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Senate Bill 2216

Senate Bill sb2216c2

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    Florida Senate - 2004                    CS for CS for SB 2216

    By the Committees on Appropriations; Health, Aging, and
    Long-Term Care; and Senator Jones




    309-2515-04

  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. 381.0065,

12         F.S.; modifying standards for rulemaking

13         applicable to regulation of onsite sewage

14         treatment and disposal systems; revising

15         research award qualifications; providing for an

16         extended right of entry; amending s. 381.0101,

17         F.S.; revising definitions; revising

18         environmental health professional certification

19         requirements; clarifying exemptions; creating

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

21         and wellness program; providing requirements;

22         authorizing state agencies to undertake certain

23         activities relating to agency resources for

24         program purposes; requiring each participating

25         agency to make an annual report; providing

26         duties of the department; amending s. 384.25,

27         F.S.; revising reporting requirements for

28         sexually transmissible diseases; authorizing

29         the department to adopt rules; amending s.

30         384.31, F.S.; revising sexually transmissible

31         disease testing requirements for pregnant

                                  1

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 1         women; providing notice requirements; creating

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

 3         Promotion and Health Education Statewide

 4         Initiative for certain purposes; providing

 5         requirements; authorizing the department to

 6         award funding to county health departments for

 7         certain purposes; providing funding

 8         requirements; providing participation

 9         requirements for county health departments;

10         amending s. 945.601, F.S.; revising a

11         cross-reference, to conform; creating s.

12         945.6038, F.S.; authorizing the State of

13         Florida Correctional Medical Authority to enter

14         into agreements with other state agencies to

15         provide additional medical services; providing

16         a limitation; amending s. 381.005, F.S.;

17         requiring hospitals licensed under ch. 395,

18         F.S., to implement a program offering

19         immunizations against the influenza virus and

20         pneumococcal bacteria to all patients who have

21         attained a specified age; providing an

22         effective date.

23  

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

25  

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

27  section 381.0012, Florida Statutes, to read:

28         381.0012  Enforcement authority.--

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

30  environmental health rules adopted under this chapter occurs,

31  and such violation is enforceable by administrative or civil

                                  2

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

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

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

 4  subsection constitutes a notice of proposed agency action.

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

 6  particular nature of the violation, including specific

 7  reference to the provision of statute or rule allegedly

 8  violated.

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

10  violation. Each day constitutes a separate violation for which

11  a citation may be issued.

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

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

14  right to an administrative hearing. The citation must contain

15  a conspicuous statement that failure to pay the fine within

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

17  citation after having requested a hearing, constitutes a

18  waiver of the right to contest the citation.

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

20  imposed by the citation after giving due consideration to such

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

22  person who has allegedly committed the violation, and the

23  person's history of previous violations, including violations

24  for which enforcement actions were taken under this section or

25  other provisions of law.

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

27  accept a citation issued by the department commits a

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

29  775.082 or s. 775.083.

30         (f)  The department shall deposit all fines collected

31  under the authority of this subsection in the County Health

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 1  Department Trust Fund for use in the environmental health

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

 3  fines to improve the respective programs or to provide

 4  training to the regulated industry and department staff

 5  working in such programs.

 6         (g)  The provisions of this subsection are an

 7  alternative means of enforcing environmental health

 8  requirements which does not prohibit the department from using

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

10  only one method of enforcement for a single violation.

11         (7)  The department may use positive means of

12  enforcement to ensure compliance with environmental health

13  requirements specified in this chapter, ss. 386.01 and

14  386.041, or environmental health rules adopted under the

15  authority of this chapter. Such means of enforcement may

16  include requiring attendance at training courses applicable to

17  the violations committed and requiring the use of best

18  management practices currently used or recognized by the

19  appropriate regulated industry or governmental agency.

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

21  381.004, Florida Statutes, is amended to read:

22         381.004  HIV testing.--

23         (3)  HUMAN IMMUNODEFICIENCY VIRUS TESTING; INFORMED

24  CONSENT; RESULTS; COUNSELING; CONFIDENTIALITY.--

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

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

27  without corroborating or confirmatory tests being conducted

28  except in the following situations:

29         1.  Preliminary test results may be released to

30  licensed physicians or the medical or nonmedical personnel

31  

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 1  subject to the significant exposure for purposes of

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

 3         2.  Preliminary test results may be released to health

 4  care providers and to the person tested when decisions about

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

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

 7  when care, treatment, or recommendations regarding her

 8  newborn, cannot await the results of confirmatory testing.

 9  Positive preliminary HIV test results shall not be

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

11  Justification for the use of preliminary test results must be

12  documented in the medical record by the health care provider

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

14  release of preliminary test results for the purpose of routine

15  identification of HIV-infected individuals or when HIV testing

16  is incidental to the preliminary diagnosis or care of a

17  patient. Corroborating or confirmatory testing must be

18  conducted as followup to a positive preliminary test. Results

19  shall be communicated to the patient according to statute

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

21  test results are confidential and exempt from the provisions

22  of s. 119.07(1).

23         3.  Positive rapid test results are considered

24  preliminary and may be released in accordance with the

25  manufacturer's instructions as approved by the United States

26  Food and Drug Administration. Positive rapid test results

27  require confirmatory testing for diagnosis and reporting of

28  HIV infection.

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

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

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

                                  5

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 1         381.0065  Onsite sewage treatment and disposal systems;

 2  regulation.--

 3         (3)  DUTIES AND POWERS OF THE DEPARTMENT OF

 4  HEALTH.--The department shall:

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

 6  including definitions that are consistent with the definitions

 7  in this section, decreases to setback requirements where no

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

 9  performance-based systems, requirements for separation from

10  water table elevation during the wettest season, requirements

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

12  onsite sewage treatment and disposal system, application and

13  permit requirements for persons who maintain an onsite sewage

14  treatment and disposal system, requirements for maintenance

15  and service agreements for aerobic treatment units and

16  performance-based treatment systems, and recommended

17  standards, including disclosure requirements, for voluntary

18  system inspections to be performed by individuals who are

19  authorized by law to perform such inspections and who shall

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

21  sewage treatment and disposal system of the inspection

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

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

24  requirements for implementation of the United States

25  Environmental Protection Agency's voluntary national

26  guidelines for management of onsite and clustered or

27  decentralized wastewater treatment systems.

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

29  training on the performance, environmental impact, and public

30  health impact of onsite sewage treatment and disposal systems

31  within this state. Research fees collected under s.

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 1  381.0066(2)(k) must be used to develop and fund hands-on

 2  training centers designed to provide practical information

 3  about onsite sewage treatment and disposal systems to septic

 4  tank contractors, master septic tank contractors, contractors,

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

 6  fund research projects which focus on improvements of onsite

 7  sewage treatment and disposal systems, including use of

 8  performance-based standards and reduction of environmental

 9  impact. Research projects shall be initially approved by the

10  technical advisory panel and shall be applicable to and

11  reflect the soil conditions specific to Florida. Such projects

12  shall be awarded through competitive negotiation, using the

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

14  entities that have experience in onsite sewage treatment and

15  disposal systems in Florida and that are principally located

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

17  entities that employ or are associated with persons who serve

18  on either the technical advisory panel or the research review

19  and advisory committee.

20         (5)  ENFORCEMENT; RIGHT OF ENTRY; CITATIONS.--

21         (c)  Department personnel may enter the premises of

22  others when necessary to conduct site evaluations and

23  inspections relating to the permitting of onsite sewage

24  treatment and disposal systems. Such entry does not constitute

25  trespass, and department personnel making such entry are not

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

27  entry. This paragraph does not authorize a department employee

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

29  of another without the written permission of the landowner.

30  

31  

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 1         Section 4.  Subsections (1), (2), (3), and (6) and

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

 3  Statutes, are amended to read:

 4         381.0101  Environmental health professionals.--

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

 6  providing technical and scientific evaluations of

 7  environmental health and sanitary conditions in business

 8  establishments and communities throughout the state may create

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

10  competent to perform such evaluations. The public relies on

11  the judgment of environmental health professionals employed by

12  both government agencies and private industries to assure them

13  that environmental hazards are identified and removed before

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

15  of this section is to assure the public that persons

16  specifically responsible for performing environmental health

17  and sanitary evaluations have been certified by examination as

18  competent to perform such work.

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

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

21  Council on Education as meeting acceptable levels of quality

22  and performance.

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

24  Professionals Advisory Board.

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

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

27  public health work which deals with the examination of those

28  factors in the human environment which may impact adversely on

29  the health status of an individual or the public.

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

31  person who is employed or assigned the responsibility for

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 1  assessing the environmental health or sanitary conditions, as

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

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

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

 5  these tasks. Environmental health professionals may be either

 6  field, supervisory, or administrative staff members.

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

 8  competency to perform evaluations of environmental or sanitary

 9  conditions through examination.

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

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

12  who has been certified by either the National Environmental

13  Health Association or the Florida Environmental Health

14  Association as knowledgeable in the environmental health

15  profession.

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

17  those programs determined by the department to be essential

18  for providing basic environmental and sanitary protection to

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

20  at a minimum, these programs shall include food protection

21  program work and onsite sewage treatment and disposal systems

22  program work system evaluations.

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

24  environmental health or sanitary evaluations in any primary

25  program area of environmental health without being certified

26  by the department as competent to perform such evaluations.

27  The requirements of this section shall not be mandatory for

28  persons performing inspections of public or retail food

29  service establishments licensed under chapter 500 or chapter

30  509.

31  

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

 2  adopt rules that establish definitions of terms and minimum

 3  standards of education, training, or experience for those

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

 5  the process for application, examination, issuance,

 6  expiration, and renewal of certification and ethical standards

 7  of practice for the profession.

 8         (a)  Persons employed as environmental health

 9  professionals shall exhibit a knowledge of rules and

10  principles of environmental and public health law in Florida

11  through examination. A person may not conduct environmental

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

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

14  direct supervision, during his or her initial probationary

15  period for that position, of a certified environmental health

16  professional.

17         1.  All persons who begin employment in a primary

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

19  must be certified in that program within the initial

20  probationary period for that position 6 months after

21  employment.

22         2.  Persons employed in the primary environmental

23  health programs program of a food protection program or an

24  onsite sewage treatment and disposal systems system prior to

25  September 21, 1994, shall be considered certified while

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

27  any professional standards established by the department

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

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

30  certificate renewal fee imposed under subsection (7).

31  

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 1         3.  Persons employed in the primary environmental

 2  health programs program of a food protection program or an

 3  onsite sewage treatment and disposal systems system prior to

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

 5  transfer into another primary environmental health program

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

 7  examination in that program within 6 months after such

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

 9  college degree required under paragraph (e).

10         4.  Registered sanitarians shall be considered

11  certified and shall be required to adhere to any professional

12  standards established by the department pursuant to paragraph

13  (b).

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

15  environmental evaluation activities and maintains a current

16  registration or certification from another state agency which

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

18  and requires comparable continuing education to maintain the

19  certificate shall not be required to be certified by this

20  section. Examples of persons not subject to certification are

21  physicians, registered dietitians, certified laboratory

22  personnel, and nurses.

23         Section 5.  Section 381.104, Florida Statutes, is

24  created to read:

25         381.104  Employee health and wellness program.--

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

27  resources, the necessary funding and facilities for the

28  development and maintenance of an employee health and wellness

29  program and may seek additional funding from other sources to

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

31  

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 1         (2)  Each state agency may dedicate resources to

 2  develop and coordinate an employee health and wellness program

 3  or arrange to cooperate with other agencies within such

 4  agency's geographic proximity for program coordination,

 5  including providers of state employee benefits.

 6         (3)  Each state agency electing to participate shall

 7  establish an employee health and wellness coordinator and

 8  advisory committee to guide the development of an operational

 9  plan, including the collection of data and development of

10  goals and objectives, and to oversee program evaluation and

11  use of any agency-allocated funds.

12         (4)  Each state agency may conduct and dedicate

13  resources toward an employee needs assessment to ascertain the

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

15         (5)  Each state agency may establish policies that

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

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

18  purpose of engaging in health and wellness activities which

19  may include physical activity, stress reduction, tobacco

20  cessation, personal training, nutrition counseling, or weight

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

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

23  hour.

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

25  wellness activity agreement form, developed by the Department

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

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

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

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

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

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

                                  12

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

 2  violation of the submitted agreement form is not allowed

 3  further participation in the program.

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

 5  month for the purpose of providing inservice health and

 6  wellness training for its employees.

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

 8  other communication systems to promote the agency's employee

 9  health and wellness activities.

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

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

12  public or private entities to collaborate or participate

13  jointly in health or wellness education or activity programs.

14         (b)  Implement health education activities that focus

15  on skill development and lifestyle behavior change along with

16  information dissemination and awareness building, preferably

17  tailored to the employees' interests and needs.

18         (c)  Review and offer recommendations to agency

19  leadership on environmental and social support policies that

20  pertain to improving the health of employees.

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

22  other programs such as the employee assistance program and

23  other related programs to help employees balance work and

24  family.

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

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

27  express purpose of physical activity, nutrition, stress

28  reduction, and weight control activities. Participating

29  agencies with established employee health and wellness

30  programs may purchase exercise equipment to be used in the

31  room designated for this purpose.

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

 2  employee health and wellness program shall include and

 3  document an evaluation and improvement process in an annual

 4  report to help enhance the program's efficiency and

 5  effectiveness. The annual report shall be submitted to the

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

 7  use an annual report template provided by the Department of

 8  Health to ensure consistency in the presentation of data and

 9  other evaluation results.

10         (11)  The Department of Health shall provide employee

11  health and wellness model program guidelines and ongoing

12  technical assistance to other state agencies to assist in the

13  development of each agency's employee health and wellness

14  program.

15         Section 6.  Section 384.25, Florida Statutes, is

16  amended to read:

17         384.25  Reporting required.--

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

19  person with a sexually transmissible disease, including, but

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

21  performs a test for a sexually transmissible disease,

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

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

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

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

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

27  information required in and a maximum minimum time period for

28  reporting a sexually transmissible disease, including, but not

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

30  department shall consider the need for information,

31  protections for the privacy and confidentiality of the

                                  14

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 1  patient, and the practical ability of persons and laboratories

 2  to report in a reasonable fashion. To ensure the

 3  confidentiality of persons infected with HIV the human

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

 5  AIDS acquired immune deficiency syndrome (AIDS) must be

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

 7  developed by the Centers for Disease Control and Prevention of

 8  the United States Public Health Service or an equivalent

 9  system.

10         (3)  The department shall require reporting of

11  physician diagnosed cases of AIDS based upon diagnostic

12  criteria from the Centers for Disease Control and Prevention.

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

14  laboratory reporting of HIV infection. However, only reports

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

16  the rule developed by the department pursuant to this

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

18  relate to anonymous HIV testing programs conducted pursuant to

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

20  protocols as determined by the department.

21         (2)(5)  After notification of the test subject under

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

23  test subject, notify school superintendents of students and

24  school personnel whose HIV tests are positive.

25         (3)  The department shall adopt rules requiring each

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

27  18 months of age who has been exposed to HIV. The rules may

28  include the method and time period for reporting, information

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

30  and followup activities by the department.

31  

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

 2  submit to the Legislature an annual report relating to all

 3  information obtained pursuant to this section.

 4         (5)(7)  Each person who violates the provisions of this

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

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

 7  report each violation of this section to the regulatory agency

 8  responsible for licensing each health care professional and

 9  each laboratory to which these provisions apply.

10         Section 7.  Section 384.31, Florida Statutes, is

11  amended to read:

12         384.31  Serological Testing of pregnant women; duty of

13  the attendant.--

14         (1)  Every person, including every physician licensed

15  under chapter 458 or chapter 459 or midwife licensed under

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

17  woman for conditions relating to pregnancy during the period

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

19  tested for sexually transmissible diseases, including, but not

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

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

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

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

24  laboratory approved for such purposes under part I of chapter

25  483 for sexually transmissible diseases as required by rule of

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

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

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

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

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

31  

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

 2  testing for human immunodeficiency virus (HIV) infection shall

 3  be offered to each pregnant woman. The prevailing professional

 4  standard of care in this state requires each health care

 5  provider and midwife who attends a pregnant woman to counsel

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

 7  Counseling shall include a discussion of the availability of

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

 9  pregnant woman objects to HIV testing, reasonable steps shall

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

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

12  medical record. Every person, including every physician

13  licensed under chapter 458 or chapter 459 or midwife licensed

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

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

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

17  the contracting of HIV infection or acquired immune deficiency

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

19         Section 8.  Section 385.104, Florida Statutes, is

20  created to read:

21         385.104  Health Promotion and Health Education

22  Statewide Initiative.--

23         (1)  The Department of Health shall establish the

24  Health Promotion and Health Education Statewide Initiative to

25  provide a comprehensive and community-based health promotion

26  and education program. The program is designed to provide

27  funding to counties in this state to improve individual and

28  community health, aimed specifically at preventing and

29  reducing the impact of chronic diseases and promoting healthy

30  lifestyles.

31  

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

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

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

 4  tobacco use, physical inactivity, and poor nutrition.

 5         (3)  The implementation of these activities shall be

 6  coordinated with and linked to existing state plans and

 7  national priorities, focusing on evidence-based programs and

 8  population-based efforts that specifically address social and

 9  environmental policy strategies.

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

11  Department of Health may award funding to county health

12  departments for purposes of improving individual and community

13  health by expanding and improving the health infrastructure

14  through environmental and policy changes aimed specifically at

15  preventing and reducing the impact of chronic diseases and

16  promoting healthy lifestyles.

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

18  section, a county health department shall submit an

19  application to the secretary of the Department of Health

20  containing information as required, including:

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

22  they promote tobacco cessation, healthy eating, or physical

23  fitness and address the health and social consequences to

24  residents of this state that have chronic diseases.

25         (b)  Information describing how health promotion and

26  education activities are to be coordinated at the local level

27  with other health activities conducted by other education,

28  health, and agricultural agencies.

29         (c)  Information describing how local health promotion

30  and education activities reflect state and national objectives

31  for health.

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 1         (d)  A description of the collaborative process that

 2  the county health department employed in the development of

 3  the health promotion and education program, including

 4  consultations with individuals and organizations with

 5  expertise in promoting public health, nutrition, or physical

 6  activity.

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

 8  will evaluate the effectiveness of its program.

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

10  health department receiving funds under this section shall,

11  pending successful implementation or evaluation as determined

12  by department headquarters staff, conduct the project for at

13  least a period of 3 consecutive years.

14         (7)  A county health department that receives funds

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

16  of the following activities:

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

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

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

20  inactivity, and poor nutrition.

21         (b)  Develop and implement activities to create a

22  comprehensive, coordinated nutrition and physical fitness

23  awareness and chronic disease prevention program.

24         (c)  Develop and implement programs in schools and

25  worksites to increase physical fitness and to enhance the

26  nutritional status of residents of this state.

27         (d)  Develop and implement policy and environmental

28  changes related to the cessation of tobacco, healthful

29  nutrition, and physical education.

30         (e)  Collaborate with community-based organizations,

31  volunteer organizations, state medical associations, and

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 1  public health groups to develop and implement health education

 2  and promotion activities.

 3         (f)  Collaborate with public and private organizations

 4  that have a mission to increase public awareness of the

 5  importance of a balanced diet and an active lifestyle.

 6         Section 9.  Section 945.601, Florida Statutes, is

 7  amended to read:

 8         945.601  Correctional Medical Authority; ss.

 9  945.601-945.6038; 945.601-945.6035, definitions.--As used in

10  this act:

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

12  Correctional Medical Authority created in this act.

13         (2)  "Health care provider" means:

14         (a)  A regional research hospital or research center

15  which is authorized by law to provide hospital services in

16  accordance with chapter 395, which has a contractual or

17  operating arrangement with a regional school of medicine, and

18  which is located at that regional school of medicine;

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

20  services to inmates in the Department of Corrections; or

21         (c)  Any entity licensed to provide hospital services

22  in accordance with chapter 395.

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

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

25  health facility in connection with its operations or proposed

26  operations, including, without limitation, real property

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

28  firefighting facility, fire prevention facility, long-term

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

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

31  parking area, pharmacy, recreational facility, research

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

 2  combination of the foregoing; and other structure or facility

 3  related thereto or required or useful for health care

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

 5  health facility, including a facility or structure essential

 6  or convenient for the orderly conduct of the health facility

 7  and other similar items necessary or convenient for the

 8  operation of a particular facility or structure in the manner

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

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

11  deemed to result in a current operating charge.

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

13  evaluate inmate health care and includes the following

14  objectives:

15         (a)  Assuring that all inmates receive appropriate and

16  timely services in a safe environment.

17         (b)  Assuring systematic monitoring of the treatment

18  environment.

19         (c)  Assisting in the reduction of professional and

20  general liability risks.

21         (d)  Enhancing efficient utilization of resources.

22         (e)  Assisting in credential review and privilege

23  delineation.

24         (f)  Enhancing the identification of continuing

25  educational needs.

26         (g)  Facilitating the identification of strengths,

27  weaknesses, and opportunities for improvement.

28         (h)  Facilitating the coordination and integration of

29  information systems.

30         (i)  Assuring the resolution of identified problems.

31  

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

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

 3  property of any nature appurtenant thereto or used in

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

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

 6  term of years.

 7         Section 10.  Section 945.6038, Florida Statutes, is

 8  created to read:

 9         945.6038  Additional services.--The authority is

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

11  Department of Children and Family Services, subject to the

12  availability of funding, to conduct surveys of medical

13  services and to provide medical quality assurance and

14  improvement assistance at secure confinement and treatment

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

16  The authority may enter into similar agreements with other

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

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

19  would impair the authority's ability to fulfill its

20  obligations with regard to the Department of Corrections as

21  set forth in this chapter.

22         Section 11.  Present subsection (2) of section 381.005,

23  Florida Statutes, is redesignated as subsection (3), and a new

24  subsection (2) is added to that section, to read:

25         381.005  Primary and preventive health services.--

26         (2)  Between October 1, or earlier if the vaccination

27  is available, and February 1 of each year, subject to the

28  availability of an adequate supply of the necessary vaccine,

29  each hospital licensed pursuant to chapter 395 shall implement

30  a program to offer immunizations against the influenza virus

31  and pneumococcal bacteria to all patients age 65 or older, in

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 1  accordance with the recommendations of the Advisory Committee

 2  on Immunization Practices of the United States Centers for

 3  Disease Control and Prevention and subject to the clinical

 4  judgment of the responsible practitioner.

 5         Section 12.  This act shall take effect upon becoming a

 6  law.

 7  

 8          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
 9                          CS for SB 2216

10                                 

11  Requires hospitals to implement a program to offer
    immunizations against the influenza virus and pneumococcal
12  bacteria, subject to availability of an adequate supply, to
    all patients age 65 and older.
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