STATE OF NEW YORK
________________________________________________________________________
6505--B
2015-2016 Regular Sessions
IN ASSEMBLY
March 25, 2015
___________
Introduced by M. of A. CRESPO, PICHARDO, RIVERA, COOK, CROUCH, FINCH,
RAIA, DILAN -- Multi-Sponsored by -- M. of A. LUPINACCI -- read once
and referred to the Committee on Health -- committee discharged, bill
amended, ordered reprinted as amended and recommitted to said commit-
tee -- recommitted to the Committee on Health in accordance with
Assembly Rule 3, sec. 2 -- committee discharged, bill amended, ordered
reprinted as amended and recommitted to said committee
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:
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD03883-06-5
A. 6505--B 2
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
7 a Part, including the effective date of the Part, which makes a refer-
8 ence to a section "of this act", when used in connection with that
9 particular component, shall be deemed to mean and refer to the corre-
10 sponding section of the Part in which it is found. Section four of this
11 act sets forth the general effective date of this act.
12 § 2. Legislative findings and purpose. The legislature finds that
13 asthma is a chronic, potentially life-threatening, respiratory illness
14 that affects over a million New Yorkers, including thousands of children
15 and adolescents. Asthma is the leading cause of school absences attri-
16 buted to chronic conditions. Asthma is also directly linked to large and
17 growing inpatient bills for medicaid and other health care payers.
18 Therefore, the legislature finds that establishing a comprehensive
19 statewide asthma prevention management and control program which coordi-
20 nates the efforts of individuals, families, health care providers,
21 schools and community-based organizations is in the public interest and
22 would benefit the people of the state of New York.
23 PART A
24 Section 1. The public health law is amended by adding a new article
25 27-BB to read as follows:
26 ARTICLE 27-BB
27 ASTHMA DISEASE MANAGEMENT AND CONTROL
28 Section 2725. Asthma disease management and control program.
29 2726. Study of asthma incidence and prevalence.
30 2727. Annual report.
31 § 2725. Asthma disease management and control program. 1. There is
32 hereby created within the department the asthma disease management and
33 control program (hereinafter referred to in this article as the
34 "program"). The purpose of the program is to promote asthma disease
35 management and education and outreach about asthma to people who suffer
36 from asthma and their families, health care providers, and the general
37 public.
38 2. Services to be provided by the program may include:
39 (a) asthma disease management and case management for patients and
40 their families;
41 (b) asthma outreach and screening;
42 (c) the promotion of awareness of the causes of asthma;
43 (d) education on prevention strategies;
44 (e) education on proper disease management practices; and
45 (f) education on available treatment modalities.
46 3. The commissioner shall make grants within the amounts appropriated
47 therefor to local health agencies, health care providers, schools,
48 school based health centers and community-based organizations, and other
49 organizations with demonstrated interest and expertise in serving
50 persons with asthma to provide the services set out in this section.
51 Grant recipients shall be government entities or not-for-profit organ-
52 izations.
53 The commissioner may coordinate grants under this subdivision with the
54 availability of grants from other sources. The commissioner may also
A. 6505--B 3
1 accept or seek grants from other sources to enhance the amounts appro-
2 priated to the program.
3 § 2726. Study of asthma incidence and prevalence. 1. The department
4 shall study the incidence and prevalence of asthma in the state's popu-
5 lation and current disease management practices. Such study shall
6 utilize information obtained pursuant to article twenty-four-F of this
7 chapter, and include:
8 (a) the cause and nature of the disease;
9 (b) behavioral and environmental triggers;
10 (c) an assessment of the need for patient-centered case management to
11 meet specific physical and environmental needs of patients;
12 (d) outcome evaluations, including, but not limited to, patient
13 perceptions of improvement, signs and symptoms of asthma, pulmonary
14 function, history of asthma exacerbations, pharmacotherapy, assessment
15 of hospital emergency room visits for asthma, and patient-provider
16 communication; and
17 (e) an assessment of the ability of providers, including non-profes-
18 sionals and health care professionals such as physicians, nurses, phar-
19 macists and respiratory therapists, to systemically instruct and develop
20 asthma management plans for patients and frequently review with patients
21 and their families how to manage and control their asthma.
22 2. The department shall gather data for monitoring the occurrence,
23 frequency, incidence, cause, effect and severity of asthma.
24 (a) The department may require the following to report data under this
25 subdivision:
26 i. the statewide planning and research cooperative system (SPARCS);
27 ii. health maintenance organizations licensed pursuant to article
28 forty-three of the insurance law or certified pursuant to this chapter
29 or an independent practice association certified or recognized pursuant
30 to this chapter;
31 iii. other insurers;
32 iv. the Medicaid (title XIX of the federal social security act)
33 program;
34 v. health facilities;
35 vi. health care practitioners;
36 vii. patients: self reporting;
37 viii. the department of environmental conservation; and
38 ix. any other source the commissioner deems appropriate.
39 (b) The department shall compile and analyze data gathered under para-
40 graph (a) of this subdivision and article twenty-four-F of this chapter,
41 and correlate it with data as to places of employment, areas of resi-
42 dence, schools attended, ages of those afflicted, environmental factors
43 including proximity to source of pollution and such other data as the
44 department deems appropriate.
45 (c) The department shall maintain and compile reported data in a
46 manner suitable for research purposes and shall collect and make such
47 data available to persons in the manner set forth in subdivision three
48 of this section.
49 3. Any data collected or reported shall not contain the name of any
50 patient, his or her social security number, or any other information
51 which would permit a patient to be identified. The department shall
52 develop a unique, confidential identifier to be used in the collection
53 of patient information as required by this section.
54 § 2727. Annual report. On or before the first of January during the
55 two calendar years next succeeding the effective date of this section
56 and biennially thereafter, the commissioner shall submit a report
A. 6505--B 4
1 regarding the status and accomplishments of the program and provide
2 recommendations to the governor, the temporary president and the minori-
3 ty leader of the senate, and the speaker and the minority leader of the
4 assembly. Such report may be submitted in conjunction with the report
5 required by article twenty-four-F of this chapter.
6 § 2. This act shall take effect on the one hundred eightieth day after
7 it shall have become a law. Effective immediately the commissioner of
8 health is authorized to promulgate any and all rules and regulations and
9 take any other measures necessary to implement the provisions of this
10 act on its effective date.
11 PART B
12 Section 1. The public health law is amended by adding a new article
13 13-I to read as follows:
14 ARTICLE 13-I
15 IN-UTERO EXPOSURE TO TOBACCO SMOKE PREVENTION
16 Section 1399-xx. In-utero exposure prevention.
17 1399-yy. Programs.
18 § 1399-xx. In-utero exposure prevention. 1. Every healthcare provider,
19 healthcare insurer and pregnancy program shall distribute information on
20 the adverse effects of smoking during pregnancy for both firsthand and
21 secondhand smoke. Such adverse effects to the infant include lower birth
22 rates, higher incidence of asthma and obesity, and cognitive and devel-
23 opmental damage.
24 2. Every healthcare provider shall monitor expectant mothers' smoking
25 statuses and offer continuous tailored discussion of quitting smoking
26 with expectant mothers during their prenatal care.
27 § 1399-yy. Programs. The following programs shall be added to existing
28 tobacco control programs for pregnant women or to other pregnancy
29 related programs:
30 1. Carbon monoxide monitoring;
31 2. Depression, social support and domestic violence screening and
32 referrals;
33 3. Referrals for smoking cessation for household members;
34 4. Ongoing support by counseling and educational materials; and
35 5. Financial incentives such as shipping voucher or diaper coupons for
36 quitting for more than four weeks.
37 § 2. This act shall take effect on the one hundred eightieth day after
38 it shall have become a law. Provided, that effective immediately the
39 commissioner of health is authorized and directed to promulgate any and
40 all rules and regulations, and take any other measures necessary to
41 implement the provisions of this act on its effective date.
42 PART C
43 Section 1. The public health law is amended by adding a new article
44 24-F to read as follows:
45 ARTICLE 24-F
46 ASTHMA REPORTING
47 Section 2499-b. Asthma; duty to report.
48 2499-c. Reporting.
49 2499-d. Asthma; reports confidential.
50 § 2499-b. Asthma; duty to report. 1. Every physician and other health
51 care provider shall give notice to the department within thirty days of
A. 6505--B 5
1 every incident of an asthma attack coming under his or her care, except
2 as otherwise provided.
3 2. The person in charge of every asthma reporting facility shall give
4 notice to the department within thirty days of every incident of an
5 asthma attack coming under the care of such facility.
6 3. The department shall establish regulations designating which
7 specific information shall be reported to the department pursuant to
8 this section.
9 4. A physician or health care provider or asthma reporting facility
10 which violates any provision of this section shall be subject to a civil
11 penalty pursuant to section twelve of this chapter.
12 5. The notices required by this section shall be upon forms supplied
13 by the commissioner and shall contain such information as shall be
14 required by the commissioner.
15 6. For the purposes of this section, an "asthma reporting facility"
16 means a hospital as defined in article twenty-eight of this chapter,
17 clinic, any organization certified pursuant to article forty-four of
18 this chapter, or other similar public or private institution.
19 § 2499-c. Reporting. 1. The commissioner shall submit biennial reports
20 to the governor, the temporary president of the senate, the speaker of
21 the assembly, the minority leader of the senate and the minority leader
22 of the assembly. The reports shall include an evaluation of the asthma
23 registry as it relates to timeliness, quality and completeness; an eval-
24 uation of the utility of the registry for scientific research; an evalu-
25 ation of the access, timeliness and quality of reporting information to
26 researchers and other similar individuals; an evaluation of the regis-
27 try's data elements, including treatment, severity of disease, occupa-
28 tion, age and residence; an evaluation of the feasibility and utility of
29 inclusion of occupational history and residence history; and an evalu-
30 ation of integrating the registry with other databases maintained by
31 state agencies and departments, including the statewide planning and
32 research cooperative system.
33 2. The commissioner shall submit an annual report to the governor, the
34 temporary president of the senate, the speaker of the assembly, the
35 minority leader of the senate and the minority leader of the assembly.
36 Such report shall include an evaluation of whether the registry is
37 achieving asthma incidence registry goals established by a nationally
38 recognized asthma registry organization, including numerical goals
39 concerning timeliness, quality, and completeness.
40 § 2499-d. Asthma; reports confidential. The reports of asthma attacks
41 made pursuant to the provisions of this article shall not be divulged or
42 made public by any person so as to disclose the identity of any person
43 to whom they relate, except in so far as may be authorized in the sani-
44 tary code.
45 § 2. This act shall take effect on the one hundred eightieth day after
46 it shall have become a law. Effective immediately, the commissioner of
47 health is authorized to promulgate any and all rules and regulations and
48 take any other measures necessary to implement this act on its effective
49 date on or before such date.
50 PART D
51 Section 1. Subdivisions 2 and 4 of section 2111 of the public health
52 law, as added by section 21 of part C of chapter 58 of the laws of 2004,
53 are amended to read as follows:
A. 6505--B 6
1 2. The department shall establish the criteria by which individuals
2 will be identified as eligible for enrollment in the demonstration
3 programs. Persons eligible for enrollment in the disease management
4 demonstration program shall be limited to individuals who: receive
5 medical assistance pursuant to title eleven of article five of the
6 social services law and may be eligible for benefits pursuant to title
7 18 of the social security act (Medicare); are not enrolled in a Medicaid
8 managed care plan, including individuals who are not required or not
9 eligible to participate in Medicaid managed care programs pursuant to
10 section three hundred sixty-four-j of the social services law; are diag-
11 nosed with chronic health problems as may be specified by the entity
12 undertaking the demonstration program, including, but not limited to one
13 or more of the following: congestive heart failure, chronic obstructive
14 pulmonary disease, asthma, emphysema, chronic bronchitis, other respir-
15 atory diseases, diabetes or other chronic health conditions as may be
16 specified by the department; or have experienced or are likely to expe-
17 rience one or more hospitalizations or are otherwise expected to incur
18 excessive costs and high utilization of health care services.
19 4. The demonstration program shall offer evidence-based services and
20 interventions designed to ensure that the enrollees receive high quali-
21 ty, preventative and cost-effective care, aimed at reducing the necessi-
22 ty for hospitalization or emergency room care or at reducing lengths of
23 stay when hospitalization is necessary. The demonstration program may
24 include screening of eligible enrollees, developing an individualized
25 care management plan for each enrollee and implementing that plan.
26 Disease management demonstration programs that utilize information tech-
27 nology systems that allow for continuous application of evidence-based
28 guidelines to medical assistance claims data and other available data to
29 identify specific instances in which clinical interventions are justi-
30 fied and communicate indicated interventions to physicians, health care
31 providers and/or patients, and monitor physician and health care provid-
32 er response to such interventions, shall have the enrollees, or groups
33 of enrollees, approved by the department for participation. The services
34 provided by the demonstration program as part of the care management
35 plan may include, but are not limited to, case management, social work,
36 individualized health counselors, multi-behavioral goals plans, claims
37 data management, health and self-care education, drug therapy management
38 and oversight, personal emergency response systems and other monitoring
39 technologies, systematic chronic health conditions identified for moni-
40 toring, telehealth services and similar services designed to improve the
41 quality and cost-effectiveness of health care services.
42 § 2. This act shall take effect immediately.
43 PART E
44 Section 1. Legislative intent. The legislature recognizes that expo-
45 sure to second-hand smoke is known to cause cancer, pneumonia, asthma,
46 bronchitis and heart disease in humans, and to trigger asthma attacks.
47 The legislature finds that prohibiting smoking within a presumptively
48 reasonable minimum distance of fifteen feet from entrances and exits
49 that serve enclosed areas where smoking is prohibited is consistent with
50 such prohibition. This legislation will apply to any individual occupy-
51 ing such area with the purpose of smoking, but provides exceptions for
52 individuals passing through such area. Therefore, the legislature finds
53 that smoking in such area shall be prohibited and owners and other indi-
54 viduals in control of such area are recommended to post signs indicating
55 no smoking areas and providing for fines for violations.
A. 6505--B 7
1 § 2. Section 1399-o-1 of the public health law, as added by chapter
2 102 of the laws of 2013, is amended to read as follows:
3 § 1399-o-1. Smoking restrictions; certain outdoor areas. 1. a. Smok-
4 ing shall not be permitted and no person shall smoke during the hours
5 between sunrise and sunset, when one or more persons under the age of
6 twelve are present at any playground. For the purposes of this [section]
7 subdivision, the term "playground" means an improved area designed,
8 equipped, and set aside for play of six or more children which is not
9 intended for use as an athletic playing field or athletic court, and
10 shall include any play equipment, surfacing, fencing, signs, internal
11 pathways, internal land forms, vegetation, and related structures. Play-
12 grounds or playground equipment constructed upon one, two and three-fa-
13 mily residential real property are exempt from the requirements of this
14 [section] subdivision. This [section] subdivision shall not apply to
15 any playground located within the city of New York.
16 [2.] b. No police officer, peace officer, regulatory officer or law
17 enforcement official may arrest, ticket, stop or question any person
18 based solely or in part on an alleged violation of paragraph a of this
19 subdivision [one of this section], nor may an alleged violation of para-
20 graph a of this subdivision [one of this section] support probable cause
21 to conduct any search or limited search of any person or his or her
22 immediate surroundings.
23 2. a. Smoking is prohibited within a presumptively reasonable minimum
24 distance of fifteen feet from entrances or exits of public buildings or
25 private buildings that contain state or municipal offices or educational
26 facilities for elementary or secondary school students. Such distance
27 shall become a designated no smoking zone.
28 b. Local health departments are authorized to adopt regulations as are
29 required to implement this subdivision. Any penalty assessed and recov-
30 ered in an action brought under this subdivision shall be paid to and
31 used by the municipality bringing the action.
32 c. This subdivision shall not apply to individuals walking through the
33 designated no smoking zone of such area for the purpose of getting to
34 another destination, but shall only apply to individuals occupying the
35 designated no smoking zone for the purpose of smoking.
36 d. Any person violating the provisions of this subdivision shall be
37 guilty of a violation, and is subject to a fine of thirty-five dollars.
38 e. The commissioner may recommend designs for signs which may be used
39 by the owners, operators, managers, employers or other persons, at their
40 option, who control areas where smoking is prohibited pursuant to
41 section thirteen hundred ninety-nine-o of this article. Such signs shall
42 include the warning that "smoking in this area is punishable by law and
43 all violators shall be subject to a fine of thirty-five dollars."
44 f. Nothing contained in this subdivision is intended to regulate smok-
45 ing in a private residence or in the general public outdoors, excepting
46 places in which smoking is prohibited through the local fire department,
47 or by other law, ordinance or regulation.
48 § 3. This act shall take effect on the one hundred twentieth day after
49 it shall have become a law.
50 PART F
51 Section 1. The education law is amended by adding a new section 3001-e
52 to read as follows:
53 § 3001-e. Asthma emergencies; training in identification and response.
54 The commissioner, in consultation with the commissioner of health, shall
A. 6505--B 8
1 establish standards for the training of teachers and other appropriate
2 personnel in identifying and responding to asthma emergencies in pupils
3 and other persons. Such standards shall specify minimum levels of know-
4 ledge and procedures to be followed. Such standards shall permit train-
5 ing to be given by persons or organizations deemed qualified to do so by
6 the commissioner.
7 § 2. This act shall take effect one year after it shall have become a
8 law.
9 PART G
10 Section 1. The real property law is amended by adding a new section
11 235-h to read as follows:
12 § 235-h. Residential rental property smoking policies. Every rental
13 agreement for a dwelling unit, in a multiple dwelling building with four
14 or more units, shall include a disclosure of the smoking policy for the
15 premises on which the dwelling unit is located. The disclosure must
16 state whether smoking is prohibited on the premises, allowed on the
17 entire premises or allowed in limited areas on the premises. If the
18 smoking policy allows smoking in limited areas on the premises, the
19 disclosure must identify the areas on the premises where smoking is
20 allowed.
21 § 2. This act shall take effect on the first of January next succeed-
22 ing the date on which it shall have become a law.
23 PART H
24 Section 1. The education law is amended by adding a new section 1527-a
25 to read as follows:
26 § 1527-a. Idling motor vehicles on school grounds. 1. On or before
27 September first, two thousand eighteen and consistent with the commis-
28 sioner's regulations, adopted pursuant to section thirty-six hundred
29 thirty-seven of this chapter, the board of education or board of trus-
30 tees of every school district and the governing body of every private
31 elementary or secondary school in the state shall promulgate and imple-
32 ment rules prohibiting the engine of any motor vehicle, as defined in
33 section one hundred twenty-five of the vehicle and traffic law, to
34 remain idling for more than one minute while such vehicle is parked or
35 standing on school grounds, adjacent to school grounds, or in front of
36 any school while loading or off loading passengers.
37 2. Each school district and private elementary and secondary school
38 shall conspicuously post signs upon, adjacent and in front of school
39 grounds advising operators of motor vehicles of the provisions of the
40 rules adopted pursuant to subdivision one of this section.
41 § 2. This act shall take effect immediately.
42 PART I
43 Section 1. The education law is amended by adding a new section 923
44 to read as follows:
45 § 923. Use of nebulizer. 1. Every school district and board of cooper-
46 ative educational services in this state may maintain one or more nebu-
47 lizers in the office of the school nurse or in a similar accessible
48 location.
49 2. The commissioner, in consultation with the commissioner of health,
50 may promulgate regulations for the administration of asthma medication
A. 6505--B 9
1 through the use of a nebulizer by the school nurse or person authorized
2 by regulation. The regulations may include:
3 a. a requirement that each certified nurse or other person authorized
4 to administer asthma medication in schools receive training in airway
5 management and in the use of nebulizers and inhalers consistent with
6 nationally recognized standards; and
7 b. a requirement that each pupil authorized to use asthma medication
8 pursuant to subdivision one of section nine hundred sixteen of this
9 article or a nebulizer have an asthma treatment plan prepared by the
10 physician of the pupil, which identify, at a minimum, asthma triggers,
11 the treatment plan, and such other elements as shall be determined by
12 the regents.
13 § 2. This act shall take effect on the one hundred eightieth day after
14 it shall have become a law; provided, however, that effective immediate-
15 ly the commissioner of education is authorized to promulgate rules and
16 regulations for the implementation of this act on such effective date.
17 PART J
18 Section 1. Subdivision 7 of section 33-0303 of the environmental
19 conservation law, as added by chapter 85 of the laws of 2010, is amended
20 to read as follows:
21 7. The commissioner, in consultation with the commissioner of educa-
22 tion and the commissioner of health, shall develop guidance and regu-
23 lations on pesticide alternatives to facilitate compliance with section
24 four hundred nine-k of the education law and three hundred ninety-g of
25 the social services law. Provided, further, that such pesticide alterna-
26 tives shall help to minimize the incidence of asthma attacks in public
27 and private buildings and residences, while still effectively control-
28 ling the targeted pest or organism. Such regulations shall provide for
29 the use of the least toxic pesticide or pesticides, which effectively
30 eradicates the targeted pest or organism.
31 § 2. This act shall take effect immediately.
32 PART K
33 Section 1. The public buildings law is amended by adding a new
34 section 144 to read as follows:
35 § 144. Curtail use of chemicals that induce or trigger asthma attacks.
36 1. Notwithstanding any other provision of law to the contrary, the
37 superintendent of every state public building, and of every transporta-
38 tion facility operated by a public authority, public benefit corporation
39 or municipality shall to the best of his or her ability curtail the use
40 of cleaning materials or chemicals, exposure to which may cause either
41 the building cleaning staff or other persons who enter such building to
42 develop the disease of asthma, or which may exacerbate or trigger an
43 asthma attack.
44 2. A determination of which or the quantity or concentration of such
45 cleaning materials or chemicals exposure to which may cause persons to
46 develop the disease of asthma, or which may exacerbate or trigger an
47 asthma attack, shall be made by the commissioner of health who shall
48 promulgate a list of such cleaning materials or chemicals.
49 § 2. This act shall take effect on the one hundred eightieth day after
50 it shall have become a law.
51 § 3. Severability clause. If any clause, sentence, paragraph, subdi-
52 vision, section or part of this act shall be adjudged by any court of
A. 6505--B 10
1 competent jurisdiction to be invalid, such judgment shall not affect,
2 impair, or invalidate the remainder thereof, but shall be confined in
3 its operation to the clause, sentence, paragraph, subdivision, section
4 or part thereof directly involved in the controversy in which such judg-
5 ment shall have been rendered. It is hereby declared to be the intent of
6 the legislature that this act would have been enacted even if such
7 invalid provisions had not been included herein.
8 § 4. This act shall take effect immediately provided, however, that
9 the applicable effective date of Parts A through K of this act shall be
10 as specifically set forth in the last section of such Parts.
