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A05161 Summary:

BILL NOA05161
 
SAME ASSAME AS S02723
 
SPONSORCrespo
 
COSPNSR
 
MLTSPNSR
 
Add Art 27-BB 2725 - 2727, Art 13-l 1399-xx & 1399-yy, Art 24-F 2499-b - 2499-d, amd 2111 & 1399-o-1, Pub Health L; add 3001-e, 1527-a & 923, Ed L; add 235-h, RP L; amd 33-0303, En Con L; add $144, Pub Bldg L
 
Enacts comprehensive provisions to curtail the incidence of asthma and other respiratory diseases; requires teachers in public and non-public school systems to be trained in identifying and responding to asthma emergencies in accordance with standards to be prescribed by the commissioner of education in consultation with the commissioner of health; provides for a program of asthma disease management and control within the department of health; program shall provide various services to health care providers, patients, and others; authorizes the commissioner of health to make grants; provides for a study of asthma incidence and prevalence; provides for an annual report on the program; requires health care providers to provide pregnant women with information on in-utero exposure to tobacco smoke; requires residential leases to include information on the smoking restrictions for the leased premises and in common areas; prohibits idling of motor vehicle engines upon school grounds; authorizes school boards to allow certain students to use inhalers or nebulizers; requires the school that authorizes the use of an inhaler to prepare an asthma treatment plan for the student; ensures safety of all students who suffer from respiratory illnesses in New York; requires reporting of cases of asthma; provides for the curtailing of the use of chemicals which may trigger asthma episodes; provides for the use of the least toxic pesticides which effectively eradicate the targeted organism; includes certain respiratory diseases within the disease management demonstration program; provides for the reduction of emphysema, chronic bronchitis and other chronic respiratory diseases in children; relates to smoking restrictions in certain outdoor areas.
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A05161 Actions:

BILL NOA05161
 
02/06/2017referred to health
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A05161 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A5161
 
SPONSOR: Crespo
  TITLE OF BILL: An act to amend the public health law, in relation to establishing the asthma prevention and education program (Part A); to amend the public health law, in relation to in-utero exposure to tobacco smoke prevention (Part B); to amend the public health law, in relation to reporting on the incidence of asthma (Part C); to amend the public health law, in relation to including certain respiratory diseases within disease management demonstration programs (Part D); to amend the public health law, in relation to smoking restrictions in certain outdoor areas (Part E); to amend the education law, in relation to requiring all teachers to be trained in identifying and responding to asthma emergencies (Part F); to amend the real property law, in relation to residential rental prop- erty smoking policies (Part G); to amend the education law, in relation to requiring school districts and private elementary and secondary schools to establish and implement rules prohibiting the engine of any motor vehicle to remain idling while parked or standing on school grounds (Part H); to amend the education law, in relation to the use of inhalers and nebulizers (Part I); to amend the environmental conserva- tion law, in relation to pesticide alternatives used at schools and day care centers (Part J); and to amend the public buildings law, in relation to curtailing the use of cleaning materials that induce or trigger asthma episodes (Part K)   PURPOSE: To establish a comprehensive statewide asthma management and control program which coordinates the efforts of individuals, families, health care providers, schools and community-based organizations to benefit the people of the State of New York at many levels.   SUMMARY OF PROVISIONS: Section 1: Legislative Intent. Section 2: (Part A) Adds a new Public Health Law Article 27-BB as follows: Creates a new Public Health Law section 2725 to create an Asth- ma disease management and control program. The purpose of the program is to promote asthma disease management and education and outreach about asthma to people who suffer from asthma and their families, health care providers, and the general public. Creates a new Public Health Law (PHL) section 2726 to require the Department of Health (DOH) to study the incidence and prevalence of asthma in New York state including current disease management practices. Such study shall include the cause and nature of the disease, behavioral and environmental triggers, an assessment of the need for patient-cen- tered case management to meet specific physical and environmental needs of patients, outcome evaluations and an assessment of the ability of providers to systemically instruct and develop asthma management plans for patients and frequently review with patients and their families how to manage and control their asthma. DOH shall also gather demographic information for monitoring the occurrence, frequency, incidence, cause, effect and severity of asthma. The gathered data can be used for research purposes and the Department of Health will develop a unique and confidential identifier to be used in the collection of patient informa- tion for the purposes described above. Information gathered pursuant to the Asthma incident reporting provisions of PHL Article 24-F can be used for the preparation of any reports contained in this Part A of this bill. Creates a new PHL section § 2727 to require the Commissioner to submit an annual report, commencing January first, after the bill is enacted and continue annually thereafter. The report shall include the status and accomplishments of the program and provide recommendations to the governor, the temporary president and the minority leader of the senate, and the speaker and the minority leader of the assembly. Section 3: (Part B) Adds a new Article 13-I to the Public Health Law to establish a program to prevent in-utero exposure to tobacco smoke. Under this program, health care providers, health insurers, and pregnan- cy programs shall distribute information on the adverse effects of smok- ing during pregnancy, both first hand and second hand smoke. In-utero exposure to tobacco smoke leads to lower birth rates, higher incidences of asthma and childhood obesity, and can lead to cognitive and develop- mental damage to the child. Under this article, individualized smoking cessation programs would be established to increase the success rates for mothers who smoke tobacco or live in households where others smoke tobacco. This program will help to reduce the incidence of asthma. Section 4: (Part C) Adds a new Public Health Law Article 24-F to estab- lish an Asthma Incidence Reporting program that is similar to one that already exists to map the incidence of cancer in New York. The bill defines asthma attacks as a reportable disease that physicians, other health care providers, hospitals, and other health care facilities are required to report to the Health Department (DOH). The Department shall establish what constitutes a reportable event, so that information received by DOH can be used to track where and who is affected by asthma attacks. Among the demographic information to be collected and sorted for those afflicted with asthma includes by age, residence, location, proximity to industrial and transportation sites, race, and by school. Section 5: (Part D) Amends Public Health Law section 2111 to expand the scope of disease management demonstration programs administered by DOH to enhance the quality and cost-effectiveness of care rendered to Medi- caid-eligible persons who do not participate in Medicaid. Managed Care who have chronic health problems. Under current law, demonstration programs can include chronic conditions related to congestive heart failure, chronic obstructive pulmonary disease, asthma and diabetes. This provision expands the scope of demonstration programs to include chronic conditions related to emphysema, chronic bronchitis, and other respiratory diseases. Section 6: (Part E) Expands provisions from section 1399-0-1 of the Public health law added by chapter 102 of the laws of 2013 to regulate smoking in certain indoor areas open to the public to also include certain outdoor areas open to the public. Under this provision, it is prohibited to smoke within 15 feet from the entrance or exit of public buildings or private buildings that contain state or municipal offices or educational facilities. The underlying purpose of this provision is to ensure that a person who needs to conduct public business or students who enter into elementary and secondary schools, that are located in private buildings, are not exposed to second-hand tobacco smoke that may trigger an asthma episode or attack. Section 7: (Part F) Adds a new Education Law section 3001-e to require the Education Commissioner, in consultation with the Commissioner of Health, to establish standards for the training of teachers and other appropriate personnel in identifying and responding to asthma emergen- cies. Section 8: (Part G) Adds Real Property Law section 235-h to require that every rental agreement for an apartment in a building that has four units or more must disclose the smoking policy of such building, The landlord is still free to either fully ban, partially ban, or generally permit smoking in such building's apartments and common areas. It is the purpose of this section to encourage landlords to think about the building's smoking policy and to give tenants notice of such policies. This in turn may encourage non-smoker tenants to seek out apartment buildings that have a no smoking policy and encourage landlords to at least minimize smoke exposure to those tenants who do not smoke to increase the marketability of their apartments. While this bill is a comprehensive bill to address asthma issues, there is a correlation between those who are exposed, either voluntary or otherwise, to first and second hand tobacco smoke, and asthma. It would be difficult to address asthma issues without looking at the incidence of tobacco smok- ing and exposing, particularly children, to such conditions that can trigger asthma attacks and increase the incidence of asthma conditions generally. Section 9: (Part H) Adds a new Education Law section 1527-a to expand the concept and provisions contained in Chapter 670-of the Laws of 2007 which mandated that the Department of Education promulgate rules and regulations to minimize the discharge of school bus exhaust on school grounds when such vehicles were loading and unloading students. The underlying purpose of this law was to minimize diesel exhaust from idling school busses to help lower the incidence of asthma and reduce the number of asthma attacks sustained by school children. This bill proposes to expand the prohibition on idling school busses to include all other private vehicles that deliver or discharge students on school grounds. While many students are transported to and from school by school busses, many others are transported by family members individual- ly to school. The standard operating procedure for most schools is that a separate line of cars is established and the 'students must remain in those private vehicles until a designated time, at which time the students are discharged or picked up. During the wait time, many private vehicles continue to operate and discharge emissions which can lead to an increased incidence of asthma conditions or a full fledged asthma attack. This provision encourages such private vehicles to turn off their engines to reduce the amount of emissions and triggers for asthma attacks. Section 10: (Part I) Amends Education Law section 923 to expand the number of students who can have and use an inhaler at school to maintain appropriate airflow to their lungs or suppress an asthmatic attack. The medical community maintains that it is better to monitor and address those who are susceptible to asthma conditions and treat such conditions before an asthmatic attack occurs, This bill increases the number of persons who can have and use an inhaler at school to include not only those who have a 'severe asthmatic condition", to also include those who have a "moderately severe asthmatic condition" or have other potentially life-threatening respiratory illnesses". Section 2 of this Part J also adds a new Education Law section 921 to authorize school districts to posses and use nebulizers for those students that need such treatments. As the number and severity asthma attacks increases in the student body, it is important that such students have access not only to their inhalers, but nebulizers as well. The bill provides safeguards to ensure that only students that have a physician's treatment plan can use such nebulizers on school grounds. Further, such nebulizer treatment must be monitored by the school nurse or other person authorized by regulation. Section 11: (Part J) Amends Environmental Conservation Law section 33-0303 (7) to expand the scope of this section of law which empowers the Commissioner of Environmental Conservation (DEC) to promulgate rules aria guidance on the use pesticide alternatives to minimize pesticide applications in day care centers and in schools. This proposed provision allows DEC to identify pesticide alternatives that can help to minimize the incidence of asthma attacks in public buildings and homes, while still effectively controlling the targeted pest or organization. Studies have shown that higher levels of cockroach and mouse allergens can increase the incidence of asthma episodes or attacks. To control these conditions, the heightened use of pesticides is generally required to keep such pests under control. However, the application of pesticides also, can increase the incidence of asthma episodes or attacks. Hence, lower levels of pesticide applications are a desired to minimize asthma conditions. This provision asks DEC, in consultation with DOH, to advise those who apply pesticides in homes and public buildings to use pesticides that can help to minimize targeted pests, but also which does not, as best as possible, heighten the incidence of asthma conditions or attacks. It is important to embody in the law the conflicting goals of pesticide use,, while still considering its effect asthma conditions. Section 12: (Part K) Adds a new Public Buildings Law section 143 to curtail the use of cleaning materials or chemicals that can induce or trigger asthma attacks. The superintendent of every state public build- ing and every public transportation facility operated by a public authority, public benefit corporation or municipality shall curtail, to the best of their ability, the use of cleaning materials or chemicals that may cause their the building's cleaning staff or the general public to have an asthma attack or increase the incidence of such an asthma condition. In determining which cleaning products and concentration of cleaning chemicals that may trigger an asthma attack or increase the incidence of an asthmatic condition for cleaning staff or the general public, DOH shall promulgate a list-of such chemicals to guide the actions of building superintendents.   JUSTIFICATION: Asthma is a chronic, potentially life-threatening, respiratory illness that affects over a million New Yorkers, including many who arc children and adolescents. Asthma i3 also directly linked to large and growing inpatient and outpatient bills paid for by Medicaid and other health care payers, which in most cases could be avoided through early educa- tion and treatment of this condition. Asthma is the most common chronic disorder in children and adolescents and is responsible for approximate- ly 10 million missed school days each year which is three times the amount for children without this debilitating ailment. In recent years, asthma has become the leading cause of hospitalization among children in New York and since 1980, the death rate among sufferers has increased a staggering 50%. In one area of the Bronx known as "Asthma Alley" the rate of asthma sufferers is 7 1/2 times that of the national average. Research and preventive efforts need to be increased. This is because numerous studies show that early education, screening, and treatment is a very-cost effective method to address this growing public health prob- lem. Establishing a comprehensive statewide asthma management program which coordinates the efforts of individuals, families, health care providers, schools and community-based organizations would help New York track the disease, better understand its causes and triggers, and direct asthma education and preventive care to the children and families who need it the most.   LEGISLATIVE HISTORY: 2015/2016 - S. 1105 - Referred to Health 2014 - S. 2363 - Referred to Health 2012 - S. 5863 Referred to Health   FISCAL IMPLICATIONS: Some of the provisions of this bill may be subject to fiscal appropri- ation.   EFFECTIVE DATE: See the individual effective dates for each Part of this bill.
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A05161 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          5161
 
                               2017-2018 Regular Sessions
 
                   IN ASSEMBLY
 
                                    February 6, 2017
                                       ___________
 
        Introduced by M. of A. CRESPO -- read once and referred to the Committee
          on Health
 
        AN  ACT  to amend the public health law, in relation to establishing the
          asthma prevention and education program (Part A); to amend the  public
          health  law,  in  relation  to  in-utero  exposure  to  tobacco  smoke
          prevention (Part B); to amend the public health law,  in  relation  to
          reporting  on  the  incidence  of asthma (Part C); to amend the public
          health law, in relation  to  including  certain  respiratory  diseases
          within  disease  management  demonstration programs (Part D); to amend
          the public health law, in relation to smoking restrictions in  certain
          outdoor  areas  (Part  E);  to amend the education law, in relation to
          requiring all teachers to be trained in identifying and responding  to
          asthma  emergencies  (Part  F);  to  amend  the  real property law, in
          relation to residential rental property smoking policies (Part G);  to
          amend the education law, in relation to requiring school districts and
          private  elementary  and  secondary schools to establish and implement
          rules prohibiting the engine of any motor  vehicle  to  remain  idling
          while  parked  or  standing  on  school grounds (Part H); to amend the
          education law, in relation to the use of inhalers and nebulizers (Part
          I); to amend the environmental conservation law, in relation to pesti-
          cide alternatives used at schools and day care centers (Part  J);  and
          to  amend  the public buildings law, in relation to curtailing the use
          of cleaning materials that induce or trigger asthma episodes (Part K)
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section  1.  This  act enacts into law major components of legislation
     2  which combat the incidence of asthma and other respiratory diseases such
     3  as emphysema and chronic bronchitis. Each component is wholly  contained
     4  within  a  Part  identified as Parts A through K. The effective date for
     5  each particular provision contained within such Part is set forth in the
     6  last section of such Part. Any provision in any section contained within
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD08181-01-7

        A. 5161                             2
 
     1  a Part, including the effective date of the Part, which makes  a  refer-
     2  ence  to  a  section  "of  this  act", when used in connection with that
     3  particular component, shall be deemed to mean and refer  to  the  corre-
     4  sponding  section of the Part in which it is found. Section four of this
     5  act sets forth the general effective date of this act.
     6    § 2. Legislative findings and  purpose.  The  legislature  finds  that
     7  asthma  is  a chronic, potentially life-threatening, respiratory illness
     8  that affects over a million New Yorkers, including thousands of children
     9  and adolescents. Asthma is the leading cause of school  absences  attri-
    10  buted to chronic conditions. Asthma is also directly linked to large and
    11  growing  inpatient  bills  for  medicaid  and  other health care payers.
    12  Therefore, the  legislature  finds  that  establishing  a  comprehensive
    13  statewide asthma prevention management and control program which coordi-
    14  nates  the  efforts  of  individuals,  families,  health care providers,
    15  schools and community-based organizations is in the public interest  and
    16  would benefit the people of the state of New York.
 
    17                                   PART A
 
    18    Section  1.  The  public health law is amended by adding a new article
    19  27-BB to read as follows:
    20                                 ARTICLE 27-BB
    21                    ASTHMA DISEASE MANAGEMENT AND CONTROL
    22  Section 2725. Asthma disease management and control program.
    23          2726. Study of asthma incidence and prevalence.
    24          2727. Annual report.
    25    § 2725. Asthma disease management and control  program.  1.  There  is
    26  hereby  created  within the department the asthma disease management and
    27  control  program  (hereinafter  referred  to  in  this  article  as  the
    28  "program").  The  purpose  of  the  program is to promote asthma disease
    29  management and education and outreach about asthma to people who  suffer
    30  from  asthma  and their families, health care providers, and the general
    31  public.
    32    2. Services to be provided by the program may include:
    33    (a) asthma disease management and case  management  for  patients  and
    34  their families;
    35    (b) asthma outreach and screening;
    36    (c) the promotion of awareness of the causes of asthma;
    37    (d) education on prevention strategies;
    38    (e) education on proper disease management practices; and
    39    (f) education on available treatment modalities.
    40    3.  The commissioner shall make grants within the amounts appropriated
    41  therefor to local  health  agencies,  health  care  providers,  schools,
    42  school based health centers and community-based organizations, and other
    43  organizations  with  demonstrated  interest  and  expertise  in  serving
    44  persons with asthma to provide the services set  out  in  this  section.
    45  Grant  recipients  shall be government entities or not-for-profit organ-
    46  izations.
    47    The commissioner may coordinate grants under this subdivision with the
    48  availability of grants from other sources.  The  commissioner  may  also
    49  accept  or  seek grants from other sources to enhance the amounts appro-
    50  priated to the program.
    51    § 2726. Study of asthma incidence and prevalence.  1.  The  department
    52  shall  study the incidence and prevalence of asthma in the state's popu-
    53  lation and  current  disease  management  practices.  Such  study  shall

        A. 5161                             3

     1  utilize  information  obtained pursuant to article twenty-four-F of this
     2  chapter, and include:
     3    (a) the cause and nature of the disease;
     4    (b) behavioral and environmental triggers;
     5    (c)  an assessment of the need for patient-centered case management to
     6  meet specific physical and environmental needs of patients;
     7    (d) outcome  evaluations,  including,  but  not  limited  to,  patient
     8  perceptions  of  improvement,  signs  and  symptoms of asthma, pulmonary
     9  function, history of asthma exacerbations,  pharmacotherapy,  assessment
    10  of  hospital  emergency  room  visits  for  asthma, and patient-provider
    11  communication; and
    12    (e) an assessment of the ability of providers,  including  non-profes-
    13  sionals  and health care professionals such as physicians, nurses, phar-
    14  macists and respiratory therapists, to systemically instruct and develop
    15  asthma management plans for patients and frequently review with patients
    16  and their families how to manage and control their asthma.
    17    2. The department shall gather data  for  monitoring  the  occurrence,
    18  frequency, incidence, cause, effect and severity of asthma.
    19    (a) The department may require the following to report data under this
    20  subdivision:
    21    i. the statewide planning and research cooperative system (SPARCS);
    22    ii.  health  maintenance  organizations  licensed  pursuant to article
    23  forty-three of the insurance law or certified pursuant to  this  chapter
    24  or  an independent practice association certified or recognized pursuant
    25  to this chapter;
    26    iii. other insurers;
    27    iv. the Medicaid (title  XIX  of  the  federal  social  security  act)
    28  program;
    29    v. health facilities;
    30    vi. health care practitioners;
    31    vii. patients: self reporting;
    32    viii. the department of environmental conservation; and
    33    ix. any other source the commissioner deems appropriate.
    34    (b) The department shall compile and analyze data gathered under para-
    35  graph (a) of this subdivision and article twenty-four-F of this chapter,
    36  and  correlate  it  with data as to places of employment, areas of resi-
    37  dence, schools attended, ages of those afflicted, environmental  factors
    38  including  proximity  to  source of pollution and such other data as the
    39  department deems appropriate.
    40    (c) The department shall maintain  and  compile  reported  data  in  a
    41  manner  suitable  for  research purposes and shall collect and make such
    42  data available to persons in the manner set forth in  subdivision  three
    43  of this section.
    44    3.  Any  data  collected or reported shall not contain the name of any
    45  patient, his or her social security number,  or  any  other  information
    46  which  would  permit  a  patient  to be identified. The department shall
    47  develop a unique, confidential identifier to be used in  the  collection
    48  of patient information as required by this section.
    49    §  2727.  Annual  report. On or before the first of January during the
    50  two calendar years next succeeding the effective date  of  this  section
    51  and  biennially  thereafter,  the  commissioner  shall  submit  a report
    52  regarding the status and accomplishments  of  the  program  and  provide
    53  recommendations to the governor, the temporary president and the minori-
    54  ty  leader of the senate, and the speaker and the minority leader of the
    55  assembly. Such report may be submitted in conjunction  with  the  report
    56  required by article twenty-four-F of this chapter.

        A. 5161                             4
 
     1    § 2. This act shall take effect on the one hundred eightieth day after
     2  it  shall  have  become a law. Effective immediately the commissioner of
     3  health is authorized to promulgate any and all rules and regulations and
     4  take any other measures necessary to implement the  provisions  of  this
     5  act on its effective date.
 
     6                                   PART B
 
     7    Section  1.  The  public health law is amended by adding a new article
     8  13-I to read as follows:
     9                                ARTICLE 13-I
    10                IN-UTERO EXPOSURE TO TOBACCO SMOKE PREVENTION
    11  Section 1399-xx. In-utero exposure prevention.
    12          1399-yy. Programs.
    13    § 1399-xx. In-utero exposure prevention. 1. Every healthcare provider,
    14  healthcare insurer and pregnancy program shall distribute information on
    15  the adverse effects of smoking during pregnancy for both  firsthand  and
    16  secondhand smoke. Such adverse effects to the infant include lower birth
    17  rates,  higher incidence of asthma and obesity, and cognitive and devel-
    18  opmental damage.
    19    2. Every healthcare provider shall monitor expectant mothers'  smoking
    20  statuses  and  offer  continuous tailored discussion of quitting smoking
    21  with expectant mothers during their prenatal care.
    22    § 1399-yy. Programs. The following programs shall be added to existing
    23  tobacco control programs  for  pregnant  women  or  to  other  pregnancy
    24  related programs:
    25    1. Carbon monoxide monitoring;
    26    2.  Depression,  social  support  and  domestic violence screening and
    27  referrals;
    28    3. Referrals for smoking cessation for household members;
    29    4. Ongoing support by counseling and educational materials; and
    30    5. Financial incentives such as shipping voucher or diaper coupons for
    31  quitting for more than four weeks.
    32    § 2. This act shall take effect on the one hundred eightieth day after
    33  it shall have become a law. Provided,  that  effective  immediately  the
    34  commissioner  of health is authorized and directed to promulgate any and
    35  all rules and regulations, and take  any  other  measures  necessary  to
    36  implement the provisions of this act on its effective date.
 
    37                                   PART C
 
    38    Section  1.  The  public health law is amended by adding a new article
    39  24-F to read as follows:
    40                                ARTICLE 24-F
    41                              ASTHMA REPORTING
    42  Section 2499-b. Asthma; duty to report.
    43          2499-c. Reporting.
    44          2499-d. Asthma; reports confidential.
    45    § 2499-b. Asthma; duty to report. 1. Every physician and other  health
    46  care  provider shall give notice to the department within thirty days of
    47  every incident of an asthma attack coming under his or her care,  except
    48  as otherwise provided.
    49    2.  The person in charge of every asthma reporting facility shall give
    50  notice to the department within thirty days  of  every  incident  of  an
    51  asthma attack coming under the care of such facility.

        A. 5161                             5
 
     1    3.  The  department  shall  establish  regulations  designating  which
     2  specific information shall be reported to  the  department  pursuant  to
     3  this section.
     4    4.  A  physician  or health care provider or asthma reporting facility
     5  which violates any provision of this section shall be subject to a civil
     6  penalty pursuant to section twelve of this chapter.
     7    5. The notices required by this section shall be upon  forms  supplied
     8  by  the  commissioner  and  shall  contain  such information as shall be
     9  required by the commissioner.
    10    6. For the purposes of this section, an  "asthma  reporting  facility"
    11  means  a  hospital  as  defined in article twenty-eight of this chapter,
    12  clinic, any organization certified pursuant  to  article  forty-four  of
    13  this chapter, or other similar public or private institution.
    14    § 2499-c. Reporting. 1. The commissioner shall submit biennial reports
    15  to  the  governor, the temporary president of the senate, the speaker of
    16  the assembly, the minority leader of the senate and the minority  leader
    17  of  the assembly.  The reports shall include an evaluation of the asthma
    18  registry as it relates to timeliness, quality and completeness; an eval-
    19  uation of the utility of the registry for scientific research; an evalu-
    20  ation of the access, timeliness and quality of reporting information  to
    21  researchers  and  other similar individuals; an evaluation of the regis-
    22  try's data elements, including treatment, severity of  disease,  occupa-
    23  tion, age and residence; an evaluation of the feasibility and utility of
    24  inclusion  of  occupational history and residence history; and an evalu-
    25  ation of integrating the registry with  other  databases  maintained  by
    26  state  agencies  and  departments,  including the statewide planning and
    27  research cooperative system.
    28    2. The commissioner shall submit an annual report to the governor, the
    29  temporary president of the senate, the  speaker  of  the  assembly,  the
    30  minority  leader  of the senate and the minority leader of the assembly.
    31  Such report shall include an  evaluation  of  whether  the  registry  is
    32  achieving  asthma  incidence  registry goals established by a nationally
    33  recognized  asthma  registry  organization,  including  numerical  goals
    34  concerning timeliness, quality, and completeness.
    35    §  2499-d. Asthma; reports confidential. The reports of asthma attacks
    36  made pursuant to the provisions of this article shall not be divulged or
    37  made public by any person so as to disclose the identity of  any  person
    38  to  whom they relate, except in so far as may be authorized in the sani-
    39  tary code.
    40    § 2. This act shall take effect on the one hundred eightieth day after
    41  it shall have become a law. Effective immediately, the  commissioner  of
    42  health is authorized to promulgate any and all rules and regulations and
    43  take any other measures necessary to implement this act on its effective
    44  date on or before such date.
 
    45                                   PART D
 
    46    Section  1.  Subdivisions 2 and 4 of section 2111 of the public health
    47  law, as added by section 21 of part C of chapter 58 of the laws of 2004,
    48  are amended to read as follows:
    49    2. The department shall establish the criteria  by  which  individuals
    50  will  be  identified  as  eligible  for  enrollment in the demonstration
    51  programs.  Persons eligible for enrollment  in  the  disease  management
    52  demonstration  program  shall  be  limited  to  individuals who: receive
    53  medical assistance pursuant to title  eleven  of  article  five  of  the
    54  social  services  law and may be eligible for benefits pursuant to title

        A. 5161                             6
 
     1  18 of the social security act (Medicare); are not enrolled in a Medicaid
     2  managed care plan, including individuals who are  not  required  or  not
     3  eligible  to  participate  in Medicaid managed care programs pursuant to
     4  section three hundred sixty-four-j of the social services law; are diag-
     5  nosed  with  chronic  health  problems as may be specified by the entity
     6  undertaking the demonstration program, including, but not limited to one
     7  or more of the following: congestive heart failure, chronic  obstructive
     8  pulmonary  disease, asthma, emphysema, chronic bronchitis, other respir-
     9  atory diseases, diabetes or other chronic health conditions  as  may  be
    10  specified  by the department; or have experienced or are likely to expe-
    11  rience one or more hospitalizations or are otherwise expected  to  incur
    12  excessive costs and high utilization of health care services.
    13    4.  The  demonstration program shall offer evidence-based services and
    14  interventions designed to ensure that the enrollees receive high  quali-
    15  ty, preventative and cost-effective care, aimed at reducing the necessi-
    16  ty  for hospitalization or emergency room care or at reducing lengths of
    17  stay when hospitalization is necessary. The  demonstration  program  may
    18  include  screening  of  eligible enrollees, developing an individualized
    19  care management plan for  each  enrollee  and  implementing  that  plan.
    20  Disease management demonstration programs that utilize information tech-
    21  nology  systems  that allow for continuous application of evidence-based
    22  guidelines to medical assistance claims data and other available data to
    23  identify specific instances in which clinical interventions  are  justi-
    24  fied  and communicate indicated interventions to physicians, health care
    25  providers and/or patients, and monitor physician and health care provid-
    26  er response to such interventions, shall have the enrollees,  or  groups
    27  of enrollees, approved by the department for participation. The services
    28  provided  by  the  demonstration  program as part of the care management
    29  plan may include, but are not limited to, case management, social  work,
    30  individualized  health  counselors, multi-behavioral goals plans, claims
    31  data management, health and self-care education, drug therapy management
    32  and oversight, personal emergency response systems and other  monitoring
    33  technologies,  systematic chronic health conditions identified for moni-
    34  toring, telehealth services and similar services designed to improve the
    35  quality and cost-effectiveness of health care services.
    36    § 2. This act shall take effect immediately.
 
    37                                   PART E
 
    38    Section 1. Legislative intent.  The legislature recognizes that  expo-
    39  sure  to  second-hand smoke is known to cause cancer, pneumonia, asthma,
    40  bronchitis and heart disease in humans, and to trigger  asthma  attacks.
    41  The  legislature  finds  that prohibiting smoking within a presumptively
    42  reasonable minimum distance of fifteen feet  from  entrances  and  exits
    43  that serve enclosed areas where smoking is prohibited is consistent with
    44  such prohibition.  This legislation will apply to any individual occupy-
    45  ing  such  area with the purpose of smoking, but provides exceptions for
    46  individuals passing through such area. Therefore, the legislature  finds
    47  that smoking in such area shall be prohibited and owners and other indi-
    48  viduals in control of such area are recommended to post signs indicating
    49  no smoking areas and providing for fines for violations.
    50    §  2.  Section  1399-o-1 of the public health law, as added by chapter
    51  102 of the laws of 2013, is amended to read as follows:
    52    § 1399-o-1. Smoking restrictions; certain outdoor areas. 1.  a.  Smok-
    53  ing  shall  not  be permitted and no person shall smoke during the hours
    54  between sunrise and sunset, when one or more persons under  the  age  of

        A. 5161                             7
 
     1  twelve are present at any playground. For the purposes of this [section]
     2  subdivision,  the  term  "playground"  means  an improved area designed,
     3  equipped, and set aside for play of six or more children  which  is  not
     4  intended  for  use  as  an athletic playing field or athletic court, and
     5  shall include any play equipment, surfacing,  fencing,  signs,  internal
     6  pathways, internal land forms, vegetation, and related structures. Play-
     7  grounds  or playground equipment constructed upon one, two and three-fa-
     8  mily residential real property are exempt from the requirements of  this
     9  [section]  subdivision.    This [section] subdivision shall not apply to
    10  any playground located within the city of New York.
    11    [2.] b. No police officer, peace officer, regulatory  officer  or  law
    12  enforcement  official  may  arrest,  ticket, stop or question any person
    13  based solely or in part on an alleged violation of paragraph a  of  this
    14  subdivision [one of this section], nor may an alleged violation of para-
    15  graph a of this subdivision [one of this section] support probable cause
    16  to  conduct  any  search  or  limited search of any person or his or her
    17  immediate surroundings.
    18    2. a. Smoking is prohibited within a presumptively reasonable  minimum
    19  distance  of fifteen feet from entrances or exits of public buildings or
    20  private buildings that contain state or municipal offices or educational
    21  facilities for elementary or secondary school students.   Such  distance
    22  shall become a designated no smoking zone.
    23    b. Local health departments are authorized to adopt regulations as are
    24  required  to implement this subdivision. Any penalty assessed and recov-
    25  ered in an action brought under this subdivision shall be  paid  to  and
    26  used by the municipality bringing the action.
    27    c. This subdivision shall not apply to individuals walking through the
    28  designated  no  smoking  zone of such area for the purpose of getting to
    29  another destination, but shall only apply to individuals  occupying  the
    30  designated no smoking zone for the purpose of smoking.
    31    d.  Any  person  violating the provisions of this subdivision shall be
    32  guilty of a violation, and is subject to a fine of thirty-five dollars.
    33    e. The commissioner may recommend designs for signs which may be  used
    34  by the owners, operators, managers, employers or other persons, at their
    35  option,  who  control  areas  where  smoking  is  prohibited pursuant to
    36  section thirteen hundred ninety-nine-o of this article. Such signs shall
    37  include the warning that "smoking in this area is punishable by law  and
    38  all violators shall be subject to a fine of thirty-five dollars."
    39    f. Nothing contained in this subdivision is intended to regulate smok-
    40  ing  in a private residence or in the general public outdoors, excepting
    41  places in which smoking is prohibited through the local fire department,
    42  or by other law, ordinance or regulation.
    43    § 3. This act shall take effect on the one hundred twentieth day after
    44  it shall have become a law.
 
    45                                   PART F
 
    46    Section 1. The education law is amended by adding a new section 3001-e
    47  to read as follows:
    48    § 3001-e. Asthma emergencies; training in identification and response.
    49  The commissioner, in consultation with the commissioner of health, shall
    50  establish standards for the training of teachers and  other  appropriate
    51  personnel  in identifying and responding to asthma emergencies in pupils
    52  and other persons. Such standards shall specify minimum levels of  know-
    53  ledge  and procedures to be followed. Such standards shall permit train-

        A. 5161                             8
 
     1  ing to be given by persons or organizations deemed qualified to do so by
     2  the commissioner.
     3    §  2. This act shall take effect one year after it shall have become a
     4  law.
 
     5                                   PART G
 
     6    Section 1. The real property law is amended by adding  a  new  section
     7  235-h to read as follows:
     8    §  235-h.  Residential  rental property smoking policies. Every rental
     9  agreement for a dwelling unit, in a multiple dwelling building with four
    10  or more units, shall include a disclosure of the smoking policy for  the
    11  premises  on  which  the  dwelling  unit is located. The disclosure must
    12  state whether smoking is prohibited on  the  premises,  allowed  on  the
    13  entire  premises  or  allowed  in  limited areas on the premises. If the
    14  smoking policy allows smoking in limited  areas  on  the  premises,  the
    15  disclosure  must  identify  the  areas  on the premises where smoking is
    16  allowed.
    17    § 2. This act shall take effect on the first of January next  succeed-
    18  ing the date on which it shall have become a law.
 
    19                                   PART H
 
    20    Section 1. The education law is amended by adding a new section 1527-a
    21  to read as follows:
    22    §  1527-a.  Idling  motor  vehicles on school grounds. 1. On or before
    23  September first, two thousand nineteen and consistent with  the  commis-
    24  sioner's  regulations,  adopted  pursuant  to section thirty-six hundred
    25  thirty-seven of this chapter, the board of education or board  of  trus-
    26  tees  of  every  school district and the governing body of every private
    27  elementary or secondary school in the state shall promulgate and  imple-
    28  ment  rules  prohibiting  the engine of any motor vehicle, as defined in
    29  section one hundred twenty-five of  the  vehicle  and  traffic  law,  to
    30  remain  idling  for more than one minute while such vehicle is parked or
    31  standing on school grounds, adjacent to school grounds, or in  front  of
    32  any school while loading or off loading passengers.
    33    2.  Each  school  district and private elementary and secondary school
    34  shall conspicuously post signs upon, adjacent and  in  front  of  school
    35  grounds  advising  operators  of motor vehicles of the provisions of the
    36  rules adopted pursuant to subdivision one of this section.
    37    § 2. This act shall take effect immediately.
 
    38                                   PART I
 
    39    Section 1.  The education law is amended by adding a new  section  923
    40  to read as follows:
    41    § 923. Use of nebulizer. 1. Every school district and board of cooper-
    42  ative  educational services in this state may maintain one or more nebu-
    43  lizers in the office of the school nurse  or  in  a  similar  accessible
    44  location.
    45    2.  The commissioner, in consultation with the commissioner of health,
    46  may promulgate regulations for the administration of  asthma  medication
    47  through  the use of a nebulizer by the school nurse or person authorized
    48  by regulation. The regulations may include:
    49    a. a requirement that each certified nurse or other person  authorized
    50  to  administer  asthma  medication in schools receive training in airway

        A. 5161                             9
 
     1  management and in the use of nebulizers  and  inhalers  consistent  with
     2  nationally recognized standards; and
     3    b.  a  requirement that each pupil authorized to use asthma medication
     4  pursuant to subdivision one of section  nine  hundred  sixteen  of  this
     5  article  or  a  nebulizer  have an asthma treatment plan prepared by the
     6  physician of the pupil, which identify, at a minimum,  asthma  triggers,
     7  the  treatment  plan,  and such other elements as shall be determined by
     8  the regents.
     9    § 2. This act shall take effect on the one hundred eightieth day after
    10  it shall have become a law; provided, however, that effective immediate-
    11  ly the commissioner of education is authorized to promulgate  rules  and
    12  regulations for the implementation of this act on such effective date.
 
    13                                   PART J
 
    14    Section  1.  Subdivision  7  of  section  33-0303 of the environmental
    15  conservation law, as added by chapter 85 of the laws of 2010, is amended
    16  to read as follows:
    17    7. The commissioner, in consultation with the commissioner  of  educa-
    18  tion  and  the  commissioner of health, shall develop guidance and regu-
    19  lations on pesticide alternatives to facilitate compliance with  section
    20  four  hundred  nine-k of the education law and three hundred ninety-g of
    21  the social services law. Provided, further, that such pesticide alterna-
    22  tives shall help to minimize the incidence of asthma attacks  in  public
    23  and  private  buildings and residences, while still effectively control-
    24  ling the targeted pest or organism.  Such regulations shall provide  for
    25  the  use  of  the least toxic pesticide or pesticides, which effectively
    26  eradicates the targeted pest or organism.
    27    § 2. This act shall take effect immediately.
 
    28                                   PART K

    29    Section 1.   The public buildings law  is  amended  by  adding  a  new
    30  section 144 to read as follows:
    31    § 144. Curtail use of chemicals that induce or trigger asthma attacks.
    32  1.    Notwithstanding  any  other  provision of law to the contrary, the
    33  superintendent of every state public building, and of every  transporta-
    34  tion facility operated by a public authority, public benefit corporation
    35  or  municipality shall to the best of his or her ability curtail the use
    36  of cleaning materials or chemicals, exposure to which may  cause  either
    37  the  building cleaning staff or other persons who enter such building to
    38  develop the disease of asthma, or which may  exacerbate  or  trigger  an
    39  asthma attack.
    40    2.  A  determination of which or the quantity or concentration of such
    41  cleaning materials or chemicals exposure to which may cause  persons  to
    42  develop  the  disease  of  asthma, or which may exacerbate or trigger an
    43  asthma attack, shall be made by the commissioner  of  health  who  shall
    44  promulgate a list of such cleaning materials or chemicals.
    45    § 2. This act shall take effect on the one hundred eightieth day after
    46  it shall have become a law.
    47    §  3.  Severability clause. If any clause, sentence, paragraph, subdi-
    48  vision, section or part of this act shall be adjudged by  any  court  of
    49  competent  jurisdiction  to  be invalid, such judgment shall not affect,
    50  impair, or invalidate the remainder thereof, but shall  be  confined  in
    51  its  operation  to the clause, sentence, paragraph, subdivision, section
    52  or part thereof directly involved in the controversy in which such judg-

        A. 5161                            10
 
     1  ment shall have been rendered. It is hereby declared to be the intent of
     2  the legislature that this act would  have  been  enacted  even  if  such
     3  invalid provisions had not been included herein.
     4    §  4.  This  act shall take effect immediately provided, however, that
     5  the applicable effective date of Parts A through K of this act shall  be
     6  as specifically set forth in the last section of such Parts.
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