Florida Senate - 2014                              CS for SB 734
       
       
        
       By the Committee on Appropriations; and Senators Sobel and
       Abruzzo
       
       
       
       
       576-04691-14                                           2014734c1
    1                        A bill to be entitled                      
    2         An act relating to cancer control and research;
    3         amending s. 1004.435, F.S.; revising definitions;
    4         revising the membership of the Florida Cancer Control
    5         and Research Advisory Council and selection of the
    6         council chairperson; authorizing renewal of member
    7         terms; revising compensation of council members;
    8         renaming the Florida Cancer Plan; requiring the
    9         council to collaborate with the Florida Biomedical
   10         Research Advisory Council to formulate and review a
   11         statewide research plan; requiring the council to
   12         develop and review a statewide treatment plan;
   13         deleting council, Board of Governors, and State
   14         Surgeon General duties relating to the awarding of
   15         grants and contracts for cancer-related programs;
   16         deleting council duties relating to the development of
   17         written summaries of treatment alternatives; deleting
   18         financial aid provisions and the Florida Cancer
   19         Control and Research Fund; amending ss. 458.324 and
   20         459.0125, F.S.; conforming provisions; providing an
   21         effective date.
   22          
   23  Be It Enacted by the Legislature of the State of Florida:
   24  
   25         Section 1. Paragraphs (d) and (e) of subsection (3) and
   26  subsections (4), (5), and (6) of section 1004.435, Florida
   27  Statutes, are amended to read:
   28         1004.435 Cancer control and research.—
   29         (3) DEFINITIONS.—The following words and phrases when used
   30  in this section have, unless the context clearly indicates
   31  otherwise, the meanings given to them in this subsection:
   32         (d) “Fund” means the Florida Cancer Control and Research
   33  Fund established by this section.
   34         (e) “Qualified nonprofit association” means any
   35  association, incorporated or unincorporated, that has received
   36  tax-exempt status from the Internal Revenue Service.
   37         (4) FLORIDA CANCER CONTROL AND RESEARCH ADVISORY COUNCIL;
   38  CREATION; COMPOSITION.—
   39         (a) There is created within the H. Lee Moffitt Cancer
   40  Center and Research Institute, Inc., the Florida Cancer Control
   41  and Research Advisory Council. The council shall consist of 15
   42  35 members, which includes the chairperson, all of whom must be
   43  residents of this state. The State Surgeon General or his or her
   44  designee within the Department of Health shall be one of the 15
   45  members. All Members, except those appointed by the Governor,
   46  the Speaker of the House of Representatives, or and the
   47  President of the Senate, must be appointed by the chief
   48  executive officer of the institution or organization
   49  represented, or his or her designee Governor. At least one of
   50  the members appointed by the Governor must be 60 years of age or
   51  older. One member must be a representative of the American
   52  Cancer Society; one member must be a representative of the
   53  Florida Tumor Registrars Association; one member must be a
   54  representative of the Sylvester Comprehensive Cancer Center of
   55  the University of Miami; one member must be a representative of
   56  the Department of Health; one member must be a representative of
   57  the University of Florida Shands Cancer Center; one member must
   58  be a representative of the Agency for Health Care
   59  Administration; one member must be a representative of the
   60  Florida Nurses Association who specializes in the field of
   61  oncology and is not from an institution or organization already
   62  represented on the council; one member must be a representative
   63  of the Florida Osteopathic Medical Association who specializes
   64  in the field of oncology; one member must be a representative of
   65  the American College of Surgeons; one member must be a
   66  representative of the School of Medicine of the University of
   67  Miami; one member must be a representative of the College of
   68  Medicine of the University of Florida; one member must be a
   69  representative of NOVA Southeastern College of Osteopathic
   70  Medicine; one member must be a representative of the College of
   71  Medicine of the University of South Florida; one member must be
   72  a representative of the College of Public Health of the
   73  University of South Florida; one member must be a representative
   74  of the Florida Society of Clinical Oncology; one member must be
   75  a representative of the Florida Obstetric and Gynecologic
   76  Society who has had training in the specialty of gynecologic
   77  oncology; one member must be a representative of the Florida
   78  Ovarian Cancer Alliance Speaks (FOCAS) organization; one member
   79  must be a member representative of the Florida Medical
   80  Association who specializes in the field of oncology and who
   81  represents a cancer center not already represented on the
   82  council; one member must be a member of the Florida Pediatric
   83  Society; one member must be a representative of the Florida
   84  Radiological Society; one member must be a representative of the
   85  Florida Society of Pathologists; one member must be a
   86  representative of the H. Lee Moffitt Cancer Center and Research
   87  Institute, Inc.; one member must be a member of the Florida
   88  Hospital Association who specializes in the field of oncology
   89  and who represents a comprehensive cancer center not already
   90  represented on the council; one member must be a representative
   91  of the Association of Community Cancer Centers; one member must
   92  specialize in pediatric oncology research or clinical care
   93  appointed by the Governor; one member must specialize in
   94  oncology clinical care or research appointed by the President of
   95  the Senate; one member must be a current or former cancer
   96  patient or a current or former caregiver to a cancer patient
   97  appointed by the Speaker of the House of Representatives three
   98  members must be representatives of the general public acting as
   99  consumer advocates; one member must be a member of the House of
  100  Representatives appointed by the Speaker of the House of
  101  Representatives; and one member must be a member of the Senate
  102  appointed by the President of the Senate; one member must be a
  103  representative of the Florida Dental Association; one member
  104  must be a representative of the Florida Hospital Association;
  105  one member must be a representative of the Association of
  106  Community Cancer Centers; one member shall be a representative
  107  from a statutory teaching hospital affiliated with a community
  108  based cancer center; one member must be a representative of the
  109  Florida Association of Pediatric Tumor Programs, Inc.; one
  110  member must be a representative of the Cancer Information
  111  Service; one member must be a representative of the Florida
  112  Agricultural and Mechanical University Institute of Public
  113  Health; and one member must be a representative of the Florida
  114  Society of Oncology Social Workers. Of the members of the
  115  council appointed by the Governor, At least four of the members
  116  10 must be individuals who are minority persons as defined by s.
  117  288.703.
  118         (b) The terms of the members shall be 4 years from their
  119  respective dates of appointment with the option of renewal.
  120         (c) A chairperson shall be selected by the council
  121  appointed by the Governor for a term of 2 years. The chairperson
  122  shall appoint an executive committee of no fewer than three
  123  persons to serve at the pleasure of the chairperson. This
  124  committee will prepare material for the council but make no
  125  final decisions.
  126         (d) The council shall meet no less than semiannually at the
  127  call of the chairperson or, in his or her absence or incapacity,
  128  at the call of the State Surgeon General. Eight Sixteen members
  129  constitute a quorum for the purpose of exercising all of the
  130  powers of the council. A vote of the majority of the members
  131  present is sufficient for all actions of the council.
  132         (e) The council members shall serve without pay. Pursuant
  133  to the provisions of s. 112.061, the council members may be
  134  entitled to be reimbursed for per diem and travel expenses by
  135  the institution or organization the member represents. If a
  136  member is not affiliated with an institution or organization,
  137  the member shall be reimbursed for travel expenses by the H. Lee
  138  Moffitt Cancer Center and Research Institute, Inc.
  139         (f) No member of the council shall participate in any
  140  discussion or decision to recommend grants or contracts to any
  141  qualified nonprofit association or to any agency of this state
  142  or its political subdivisions with which the member is
  143  associated as a member of the governing body or as an employee
  144  or with which the member has entered into a contractual
  145  arrangement.
  146         (f)(g) The council may prescribe, amend, and repeal bylaws
  147  governing the manner in which the business of the council is
  148  conducted.
  149         (g)(h) The council shall advise the Board of Governors, the
  150  State Surgeon General, and the Legislature with respect to
  151  cancer control and research in this state.
  152         (h)(i) The council shall approve each year a program for
  153  cancer control and research to be known as the “Florida Cancer
  154  Control and Research Plan” which shall be consistent with the
  155  State Health Plan and integrated and coordinated with existing
  156  programs in this state.
  157         (i)(j) The council shall collaborate with the Florida
  158  Biomedical Research Advisory Council to formulate and annually
  159  review and recommend to the State Surgeon General a statewide
  160  research plan. Additionally, the council shall develop and
  161  annually review a statewide “Florida Cancer Treatment Plan” plan
  162  for the care and treatment of persons suffering from cancer. The
  163  council shall and recommend the establishment of standard
  164  requirements for the organization, equipment, and conduct of
  165  cancer units or departments in hospitals and clinics in this
  166  state. The council may recommend to the State Surgeon General
  167  the designation of cancer units following a survey of the needs
  168  and facilities for treatment of cancer in the various localities
  169  throughout the state. The State Surgeon General shall consider
  170  the plans plan in developing departmental priorities and funding
  171  priorities and standards under chapter 395.
  172         (j)(k) The council is responsible for including in the
  173  Florida Cancer Control and Research Plan recommendations for the
  174  coordination and integration of medical, nursing, paramedical,
  175  lay, and other plans concerned with cancer control and research.
  176  Committees shall be formed by the council so that the following
  177  areas will be established as entities for actions:
  178         1. Cancer plan evaluation: tumor registry, data retrieval
  179  systems, and epidemiology of cancer in the state and its
  180  relation to other areas.
  181         2. Cancer prevention.
  182         3. Cancer detection.
  183         4. Cancer patient management: treatment, rehabilitation,
  184  terminal care, and other patient-oriented activities.
  185         5. Cancer education: lay and professional.
  186         6. Unproven methods of cancer therapy: quackery and
  187  unorthodox therapies.
  188         7. Investigator-initiated project research.
  189         (l) In order to implement in whole or in part the Florida
  190  Cancer Plan, the council shall recommend to the Board of
  191  Governors or the State Surgeon General the awarding of grants
  192  and contracts to qualified profit or nonprofit associations or
  193  governmental agencies in order to plan, establish, or conduct
  194  programs in cancer control or prevention, cancer education and
  195  training, and cancer research.
  196         (m) If funds are specifically appropriated by the
  197  Legislature, the council shall develop or purchase standardized
  198  written summaries, written in layperson’s terms and in language
  199  easily understood by the average adult patient, informing actual
  200  and high-risk breast cancer patients, prostate cancer patients,
  201  and men who are considering prostate cancer screening of the
  202  medically viable treatment alternatives available to them in the
  203  effective management of breast cancer and prostate cancer;
  204  describing such treatment alternatives; and explaining the
  205  relative advantages, disadvantages, and risks associated
  206  therewith. The breast cancer summary, upon its completion, shall
  207  be printed in the form of a pamphlet or booklet and made
  208  continuously available to physicians and surgeons in this state
  209  for their use in accordance with s. 458.324 and to osteopathic
  210  physicians in this state for their use in accordance with s.
  211  459.0125. The council shall periodically update both summaries
  212  to reflect current standards of medical practice in the
  213  treatment of breast cancer and prostate cancer. The council
  214  shall develop and implement educational programs, including
  215  distribution of the summaries developed or purchased under this
  216  paragraph, to inform citizen groups, associations, and voluntary
  217  organizations about early detection and treatment of breast
  218  cancer and prostate cancer.
  219         (k)(n) The council shall have the responsibility to advise
  220  the Board of Governors and the State Surgeon General on methods
  221  of enforcing and implementing laws already enacted and concerned
  222  with cancer control, research, and education.
  223         (l)(o) The council may recommend to the Board of Governors
  224  or the State Surgeon General rules not inconsistent with law as
  225  it may deem necessary for the performance of its duties and the
  226  proper administration of this section.
  227         (m)(p) The council shall formulate and put into effect a
  228  continuing educational program for the prevention of cancer and
  229  its early diagnosis and disseminate to hospitals, cancer
  230  patients, and the public information concerning the proper
  231  treatment of cancer.
  232         (n)(q) The council shall be physically located at the H.
  233  Lee Moffitt Cancer Center and Research Institute, Inc., at the
  234  University of South Florida.
  235         (o)(r) The council shall select, by majority vote, seven
  236  members of the council who must combine with six members of the
  237  Biomedical Research Advisory Council to form a joint committee
  238  to develop performance measures, a rating system, a rating
  239  standard, and an application form for the Cancer Center of
  240  Excellence Award created in s. 381.925.
  241         (p)(s) On February 15 of each year, the council shall
  242  report to the Governor and to the Legislature.
  243         (5) RESPONSIBILITIES OF THE BOARD OF GOVERNORS, THE H. LEE
  244  MOFFITT CANCER CENTER AND RESEARCH INSTITUTE, INC., AND THE
  245  STATE SURGEON GENERAL.—
  246         (a) The Board of Governors or the State Surgeon General,
  247  after consultation with the council, shall award grants and
  248  contracts to qualified nonprofit associations and governmental
  249  agencies in order to plan, establish, or conduct programs in
  250  cancer control and prevention, cancer education and training,
  251  and cancer research.
  252         (b) The H. Lee Moffitt Cancer Center and Research
  253  Institute, Inc., shall provide such staff, information, and
  254  other assistance as reasonably necessary for the completion of
  255  the responsibilities of the council.
  256         (c) The department may furnish to citizens of this state
  257  who are afflicted with cancer financial aid to the extent of the
  258  appropriation provided for that purpose in a manner which in its
  259  opinion will afford the greatest benefit to those afflicted and
  260  may make arrangements with hospitals, laboratories, or clinics
  261  to afford proper care and treatment for cancer patients in this
  262  state.
  263         (6) FLORIDA CANCER CONTROL AND RESEARCH FUND.—
  264         (a) There is created the Florida Cancer Control and
  265  Research Fund consisting of funds appropriated therefor from the
  266  General Revenue Fund and any gifts, grants, or funds received
  267  from other sources.
  268         (b) The fund shall be used exclusively for grants and
  269  contracts to qualified nonprofit associations or governmental
  270  agencies for the purpose of cancer control and prevention,
  271  cancer education and training, cancer research, and all expenses
  272  incurred in connection with the administration of this section
  273  and the programs funded through the grants and contracts
  274  authorized by the State Board of Education or the State Surgeon
  275  General.
  276         Section 2. Subsections (1) and (2) of section 458.324,
  277  Florida Statutes, are amended to read:
  278         458.324 Breast cancer; information on treatment
  279  alternatives.—
  280         (1) DEFINITION.—As used in this section, the term
  281  “medically viable,” as applied to treatment alternatives, means
  282  modes of treatment generally considered by the medical
  283  profession to be within the scope of current, acceptable
  284  standards, including treatment alternatives described in the
  285  written summary prepared by the Florida Cancer Control and
  286  Research Advisory Council in accordance with s. 1004.435(4)(m).
  287         (2) COMMUNICATION OF TREATMENT ALTERNATIVES.—
  288         (a) Each physician treating a patient who is, or in the
  289  judgment of the physician is at high risk of being, diagnosed as
  290  having breast cancer shall inform such patient of the medically
  291  viable treatment alternatives available to such patient; shall
  292  describe such treatment alternatives; and shall explain the
  293  relative advantages, disadvantages, and risks associated with
  294  the treatment alternatives to the extent deemed necessary to
  295  allow the patient to make a prudent decision regarding such
  296  treatment options. In compliance with this subsection,:
  297         (a) the physician may, in his or her discretion,:
  298         1. orally communicate such information directly to the
  299  patient or the patient’s legal representative;
  300         2. Provide the patient or the patient’s legal
  301  representative with a copy of the written summary prepared in
  302  accordance with s. 1004.435(4)(m) and express a willingness to
  303  discuss the summary with the patient or the patient’s legal
  304  representative; or
  305         3. Both communicate such information directly and provide a
  306  copy of the written summary to the patient or the patient’s
  307  legal representative for further consideration and possible
  308  later discussion.
  309         (b) In providing such information, the physician shall take
  310  into consideration the emotional state of the patient, the
  311  physical state of the patient, and the patient’s ability to
  312  understand the information.
  313         (c) The physician may, in his or her discretion and without
  314  restriction, recommend any mode of treatment which is in his or
  315  her judgment the best treatment for the patient.
  316  
  317  Nothing in this subsection shall reduce other provisions of law
  318  regarding informed consent.
  319         Section 3. Subsections (1) and (2) of section 459.0125,
  320  Florida Statutes, are amended to read:
  321         459.0125 Breast cancer; information on treatment
  322  alternatives.—
  323         (1) DEFINITION.—As used in this section, the term
  324  “medically viable,” as applied to treatment alternatives, means
  325  modes of treatment generally considered by the medical
  326  profession to be within the scope of current, acceptable
  327  standards, including treatment alternatives described in the
  328  written summary prepared by the Florida Cancer Control and
  329  Research Advisory Council in accordance with s. 1004.435(4)(m).
  330         (2) COMMUNICATION OF TREATMENT ALTERNATIVES.—
  331         (a) It is the obligation of every physician treating a
  332  patient who is, or in the judgment of the physician is at high
  333  risk of being, diagnosed as having breast cancer to inform such
  334  patient of the medically viable treatment alternatives available
  335  to such patient; to describe such treatment alternatives; and to
  336  explain the relative advantages, disadvantages, and risks
  337  associated with the treatment alternatives to the extent deemed
  338  necessary to allow the patient to make a prudent decision
  339  regarding such treatment options. In compliance with this
  340  subsection,:
  341         (a) the physician may, in her or his discretion,:
  342         1. orally communicate such information directly to the
  343  patient or the patient’s legal representative;
  344         2. Provide the patient or the patient’s legal
  345  representative with a copy of the written summary prepared in
  346  accordance with s. 1004.435(4)(m) and express her or his
  347  willingness to discuss the summary with the patient or the
  348  patient’s legal representative; or
  349         3. Both communicate such information directly and provide a
  350  copy of the written summary to the patient or the patient’s
  351  legal representative for further consideration and possible
  352  later discussion.
  353         (b) In providing such information, the physician shall take
  354  into consideration the emotional state of the patient, the
  355  physical state of the patient, and the patient’s ability to
  356  understand the information.
  357         (c) The physician may, in her or his discretion and without
  358  restriction, recommend any mode of treatment which is in the
  359  physician’s judgment the best treatment for the patient.
  360  
  361  Nothing in this subsection shall reduce other provisions of law
  362  regarding informed consent.
  363         Section 4. This act shall take effect July 1, 2014.