Florida State Profile and Policy Report
Heart Disease and Stroke Burden
Florida - State Deaths for Heart Disease and Stroke
More than 1 out of 4 deaths in Florida are due to heart disease.
44,305 Floridians died from heart disease in 2006 (26.1 percent of total deaths in Florida).
8.925 Floridians died from stroke in 2006 (5.2 percent of total deaths in Florida).
Source: National Vital Statistics Report, 2009.
Florida - 2007 State Risk Factors for Heart Disease and Stroke
Florida - 2003 State Costs for Cardiovascular Disease
In October 2007, the Milken Institute, an independent research group, released a study, An Unhealthy America: The Economic Impact of Chronic Disease. The study details the economic effects of treatment costs resulting from chronic disease in the United States. Below is a breakdown of Florida’s estimated medical costs to treat heart disease, hypertension and stroke based on 2003 Medical Expenditure Panel Survey data.
Florida Annual Cost of Hypertension, Heart Disease and Stroke
Treatment Expenditures (Direct Costs) - Total annual medical cost.
Milken Institute, An Unhealthy America: The Economic Impact of Chronic Disease, October 2007.
Florida - Estimated 2007 Medicaid Treatment Costs for Cardiovascular Diseases
Based on Florida's Medicaid population, economic estimates for 2007 were projected using Medical Expenditure Panel Survey data. Medicaid spending has grown rapidly in recent years, placing a significant burden on state budgets. To help states estimate the financial impact of cardiovascular diseases among their Medicaid beneficiaries, the Centers for Disease Control and Prevention (CDC) and RTI International developed the Chronic Disease Cost Calculator, which was used to estimate the Medicaid costs below.
Congestive Heart Failure
Funded CDC Heart Disease and Stroke Prevention Program in Florida
The Centers for Disease Control and Prevention funds Florida's Heart Disease and Stroke Prevention program to increase control of high blood pressure and cholesterol; increase awareness of the signs and symptoms of heart attack and stroke and the importance of promptly calling 911; improve emergency response; improve quality of care; and eliminate related health disparities. These efforts are informed by monitoring heart disease, stroke and related risk factors statewide.
Florida State Highlight - Heart Disease and Stroke Prevention Program
The Florida Heart Disease and Stroke Prevention program partnered with Florida’s primary care association, Florida Association of Community Health Centers Inc. and the American Heart Association to increase the number of community health centers that are using the Health Resources and Services Administration, Health Disparity Collaborative for cardiovascular disease. The collaborative is an innovative health initiative using the recognized chronic care model to redesign approaches to patient care by identifying high risk patients, proactively managing their health care, and promoting lifestyle changes and preventive services to improve health outcomes.
State Laws and Policies
Public Awareness of Heart Disease and Stroke
FL H 9095 (2010, adopted) - Recognizes February 6-12, 2011 as “Congenital Heart Defect Awareness Week” in State of Florida.
HR9043/SR1460 (2008) - In recognition of the importance of the ongoing fight against cardiovascular diseases, March 19, 2008, is recognized as "Go Red For Women Day" in the State of Florida and all residents are encouraged to show their support for women and the fight against cardiovascular diseases bycommemorating this day with the wearing of the color red.
HR9163/SR2090 (2008) - The Senate/House of Representatives recognizes May 2008 as "Power to End Stroke Month" in Florida and urges all residents of this state to recognize that stroke must be taken seriously in order to reduce its risks. The Senate/House of Representatives urges all Floridians to support the American Stroke Association's "Power to End Stroke"campaign by becoming familiar with the warning signs, symptoms, and risk factors associated with stroke and live stronger, healthier lives.
Florida Statute Chapter 401.2916 (2006) - The Department of Health shall implement an educational campaign to inform any person who acquires an automated external defibrillator device of the scope and limitations of the immunity from liability provided under statute 768.1325.
Florida Statute Chapter 381.981 (2004) - (1) The Florida Public Health Foundation Inc., in consultation with the Department of Health, shall coordinate monthly health awareness campaigns with national, state, and local health care organizations and government entities targeting a wide range of the public, including: parents; teachers and other school employees; students in 4th through 12th grades, colleges, and universities; state agency employees; county and local government employees; patients of county health departments; Medicaid recipients; health care professionals and providers; and the public in general. (2) The awareness campaigns shall include the provision of educational information about preventing, detecting, treating, and curing diseases or conditions [including heart disease and stroke].
SR2622 (2003) - The Florida Senate recognizes the month of May 2003 as "Stroke Awareness Month" in the State of Florida.
Prevention of Risk Factors (Nutrition, Physical Activity and Tobacco)
Florida's state employee tobacco cessation program meets all three of the CDC guidelines that include:
1) Coverage for at least four counseling sessions of at least 30 minutes; YES
2) Access to smoking cessation agents, including prescriptions and nicotine replacement; YES
3) Counseling and medication coverage for at least two quit attempts annually; YES
The cigarette excise tax in Florida is $.339.
Florida's statewide Medicaid tobacco cessation program covers over-the-counter and prescription products, therapy, counseling and social support. A statewide public program is also available; coverage may vary from other programs.
Florida Statute Chapter 215.5601 (2008) - There is created the Lawton Chiles Endowment Fund, to be administered by the State Board of Administration. The endowment shall receive moneys from the sale of the state's right, title, and interest in and to the tobacco settlement agreement as defined in s. 215.56005, including the right to receive payments under such agreement, and from accounts transferred from the Department of Financial Services Tobacco Settlement Clearing Trust Fund established under s. 17.41. For fiscal year 2001-2002, $150 million of the existing principal in the endowment shall be reserved and accounted for within the endowment, the income from which shall be used solely for the funding for biomedical research activities as provided in s. 215.5602. The income from the remaining principal shall be used solely as the source of funding for health and human services programs for children and elders as provided in subsection (5). The separate account for biomedical research shall be dissolved and the entire principal in the endowment shall be used exclusively for health and human services programs when cures have been found for tobacco-related cancer, heart, and lung disease.
Florida Statute Chapter 20.43 (2007) - To protect and improve the public health, the department may use state or federal funds to: (a) Provide incentives, including, but not limited to food and including food coupons and payment for travel expenses, for encouraging healthy lifestyle and disease prevention behaviors and patient compliance with medical treatment, such as tuberculosis therapy and smoking cessation programs. (b) Plan and conduct health education campaigns for the purpose of protecting or improving public health. The department may purchase promotional items, such as, but not limited to, t-shirts, hats, sports items such as water bottles and sweat bands, calendars, nutritional charts, baby bibs, growth charts, and other items printed with health promotion messages, and advertising, such as space on billboards or in publications or radio or television time, for health information and promotional messages that recognize that certain behaviors [including cardiovascular disease] are detrimental to public health: (c) Plan and conduct promotional campaigns to recruit health professionals to be employed by the department or to recruit participants in departmental programs for health practitioners, such as scholarship, loan repayment, or volunteer programs.
Increase Detection and Treatment of Risk Factors
No policy listed at this time
State Employee Health and Wellness
Health Savings Accounts
Florida: (2005) The state will contribute $500 for an individual, $1,000 for a family account and pair that with a $1,250 (individual) $2,500 (family) deductible plan.
Florida: To state workers: Get fit or lose your job? "The state's new secretary of Corrections, Mr. McDonough, has proposed mandatory fitness levels for 19,000 of his employees – some of whom have desk jobs. It's meeting resistance from a union representing prison and probation officers and making experts wonder whether requiring workers to become physically fit, or risk losing their jobs, is the best way to tackle the country's growing obesity crisis. - news article, 1/31/07.
Florida: In May 2004 Governor Bush signed HB 1837, which established the state employees' prescription drug program. The new program "shall create a preferred drug list" and shall be subject to new co-payments (effective 1/1/04) as follows: For generic drug with card....$10. For preferred brand name drug with card....$25. For non-preferred brand name drug with card....$40. For generic mail order drug....$20. For preferred brand name mail order drug....$50. For non-preferred brand name drug....$80.
Improve Quality of Care and Access to Care
FL H 331 (2009, enacted) - A Public Health Initiatives act that relates to public health initiatives; amends s. 381.98, F.S.; establishes the Florida Public Health Institute, Inc., and deleting provisions relating to the Florida Public Health Foundation, Inc.; provides purposes of the institute; provides for the institute to operate as a not-for-profit corporation; revises composition of the board of directors; removes obsolete language relating to certain research; requires annual reports to the Legislature; amends ss. 381.855, 381.911, and 381.981, F.S.; conforms terminology; and provides an effective date.
Florida Statute Chapter 215.5602 (2008) - There is established within the Department of Health the James and Esther King Biomedical Research Program funded by the proceeds of the Lawton Chiles Endowment Fund pursuant to s. 215.5601. The purpose of the James and Esther King Biomedical Research Program is to provide an annual and perpetual source of funding in order to support research initiatives that address the health care problems of Floridians in the areas of tobacco-related cancer, cardiovascular disease, stroke, and pulmonary disease. The long-term goals of the program are to: (a) Improve the health of Floridians by researching better prevention, diagnoses, treatments, and cures for cancer, cardiovascular disease, stroke, and pulmonary disease. (b) Expand the foundation of biomedical knowledge relating to the prevention, diagnosis, treatment, and cure of diseases related to tobacco use, including cancer, cardiovascular disease, stroke, and pulmonary disease. (c) Improve the quality of the state's academic health centers by bringing the advances of biomedical research into the training of physicians and other health care providers. (d) Increase the state's per capita funding for research by undertaking new initiatives in public health and biomedical research that will attract additional funding from outside the state. (e) Stimulate economic activity in the state in areas related to biomedical research, such as the research and production of pharmaceuticals, biotechnology, and medical devices.
Florida Statute Chapter 381.855 (2008) - There is established within the Department of Health the Florida Center for Universal Research to Eradicate Disease, which shall be known as "CURED." (a) The purpose of the center is to coordinate, improve, expand, and monitor all biomedical research programs within the state, facilitate funding opportunities, and foster improved technology transfer of research findings into clinical trials and widespread public use. (b) The goal of the center is to find cures for diseases such as cancer, heart disease, lung disease, diabetes, autoimmune disorders, and neurological disorders, including Alzheimer's disease, epilepsy, and Parkinson's disease.
Florida Statute Chapter 320.08058 (2008) - The department shall develop a Stop Heart Disease license plate as provided in this section. The department shall remit the proceeds of the annual use fee to the Florida Heart Research Foundation, Inc. The first $80,000 of the use fee given to the Florida Heart Research Foundation, Inc. shall be used to pay startup costs, including costs incurred developing and issuing the plates. Thereafter, the Florida Heart Research Foundation, Inc., shall provide for a peer review grant solicitation and award process to distribute fees for cardiovascular disease research, education, and prevention within the state and shall make the funds available for any one or more of the following: 1. Quality research to pursue top quality cardiovascular research that will further understanding of heart disease and its cause, treatment, cure, and prevention. Accepted projects must conform to the highest standards of scientific research, be efficiently organized, and report updates continually to ensure research credibility and excellence. 2. Heart disease prevention programs to provide cardiovascular screenings to state residents. 3. Educational programs to offer educational programs, literature, seminars, or speakers for both clinicians and lay people so that the latest risk factors, technologies, treatments, methodologies, protocols, and preventive measures are well known and used in the state. In the first year in which the plate is issued, no more than 25 percent of the fees collected may be used for administrative costs directly associated with the operation of the Florida Heart Research Foundation, Inc., and marketing and promotion of the Stop Heart Disease license plate. In the second and subsequent years in which the plate is sold, no more than 20 percent of the fees collected may be used for administrative costs directly associated with the operation of the Florida Heart Research Foundation, Inc. and marketing and promotion of the Stop Heart Disease license plate.
SR1758 (2006) - The Florida Senate recognizes the significance of new research on the origin, manifestations of, and potential surgical remedies for Congenital Heart Defects; commends this research in the interests of preserving the lives of newborns and children; and urges that the public be informed of these medical developments.
Florida Statute Chapter 385.103 (2004) - (a) The [Department of Health] shall assist the county health departments in developing and operating community intervention programs throughout the state. At a minimum, the community intervention programs shall address one to three of the following chronic diseases: cancer, diabetes, heart disease, stroke, hypertension, renal disease, and chronic obstructive lung disease. (b) Existing community resources, when available, shall be used to support the programs. The department shall seek funding for the programs from federal and state financial assistance programs which presently exist or which may be hereafter created. Additional services, as appropriate, may be incorporated into a program to the extent that resources are available. The department may accept gifts and grants in order to carry out a program. (c) Volunteers shall be used to the maximum extent possible in carrying out the programs. The department shall contract for the necessary insurance coverage to protect volunteers from personal liability while acting within the scope of their volunteer assignments under a program.
Address and Eliminate Disparities
Florida Statute Chapters 381.7351-7355 (2000) - It is the intent of the Legislature to provide funds within Florida counties and Front Porch Florida Communities, in the form of Reducing Racial and Ethnic Health Disparities: Closing the Gap grants, to stimulate the development of community-based and neighborhood-based projects which will improve the health outcomes of racial and ethnic populations. The Reducing Racial and Ethnic Health Disparities: Closing the Gap grant program shall be administered by the Department of Health. A proposal must include the purpose and objectives of the proposal [for a grant], including identification of the particular racial or ethnic disparity [such as decreasing racial and ethnic disparities in morbidity and mortality rates relating to cardiovascular disease] that the project will address.
SB352/ H111 (2000) - The Women and Heart Disease Task Force is created to (1) identify where public awareness, public education, research, and coordination regarding women and heart disease are lacking; (2) prepare recommendations to establish research on the reasons women suffer more severe first heart attacks than men and the reasons women die more often from heart attacks; and (3) increase the public's awareness of the importance of identifying the symptoms of, and treating, heart disease in women. The task force shall exist for 2 years and shall meet as often as necessary to carry out its duties and responsibilities. Within existing resources, the Department of Health shall provide support services to the task force. The task force shall collect research and information on heart disease in women and shall prepare recommendations and proposed legislation for reducing the incidence and the number of women's deaths related to heart disease in this state, to be included in a report submitted to the Governor and the Legislature by January 15, 2002. The task force shall also review and report on The Florida Insurance Code as it relates to coverage for women's heart disease screening and treatment options. The task force shall include in its report recommended changes to the Florida Insurance Code, including specific statutory language, if the task force determines such changes are necessary to ensure that policyholders have coverage for appropriate and necessary heart disease prevention, screening, and treatment. There is appropriated from the General Revenue Fund to the Department of Health the sum of $100,000 for fiscal year 2000-2001 and $100,000 for fiscal year 2001-2002, to be used to produce or purchase and to distribute summaries in English, Spanish, and Creole which inform women patients about their risk of heart disease and about treatment alternatives for heart disease, and to develop and implement an educational program that includes the distribution of information specific to women and heart disease.
Emergency Medical Services (EMS) and Automated External Defibrillators (AED)
Florida Statute Chapter 401.2915/SB 564 (2008) - In order to promote public health and safety: (a) All persons who use an automated external defibrillator are encouraged to obtain appropriate training, to include completion of a course in cardiopulmonary resuscitation or successful completion of a basic first aid course that includes cardiopulmonary resuscitation training, and demonstrated proficiency in the use of an automated external defibrillator. (b) Any person or entity in possession of an automated external defibrillator is encouraged to notify the local emergency medical services medical director of the location of the automated external defibrillator. (c) Any person who uses an automated external defibrillator shall activate the emergency medical services system as soon as possible upon use of the automated external defibrillator. (3) Any person who intentionally or willfully: (a) Tampers with or otherwise renders an automated external defibrillator inoperative, except during such time as the automated external defibrillator is being serviced, tested, repaired, recharged, or inspected or except pursuant to court order; or (b) Obliterates the serial number on an automated external defibrillator for purposes of falsifying service records, commits a misdemeanor of the first degree, punishable as provided in s. 775.082 or s. 775.083. Paragraph (a) does not apply to the owner of the automated external defibrillator or the owner's authorized representative or agent. (4) Each local and state law enforcement vehicle may carry an automated external defibrillator.
Florida Statute Chapter 768.1325 (2008) - Notwithstanding any other provision of law to the contrary any person who uses or attempts to use an automated external defibrillator device on a victim of a perceived medical emergency, without objection of the victim of the perceived medical emergency, is immune from civil liability for any harm resulting from the use or attempted use of such device. In addition, notwithstanding any other provision of law to the contrary, any person who acquired the device and makes it available for use, including, but not limited to, a community association organized under chapter 617, chapter 718, chapter 719, chapter 720, chapter 721, or chapter 723, is immune from such liability, if the harm was not due to the failure of such person to: (a) Properly maintain and test the device; or (b) Provide appropriate training in the use of the device to an employee or agent of the acquirer when the employee or agent was the person who used the device on the victim.
Florida Statute Chapter 768.1326/SB1682 (2008) - No later than January 1, 2003, the State Surgeon General shall adopt rules to establish guidelines on the appropriate placement of automated external defibrillator devices in buildings or portions of buildings owned or leased by the state, and shall establish, by rule, recommendations on procedures for the deployment of automated external defibrillator devices in such buildings in accordance with the guidelines. The Secretary of Management Services shall assist the State Surgeon General in the development of the guidelines. The guidelines for the placement of the automated external defibrillators shall take into account the typical number of employees and visitors in the buildings, the extent of the need for security measures regarding the buildings, special circumstances in buildings or portions of buildings such as high electrical voltages or extreme heat or cold, and such other factors as the State Surgeon General and Secretary of Management Services determine to be appropriate. The State Surgeon General's recommendations for deployment of automated external defibrillators in buildings or portions of buildings owned or leased by the state shall include: (1) A reference list of appropriate training courses in the use of such devices, including the role of cardiopulmonary resuscitation; (2) The extent to which such devices may be used by laypersons; (3) Manufacturer recommended maintenance and testing of the devices; and (4) Coordination with local emergency medical services systems regarding the incidents of use of the devices.
Florida Statute Chapter 932.7055 (2008) - If the seizing agency [of property] is a county or municipal agency, the remaining proceeds shall be deposited in a special law enforcement trust fund established by the board of county commissioners or the governing body of the municipality. Such proceeds and interest earned therefore shall be used for school resource officer, crime prevention, safe neighborhood, drug abuse education and prevention programs, or for other law enforcement purposes, which include defraying the cost of protracted or complex investigations, providing additional equipment or expertise, purchasing automated external defibrillators for use in law enforcement vehicles, and providing matching funds to obtain federal grants. The proceeds and interest may not be used to meet normal operating expenses of the law enforcement agency.
Florida Statute Chapter 1006.165/SB772 (2006) - (1) Each public school that is a member of the Florida High School Athletic Association must have an operational automated external defibrillator on the school grounds. Public and private partnerships are encouraged to cover the cost associated with the purchase and placement of the defibrillator and training in the use of the defibrillator. (2) Each school must ensure that all employees or volunteers who are reasonably expected to use the device obtain appropriate training, including completion of a course in cardiopulmonary resuscitation or a basic first aid course that includes cardiopulmonary resuscitation training, and demonstrated proficiency in the use of an automated external defibrillator. (3) The location of each automated external defibrillator must be registered with a local emergency medical services medical director. (4) The use of automated external defibrillators by employees and volunteers is covered under ss. 768.13 and 768.1325.
Florida Statute Chapter 258.0165/SB274 (2006) - (1) Each state park is encouraged to have on the premises at all times a functioning automated external defibrillator. (2) State parks that provide automated external defibrillators shall ensure that employees and volunteers are properly trained in accordance with s. 401.2915. (3) The location of each automated external defibrillator shall be registered with a local emergency medical services medical director.
Florida Statute Chapter 401.111 (2006) - The department is hereby authorized to make grants to local agencies, emergency medical services organizations, and youth athletic organizations in accordance with any agreement entered into pursuant to this part. These grants shall be designed to assist local agencies and emergency medical services organizations in providing emergency medical services, including emergency medical dispatch, and to assist youth athletic organizations that work in conjunction with local emergency medical services organizations to expand the use of automated external defibrillator devices in the community. The cost of administering this program shall be paid by the department from funds appropriated to it.
Florida Statute Chapter 430.902 /SB1722 (2005) - (a) Each multiservice senior center is encouraged to have on the premises at all times a functioning automated external defibrillator. (b) Multiservice senior centers that provide automated external defibrillators shall ensure that personnel are properly trained in accordance with s. 401.2915. (c) The location of each automated external defibrillator shall be registered with a local emergency medical services medical director. (d) The use of automated external defibrillators by employees and volunteers shall be covered under the provisions of ss. 768.13 and 768.1325.
Stroke Systems of Care
Florida Statute Chapter 395.3038/SB1599 (2004) - The agency shall make available on its website and to the department a list of the name and address of each hospital that meets the criteria for a primary stroke center and the name and address of each hospital that meets the criteria for a comprehensive stroke center. The list of primary and comprehensive stroke centers shall include only those hospitals that attest in an affidavit submitted to the agency that the hospital meets the named criteria, or those hospitals that attest in an affidavit submitted to the agency that the hospital is certified as a primary or a comprehensive stroke center by the Joint Commission on Accreditation of Healthcare Organizations.
Florida Statute Chapter 395.3041 (2004) - (1) By June 1 of each year, the department shall send the list of primary stroke centers and comprehensive stroke centers to the medical director of each licensed emergency medical services provider in this state. (2) The department shall develop a sample stroke-triage assessment tool. The department must post this sample assessment tool on its website and provide a copy of the assessment tool to each licensed emergency medical services provider no later than June 1, 2005. Each licensed emergency medical services provider must use a stroke-triage assessment tool that is substantially similar to the sample stroke-triage assessment tool provided by the department. (3) The medical director of each licensed emergency medical services provider shall develop and implement assessment, treatment, and transport-destination protocols for stroke patients with the intent to assess, treat, and transport stroke patients to the most appropriate hospital. (4) Each emergency medical services provider licensed under chapter 401 must comply with all sections of this act by July 1, 2005.