  programs on site, including the designation of rooms for the

29  express purpose of physical activity, nutrition, stress

30  reduction, and weight control activities. Participating

31  agencies with established employee health and wellness


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    Florida Senate - 2004                                  SB 2216
    13-1285-04                                          See HB 913

 1  programs may purchase exercise equipment to be used in the

 2  room designated for this purpose.

 3         (10)  Each state agency that develops and implements an

 4  employee health and wellness program shall include and

 5  document an evaluation and improvement process in an annual

 6  report to help enhance the program's efficiency and

 7  effectiveness. The annual report shall be submitted to the

 8  Department of Health on July 1 of each year. Agencies shall

 9  use an annual report template provided by the Department of

10  Health to ensure consistency in the presentation of data and

11  other evaluation results.

12         (11)  The Department of Health shall provide employee

13  health and wellness model program guidelines and ongoing

14  technical assistance to other state agencies to assist in the

15  development of each agency's employee health and wellness

16  program.

17         Section 7.  Section 384.25, Florida Statutes, is

18  amended to read:

19         384.25  Reporting required.--

20         (1)  Each person who makes a diagnosis of or treats a

21  person with a sexually transmissible disease, including, but

22  not limited to, HIV and AIDS, and each laboratory that

23  performs a test for a sexually transmissible disease,

24  including, but not limited to, HIV, which concludes with a

25  positive result shall report such facts as may be required by

26  the department by rule, within a time period as specified by

27  rule of the department, but in no case to exceed 2 weeks.

28         (a)(2)  The department shall adopt rules specifying the

29  information required in and a maximum minimum time period for

30  reporting a sexually transmissible disease, including, but not

31  limited to, HIV and AIDS. In adopting such rules, the


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    Florida Senate - 2004                                  SB 2216
    13-1285-04                                          See HB 913

 1  department shall consider the need for information,

 2  protections for the privacy and confidentiality of the

 3  patient, and the practical ability of persons and laboratories

 4  to report in a reasonable fashion. To ensure the

 5  confidentiality of persons infected with HIV the human

 6  immunodeficiency virus (HIV), reporting of HIV infection and

 7  AIDS acquired immune deficiency syndrome (AIDS) must be

 8  conducted using a system the HIV/AIDS Reporting System (HARS)

 9  developed by the Centers for Disease Control and Prevention of

10  the United States Public Health Service or an equivalent

11  system.

12         (3)  The department shall require reporting of

13  physician diagnosed cases of AIDS based upon diagnostic

14  criteria from the Centers for Disease Control and Prevention.

15         (b)(4)  The department may require physician and

16  laboratory reporting of HIV infection. However, only reports

17  of HIV infection identified on or after the effective date of

18  the rule developed by the department pursuant to this

19  subsection shall be accepted. The Reporting may not affect or

20  relate to anonymous HIV testing programs conducted pursuant to

21  s. 381.004(4) or to university-based medical research

22  protocols as determined by the department.

23         (2)(5)  After notification of the test subject under

24  subsection (4), the department may, with the consent of the

25  test subject, notify school superintendents of students and

26  school personnel whose HIV tests are positive.

27         (3)  The department shall adopt rules requiring each

28  physician and laboratory to report any newborn or infant up to

29  18 months of age who has been exposed to HIV. The rules may

30  include the method and time period for reporting, information



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    Florida Senate - 2004                                  SB 2216
    13-1285-04                                          See HB 913

 1  to be included in the report, requirements for enforcement,

 2  and followup activities by the department.

 3         (4)(6)  The department shall by February 1 of each year

 4  submit to the Legislature an annual report relating to all

 5  information obtained pursuant to this section.

 6         (5)(7)  Each person who violates the provisions of this

 7  section or the rules adopted hereunder may be fined by the

 8  department up to $500 for each offense. The department shall

 9  report each violation of this section to the regulatory agency

10  responsible for licensing each health care professional and

11  each laboratory to which these provisions apply.

12         Section 8.  Section 384.31, Florida Statutes, is

13  amended to read:

14         384.31  Serological Testing of pregnant women; duty of

15  the attendant.--

16         (1)  Every person, including every physician licensed

17  under chapter 458 or chapter 459 or midwife licensed under

18  part I of chapter 464 or chapter 467, attending a pregnant

19  woman for conditions relating to pregnancy during the period

20  of gestation and delivery shall take or cause the woman to be

21  tested for sexually transmissible diseases, including, but not

22  limited to, HIV, as required by rule of the department,

23  notwithstanding s. 381.004(3)(a), taken a sample of venous

24  blood at a time or times specified by the department. The

25  tests Each sample of blood shall be performed tested by a

26  laboratory approved for such purposes under part I of chapter

27  483 for sexually transmissible diseases as required by rule of

28  the department. Pregnant women shall be notified of the tests

29  that will be conducted and of their right to refuse testing.

30  If a woman objects to testing, a written statement of



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    Florida Senate - 2004                                  SB 2216
    13-1285-04                                          See HB 913

 1  objection, signed by the patient, shall be placed in the

 2  patient's medical record and no testing shall occur.

 3         (2)  At the time the venous blood sample is taken,

 4  testing for human immunodeficiency virus (HIV) infection shall

 5  be offered to each pregnant woman. The prevailing professional

 6  standard of care in this state requires each health care

 7  provider and midwife who attends a pregnant woman to counsel

 8  the woman to be tested for human immunodeficiency virus (HIV).

 9  Counseling shall include a discussion of the availability of

10  treatment if the pregnant woman tests HIV positive. If a

11  pregnant woman objects to HIV testing, reasonable steps shall

12  be taken to obtain a written statement of such objection,

13  signed by the patient, which shall be placed in the patient's

14  medical record. Every person, including every physician

15  licensed under chapter 458 or chapter 459 or midwife licensed

16  under part I of chapter 464 or chapter 467, who attends a

17  pregnant woman who has been offered and objects to HIV testing

18  shall be immune from liability arising out of or related to

19  the contracting of HIV infection or acquired immune deficiency

20  syndrome (AIDS) by the child from the mother.

21         Section 9.  Section 385.104, Florida Statutes, is

22  created to read:

23         385.104  Health Promotion and Health Education

24  Statewide Initiative.--

25         (1)  The Department of Health shall establish the

26  Health Promotion and Health Education Statewide Initiative to

27  provide a comprehensive and community-based health promotion

28  and education program. The program is designed to provide

29  funding to counties in this state to improve individual and

30  community health, aimed specifically at preventing and



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    Florida Senate - 2004                                  SB 2216
    13-1285-04                                          See HB 913

 1  reducing the impact of chronic diseases and promoting healthy

 2  lifestyles.

 3         (2)  The program's targeted diseases include, but are

 4  not limited to, diabetes, heart disease, stroke, asthma, and

 5  cancer, with a focus on the preventable risk factors of

 6  tobacco use, physical inactivity, and poor nutrition.

 7         (3)  The implementation of these activities shall be

 8  coordinated with and linked to existing state plans and

 9  national priorities, focusing on evidence-based programs and

10  population-based efforts that specifically address social and

11  environmental policy strategies.

12         (4)  Subject to the availability of funds, the

13  Department of Health may award funding to county health

14  departments for purposes of improving individual and community

15  health by expanding and improving the health infrastructure

16  through environmental and policy changes aimed specifically at

17  preventing and reducing the impact of chronic diseases and

18  promoting healthy lifestyles.

19         (5)  To be eligible to receive funding under this

20  section, a county health department shall submit an

21  application to the secretary of the Department of Health

22  containing information as required, including:

23         (a)  A description of the proposed activities and how

24  they promote tobacco cessation, healthy eating, or physical

25  fitness and address the health and social consequences to

26  residents of this state that have chronic diseases.

27         (b)  Information describing how health promotion and

28  education activities are to be coordinated at the local level

29  with other health activities conducted by other education,

30  health, and agricultural agencies.



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    Florida Senate - 2004                                  SB 2216
    13-1285-04                                          See HB 913

 1         (c)  Information describing how local health promotion

 2  and education activities reflect state and national objectives

 3  for health.

 4         (d)  A description of the collaborative process that

 5  the county health department employed in the development of

 6  the health promotion and education program, including

 7  consultations with individuals and organizations with

 8  expertise in promoting public health, nutrition, or physical

 9  activity.

10         (e)  A description of how the county health department

11  will evaluate the effectiveness of its program.

12         (6)  Subject to the availability of funds, a county

13  health department receiving funds under this section shall,

14  pending successful implementation or evaluation as determined

15  by department headquarters staff, conduct the project for at

16  least a period of 3 consecutive years.

17         (7)  A county health department that receives funds

18  under this section may use the funds to carry out one or more

19  of the following activities:

20         (a)  Collect, analyze, and disseminate data related to

21  diabetes, heart disease, stroke, asthma, and cancer, with a

22  focus on the preventable risk factors of tobacco use, physical

23  inactivity, and poor nutrition.

24         (b)  Develop and implement activities to create a

25  comprehensive, coordinated nutrition and physical fitness

26  awareness and chronic disease prevention program.

27         (c)  Develop and implement programs in schools and

28  worksites to increase physical fitness and to enhance the

29  nutritional status of residents of this state.




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    Florida Senate - 2004                                  SB 2216
    13-1285-04                                          See HB 913

 1         (d)  Develop and implement policy and environmental

 2  changes related to the cessation of tobacco, healthful

 3  nutrition, and physical education.

 4         (e)  Collaborate with community-based organizations,

 5  volunteer organizations, state medical associations, and

 6  public health groups to develop and implement health education

 7  and promotion activities.

 8         (f)  Collaborate with public and private organizations

 9  that have a mission to increase public awareness of the

10  importance of a balanced diet and an active lifestyle.

11         Section 10.  Section 458.3215, Florida Statutes, is

12  created to read:

13         458.3215  Reactivation of license for clinical research

14  purposes.--

15         (1)  Any person who left the practice of medicine for

16  purposes of retirement and who, at the time of retirement, was

17  in good standing with the board may apply to have his or her

18  license reactivated, without examination, for purposes of

19  seeing patients solely in a clinical research setting. Such

20  person must not have been out of the practice of medicine for

21  more than 10 years at the time of application under this

22  section.

23         (2)  The board shall by rule set the reactivation fee,

24  not to exceed $300, and develop criteria for reactivation of a

25  license under this section, including appropriate continuing

26  education requirements, not to exceed those prescribed in s.

27  458.321 for reactivation of a license.

28         Section 11.  Section 945.601, Florida Statutes, is

29  amended to read:




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    Florida Senate - 2004                                  SB 2216
    13-1285-04                                          See HB 913

 1         945.601  Correctional Medical Authority; ss.

 2  945.601-945.6038; 945.601-945.6035, definitions.--As used in

 3  this act:

 4         (1)  "Authority" means the State of Florida

 5  Correctional Medical Authority created in this act.

 6         (2)  "Health care provider" means:

 7         (a)  A regional research hospital or research center

 8  which is authorized by law to provide hospital services in

 9  accordance with chapter 395, which has a contractual or

10  operating arrangement with a regional school of medicine, and

11  which is located at that regional school of medicine;

12         (b)  Any entity which has agreed to provide hospital

13  services to inmates in the Department of Corrections; or

14         (c)  Any entity licensed to provide hospital services

15  in accordance with chapter 395.

16         (3)  "Project" means any structure, facility,

17  machinery, equipment, or other property suitable for use by a

18  health facility in connection with its operations or proposed

19  operations, including, without limitation, real property

20  therefor; a clinic, computer facility, dining hall,

21  firefighting facility, fire prevention facility, long-term

22  care facility, hospital, interns' residence, laboratory,

23  laundry, maintenance facility, nurses' residence, office,

24  parking area, pharmacy, recreational facility, research

25  facility, storage facility, utility, or X-ray facility, or any

26  combination of the foregoing; and other structure or facility

27  related thereto or required or useful for health care

28  purposes, the conducting of research, or the operation of a

29  health facility, including a facility or structure essential

30  or convenient for the orderly conduct of the health facility

31  and other similar items necessary or convenient for the


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    Florida Senate - 2004                                  SB 2216
    13-1285-04                                          See HB 913

 1  operation of a particular facility or structure in the manner

 2  for which its use is intended. "Project" does not include such

 3  items as fuel, supplies, or other items which are customarily

 4  deemed to result in a current operating charge.

 5         (4)  "Quality management program" means to monitor and

 6  evaluate inmate health care and includes the following

 7  objectives:

 8         (a)  Assuring that all inmates receive appropriate and

 9  timely services in a safe environment.

10         (b)  Assuring systematic monitoring of the treatment

11  environment.

12         (c)  Assisting in the reduction of professional and

13  general liability risks.

14         (d)  Enhancing efficient utilization of resources.

15         (e)  Assisting in credential review and privilege

16  delineation.

17         (f)  Enhancing the identification of continuing

18  educational needs.

19         (g)  Facilitating the identification of strengths,

20  weaknesses, and opportunities for improvement.

21         (h)  Facilitating the coordination and integration of

22  information systems.

23         (i)  Assuring the resolution of identified problems.

24         (5)  "Real property" includes all lands, including

25  buildings, structures, improvements, and fixtures thereon; any

26  property of any nature appurtenant thereto or used in

27  connection therewith; and every estate, interest, and right,

28  legal or equitable, therein, including any such interest for a

29  term of years.

30         Section 12.  Section 945.6038, Florida Statutes, is

31  created to read:


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    Florida Senate - 2004                                  SB 2216
    13-1285-04                                          See HB 913

 1         945.6038  Additional services.--The authority is

 2  authorized to enter into an agreement or may contract with the

 3  Department of Children and Family Services, subject to the

 4  availability of funding, to conduct surveys of medical

 5  services and to provide medical quality assurance and

 6  improvement assistance at secure confinement and treatment

 7  facilities for persons confined under part V of chapter 394.

 8  The authority may enter into similar agreements with other

 9  state agencies, subject to the availability of funds. The

10  authority may not enter into any such agreement if doing so

11  would impair the authority's ability to fulfill its

12  obligations with regard to the Department of Corrections as

13  set forth in this chapter.

14         Section 13.  This act shall take effect upon becoming a

15  law.


















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