senate Bill S2374

Amended

Enacts the "omnibus obesity and respiratory illness reduction act"

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Bill Status


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor
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actions

  • 16 / Jan / 2013
    • REFERRED TO AGRICULTURE
  • 08 / Jan / 2014
    • REFERRED TO AGRICULTURE
  • 24 / Jan / 2014
    • AMEND (T) AND RECOMMIT TO AGRICULTURE
  • 24 / Jan / 2014
    • PRINT NUMBER 2374A

Summary

Enacts the "omnibus obesity and respiratory illness reduction act"; establishes a community gardens task force and provides for direct marketing of fresh vegetables and fruits in areas with a high incidence of adult and child obesity; provides for the screening for childhood obesity by elementary and secondary schools and promotes the availability of certain healthy foods and beverages; provides for the regulation of the use of trans fats and requires the provision of nutritional information by food service facilities; restricts the sale, lease, transfer or authorization of open-air schoolhouse playgrounds for certain uses; requires instruction in schools on good health practices; includes certain respiratory diseases and obesity in disease management demonstration programs; enacts provisions to reduce the incidence of certain respiratory diseases; enacts provisions to prevent in-utero exposure to tobacco smoke; provides for the use of inhalers and nebulizers by certain students; provides for residential real property smoking policies; adds weight control and schools to the health care and wellness education and outreach program; expands the collection and reporting of data on obesity in the state; directs the health research science board to study obesity and respiratory diseases; provides for expanded obesity prevention and screening; expands ease of breast feeding in child day care centers and at work; provides for nutrition counseling to pregnant teenagers; establishes the obesity and respiratory disease research and education fund; includes weight management and physical fitness in wellness programs; provides for health and nutritional education and services to teen parents; requires day care centers to provide healthy foods and exercise; directs cooperative extension to offer obesity and respiratory disease prevention programs.

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Bill Details

See Assembly Version of this Bill:
A5322
Versions:
S2374
S2374A
Legislative Cycle:
2013-2014
Current Committee:
Senate Agriculture
Law Section:
Agriculture and Markets Law
Laws Affected:
Amd Ag & Mkts L, generally; amd Ed L, generally; amd Pub Health L, generally; add §235-h, RP L; add §91-h, St Fin L; amd §3239, Ins L; amd §§366, 390 & 390-a, Soc Serv L; amd §224-b, County L
Versions Introduced in 2011-2012 Legislative Cycle:
S6423A, A9394, A9394A, S6423A

Sponsor Memo

BILL NUMBER:S2374

TITLE OF BILL:
An act
to amend the agriculture and markets law, in relation to combating the
incidence of adult and child obesity, establishing a community gardens
task force and encouraging
direct marketing of fresh fruits and vegetables in areas
with a high incidence of adult and child obesity (Part A); to amend the
education law, in relation to screening for childhood obesity and
promotion of the availability of certain foods and beverages
in schools
(Part B); to amend the public health law, in relation to regulating the
use of artificial trans fats and requiring food service facilities
to post
or provide nutritional information on the food products served, and
the
inclusion of weight control in the health care and wellness education
and outreach program (Part C);
to amend the education law, in relation to restricting the sale, lease,
transfer or authorization of open-air schoolhouse playgrounds for
certain uses (Part D); to amend the education law, in relation to
instruction in good health and reducing the incidence of obesity (Part
E);
to
amend the public health law, in relation to in-utero exposure to tobacco
smoke prevention (Part F);
to amend the public health law, in relation to including
certain respiratory diseases and obesity
within disease management demonstration
programs (Part G);
to amend the public
health law, in relation to the reduction of emphysema, chronic
bronchitis and other chronic respiratory diseases in children (Part H);
to amend the
public health law, in relation to the collection and reporting of
obesity data (Part I); to amend the public health law, in relation to
directing the health research science board to study respiratory
diseases and obesity, and childhood obesity prevention and screening
(Part J); to amend the public health law, in relation to breastfeeding
of infants and the adolescent pregnancy nutrition counseling program
(Part K);
to amend the education law, in relation to the use of inhalers and
nebulizers (Part L);
to amend the real property law, in relation
to residential rental property smoking policies (Part M); to amend the
state
finance law, in relation to establishing the obesity and respiratory
disease research and education fund (Part N); to amend the insurance
law, in relation to wellness programs (Part O); to amend the social
services law, in relation to health and nutritional education and
services and child day care facilities; and to amend the county law, in
relation to the Cornell cooperative extension system relating to adult
and childhood obesity, asthma, and respiratory illness prevention (Part
P)


PURPOSE OR GENERAL IDEA OF BILL:
The purpose of this bill is to establish a comprehensive
inter-disciplinary program to combat childhood obesity. The incidence
of childhood
obesity is a rapidly growing public health, social, and economic
concern that is adversely affecting the overall health and wellbeing
of our next generation of New Yorkers. in fact, acute and chronic
adverse health conditions such as diabetes, chronic coronary
conditions, and respiratory illnesses caused by obesity conditions is
about to overtake those acute and chronic adverse health conditions
caused by smoking tobacco. This hill attempts to better integrate
current programs and laws that relate to combating childhood obesity.

Further, this bill attempts to integrate activities to be conducted
by: A) the Department of Agriculture and Markets to facilitate the
increased availability and affordability of locally produced fresh
produce to areas of the state that have a high incidence of childhood
obesity. Such initiatives to increase the volume, availability and
consumption of more fresh produce in at-risk targeted areas that have
a high incidence of obese individuals could be supplied by locally
producing community gardens and by the shipment of fresh produce by
commercial growers into such targeted areas. The rational being that
increasing the availability of fresh fruits and vegetables to
underserved areas will increase the consumption of such foods because
they are tastier and more likely to be consumed by at-risk populations.

B) the Education Department to better educate students and parents on
the important economic and health reasons for consuming a balanced
and nutritious diet. In addition to teaching such subjects in Health
class, the scientific reasons for the importance of having a balanced
diet should be presented in science classes such as biology and
chemistry. Further, the Department will more actively provide for
more opportunities for physical recreational activities to foster
physical fitness and create an environment so that students are more
capable to learn because they have "burned off" energy during recess,

C) the Department of Health will be encouraged to better track areas
of the state that have high incidences of childhood obesity and
encourage health care facilities and health care providers to
identify and treat such conditions at an earlier time of a patient's
life.

D) the Insurance Department, will encourage health insurers and their
insureds to more actively participate in Wellness Programs that
combat the high incidence of adult and childhood obesity. Further,
altering the eating and exercise habits of parents can have positive
effects on the eating and exercise habits of their children,

E) the Office of Children and Family Services with regard to its
regulatory powers over the provision of child care by child day care
centers should become more proactive in encouraging such centers to
provide more low calorie foods to children and encourage more
physical activity. In addition, help to increase the awareness of the
problem of childhood obesity by teenage mothers will go a long way to
help reduce the incidence of childhood obesity, and


E) better integrate the work of the Departments of Agriculture &
Markets, Education, and Health, and the Office of Children & Family
Services with activities conducted by local volunteer groups, health
care providers, local governments, schools and cooperative Extension
Services.

SUMMARY OF PROVISIONS:
This bill is a comprehensive inter-disciplinary approach to address
the high incidence of childhood obesity in New York State. Further,
this bill amends many sections of law, so it is broken down into
Parts A through P, depending on the laws to be amended.

PART A:

Section 1: Amends Agriculture & Markets Law (Ag. & Markets Law)
Section 3 to expand the Declaration of Policy and purposes of the
Department to improve the overall health of New yorkers and to help
combat the increasing incidence of adult and childhood obesity. The
Department already is charged with the duty to encourage the
production of fresh farm products in this State, this provision
merely encourages the Department to also encourage the consumption of
such products by persons who are obese and in those areas of the
State that have a high incidence of childhood obesity.

Section 2: Amends Ag. & Markets Law section 16 (5-b) which outlines
the General powers and Duties of the Department to also cooperate
with the Health Department in implementing the Childhood Obesity
Program pursuant to Article 25 of the public Health Law (PHL) and
with the Commissioner of Education to encourage the production and
consumption of fresh locally produced fruits and vegetables by
primary and secondary school students to help combat the increasing
incidence of childhood obesity. In addition, the Department is to
cooperate with other federal, state and local agencies to encourage
the expansion of community gardens so as to increase the availability
and affordability of locally grown produce, to help combat adult and
childhood obesity, especially in areas of the state that have a high
incidence of obesity.

Section 3: Adds a new Ag. & Markets Law section 31-f to establish
legislative findings that community gardens provide significant
health, educational, and social benefits to the general public,
especially for those who reside in urban and suburban areas of this
State. Community gardens help to provide low cost nutritious and
fresh foods to the general public, especially to the disadvantaged
and poor; promotes health and healthier lifestyles by encouraging
better eating habits and increased physical activity, fosters the
retention of open spaces in urban areas of our state's cities and
villages, provides inexpensive community building activities, helps
to reduce the incidence of crime, and engenders a closer relationship
between urban residents and nature and their local environment. This
provision is needed so that the Office of Community Gardens has a
mission statement so that it can more effectively work with other
federal, state, and local agencies to help promote the concept of
community gardens and do what it can to help combat the high
incidence of childhood and adult obesity.


Section 4: Amends Ag. & Markets Law section 31-g to expand the duties
of the Office of Community Gardens. In the definitional section, it
expands what types of activities are considered to be "garden"
activities, expands the definition of "municipality", and adds a new
definition for "state agency" to reduce the verbiage in this Article
2-C.

Section 5: Amend Ag. & Markets Law section 31-h to expand the number
of activities that the Office of Community Gardens may engage in if
they choose to do so. Among the new types of activities that the
Office may participate in, if the Office wishes to do so, are the
following:

-To assist groups that wish to establish community gardens, the Office
can help to develop a single recommended application form to request
a state agency or municipality to use certain vacant lands for
community garden purposes.

-assist community garden groups in their activities and encourage the
better coordination of activities between such groups and school
garden programs and local voluntary food assistance programs, such as
food pantry's and soup kitchens that provide food for the poor and
disadvantaged, hospitals, other health care facilities, and
educational facilities.

- encourage better communication between and sharing of resources
between community garden groups and the New York Kids Week Program
provided for under the Ag. & Markets Law, and individual
farm-to-school and school garden programs. The purpose of this
section is to make a better connection between the activities of
community gardens and the educational activities of existing school
programs, if such schools wish to do so.

-support efforts by the Departments of Health and Education to combat
the high incidence of adult and childhood obesity by encouraging the
consumption of community garden produced fruits and vegetables.

Section 6: Amend Ag. & Markets Law section 31-i to include municipal
vacant land in addition to state agency controlled vacant land to be
used for community gardens.

Section 7: Adds Ag. & Markets Law section 31-j to allow the Office of
Community Gardens, at their own option, to convene a Community
Gardens Task Force if authorized by the commissioner of Ag. &
Markets. The membership of the Task Force must be no more than 25
members. Further the Task Force can utilize the opinions of various
state agencies such as education, health, environmental conservation,
corrections, and the office of state parks. In addition, the various
state-wide municipal associations can have input into the activities
of the task force. The task force is to look into encouraging the
establishment and expansion of community gardens, encourage
cooperation between community gardens and voluntary food assistance
programs, and increase the benefits provided by community gardens.

Section 8: Amends Ag & Markets Law section 281, the Declaration of
Legislative Findings for Article 23, which relates to the
Department's powers to encourage the direct marketing of New York


agricultural products. This provision encourages the Department to
also help to encourage the consumption of such locally produced
products in a manner that helps to combat the high incidence of adult
and childhood obesity.

Section 9: Amends Ag. & Markets Law section 283 (5) and creates a new
(8-a) which relates to the Department's powers and duties to promote
the direct sale of farm and food products produced in New York to
increase
the supply of fresh wholesome foods that can be obtained more
inexpensively. Doing so, may help to increase the consumption of
foods that can help to combat the high incidence of childhood
obesity. Under this provision, the Department is encouraged to
develop direct marketing programs for the provision of fresh fruits
and vegetables in areas designated by DOH as having a high incidence
of childhood obesity.

Section 10: Effective date.
This Part shall take effect immediately.

PART B:

Section 1: Amends Education Law section 901 which relates to school
health services to be provided. This section expands the types of
services that can be provided by school health services to include
examining students for the existence, in addition to diseases or
disabilities, to include childhood obesity as defined pursuant to
existing Education Law standards contained in section 904.

Section 2: Amends Education Law section 903 to add that school health
exams may include a diabetes risk analysis if such child has risk
factors for type 1 or type 2 diabetes, such as obesity, family
history of type 2 diabetes, or other factors that heighten the risk
of diabetes.
section 3: Amends Education Law section 904 which relates to
examinations by health appraisal to include obesity.

Section 4: Amends Education Law section 912 which relates to health
and welfare services to all children, may also include childhood
obesity screening.

Section 5: Amends Education Law section 918 (4)and(5)which relates to
the formation of school district nutrition advisory committees. Under
this provision, such advisory committees can study and make
recommendations on current nutritional policies of the school
district to reduce the incidence of childhood obesity. Further, such
advisory committees can make recommendations on educational
information that can be provided to parents and guardians of students
regarding healthy nutrition and health risks associated with asthma,
chronic bronchitis, and other chronic respiratory diseases. Provided
further, make recommendations to teachers and other staff as to the
dangers of childhood obesity.

Section 6: This Part B shall take effect 2 years after it shall have
become law.

PART C:


Section 1: Amends Public Health Law section 206 (1) which relates to
the general powers and duties of the Commissioner of Health. This
provision adds a new subdivision to authorize that the Department of
Health may promulgate rules and regulations to restrict the use of
artificial trans fats in the preparation of certain foods served by
food service establishments that offer the immediate sale of food to
the general public. Foods that DOH could regulate that have trans fat
include those prepared foods that contain vegetable shortening,
margarine, or partially hydro-genated
vegetable oil in quantities above .5 grams per serving. Such
regulations cannot apply to foods that are served to the public in
packages sealed by the manufacturer. Further such regulations cannot
apply to the City of New York or any other municipality that has
adopted a local law to regulate such products. This bill provision
does not mandate DOH to promulgate such rules, but establishes a
framework should the Department deem it appropriate to promulgate
such regulations.

This section also authorizes DOH to mandate that food service
establishments may require that warning signs be placed in such
establishments to inform the public about the health risks associated
with the over consumption of foods made with artificial trans fats.

This section also authorizes DOH to establish a voluntary artificial
trans fat reduction or program. Such a program can include a public
information dissemination program to inform the public about the
health risks associated with the over consumption of foods that have
significant amounts of artificial trans fats.

This section also authorizes DOH to require chain owned food service
establishments that have over 25 sites to disclose on their product
offerings the total number of calories, grams of carbohydrates,
saturated fats, and milligrams of sodium contained in each food
offered for sale at such establishment. Such information may, in the
discretion of the Department, be offered to the public upon request.

Section 2: Amends Public Health Law section 207 which relates to the
Health Care and Wellness Education and Outreach Program. This
provision expands the ability of DOH to conduct wellness education
and outreach programs to elementary and secondary school educators.
Further, such education and outreach programs can provide information
about the adverse health risks to adults and children who become
obese or underweight.

Section 3: Amends Public Health Law section 207 to provide that the
Department's education and outreach programs may also talk about the
short term and long term adverse health risks to adults and children
who become overweight, obese or underweight.

Section 4: This Part C shall take effect one year after this bill
shall have become law.

PART D:

Section 1: Amends Education Law section 2556(5) to add a new sentence
to encourage certain secondary and primary schools in New York City
to provide for other types of recreational play spaces if existing


playgrounds are subsequently used for school construction or siting
of temporary classroom units. Under current law, Section 2556(5)
requires open-air playgrounds be attached to all schoolhouses
constructed in the city of New York. The purpose of this provision is
to encourage the retention of adequate outdoor playground space for
New York City school children. Further, that if existing playgrounds
are sold, leased, transferred or used for school building
construction in a way that eliminates such playground space, that the
school establish a plan to secure suitable and adequate playground
space for the physical recreation needs of such pupils.

PART E:

Section 1: Amends Education Law section 803 (1) and (5) which relates
to the instruction of physical education in all elementary and
secondary schools to foster the increased overall physical fitness
and good health of its students and to foster a reduction in the
incidence of childhood obesity. Further, it encourages the regents to
ensure that all students in elementary and secondary schools have
daily physical activity to increase their physical wellbeing and to
increase their ability to absorb what is being taught in school.

Section 2: Amends Education Law section 804(1) to alter the material
taught in health, physical education, and appropriate science classes
to include information on the health risks associated with childhood
obesity and ways to combat the incidence of childhood obesity.

Section 3: Amends Education Law section 804-a which relates to the
comprehensive School Health Education Demonstration Program. These
demonstration programs can be established by individual schools for
the development, implementation, evaluation, validation, and
replication of exemplary comprehensive health education programs.
This bill expands this demonstration program to include conveying
knowledge to students on a host of social conditions to include in
addition to adolescent pregnancy, alcohol abuse, truancy, suicide,
and substance abuse to also include obesity, asthma, or other
chronic respiratory diseases.

Section 4: Amends Education Law section 813 to ensure that during a
primary and secondary student's lunch period that ample time is
devoted so that such student can consume his lunch and have time to
engage in physical exercise or recreation.

PART F:

Section 1: 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
pregnancy programs shall distribute information on the adverse
effects of smoking 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 developmental damage to the child. Under this article,
individualized smoking cessation programs would be established to
help 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 2: The effective date for this provision is 180 days after it
shall have become law.

PART G:

Section 1: 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
Medicaid-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 obesity,
chronic bronchitis, and other chronic respiratory diseases.

PART H:

Section 1: Amends Public Health Law section 2599-b to expand the scope
of programs administered by DOH to reduce the incidence and
prevalence of obesity in children and adolescents, especially among
populations with high rates of obesity. Under current law, the
program looks to address obesity related health complications such as
diabetes, heart disease, cancer, osteoarthritis, and asthma. This
bill would expand such programs to include obesity-related health
complications such as chronic bronchitis, and other chronic
respiratory diseases.

In addition a new paragraph (h)is added to encourage DOH to coordinate
with the Education Department, Office of Temporary and Disability
Assistance, Office of Children and Family Services, and other
federal, state, and local agencies to incorporate strategies to
curtail the incidence of asthma, and chronic respiratory diseases to
enable adults and children to safely increase physical activity to
help curb the incidence of obesity.

Section 2: Amends Public Health Law section 2599-c that relates to the
Department's role in encouraging more school-based childhood obesity
prevention and physical activity programs. This bill adds that the
Department in advancing school-based childhood obesity prevention and
physical activity programs should cooperate with the Commissioners of
Agriculture & Markets and Education, and county boards of cooperative
extension.

PART I:

Section 1: Amends Public Health Law section 263 that relates to an
already authorized obesity study. This provision cross references a
new Public Health Law section 2500-k and the information received
from the childhood obesity prevention and screening program
established pursuant to that section of the law.

PART J:

Section 1: Amends Public Health Law section 2411 which relates to the
powers and duties of the Commissioner. This provision authorizes the
Commissioner to act in an advisory and supervisory capacity with


regard to the Health Research Science Board as it relates to
childhood obesity, asthma, and chronic bronchitis or other
respiratory diseases. Further it expands the jurisdiction of such
Board to research issues related to childhood obesity, asthma, and
other respiratory diseases in addition to already being authorized to
research breast, prostate or testicular cancer.

Section 2: Amends Public Health Law section 2500 (1) which relates to
the Commissioner's duties as it relates to maternal and child health
to also include childhood obesity.

Section 3: Amends Public Health Law section 2500-k to establish a
childhood obesity prevention and screening program. This provision
authorizes the Department to establish a childhood obesity prevention
and screening
program so that trends may be ascertained with regard to the incidence
and location of populations that have childhood obesity conditions.
This research information may be shared with hospitals that provide
obstetric services and pediatric primary care providers. Ultimately,
this information can be used to review and improve quality of care
provided by such health care providers.

PART K:

Section 1: Amends Public Health Law section 2505-a to add child day
care facilities to the list of facilities that must post the
"statement of rights of breast feeding mothers". The goal of this
provision is to disseminate the statement of rights of breastfeeding
mothers to places where such mothers may frequent. Studies have shown
that encouraging the breast feeding of children reduces the risk that
such infants become obese later on in life.

Section 2: Amends Public Health Law section 2505, which relates to the
general powers of the Commissioner to regulate the collection,
storage and distribution of human breast milk. This provision
authorizes the Commissioner to adopt regulations or guidelines to
encourage and facilitate employers and child day care centers to
establish environments that do not discourage the practice of breast
feeding.

Section 3: Amends Public Health Law section 2515 (2) that relates to
Adolescent Pregnancy Prevention and Services Program to add to
"services for eligible adolescents" vocational and education
counseling on pregnancy and child nutrition counseling for expectant
mothers to help curtail the incidence of childhood obesity.

Section 4: Amends Public Health Law section 2515-a(2) that relates to
the administration of community service project plans. The purpose of
these demonstration plans is to develop new methodologies to advance
the provision of health care that reduces adolescent pregnancy and
provide services to assist teenage mothers. These demonstration
programs tend to be located in geographical areas where there is a
high incidence of infant mortality and low income families. This
provision expands the demonstration program areas to also include
geographical areas that have low birth weight babies or childhood
Obesity.


Section 5: Amends Public Health Law section 2522 to empower the Health
Department to provide funds, if it deems appropriate, to finance
health and nutritional education and services to both parents
regarding childhood and adult obesity and asthma, and the prevention
or mitigation thereof.

PART L:

Section 1: Amends Education Law section 916 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 "moder-
ately severe asthmatic condition" or have other potentially
life-threatening respiratory illnesses".

Section 2: 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.
The underlying justification to enact the provisions of Part I is that
if students are not able to engage in physical activity because of
restricted breathing patterns and asthma, any treatment that
encourages such students to maintain physical activity may help to
reduce the incidence of childhood obesity.

PART M:

Section 1: 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 adult
and childhood obesity issues, there is a correlation between those
who are exposed, either voluntary or otherwise, to first and second
hand tobacco smoke, and asthma and the incidence of obesity. It would
be difficult to address obesity and asthma issues without looking at
the incidence of tobacco smoking and exposing, particularly children,
to such conditions that can trigger asthma attacks and increase the
incidence of obesity conditions generally because


children are not able to conduct physical activity to maintain a
proper weight.

PART N:

Section 1: Adds a new State Finance Law section 91-h to establish the
Obesity and Respiratory Disease Research Fund. This fund is
established to support the financing of projects and research
provided for in PHL sections 2411, 2500, and 2500-k.

PART O:

Sections 1 and 2: Amends Insurance Law section 3239 that relates to
Wellness Programs that can be sponsored by health insurers or HMOs to
help promote the health and wellbeing of their insureds or
subscribers. This provision expands the types of wellness programs
that can sponsored by such carriers to include coordinated weight
management, nutrition, stress management and physical fitness
programs to combat the high incidence of adult and child obesity,
asthma, and other chronic respiratory
conditions. This section also, allows for the full or partial
reimbursement of the cost of participating in stress management
programs or activities.

PART P:

Section 1: Amends Social Services Law sections 366(4) to encourage
both parents to obtain health and nutritional education and services
regarding childhood and adult obesity, asthma, and the mitigation
thereof.

Section 2: Amends Social Services Law section 390(2-a) to authorize
the Office of Children and Family Services may promulgate rules and
regulations on appropriate physical activity, nutritional offerings,
and low calorie foods and beverages to lower the incidence of
childhood obesity for child day care homes, programs, and facilities.

Section 3: Amends Social Services Law.section 390-a to prohibit any
family day care home, group family day care home, or school age child
care program or child day care center to discriminate against any
child who is breast fed or who is fed with expressed breast milk.

Section 4: Amends County Law section 224-b to authorize cooperative
extension services to provide in a coordinated manner a local or
statewide program specialist that relates to adult and childhood
obesity, asthma, or chronic respiratory illness prevention.

JUSTIFICATION:
The growing prevalence of overweight and obese children is a crisis
that is facing the entire nation. Obesity related health care
expenditures in New York are some of the highest in the nation.
Further, contrary to the lower prevalence of obesity among adults,
children in New York are more likely to be obese or overweight when
compared to national trends. Obesity and overweight conditions in
individuals are leading to higher incidences of life threatening
conditions and substantial economic costs both to the State of New
York for health care costs and to employers in lost work time and


higher health care costs. Obesity in children tends to manifest
itself more widely among poorer children and children whose parents
have lower education levels.

The rising incidence of childhood obesity is a serious medical problem
that continues to grow, especially among poorer and minority
communities. Further, obesity is known to cause or exacerbate
a number of serious chronic medical disorders including hypertension,
dyslipidemia, cardiovascular disease, diabetes, and respiratory
dysfunction. Nearly 80%' of patients with diabetes mellitus are
obese, while nearly 7090- of diagnosed cases of cardiovascular
disease are related to obesity. Obesity ranks only second to smoking
as a preventable cause of death. Unfortunately, preventable deaths
caused by obesity conditions is rapidly approaching and will surpass
those deaths caused by smoking tobacco.

While the high prevalence of obesity and overweight conditions is an
important public health concern when it affects adults. It should be
of heightened concern that this adult affliction is now becoming more
common among children. When obesity conditions afflict children this
poses, significant quality of life detriments to such persons,
reduces the productivity of such individuals over a longer time of
their life,
and hastens the onset of many chronic conditions that can hurt the
quality of life of such persons and their families.

The provisions of this bill are derived from a report by the
Independent Democratic Conference entitled "Childhood Obesity:
Mitigation and Prevention in the State of New York". This report
outlines the trends of the increasing incidence of childhood obesity,
some of the causes of this increase, and suggested courses of action
that can be taken to help reduce this ever increasing public health
problem. It is important for state agencies such as the Departments
of Health, Education, Agriculture & Markets, and Insurance, the
Office of Children and Family Services coordinate their current
activities to curb this problem. Further, once New York's state
agencies have a more coordinated approach to curb childhood obesity,
then other public stakeholders such as school educators and BOCES can
combine forces with such state agencies and with private stakeholders
such as health care providers, health care facilities, child day care
centers, insurers, and community groups to provide a coordinated way
to address this problem.

PRIOR LEGISLATIVE HISTORY:
2012 - S. 6423 - Referred to Agriculture

EFFECTIVE DATE:
See relevant sections at the end of each Part of this bill.

view bill text
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  2374

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                            January 16, 2013
                               ___________

Introduced  by Sens. KLEIN, ADDABBO, CARLUCCI, HANNON, HASSELL-THOMPSON,
  PARKER, SAVINO, STAVISKY -- read twice and ordered printed,  and  when
  printed to be committed to the Committee on Agriculture

AN  ACT to amend the agriculture and markets law, in relation to combat-
  ing the incidence of adult and child obesity, establishing a community
  gardens task force and encouraging direct marketing  of  fresh  fruits
  and  vegetables  in  areas  with  a  high incidence of adult and child
  obesity (Part A); to amend the education law, in relation to screening
  for childhood obesity and promotion of  the  availability  of  certain
  foods  and  beverages  in schools (Part B); to amend the public health
  law, in relation to regulating the use of artificial  trans  fats  and
  requiring  food  service  facilities  to  post  or provide nutritional
  information on the food products served, and the inclusion  of  weight
  control in the health care and wellness education and outreach program
  (Part  C);  to amend the education law, in relation to restricting the
  sale, lease, transfer or authorization of open-air  schoolhouse  play-
  grounds  for  certain  uses  (Part  D); to amend the education law, in
  relation to instruction in good health and reducing the  incidence  of
  obesity  (Part  E);  to  amend  the  public health law, in relation to
  in-utero exposure to tobacco smoke prevention (Part F); to  amend  the
  public  health  law,  in  relation  to  including  certain respiratory
  diseases and obesity within disease management demonstration  programs
  (Part G); to amend the public health law, in relation to the reduction
  of   emphysema,  chronic  bronchitis  and  other  chronic  respiratory
  diseases in children (Part H); to amend  the  public  health  law,  in
  relation  to the collection and reporting of obesity data (Part I); to
  amend the public health law,  in  relation  to  directing  the  health
  research  science board to study respiratory diseases and obesity, and
  childhood obesity prevention and screening  (Part  J);  to  amend  the
  public  health  law,  in  relation to breastfeeding of infants and the
  adolescent pregnancy nutrition counseling program (Part K);  to  amend
  the  education  law, in relation to the use of inhalers and nebulizers
  (Part L); to amend the real property law, in relation  to  residential
  rental  property smoking policies (Part M); to amend the state finance

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD06771-01-3

S. 2374                             2

  law, in relation to establishing the obesity and  respiratory  disease
  research  and  education fund (Part N); to amend the insurance law, in
  relation to wellness programs (Part O); to amend the  social  services
  law,  in relation to health and nutritional education and services and
  child day care facilities; and to amend the county law, in relation to
  the Cornell cooperative extension system relating to adult and  child-
  hood obesity, asthma, and respiratory illness prevention (Part P)

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Short title. This act shall be known and may  be  cited  as
the "omnibus obesity and respiratory illness reduction act".
  S  2.  This  act enacts into law major components of legislation which
combat  the  incidence  of  adult  and  child  obesity  and  respiratory
diseases,  and  encourage the production and consumption of fresh fruits
and vegetables. Each component is wholly contained within a Part identi-
fied as Parts A through  P.  The  effective  date  for  each  particular
provision contained within such Part is set forth in the last section of
such Part. Any provision in any section contained within a Part, includ-
ing the effective date of the Part, which makes a reference to a section
"of  this  act", when used in connection with that particular component,
shall be deemed to mean and refer to the corresponding  section  of  the
Part  in  which  it  is found.   Section four of this act sets forth the
general effective date of this act.

                                 PART A

  Section 1. Section 3 of the agriculture and markets law, as amended by
chapter 651 of the laws of 1946, is amended to read as follows:
  S 3. Declaration of policy and purposes.  The agricultural industry is
basic to the life of our state. It  vitally  concerns  and  affects  the
welfare, health, economic well-being and productive and industrial capa-
bilities  of  all  our people. It is the policy and duty of the state to
promote, foster, and encourage the agricultural  industry,  with  proper
standards  of  living for those engaged therein; to design and establish
long-range programs for its stabilization and profitable  operation;  to
increase  through education, research, regulation, and scientific means,
the quantity, quality, and efficiency of its production; to improve  its
marketing system; to encourage adequate and skilled assistance for agri-
cultural  enterprises; to maintain at fair prices uncontrolled by specu-
lation the instrumentalities and  products  of  agriculture;  to  remove
unnecessary  or unfair costs and obstacles in the [transporation] TRANS-
PORTATION, storage, processing, distribution,  marketing,  and  sale  of
agricultural  products;  to  prevent  frauds  in the traffic therein; to
promote an expanded demand for the state's agricultural products and the
intelligent uses thereof by consumers as pure  and  wholesome  food;  to
protect  the  public health and to eliminate the evils of under-nourish-
ment; to encourage the selection and consumption of  food  according  to
sound dietary and nutritional principles; TO IMPROVE OUR CITIZENS' OVER-
ALL HEALTH AND TO COMBAT THE INCREASING INCIDENCE OF ADULT AND CHILDHOOD
OBESITY; and to make our people conscious of the bond of mutual self-in-
terest between our urban and our rural populations.
  Accordingly, all laws enacted concerning the agricultural industry and
its  allied subjects, whether included in this chapter or not, are to be

S. 2374                             3

deemed an exercise of the police power of the state and a  discharge  of
its  obligations for the promotion of the general welfare through state-
wide laws and regulations, local initiative and government,  cooperative
action  between  groups  and  localities, home-rule measures, individual
enterprise, civic consciousness, and appropriate coordination  with  the
federal  government  and  as  between  educational research institutions
within the state.
  Such laws and  all  governmental  measures  adopted  pursuant  thereto
should  receive  a liberal interpretation and application in furtherance
of the aforesaid policy and purposes.
  S 2. Subdivision 5-b of section 16 of the agriculture and markets law,
as added by chapter 2 of the  laws  of  2001,  is  amended  to  read  as
follows:
  5-b. (A) Establish, in cooperation with the commissioner of education,
a  farm-to-school  program to facilitate and promote the purchase of New
York farm products by schools, universities and other educational insti-
tutions under the jurisdiction of the education department. The  depart-
ment  shall  solicit information from the education department regarding
school  districts  and  other  educational  institutions  interested  in
purchasing  New  York  farm  products, including but not limited to, the
type and amount of such products schools wish to purchase and  the  name
of  the  appropriate contact person from the interested school district.
The department shall make this information readily available  to  inter-
ested  New  York  farmers, farm organizations and businesses that market
New York farm products. The department shall provide information to  the
education  department  and  interested school districts and other educa-
tional institutions about the availability of New  York  farm  products,
including  but not limited to, the types and amount of products, and the
names and contact information of farmers, farm organizations  and  busi-
nesses  marketing  such  products.  The commissioner shall report to the
legislature on the need for changes in law to facilitate  the  purchases
of such products by schools and educational institutions.
  The  department  shall  also coordinate with the education department,
and school food service, education,  health  and  nutrition,  farm,  and
other  interested  organizations in establishing a promotional event, to
be known as New York Harvest For New York Kids Week,  in  early  October
each  year, that will promote New York agriculture and foods to children
through school meal programs and the classroom, at  farms  and  farmers'
markets and other locations in the community.
  (B) COOPERATE WITH THE DEPARTMENT OF HEALTH IN IMPLEMENTING THE CHILD-
HOOD OBESITY PREVENTION PROGRAM PURSUANT TO TITLE EIGHT OF ARTICLE TWEN-
TY-FIVE  OF THE PUBLIC HEALTH LAW AND WITH THE COMMISSIONER OF EDUCATION
TO ENCOURAGE THE PRODUCTION AND CONSUMPTION OF  FRESH  LOCALLY  PRODUCED
FRUITS  AND  VEGETABLES BY ELEMENTARY AND SECONDARY SCHOOL AGED CHILDREN
PURSUANT TO PARAGRAPH  (A)  OF  THIS  SUBDIVISION  TO  HELP  COMBAT  THE
INCREASING INCIDENCE OF CHILDHOOD OBESITY.
  (C)  COOPERATE  WITH  FEDERAL,  OTHER  STATE AND MUNICIPAL AGENCIES TO
ENCOURAGE THE EXPANSION OF COMMUNITY GARDENS PURSUANT TO  ARTICLE  TWO-C
OF  THIS  CHAPTER  TO  HELP  ENCOURAGE THE PRODUCTION AND CONSUMPTION OF
FRESH LOCALLY PRODUCED FRUITS AND VEGETABLES TO HELP COMBAT THE INCREAS-
ING INCIDENCE OF ADULT AND CHILD OBESITY.
  S 3. Article 2-C of the agriculture and  markets  law  is  amended  by
adding a new section 31-f to read as follows:
  S  31-F.  LEGISLATIVE  FINDINGS.    THE  LEGISLATURE  HEREBY FINDS AND
DECLARES THAT COMMUNITY GARDENS PROVIDE SIGNIFICANT HEALTH,  EDUCATIONAL
AND  SOCIAL  BENEFITS  TO  THE  GENERAL PUBLIC, ESPECIALLY FOR THOSE WHO

S. 2374                             4

RESIDE IN URBAN AND SUBURBAN AREAS OF THIS STATE. FURTHERMORE, IT IS THE
ARTICULATED PUBLIC POLICY OF THIS STATE TO PROMOTE AND FOSTER GROWTH  IN
THE  NUMBER  OF  COMMUNITY  GARDENS AND THE ACREAGE OF SUCH GARDENS. THE
COMMUNITY  GARDEN  MOVEMENT  CONTINUES  TO PROVIDE LOW COST FOOD THAT IS
FRESH AND NUTRITIOUS FOR THOSE WHO MAY BE UNABLE TO READILY AFFORD FRESH
FRUITS AND VEGETABLES FOR THEMSELVES OR THEIR FAMILIES, PROMOTES  PUBLIC
HEALTH  AND HEALTHIER INDIVIDUAL LIFESTYLES BY ENCOURAGING BETTER EATING
HABITS AND INCREASED  PHYSICAL  ACTIVITY  BY  GROWING  THEIR  OWN  FOOD,
FOSTERS  THE  RETENTION  AND  EXPANSION  OF OPEN SPACES, PARTICULARLY IN
URBAN ENVIRONMENTS, ENHANCES URBAN AND  SUBURBAN  ENVIRONMENTAL  QUALITY
AND  COMMUNITY  BEAUTIFICATION,  PROVIDES INEXPENSIVE COMMUNITY BUILDING
ACTIVITIES, RECREATION AND PHYSICAL EXERCISE FOR ALL AGE GROUPS,  ESTAB-
LISHES  A  SAFE  PLACE FOR COMMUNITY INVOLVEMENT AND HELPS TO REDUCE THE
INCIDENCE OF CRIME, ENGENDERS A CLOSER RELATIONSHIP BETWEEN URBAN  RESI-
DENTS,  NATURE AND THEIR LOCAL ENVIRONMENT, AND FOSTERS GREEN JOB TRAIN-
ING AND ECOLOGICAL EDUCATION AT ALL LEVELS. FURTHER,  THE  PROMOTION  OF
COMMUNITY  GARDENS  CAN  HELP  THE  COMMUNITY  TO CONDUCT ACTIVITIES FOR
ITSELF TO COMBAT CHILDHOOD AND ADULT  OBESITY  TO  ADVANCE  THE  OVERALL
HEALTH   OF COMMUNITY MEMBERS.  IT IS THEREFORE THE INTENT OF THE LEGIS-
LATURE AND THE PURPOSE OF THIS ARTICLE TO FOSTER GROWTH IN  THE  NUMBER,
SIZE  AND  SCOPE OF COMMUNITY GARDENS IN THIS STATE BY ENCOURAGING STATE
AGENCIES, MUNICIPALITIES AND PRIVATE PARTIES IN THEIR EFFORTS TO PROMOTE
COMMUNITY GARDENS.
  S 4. Subdivisions 2 and 3 of  section  31-g  of  the  agriculture  and
markets  law,  as  added by chapter 862 of the laws of 1986, are amended
and a new subdivision 4-a is added to read as follows:
  2. "Garden" shall mean a piece OR PARCEL of land appropriate  for  THE
cultivation  of  herbs,  fruits,  flowers,  NUTS, HONEY, POULTRY FOR EGG
PRODUCTION,  MAPLE  SYRUP,  ORNAMENTAL  OR  VEGETABLE  PLANTS,   NURSERY
PRODUCTS, or vegetables.
  3.  "Municipality"  shall mean any county, town, village, city, school
district [or], BOARD OF COOPERATIVE EDUCATIONAL SERVICES, other  special
district, OR ANY OFFICE OR AGENCY THEREOF.
  4-A.    "STATE  AGENCY" SHALL MEAN ANY DEPARTMENT, BUREAU, COMMISSION,
BOARD, PUBLIC AUTHORITY OR OTHER AGENCY  OF  THE  STATE,  INCLUDING  ANY
PUBLIC  BENEFIT  CORPORATION  OF  WHICH  ANY  MEMBER  OF  WHOSE BOARD IS
APPOINTED BY THE GOVERNOR.
  S 5. Section 31-h of the agriculture and  markets  law,  as  added  by
chapter 862 of the laws of 1986, is amended to read as follows:
  S  31-h. Office  of  community gardens; powers; duties. 1. The commis-
sioner shall establish within the  department  an  office  of  community
gardens  which  shall have the authority and responsibility for carrying
out the provisions of this  article  in  cooperation  with  the  [state]
department  of environmental conservation, the [state] education depart-
ment, THE DEPARTMENT OF HEALTH, the  department  of  state,  cooperative
extensions and other state agencies and municipalities.
  2. The duties of the office shall include:
  a.  Upon  request,  the  office  shall assist in the identification of
vacant public land within a  given  geographical  location  and  provide
information  regarding  agency jurisdiction and the relative suitability
of such lands for community gardening purposes;
  b. Serve as a coordinator on behalf of interested community groups and
the appropriate state or local agencies to facilitate the use of  vacant
public  lands  for  community  garden  use for not less than one growing
season by receiving and forwarding with recommendation completed  appli-
cations to the appropriate STATE OR MUNICIPAL agency. PROVIDED, FURTHER,

S. 2374                             5

THAT  THE OFFICE MAY DEVELOP A SINGLE RECOMMENDED APPLICATION FORM TO BE
USED BY COMMUNITY GROUPS WHEN APPLYING  TO  STATE  AGENCIES  OR  MUNICI-
PALITIES FOR USE OF VACANT PUBLIC LAND FOR COMMUNITY GARDEN PURPOSES;
  c.  Support  and  encourage  contact between community garden programs
already in existence and those programs in the initial stages of  devel-
opment; [and]
  d. Seek and provide such assistance, to the extent funds or grants may
become available, for the purposes identified in this article[.];
  E.  ASSIST, SUPPORT AND ENCOURAGE CONTACT AND COOPERATION BETWEEN, AND
THE COOPERATIVE SHARING OF RESOURCES BETWEEN  COMMUNITY  GARDEN  GROUPS,
SCHOOL  GARDEN  PROGRAMS  AND  LOCAL VOLUNTARY FOOD ASSISTANCE PROGRAMS,
SUCH AS COMMUNITY FOOD PANTRIES,  SOUP  KITCHENS,  OTHER  COMMUNITY  AND
NOT-FOR-PROFIT ORGANIZATIONS THAT PROVIDE OR DISTRIBUTE FOOD TO THE POOR
AND  DISADVANTAGED,  HOSPITALS,  OTHER HEALTH CARE FACILITIES AND EDUCA-
TIONAL FACILITIES. SUCH SUPPORT CAN INCLUDE  THE  PROVISION  OF  SURPLUS
COMMUNITY  GARDEN  FOOD  OR  OTHER  AGRICULTURAL  PRODUCTS TO SUCH LOCAL
VOLUNTARY FOOD ASSISTANCE PROGRAMS;
  F. ASSIST, SUPPORT AND ENCOURAGE COMMUNICATION,  AND  THE  SHARING  OF
RESOURCES  BETWEEN  COMMUNITY  GARDEN  ORGANIZATIONS  AND  THE  NEW YORK
HARVEST FOR NEW YORK KIDS WEEK PROGRAM  ESTABLISHED  BY  THE  DEPARTMENT
PURSUANT  TO  SUBDIVISION FIVE-B OF SECTION SIXTEEN OF THIS CHAPTER, AND
INDIVIDUAL FARM-TO-SCHOOL AND SCHOOL GARDEN PROGRAMS;
  G. SUPPORT EFFORTS BY THE  DEPARTMENTS  OF  HEALTH  AND  EDUCATION  TO
COMBAT  ADULT  AND  CHILDHOOD  OBESITY BY ENCOURAGING THE CONSUMPTION OF
COMMUNITY GARDEN PRODUCED FRUITS AND VEGETABLES; AND
  H. ESTABLISH A COMMUNITY GARDENS TASK FORCE PURSUANT TO SECTION  THIR-
TY-ONE-J OF THIS ARTICLE.
  S  6.  Section  31-i  of  the agriculture and markets law, as added by
chapter 862 of the laws of 1986, is amended to read as follows:
  S 31-i. Use of state OR MUNICIPALLY owned land for community  gardens.
1.  Any  state  agency[,  department, board, public benefit corporation,
public authority] or [commission]  MUNICIPALITY  with  title  to  vacant
public  land  may  permit  community organizations to use such lands for
community gardening purposes. Such use of  vacant  public  land  may  be
conditioned on the community organization possessing liability insurance
and  accepting  liability for injury or damage resulting from use of the
vacant public land for community gardening purposes.
  2. State agencies AND MUNICIPALITIES which have received  an  applica-
tion for use of public lands for community garden purposes shall respond
to the applicant within thirty days and make a final determination with-
in one hundred eighty days.
  S  7.  The  agriculture  and  markets  law  is amended by adding a new
section 31-j to read as follows:
  S 31-J. COMMUNITY GARDENS TASK FORCE. 1.  THE  OFFICE  MAY  CONVENE  A
COMMUNITY  GARDENS  TASK FORCE TO IDENTIFY AND DEVELOP WAYS TO ENCOURAGE
STATE AGENCIES, MUNICIPALITIES AND  PRIVATE  PARTIES  TO  ESTABLISH  AND
EXPAND COMMUNITY GARDENS AND THE ACTIVITIES CONDUCTED BY SUCH GARDENS.
  2.  THE  TASK  FORCE  SHALL BE CHAIRED BY THE COMMISSIONER, OR BY SUCH
OFFICER OR EMPLOYEE OF THE DEPARTMENT AS  SHALL  BE  DESIGNATED  BY  THE
COMMISSIONER.  THE  MEMBERSHIP  OF  THE TASK FORCE MAY INCLUDE REPRESEN-
TATION  FROM  THE  EDUCATION  DEPARTMENT,  DEPARTMENT  OF  ENVIRONMENTAL
CONSERVATION,  DEPARTMENT  OF  HEALTH,  DEPARTMENT  OF  STATE, OFFICE OF
PARKS, RECREATION AND  HISTORIC  PRESERVATION,  AND  OFFICE  OF  GENERAL
SERVICES. SUCH TASK FORCE SHALL INCLUDE MEMBERS THAT REPRESENT COUNTIES,
CITIES,  TOWNS, VILLAGES, SCHOOL DISTRICTS, OTHER SPECIAL USE DISTRICTS,
PUBLIC AUTHORITIES AND COOPERATIVE EXTENSION SERVICES.

S. 2374                             6

  3. THE TASK FORCE SHALL HAVE NOT MORE THAN TWENTY-FIVE MEMBERS.
  4. THE OFFICE, MAY REQUEST THE ASSISTANCE OF STATE AGENCIES INCLUDING,
BUT NOT LIMITED TO THE EDUCATION DEPARTMENT, DEPARTMENT OF ENVIRONMENTAL
CONSERVATION,  DEPARTMENT  OF HEALTH, DEPARTMENT OF STATE, DEPARTMENT OF
CORRECTIONS AND COMMUNITY SUPERVISION, OFFICE OF STATE PARKS, RECREATION
AND HISTORIC PRESERVATION, AND OFFICE OF GENERAL SERVICES TO  CARRY  OUT
THE WORK OF THE TASK FORCE.
  5. THE TASK FORCE MAY ONLY ACT WHEN THREE-FIFTHS OF ITS MEMBERSHIP ARE
PRESENT.  ALL ACTION OF THE TASK FORCE SHALL REQUIRE AN AFFIRMATIVE VOTE
OF ITS MEMBERSHIP. THE TASK FORCE SHALL  CONVENE  AT  THE  CALL  OF  THE
OFFICE.
  6.  THE  MEMBERS  OF  THE TASK FORCE SHALL RECEIVE NO COMPENSATION FOR
THEIR SERVICES, BUT SHALL BE ALLOWED THEIR ACTUAL AND NECESSARY EXPENSES
INCURRED IN THE PERFORMANCE OF THEIR DUTIES PURSUANT TO THIS SECTION.
  7. (A) THE GOALS OF THE TASK FORCE MAY INCLUDE, BUT  ARE  NOT  LIMITED
TO,  THE  STUDY,  EVALUATION  AND DEVELOPMENT OF RECOMMENDATIONS: (I) TO
ENCOURAGE THE ESTABLISHMENT AND EXPANSION OF COMMUNITY GARDENS BY  STATE
AGENCIES,  MUNICIPAL  GOVERNMENTS,  EDUCATIONAL  FACILITIES  AND PRIVATE
PARTIES, SUCH AS HOSPITALS,  OTHER  HEALTH  CARE  FACILITIES  AND  OTHER
HEALTH  CARE PROVIDERS, (II) TO ENCOURAGE COOPERATION BETWEEN THE ACTIV-
ITIES AND OPERATIONS OF COMMUNITY GARDENS AND PROVISION OF DONATED  FOOD
TO  LOCAL  VOLUNTARY FOOD ASSISTANCE PROGRAMS FOR THE POOR AND DISADVAN-
TAGED, (III) TO ENCOURAGE THE PRODUCTION AND CONSUMPTION OF FRESH FRUITS
AND VEGETABLES TO HELP COMBAT THE INCREASING  PREVALENCE  OF  ADULT  AND
CHILDHOOD  OBESITY,  AND  (IV)  TO  INCREASE THE BENEFITS THAT COMMUNITY
GARDENS MAY PROVIDE TO THE LOCAL COMMUNITY IN WHICH THEY ARE LOCATED.
  (B) IN ACHIEVING THE GOALS OF THE  TASK  FORCE,  THE  TASK  FORCE  MAY
CONSIDER  RECOMMENDATIONS THAT: (I) ENCOURAGE THE EXECUTION OF CONSERVA-
TION EASEMENTS BY STATE AGENCIES, MUNICIPALITIES, EDUCATIONAL FACILITIES
OR PRIVATE PARTIES TO  ESTABLISH  OR  PROTECT  COMMUNITY  GARDENS,  (II)
ENCOURAGE  THE  CREATION OF MECHANISMS TO TRANSFER DEVELOPMENT RIGHTS TO
PROTECT COMMUNITY GARDENS OR ENCOURAGE THE DONATION OR  LEASE  OF  LANDS
FOR  COMMUNITY  GARDENS,  (III) DEVELOPMENT OF MODEL ZONING CODES, LOCAL
LAND USE LAWS OR OTHER  MUNICIPAL  POLICIES  THAT  COULD  ENCOURAGE  THE
ESTABLISHMENT  OR RETENTION OF COMMUNITY GARDENS, (IV) ENCOURAGE COOPER-
ATIVE INITIATIVES BETWEEN HEALTH  CARE  FACILITIES,  OTHER  HEALTH  CARE
PROVIDERS  AND COMMUNITY GROUPS TO ENCOURAGE THE PRODUCTION AND CONSUMP-
TION OF FRESH FRUITS AND VEGETABLES TO  COMBAT  THE  HIGH  INCIDENCE  OF
ADULT AND CHILD OBESITY, AND (V) ANY OTHER ACTIVITY TO ACHIEVE THE GOALS
DEEMED APPROPRIATE BY THE TASK FORCE ACCORDING TO THE PROVISIONS OF THIS
ARTICLE.
  S  8.  The  opening  paragraph  of  section 281 of the agriculture and
markets law, as added by chapter 834 of the laws of 1981, is amended  to
read as follows:
  The  legislature  hereby finds that inflation has caused higher prices
in all phases of farm and food production and  farm  and  food  products
distribution;  and  that  the demand, by consumers within the state, for
increasing supplies of wholesome, fresh and  nutritious  farm  and  food
products  provides  a  significant  opportunity  for  the development of
alternative marketing structures for food  grown  within  the  state  by
which such products may be supplied directly to the consuming public. IN
ADDITION,  INCREASING  THE  SUPPLY OF WHOLESOME, FRESH, LOCALLY PRODUCED
FRUITS AND VEGETABLES CAN HELP TO  ENCOURAGE  THE  CONSUMPTION  OF  SUCH
PRODUCE  IN  A  MANNER  THAT HELPS TO COMBAT THE INCREASING INCIDENCE OF
ADULT AND CHILDHOOD OBESITY. REDUCING THE INCIDENCE OF OBESITY CAN  HELP
TO  IMPROVE THE OVERALL HEALTH OF THE GENERAL PUBLIC, HELP TO REDUCE THE

S. 2374                             7

COST OF PROVIDING HEALTH CARE AND REDUCE THE STATE'S COSTS OF  PROVIDING
SUCH CARE.
  S  9. Subdivision 5 of section 283 of the agriculture and markets law,
as added by chapter 834 of the laws of 1981, is amended and a new subdi-
vision 8-a is added to read as follows:
  5. Provide assistance to consumer or non-profit organizations,  PUBLIC
OR  PRIVATE AGENCIES, HOSPITALS AND OTHER HEALTH CARE FACILITIES seeking
to purchase or facilitate the purchase of farm  products  directly  from
producers.
  8-A.  ENCOURAGE  THE  DEVELOPMENT OF DIRECT MARKETING PROGRAMS, WITHIN
AREAS OF THE STATE DESIGNATED BY THE DEPARTMENT OF HEALTH  AS  HAVING  A
HIGH  INCIDENCE  OF CHILDHOOD OBESITY AND TO INCREASE THE CONSUMPTION OF
FRESH FRUITS AND VEGETABLES TO HELP  CURB  THE  INCIDENCE  OF  CHILDHOOD
OBESITY.
  S 10. This act shall take effect immediately.

                                 PART B

  Section 1. Section 901 of the education law, as amended by chapter 477
of  the laws of 2004, subdivision 1 as amended by section 57 of part A-1
of chapter 58 of the laws of 2006, is amended to read as follows:
  S 901. School  health  services  to  be  provided.  1.  School  health
services,  as  defined  in  subdivision  two  of  this section, shall be
provided by each school district for all students attending  the  public
schools in this state, except in the city school district of the city of
New  York,  as  provided  in  this article. School health services shall
include the services of a  registered  professional  nurse,  if  one  is
employed,  and  shall  also  include such services as may be rendered as
provided in this article in examining  students  for  the  existence  of
disease  or disability, OR MAY INCLUDE SERVICES RELATED TO EXAMINING FOR
CHILDHOOD OBESITY BASED UPON THE CALCULATION OF EACH STUDENT'S BODY MASS
INDEX AND WEIGHT STATUS CATEGORY PURSUANT TO SECTION NINE  HUNDRED  FOUR
OF THIS ARTICLE, and in testing the eyes and ears of such students.
  2.  School health services for the purposes of this article shall mean
the several procedures, including, but not limited to, medical  examina-
tions,  dental  inspection and/or screening, scoliosis screening, vision
screening [and], audiometer tests, AND CHILDHOOD OBESITY AS MEASURED  BY
BODY  MASS  INDEX  AND WEIGHT STATUS CATEGORY, designed to determine the
health status of the child;  to  inform  parents  or  other  persons  in
parental  relation  to  the child, pupils and teachers of the individual
child's health condition subject to federal  and  state  confidentiality
laws; to guide parents, children and teachers in procedures for prevent-
ing  and correcting defects [and], diseases AND CHILDHOOD OBESITY CONDI-
TIONS; to instruct the school personnel in procedures to take in case of
accident or  illness;  to  survey  and  make  necessary  recommendations
concerning  the  health  and safety aspects of school facilities and the
provision of health information.
  S 2. Subdivisions 1, 3 and 4 of section 903 of the education  law,  as
amended  by chapter 281 of the laws of 2007, subdivision 1 as separately
amended by section 11 of part B of chapter 58 of the laws  of  2007  and
paragraph a of subdivision 3 as amended by section 28 of part A of chap-
ter 58 of the laws of 2008, are amended to read as follows:
  1.  A  health  certificate  shall  be furnished by each student in the
public schools upon his or her entrance in such schools and upon his  or
her entry into the grades prescribed by the commissioner in regulations,
provided  that such regulations shall require such certificates at least

S. 2374                             8

twice during the elementary grades and twice in the secondary grades. An
examination and health history of any child may be required by the local
school authorities at any time in their discretion to promote the educa-
tional  interests  of  such child. Each certificate shall be signed by a
duly licensed physician, physician assistant, or nurse practitioner, who
is authorized by law to practice in this state, and consistent with  any
applicable  written practice agreement, or by a duly licensed physician,
physician assistant, or nurse practitioner, who is authorized  to  prac-
tice  in  the  jurisdiction in which the examination was given, provided
that the commissioner has determined that such jurisdiction  has  stand-
ards  of  licensure  and  practice comparable to those of New York. Each
such certificate shall describe the condition of the  student  when  the
examination  was  made, which shall not be more than twelve months prior
to the commencement of the school  year  in  which  the  examination  is
required,  and shall state whether such student is in a fit condition of
health to permit his or her attendance at the public schools.  THE EXAM-
INATION MAY INCLUDE A DIABETES RISK ANALYSIS AND, IF NECESSARY, CHILDREN
WITH RISK FACTORS FOR TYPE 1 DIABETES, OR RISK FACTORS  ASSOCIATED  WITH
TYPE 2 DIABETES SUCH AS OBESITY, A FAMILY HISTORY OF TYPE 2 DIABETES, OR
ANY  OTHER  FACTORS  CONSISTENT  WITH INCREASED RISK SHALL BE TESTED FOR
DIABETES. Each such certificate shall also state the student's body mass
index (BMI) and weight status category.  For purposes of  this  section,
BMI  is  computed  as  the  weight in kilograms divided by the square of
height in meters or the weight in pounds divided by the square of height
in inches multiplied by a conversion factor of 703. Weight status  cate-
gories  for  children and adolescents shall be as defined by the commis-
sioner of health. In all  school  districts  such  physician,  physician
assistant  or nurse practitioner shall determine whether a one-time test
for sickle cell anemia is necessary or desirable and  he  or  she  shall
conduct such a test and the certificate shall state the results.
  3.  a. Within thirty days after the student's entrance in such schools
or grades, the health certificate shall be submitted to the principal or
his or her designee and shall  be  filed  in  the  student's  cumulative
health  record. If such student does not present a health certificate as
required in this section, unless he or  she  has  been  accommodated  on
religious grounds, the principal or the principal's designee shall cause
a notice to be sent to the parents or person in parental relationship to
such  student  that  if the required health certificate is not furnished
within thirty days from the date of such notice, an examination will  be
made  of  such  student,  as  provided  in this article. Each school and
school district [chosen as part of an appropriate sampling  methodology]
shall  participate  in  surveys  directed  by the commissioner of health
pursuant to the public health law  in  relation  to  students'  BMI  and
weight  status  categories  as reported on the school health certificate
and which shall be subject to audit by the commissioner of health.  Such
surveys  shall  contain the information required pursuant to subdivision
one of this section in relation to students' BMI and weight status cate-
gories in aggregate. Parents or other persons in parental relation to  a
student  may refuse to have the student's BMI and weight status category
included in such survey.  Each school and school district shall  provide
the  commissioner of health with any information, records and reports he
or she may require for the purpose of such audit.  The  BMI  and  weight
status  survey  and  audit  as  described  in  this subdivision shall be
conducted consistent with confidentiality requirements imposed by feder-
al law.

S. 2374                             9

  b. Within thirty days after the student's entrance in such schools  or
grades,  the  dental  health certificate, if obtained, shall be filed in
the student's cumulative health record.
  4.  Notwithstanding  the provisions of subdivisions one, two and three
of this section, no examinations for  a  health  certificate  or  health
history  shall  be  required  or  dental  certificate  requested, and no
screening examinations for sickle cell anemia OR CHILDHOOD OBESITY shall
be required where a student or the parent or person in parental relation
to such student objects thereto on the grounds that such examinations or
health  history  conflict  with  their  genuine  and  sincere  religious
beliefs.
  S  3. Subdivision 1 of section 904 of the education law, as amended by
section 12 of part B of chapter 58 of the laws of 2007,  is  amended  to
read as follows:
  1.  Each  principal  of a public school, or his or her designee, shall
report to the director of school  health  services  having  jurisdiction
over  such  school,  the  names  of  all students who have not furnished
health certificates as provided in section nine hundred  three  of  this
article,  or  who  are children with disabilities, as defined by article
eighty-nine of this chapter, and the director of school health  services
shall  cause  such  students to be separately and carefully examined and
tested to ascertain whether any student has defective sight or  hearing,
or  any  other  physical disability which may tend to prevent him or her
from receiving the full benefit of school  work,  or  from  requiring  a
modification  of  such  work  to  prevent  injury to the student or from
receiving the best educational results.   Each  examination  shall  also
include  a calculation of the student's body mass index (BMI) and weight
status category. For purposes of this section, BMI is  computed  as  the
weight  in  kilograms  divided  by the square of height in meters or the
weight in pounds divided by the square of height in inches multiplied by
a conversion factor of 703. Weight status categories  for  children  and
adolescents  shall  be  as defined by the commissioner of health. In all
school districts, such physician, physician assistant or  nurse  practi-
tioner shall determine whether a one-time test for sickle cell anemia is
necessary  or  desirable  and he or she shall conduct such tests and the
certificate shall state the results. If it should be  ascertained,  upon
such test or examination, that any of such students have defective sight
or  hearing[,]  or  other  physical  disability,  including  sickle cell
anemia, as above described, OR ARE OBESE, the principal or  his  or  her
designee  shall  notify  the  parents  of,  or other persons in parental
relation to, the child as to the existence of such  disability.  If  the
parents or other persons in parental relation are unable or unwilling to
provide  the necessary relief and treatment for such students, such fact
shall be reported by the principal or his or her designee to the  direc-
tor  of school health services, whose duty it shall be to provide relief
for such students. Each school and school district [chosen as part of an
appropriate sampling methodology] shall participate in surveys  directed
by  the  commissioner  of  health  pursuant  to the public health law in
relation to students' BMI and weight status categories as determined  by
the  examination  conducted  pursuant to this section and which shall be
subject to audit by the  commissioner  of  health.  Such  surveys  shall
contain  the  information  required  pursuant  to  this  subdivision  in
relation to students' BMI and weight  status  categories  in  aggregate.
[Parents  or  other persons in parental relation to a student may refuse
to have the student's BMI and weight status category  included  in  such
survey.]  Each school and school district shall provide the commissioner

S. 2374                            10

of health with any information,  records  and  reports  he  or  she  may
require  for the purpose of such audit. The BMI and weight status survey
and audit as described in this section  shall  be  conducted  consistent
with   confidentiality   requirements  imposed  by  federal  law.  [Data
collection for such surveys shall commence on a voluntary basis  at  the
beginning  of  the  two  thousand seven academic school year, and by all
schools chosen as part of the sampling methodology at the  beginning  of
the  two thousand eight academic school year.] The department shall also
utilize the collected data to develop a  report  of  child  obesity  and
obesity related diseases.
  S  4.  Section  912 of the education law, as amended by chapter 477 of
the laws of 2004, is amended to read as follows:
  S 912. Health and welfare services to all children. The voters  and/or
trustees  or  board  of  education  of every school district shall, upon
request of the authorities of a school other than public, provide  resi-
dent  children  who attend such school with any or all of the health and
welfare services and facilities which are made available by such  voters
and/or  trustees  or board of education to or for children attending the
public schools of the district. Such services may include, but  are  not
limited  to  all services performed by a physician, physician assistant,
dentist, dental hygienist, registered professional nurse, nurse  practi-
tioner, school psychologist, school social worker or school speech ther-
apist,  and  may  also  include  dental  prophylaxis, vision and hearing
screening examinations,  CHILDHOOD  OBESITY  SCREENING,  the  taking  of
medical  histories and the administration of health screening tests, the
maintenance of cumulative health records and the administration of emer-
gency care programs for ill or injured students. Any  such  services  or
facilities  shall  be  so  provided notwithstanding any provision of any
charter or other provision of law inconsistent herewith. Where  children
residing  in  one  school  district  attend  a  school other than public
located in another  school  district,  the  school  authorities  of  the
district  of residence shall contract with the school authorities of the
district where such nonpublic school is located, for  the  provision  of
such  health and welfare services and facilities to such children by the
school district where such nonpublic school is located, for a  consider-
ation  to  be  agreed  upon  between  the  school  authorities  of  such
districts, subject to the  approval  of  the  qualified  voters  of  the
district  of  residence when required under the provisions of this chap-
ter. Every such contract shall be in writing and in the form  prescribed
by the commissioner, and before such contract is executed the same shall
be submitted for approval to the superintendent of schools having juris-
diction  over  such  district  of  residence and such contract shall not
become effective until approved by such superintendent.
  S 5. Subdivisions 4 and 5 of section 918  of  the  education  law,  as
added  by  chapter  493  of  the  laws  of  2004, are amended to read as
follows:
  4. The committee is encouraged to study AND  MAKE  RECOMMENDATIONS  ON
all  facets  of the current nutritional policies of the district includ-
ing, but not limited to, the goals of the district to promote health and
proper nutrition, REDUCE THE INCIDENCE  OF  CHILDHOOD  OBESITY,  vending
machine  sales,  menu  criteria, educational curriculum teaching healthy
nutrition, AND educational information provided to parents or  guardians
regarding  healthy nutrition and the health risks associated with obesi-
ty, ASTHMA, CHRONIC BRONCHITIS AND OTHER CHRONIC  RESPIRATORY  DISEASES.
PROVIDED,  FURTHER,  THE COMMITTEE MAY PROVIDE INFORMATION TO PERSONS IN
PARENTAL RELATION ON opportunities offered to parents  or  guardians  to

S. 2374                            11

encourage  healthier  eating  habits  to  students,  and  the  education
provided to teachers and other staff as to  the  importance  of  healthy
nutrition  AND  ABOUT THE DANGERS OF CHILDHOOD OBESITY.  In addition the
committee   shall   consider  recommendations  and  practices  of  other
districts and nutrition studies.
  5. The committee is encouraged to report periodically to the  district
regarding practices that will educate teachers, parents or guardians and
children  about  healthy nutrition and raise awareness of the dangers of
CHILDHOOD obesity, ASTHMA, CHRONIC BRONCHITIS AND OTHER CHRONIC  RESPIR-
ATORY  DISEASES.  The committee is encouraged also to provide any parent
teacher associations in the district with such findings and  recommenda-
tions.
  S 6. This act shall take effect two years after it shall have become a
law.

                                 PART C

  Section  1.  Subdivision  1 of section 206 of the public health law is
amended by adding two new paragraphs (s) and (t) to read as follows:
  (S) (I) BY RULE OR REGULATION, MAY REQUIRE FOOD SERVICE ESTABLISHMENTS
INCLUDING, BUT NOT LIMITED TO RESTAURANTS, DINING ROOMS,  DELIS,  BAKER-
IES,  ELEMENTARY  AND  SECONDARY SCHOOLS, HOSPITALS, MOBILE FOOD SERVICE
VEHICLES AND CARTS, AND CHILD CARE FACILITIES,  THAT  PREPARE,  SELL  OR
SERVE  FOOD FOR IMMEDIATE CONSUMPTION BY THE GENERAL PUBLIC, TO RESTRICT
THE USE OF ARTIFICIAL TRANS FAT IN THE PREPARATION OF SUCH FOOD. FOR THE
PURPOSES OF THIS PARAGRAPH, THE TERM "ARTIFICIAL TRANS  FAT"  MEANS  ANY
FOOD THAT IS LABELED, AND WHICH LISTS AS AN INGREDIENT OR CONTAINS VEGE-
TABLE  SHORTENING, MARGARINE OR ANY KIND OF PARTIALLY HYDROGENATED VEGE-
TABLE OIL; PROVIDED, HOWEVER, THAT ANY  FOOD  WITH  A  NUTRITIONAL  FACT
LABEL  OR  OTHER  DOCUMENTATION FROM A MANUFACTURER LIST STATING A TRANS
FAT CONTENT OF LESS THAN .5 GRAMS PER SERVING SHALL  NOT  BE  DEEMED  TO
CONTAIN ARTIFICIAL TRANS FAT. SUCH RULES AND REGULATIONS SHALL NOT APPLY
TO  ANY FOOD SERVED DIRECTLY TO THE GENERAL PUBLIC IN THE MANUFACTURER'S
ORIGINAL SEALED PACKAGE. FURTHERMORE, SUCH RULES AND  REGULATIONS  SHALL
NOT  APPLY  TO  ANY FOOD SERVICE ESTABLISHMENT OR MOBILE FOOD COMMISSARY
THAT IS SUBJECT TO ANY LOCAL LAW, ORDINANCE, CODE OR RULE THAT REGULATES
THE USE OR DISCLOSURE OF ARTIFICIAL TRANS FATS BY  FOOD  SERVICE  ESTAB-
LISHMENTS.
  (II)  THE COMMISSIONER MAY REQUIRE FOOD SERVICE ESTABLISHMENTS SERVING
FOODS WITH ARTIFICIAL TRANS FAT TO POST  WARNING  SIGNS  TO  INFORM  THE
PUBLIC  ABOUT  THE  HEALTH RISKS ASSOCIATED WITH THE OVER CONSUMPTION OF
FOODS PREPARED WITH ARTIFICIAL TRANS FATS. SUCH WARNING SIGNS  SHALL  BE
CONSPICUOUSLY  POSTED  IN  AREAS WHERE FOOD MAY BE ORDERED FROM THE FOOD
SERVICE ESTABLISHMENT AND SHALL BE IN SUBSTANTIALLY THE FOLLOWING  FORM:
"WARNING  - THIS ESTABLISHMENT USES ARTIFICIAL TRANS FAT IN THE PREPARA-
TION OF SOME OR ALL OF THE FOODS THAT ARE SOLD OR  SERVED  HERE.    WHEN
OVERCONSUMED, ARTIFICIAL TRANS FATS CAN LEAD TO INCREASES IN THE RISK OF
HEART ATTACK, STROKE AND DEVELOPMENT OF TYPE 2 DIABETES."
  (III)  THE COMMISSIONER MAY ESTABLISH A VOLUNTARY ARTIFICIAL TRANS FAT
REDUCTION PROGRAM. SUCH PROGRAM MAY CONSIST OF, BUT SHALL NOT BE LIMITED
TO, THE FOLLOWING COMPONENTS: (A)  A  PUBLIC  INFORMATION  DISSEMINATION
PROGRAM  TO  INFORM  THE  PUBLIC OF THE HEALTH RISKS ASSOCIATED WITH THE
OVERCONSUMPTION OF ARTIFICIAL TRANS FATS, AND (B) SUGGESTED FOOD  PREPA-
RATION  METHODS  THAT CAN BE FOLLOWED BY FOOD SERVICE ESTABLISHMENTS AND
THE GENERAL PUBLIC TO REDUCE OR ELIMINATE THE USE  OF  ARTIFICIAL  TRANS
FATS.

S. 2374                            12

  (T)  (I)  FOR  PURPOSES  OF  THIS PARAGRAPH, THE FOLLOWING DEFINITIONS
SHALL APPLY:
  (A)  "FOOD  SERVICE  FACILITY"  MEANS A FOOD SERVICE ESTABLISHMENT, AS
DEFINED IN THE STATE SANITARY CODE, THAT OPERATES UNDER COMMON OWNERSHIP
OR CONTROL WITH AT LEAST TWENTY-FIVE OTHER FOOD  SERVICE  ESTABLISHMENTS
WITH  THE  SAME  NAME IN THE STATE THAT OFFER FOR SALE SUBSTANTIALLY THE
SAME MENU ITEMS, OR OPERATES AS A FRANCHISED OUTLET OF A PARENT  COMPANY
WITH AT LEAST TWENTY-FIVE OTHER FRANCHISED OUTLETS WITH THE SAME NAME IN
THE STATE THAT OFFER FOR SALE SUBSTANTIALLY THE SAME MENU ITEMS.
  (B) "NUTRITIONAL INFORMATION" INCLUDES ALL OF THE FOLLOWING, PER STAN-
DARD MENU ITEM, AS THAT ITEM IS USUALLY PREPARED AND OFFERED FOR SALE:
  (I) TOTAL NUMBER OF CALORIES.
  (II) TOTAL NUMBER OF GRAMS OF CARBOHYDRATES.
  (III) TOTAL NUMBER OF GRAMS OF SATURATED FAT.
  (IV) TOTAL NUMBER OF MILLIGRAMS OF SODIUM.
  (C)  "POINT  OF  SALE"  MEANS  THE LOCATION WHERE A CUSTOMER PLACES AN
ORDER.
  (D) IN CALCULATING NUTRITIONAL INFORMATION, A  FOOD  SERVICE  FACILITY
MAY  USE  ANY  REASONABLE  MEANS RECOGNIZED BY THE FEDERAL FOOD AND DRUG
ADMINISTRATION TO DETERMINE NUTRITIONAL INFORMATION FOR A STANDARD  MENU
ITEM, AS USUALLY PREPARED AND OFFERED FOR SALE INCLUDING, BUT NOT LIMIT-
ED TO, NUTRIENT DATABASES AND LABORATORY ANALYSES.
  (II)(A) BY RULE OR REGULATION, MAY REQUIRE EVERY FOOD SERVICE FACILITY
TO  DISCLOSE  THE NUTRITIONAL INFORMATION REQUIRED BY CLAUSE (B) OF THIS
SUBPARAGRAPH.
  (B) A FOOD SERVICE FACILITY, BY RULE OR REGULATION, MAY BE REQUIRED TO
DISCLOSE THE NUTRITIONAL INFORMATION IN A CLEAR AND  CONSPICUOUS  MANNER
AT THE POINT OF SALE PRIOR TO OR DURING THE PLACEMENT OF AN ORDER.
  S  2.    The opening paragraph of subdivision 1, and subdivisions 3, 4
and 6 of section 207 of the public health law, as amended by section  16
of  part  A  of  chapter 109 of the laws of 2010, are amended to read as
follows:
  There is hereby created within the  department  the  health  care  and
wellness  education  and  outreach  program.  The department may conduct
education and outreach programs for consumers, patients, ELEMENTARY  AND
SECONDARY  SCHOOL  EDUCATORS,  and health care providers relating to any
health care matters the commissioner deems appropriate and:
  3. The department may produce, make available to  others  for  reprod-
uction,  or  contract with others to develop such materials mentioned in
this section as the  commissioner  deems  appropriate.  These  materials
shall  be  made  available to the public AND TO ELEMENTARY AND SECONDARY
SCHOOL EDUCATORS free of charge  as  appropriate  or  for  a  fee  under
certain  circumstances.  The  commissioner may require where appropriate
any health care provider to make these materials available to patients.
  4. In exercising any of his or her  powers  under  this  section,  the
commissioner  may  consult  with  appropriate health care professionals,
providers, consumers, EDUCATORS and patients or organizations represent-
ing them.
  6. The commissioner  may  appoint  as  appropriate  advisory  councils
relating  to various matters that are or are proposed to be the subjects
of programs under this section. All such councils shall  include  repre-
sentation of health care professionals, providers, EDUCATORS, consumers,
patients  and  other  appropriate interests. The members of the councils
shall receive no compensation for their services, but shall  be  allowed
their  actual  and  necessary  expenses incurred in performance of their
duties.

S. 2374                            13

  S 3. Subdivision 1 of section 207 of the public health law is  amended
by adding a new paragraph (i) to read as follows:
  (I)  ABOUT THE SHORT TERM AND LONG TERM ADVERSE HEALTH RISKS TO ADULTS
AND CHILDREN WHO BECOME OVERWEIGHT, OBESE OR UNDERWEIGHT.  THE  INFORMA-
TION  SHALL  INCLUDE,  BUT NEED NOT BE LIMITED TO PROVIDING CITATIONS TO
THE DEPARTMENT'S WEBSITE, AS WELL AS ANY OTHER WEBSITES PROVIDING INFOR-
MATION ON THE SUBJECT.
  S 4. This act shall take effect one year after it shall have become  a
law,  provided  that,  effective  immediately, any rules and regulations
necessary to implement the provisions of this act on its effective  date
are authorized and directed to be completed on or before such date.

                                 PART D

  Section  1.  Subdivision  5 of section 2556 of the education law, such
section as renumbered by chapter 762 of the laws of 1950, is amended  to
read as follows:
  5.  It  shall  be  unlawful for a schoolhouse to be constructed in the
city of New York without an open-air playground attached to or  used  in
connection  with  the  same.    EXISTING  PLAYGROUNDS SHALL NOT BE SOLD,
LEASED OR TRANSFERRED, OR PERMANENTLY AUTHORIZED FOR OTHER USES SUCH  AS
SCHOOL BUILDING CONSTRUCTION, RENOVATION, PLACEMENT OR STORAGE OF BUILD-
ING  MATERIALS  FOR SUCH WORK THAT WOULD ELIMINATE THE USE OF SUCH PLAY-
GROUND SPACE FOR OUTDOOR RECREATIONAL ACTIVITIES UNLESS A PLAN IS ESTAB-
LISHED  AND  IMPLEMENTED  TO  PROVIDE  SUITABLE  AND  ADEQUATE  PHYSICAL
ACTIVITIES  OR  SPACE TO ACCOMMODATE THE PHYSICAL AND RECREATIONAL NEEDS
OF THE PUPILS OF SUCH BUILDING.   THE  PROVISIONS  OF  THIS  SUBDIVISION
SHALL  NOT  APPLY  TO  SCHOOL CONSTRUCTION OR RENOVATION ACTIVITIES THAT
OCCUR ON OR REQUIRE THE USE OF SUCH PLAYGROUNDS FOR  A  DURATION  OF  NO
MORE THAN ONE YEAR.
  S  2.  This act shall take effect July 1, 2013; provided however, that
the commissioner of education is authorized and directed  to  promulgate
any rules or regulations necessary for the timely implementation of this
act on or before such date.

                                 PART E

  Section  1.  Subdivisions 1 and 5 of section 803 of the education law,
as amended by chapter 118 of the laws of 1957, are amended  to  read  as
follows:
  1.  All  pupils  above  the  age  of eight years in all elementary and
secondary schools, shall receive as part of the  prescribed  courses  of
instruction  therein  such physical education under the direction of the
commissioner of education as the regents  may  determine.  Such  courses
shall  be designed to aid in the well-rounded education of pupils and in
the development of character,  citizenship,  OVERALL  physical  fitness,
GOOD  health  [and],  the worthy use of leisure AND THE REDUCTION IN THE
INCIDENCE OF CHILDHOOD OBESITY.   Pupils above such  age  attending  the
public  schools shall be required to attend upon such prescribed courses
of instruction.
  5. (A) It shall be the duty of the regents to adopt rules  determining
the  subjects  to  be included in courses of physical education provided
for in this section, the period of instruction in each of such  courses,
the  qualifications of teachers, and the attendance upon such courses of
instruction.

S. 2374                            14

  (B) NOTWITHSTANDING ANY OTHER PROVISION OF THIS SECTION,  THE  REGENTS
MAY  PROVIDE  IN  ITS  RULES  THAT  THE  PHYSICAL  EDUCATION INSTRUCTION
REQUIREMENT FOR ALL STUDENTS ENROLLED IN ELEMENTARY AND SECONDARY SCHOOL
GRADES SHALL, WHERE FEASIBLE, INCLUDE DAILY PHYSICAL EXERCISE OR  ACTIV-
ITY,  INCLUDING STUDENTS WITH DISABLING CONDITIONS AND THOSE IN ALTERNA-
TIVE EDUCATION PROGRAMS. THE REGENTS  MAY  INCLUDE  IN  ITS  RULES  THAT
STUDENTS ENROLLED IN SUCH ELEMENTARY AND SECONDARY SCHOOLS SHALL PARTIC-
IPATE  IN  PHYSICAL EDUCATION, EXERCISE OR ACTIVITY FOR A MINIMUM OF ONE
HUNDRED TWENTY MINUTES DURING EACH SCHOOL WEEK. THE REGENTS MAY  PROVIDE
FOR A TWO-YEAR PHASE-IN SCHEDULE FOR DAILY PHYSICAL EDUCATION IN ELEMEN-
TARY SCHOOLS IN ITS RULES.
  S  2.  The  section  heading  and  subdivision 1 of section 804 of the
education law, the section heading as amended by chapter 401 of the laws
of 1998 and subdivision 1 as added by chapter 982 of the laws  of  1977,
are amended and a new subdivision 3-b is added to read as follows:
  Health   education   regarding  alcohol,  drugs,  tobacco  abuse,  THE
REDUCTION IN THE INCIDENCE OF OBESITY, and the prevention and  detection
of certain cancers. 1. All schools shall include, as an integral part of
health,  SCIENCE AND PHYSICAL education, instruction so as to discourage
the misuse and abuse of alcohol, tobacco[,] and other drugs,  TO  REDUCE
THE  INCIDENCE  OF  OBESITY,  and  promote  attitudes  and behavior that
enhance health, well being, and human dignity.
  3-B. INSTRUCTION REGARDING THE LONG TERM HEALTH RISKS ASSOCIATED  WITH
OBESITY AND METHODS OF PREVENTING AND REDUCING THE INCIDENCE OF OBESITY,
INCLUDING  GOOD  NUTRITION AND REGULAR EXERCISE. SUCH INSTRUCTION MAY BE
AN INTEGRAL PART OF REQUIRED  HEALTH,  SCIENCE  AND  PHYSICAL  EDUCATION
COURSES.
  S  3. Subdivision 1 of section 804-a of the education law, as added by
chapter 730 of the laws of 1986, is amended to read as follows:
  1.   Within the  amounts  appropriated,  the  commissioner  is  hereby
authorized  to establish a demonstration program and to distribute state
funds to local  school  districts,  boards  of  cooperative  educational
services  and  in  certain instances community school districts, for the
development, implementation, evaluation, validation,  demonstration  and
replication  of  exemplary  comprehensive  health  education programs to
assist the public schools in developing curricula, training  staff,  and
addressing local health education needs of students, parents, and staff.
SUCH  PROGRAMS  SHALL  SERVE  THE  PURPOSE  OF  DEVELOPING AND ENHANCING
PUPILS' HEALTH KNOWLEDGE, SKILLS,  ATTITUDES  AND  BEHAVIORS,  WHICH  IS
FUNDAMENTAL  TO  IMPROVING THEIR HEALTH STATUS AND ACADEMIC PERFORMANCE,
AS WELL AS REDUCING  THE  INCIDENCE  OF  ADOLESCENT  PREGNANCY,  ALCOHOL
ABUSE,  TOBACCO ABUSE, TRUANCY, SUICIDE, SUBSTANCE ABUSE, OBESITY, ASTH-
MA, OTHER CHRONIC RESPIRATORY DISEASES, AND OTHER PROBLEMS OF  CHILDHOOD
AND ADOLESCENCE.
  S  4. Section 813 of the education law, as added by chapter 296 of the
laws of 1994, is amended to read as follows:
  S 813. School lunch period; scheduling.  Each school shall schedule  a
reasonable time DURING EACH SCHOOL DAY for each full day pupil attending
pre-kindergarten  through  grade twelve WITH AMPLE TIME to consume lunch
AND TO ENGAGE IN PHYSICAL EXERCISE OR RECREATION.
  S 5. This act shall take effect immediately.

                                 PART F

  Section 1. The public health law is amended by adding  a  new  article
13-I to read as follows:

S. 2374                            15

                              ARTICLE 13-I
              IN-UTERO EXPOSURE TO TOBACCO SMOKE PREVENTION
SECTION 1399-XX. IN-UTERO EXPOSURE PREVENTION.
        1399-YY. PROGRAMS.
  S 1399-XX. IN-UTERO EXPOSURE PREVENTION. 1. EVERY HEALTHCARE PROVIDER,
HEALTHCARE INSURER AND PREGNANCY PROGRAM SHALL DISTRIBUTE INFORMATION ON
THE  ADVERSE  EFFECTS OF SMOKING DURING PREGNANCY FOR BOTH FIRSTHAND AND
SECONDHAND SMOKE. SUCH ADVERSE EFFECTS TO THE INFANT INCLUDE LOWER BIRTH
RATES, HIGHER INCIDENCE OF ASTHMA AND OBESITY, AND COGNITIVE AND  DEVEL-
OPMENTAL DAMAGE.
  2.  EVERY HEALTHCARE PROVIDER SHALL MONITOR EXPECTANT MOTHERS' SMOKING
STATUSES AND OFFER CONTINUOUS TAILORED DISCUSSION  OF  QUITTING  SMOKING
WITH EXPECTANT MOTHERS DURING THEIR PRENATAL CARE.
  S 1399-YY. PROGRAMS. THE FOLLOWING PROGRAMS SHALL BE ADDED TO EXISTING
TOBACCO  CONTROL  PROGRAMS  FOR  PREGNANT  WOMEN  OR  TO OTHER PREGNANCY
RELATED PROGRAMS:
  1. CARBON MONOXIDE MONITORING;
  2. DEPRESSION, SOCIAL SUPPORT  AND  DOMESTIC  VIOLENCE  SCREENING  AND
REFERRALS;
  3. REFERRALS FOR SMOKING CESSATION FOR HOUSEHOLD MEMBERS;
  4. ONGOING SUPPORT BY COUNSELING AND EDUCATIONAL MATERIALS; AND
  5. FINANCIAL INCENTIVES SUCH AS SHIPPING VOUCHER OR DIAPER COUPONS FOR
QUITTING FOR MORE THAN FOUR WEEKS.
  S 2. This act shall take effect on the one hundred eightieth day after
it  shall  have  become  a law. Provided, that effective immediately the
commissioner of health is authorized and directed to promulgate any  and
all  rules  and  regulations,  and  take any other measures necessary to
implement the provisions of this act on its effective date.

                                 PART G

  Section 1. Subdivisions 2 and 4 of section 2111 of the  public  health
law, as added by section 21 of part C of chapter 58 of the laws of 2004,
are amended to read as follows:
  2.  The  department  shall establish the criteria by which individuals
will be identified as  eligible  for  enrollment  in  the  demonstration
programs.    Persons  eligible  for enrollment in the disease management
demonstration program shall  be  limited  to  individuals  who:  receive
medical  assistance  pursuant  to  title  eleven  of article five of the
social services law and may be eligible for benefits pursuant  to  title
18 of the social security act (Medicare); are not enrolled in a Medicaid
managed  care  plan,  including  individuals who are not required or not
eligible to participate in Medicaid managed care  programs  pursuant  to
section three hundred sixty-four-j of the social services law; are diag-
nosed  with  chronic  health  problems as may be specified by the entity
undertaking the demonstration program, including, but not limited to one
or more of the following: congestive heart failure, chronic  obstructive
pulmonary disease, asthma, CHRONIC BRONCHITIS, OTHER CHRONIC RESPIRATORY
DISEASES, diabetes, ADULT AND CHILDHOOD OBESITY, or other chronic health
conditions as may be specified by the department; or have experienced or
are  likely  to experience one or more hospitalizations or are otherwise
expected to incur excessive costs and high utilization  of  health  care
services.
  4.  The  demonstration program shall offer evidence-based services and
interventions designed to ensure that the enrollees receive high  quali-
ty, preventative and cost-effective care, aimed at reducing the necessi-

S. 2374                            16

ty  for hospitalization or emergency room care or at reducing lengths of
stay when hospitalization is necessary. The  demonstration  program  may
include  screening  of  eligible enrollees, developing an individualized
care  management  plan  for  each  enrollee  and implementing that plan.
Disease management demonstration programs that utilize information tech-
nology systems that allow for continuous application  of  evidence-based
guidelines to medical assistance claims data and other available data to
identify  specific  instances in which clinical interventions are justi-
fied and communicate indicated interventions to physicians, health  care
providers and/or patients, and monitor physician and health care provid-
er  response  to such interventions, shall have the enrollees, or groups
of enrollees, approved by the department for participation. The services
provided by the demonstration program as part  of  the  care  management
plan  may include, but are not limited to, case management, social work,
individualized health counselors, multi-behavioral goals  plans,  claims
data management, health and self-care education, drug therapy management
and  oversight, personal emergency response systems and other monitoring
technologies, SYSTEMATIC CHRONIC HEALTH CONDITIONS IDENTIFIED FOR  MONI-
TORING, telehealth services and similar services designed to improve the
quality and cost-effectiveness of health care services.
  S 2. This act shall take effect immediately.

                                 PART H

  Section  1.    Section  2599-b of the public health law, as amended by
section 88 of part B of chapter 58 of the laws of 2005,  is  amended  to
read as follows:
  S  2599-b.  Program development.   1. The program shall be designed to
prevent and reduce the incidence and prevalence of obesity  in  children
and adolescents, especially among populations with high rates of obesity
and  obesity-related health complications including, but not limited to,
diabetes, heart disease, cancer, osteoarthritis, asthma,  CHRONIC  BRON-
CHITIS,  OTHER  CHRONIC  RESPIRATORY  DISEASES and other conditions. The
program shall use recommendations and goals of the United States depart-
ments of agriculture and health and human services, the surgeon  general
and  centers for disease control AND PREVENTION in developing and imple-
menting  guidelines  for  nutrition  education  and  physical   activity
projects  as  part of obesity prevention efforts. The content and imple-
mentation of the  program  shall  stress  the  benefits  of  choosing  a
balanced,  healthful  diet from the many options available to consumers,
without specifically targeting the elimination of  any  particular  food
group, food product or food-related industry.
  2.  The childhood obesity prevention program shall include, but not be
limited to:
  (a) developing media health promotion campaigns, IN COORDINATION  WITH
THE   PUBLIC   INFORMATION  PROVIDED  PURSUANT  TO  SECTION  TWENTY-FIVE
HUNDRED-K OF THIS ARTICLE, targeted  to  children  and  adolescents  and
their  parents  and  caregivers that emphasize increasing consumption of
low-calorie, high-nutrient foods, decreasing consumption  of  high-calo-
rie,  low-nutrient  foods  and  increasing physical activity designed to
prevent or reduce obesity;
  (b) establishing school-based childhood obesity  prevention  nutrition
education and physical activity programs including programs described in
section  twenty-five  hundred  ninety-nine-c of this article, as well as
other programs with linkages to physical and health  education  courses,
and  which  utilize  the  school health index of the National Center for

S. 2374                            17

Chronic Disease Prevention and  Health  Promotion  or  other  recognized
school  health  assessment PURSUANT TO ARTICLE NINETEEN OF THE EDUCATION
LAW;
  (c)  establishing  community-based childhood obesity prevention nutri-
tion education and physical activity programs including  programs  which
involve  parents  and caregivers, and which encourage communities, fami-
lies, child care and other settings to provide safe and  adequate  space
and  time for physical activity and encourage a healthy diet, AND CAN BE
IN COORDINATION WITH COUNTY COOPERATIVE EXTENSION  PROGRAMS  ESTABLISHED
PURSUANT TO SECTION TWO HUNDRED TWENTY-FOUR-B OF THE COUNTY LAW;
  (d)  coordinating  with  the state education department, department of
agriculture and markets, office of parks, recreation and historic  pres-
ervation, office of temporary and disability assistance, office of chil-
dren  and family services and other federal, state and local agencies to
incorporate strategies to prevent  and  reduce  childhood  obesity  into
government food assistance, health, education and recreation programs;
  (e)  sponsoring  periodic  conferences  or  meetings to bring together
experts in nutrition, exercise, public health, mental health, education,
parenting, media, food marketing, food security, agriculture,  community
planning  and  other  disciplines to examine societal-based solutions to
the problem of childhood obesity and issue  guidelines  and  recommenda-
tions for New York state policy and programs;
  (f)  developing training programs for medical and other health profes-
sionals to teach practical skills in nutrition and exercise education to
children and their parents and caregivers; [and]
  (g) developing screening programs, IN ACCORDANCE WITH SECTION  TWENTY-
FIVE HUNDRED-K OF THIS ARTICLE, in coordination with health care provid-
ers  and  institutions including but not limited to day care centers and
schools for overweight and obesity for children aged two  through  eigh-
teen  years, using body mass index (BMI) appropriate for age and gender,
and notification, in a manner protecting  the  confidentiality  of  such
children  and  their families, of parents of BMI status, and explanation
of the  consequences  of  such  status,  including  recommended  actions
parents  may  need to take and information about resources and referrals
available to families to enhance  nutrition  and  physical  activity  to
reduce and prevent obesity[.]; AND
  (H)  COORDINATING  WITH  THE EDUCATION DEPARTMENT, OFFICE OF TEMPORARY
AND DISABILITY ASSISTANCE, OFFICE OF CHILDREN AND  FAMILY  SERVICES  AND
OTHER  FEDERAL,  STATE  AND  LOCAL AGENCIES TO INCORPORATE STRATEGIES TO
CURTAIL THE INCIDENCE OF ASTHMA, CHRONIC BRONCHITIS  AND  OTHER  CHRONIC
RESPIRATORY  DISEASES  TO  ENABLE ADULTS AND CHILDREN TO SAFELY INCREASE
PHYSICAL ACTIVITY TO HELP CURB THE INCIDENCE OF OBESITY.
  3. The department, IN COOPERATION WITH THE EDUCATION DEPARTMENT, shall
periodically collect and analyze information from  schools,  health  and
nutrition  programs  and  other  sources  to determine the prevalence of
childhood obesity in New York state, and  to  evaluate,  to  the  extent
possible, the effectiveness of the childhood obesity prevention program.
  S 2. The opening paragraph of section 2599-c of the public health law,
as amended by section 88 of part B of chapter 58 of the laws of 2005, is
amended to read as follows:
  The  commissioner,  IN COOPERATION WITH THE COMMISSIONERS OF EDUCATION
AND AGRICULTURE AND MARKETS, AND COUNTY BOARDS OF COOPERATIVE EXTENSION,
shall encourage the  establishment  of  school-based  childhood  obesity
prevention and physical activity programs that promote:
  S 3. This act shall take effect immediately.

S. 2374                            18

                                 PART I

  Section  1.  Section 263 of the public health law, as added by chapter
538 of the laws of 2002, is amended to read as follows:
  S 263. Department authorized to study obesity - report. 1. The depart-
ment is authorized to sample and collect data on individual cases  where
obesity is being actively treated AND DATA COLLECTED PURSUANT TO SECTION
TWENTY-FIVE HUNDRED-K OF THIS CHAPTER, and to analyze such data in order
to  evaluate  the  impact  of treating obesity. Such data collection and
analysis shall include the following:
  a. The effectiveness of existing methods for  treating  or  preventing
obesity;
  b.  The  effectiveness of alternate methods for treating or preventing
obesity;
  c. The fiscal impact of treating or preventing obesity;
  d. The compliance and cooperation of patients with various methods  of
treating or preventing obesity; or
  e.  The reduction in serious medical problems associated with diabetes
that results from treating or preventing obesity.
  2. The department is authorized to fund  the  research  authorized  in
subdivision  one  of  this  section AND SECTION TWENTY-FIVE HUNDRED-K OF
THIS CHAPTER from gifts, grants, and donations from individuals, private
organizations, foundations, or any governmental  unit;  except  that  no
gift,  grant,  or  donation  may  be accepted by the department if it is
subject to conditions that are inconsistent with this title or any other
laws of this state. The department shall have the power  to  direct  the
disposition  of  any  such  gift, grant, or donation for the purposes of
this title.
  3. After completion of the research authorized in subdivision  one  of
this  section, the department shall submit a report and supporting mate-
rials to the governor and the legislature by June first of the following
year AND UPDATE SUCH REPORT EVERY THREE YEARS.
  S 2. This act shall take effect immediately.

                                 PART J

  Section 1.  Paragraphs (a), (b) and (c) of subdivision  1  of  section
2411  of the public health law, as amended by chapter 219 of the laws of
1997, are amended to read as follows:
  (a) Survey state agencies, boards, programs and  other  state  govern-
mental  entities  to  assess  what, if any, relevant data has been or is
being collected which may be of use to researchers  engaged  in  breast,
prostate  or testicular cancer research, OR ADULT AND CHILDHOOD OBESITY,
ASTHMA,  CHRONIC  BRONCHITIS  OR  OTHER  CHRONIC   RESPIRATORY   DISEASE
RESEARCH;
  (b)  Consistent with the survey conducted pursuant to paragraph (a) of
this subdivision, compile a list of data  collected  by  state  agencies
which may be of assistance to researchers engaged in breast, prostate or
testicular cancer research as established in section twenty-four hundred
twelve  of  this title, AND ADULT AND CHILDHOOD OBESITY, ASTHMA, CHRONIC
BRONCHITIS OR OTHER CHRONIC RESPIRATORY DISEASE RESEARCH;
  (c) Consult with the Centers for Disease Control and  Prevention,  the
National Institutes of Health, the Federal Agency For Health Care Policy
and  Research,  the National Academy of Sciences and other organizations
or entities which may be involved in cancer  research  to  solicit  both
information  regarding  breast,  prostate and testicular cancer research

S. 2374                            19

projects, AND ADULT AND CHILDHOOD OBESITY, ASTHMA, CHRONIC BRONCHITIS OR
OTHER CHRONIC RESPIRATORY DISEASE RESEARCH PROJECTS that  are  currently
being conducted and recommendations for future research projects;
  S  2.  Subdivision  1  of  section  2500  of the public health law, as
amended by chapter 822 of the laws  of  1987,  is  amended  to  read  as
follows:
  1. The commissioner shall act in an advisory and supervisory capacity,
in  matters pertaining to the safeguarding of motherhood, the prevention
of maternal, perinatal, infant and child mortality,  the  prevention  of
diseases,  low birth weight, CHILDHOOD OBESITY, and defects of childhood
and the promotion of maternal, prenatal and child health, including care
in hospitals, and shall administer such services bearing on  the  health
of  mothers  and children for which funds are or shall hereafter be made
available.
  S 3. The public health law is amended by adding a new  section  2500-k
to read as follows:
  S  2500-K. CHILDHOOD OBESITY PREVENTION AND SCREENING.  1. LEGISLATIVE
DECLARATION. THE LEGISLATURE HEREBY FINDS, DETERMINES AND DECLARES  THAT
OBESITY,  PARTICULARLY  CHILDHOOD  OBESITY, IS A SERIOUS MEDICAL PROBLEM
AND THAT THE HIGH INCIDENCE OF SUCH CONDITION NEEDS TO BE  CURTAILED  TO
IMPROVE  THE OVERALL HEALTH OF THE GENERAL PUBLIC AND TO HELP REDUCE THE
COST OF PROVIDING HEALTH CARE IN THIS STATE. PROVIDED FURTHER, THAT  THE
LEGISLATURE HEREBY REAFFIRMS THE LEGISLATIVE INTENT CONTAINED IN SECTION
TWO HUNDRED SIXTY-ONE OF THIS CHAPTER CONCERNING OBESITY.
  2.  THE  COMMISSIONER MAY ESTABLISH, FOR USE BY PEDIATRIC PRIMARY CARE
PROVIDERS AND HOSPITALS, BEST PRACTICE PROTOCOLS FOR THE  EARLY  SCREEN-
ING, IDENTIFICATION AND TREATMENT OF CHILDREN WHO HAVE LOW BIRTH WEIGHTS
OR  MAY  BECOME  SUSCEPTIBLE  TO  CONTRACTING ASTHMA OR MANIFEST TO HAVE
CHILDHOOD OBESITY CONDITIONS. SUCH PROTOCOLS SHALL INCORPORATE STANDARDS
AND GUIDELINES ESTABLISHED BY THE AMERICAN ACADEMY OF PEDIATRICIANS, THE
FEDERAL DEPARTMENT OF AGRICULTURE, THE FEDERAL DEPARTMENT OF HEALTH  AND
HUMAN SERVICES, THE SURGEON GENERAL, AND THE CENTERS FOR DISEASE CONTROL
AND PREVENTION.
  3.  THE  DEPARTMENT, IN ORDER TO SUPPORT QUALITY CARE IN ALL HOSPITALS
WITH OBSTETRIC SERVICES AND FOR ALL PEDIATRIC PRIMARY CARE PROVIDERS, IS
AUTHORIZED TO PROVIDE NON-PATIENT SPECIFIC INFORMATION FOR ALL BIRTHS AT
EACH AFFILIATE HOSPITAL IN EACH REGIONAL PERINATAL CENTER'S  NETWORK  TO
THE REGIONAL PERINATAL CENTER AND THE AFFILIATE, EXCEPT THAT SUCH INFOR-
MATION  SHALL  INCLUDE ZIP CODE AND A UNIQUE IDENTIFIER, SUCH AS MEDICAL
RECORD NUMBER.
  4. THE INFORMATION WHEN RECEIVED BY THE DEPARTMENT SHALL BE USED SOLE-
LY FOR THE PURPOSE OF IMPROVING QUALITY OF CARE AND SHALL NOT BE SUBJECT
TO RELEASE UNDER ARTICLE SIX OF  THE  PUBLIC  OFFICERS  LAW,  AND  WHERE
APPLICABLE,  SHALL  BE  SUBJECT  TO  THE  CONFIDENTIALITY  PROVISIONS OF
SECTION TWENTY-EIGHT HUNDRED FIVE-M OF THIS  CHAPTER,  EXCEPT  THAT  THE
RELEASE  OF  BIRTH  CERTIFICATE  INFORMATION SHALL BE SUBJECT TO SECTION
FORTY-ONE HUNDRED SEVENTY-FOUR OF THIS CHAPTER.
  5. THE COMMISSIONER MAY  RELEASE  INFORMATION  COLLECTED  THROUGH  THE
STATEWIDE   PERINATAL  DATA  SYSTEM,  PURSUANT  TO  SECTION  TWENTY-FIVE
HUNDRED-H OF THIS TITLE AND CORRESPONDING INFORMATION RELATED TO ASTHMA,
CHILDHOOD OBESITY OR UNDERWEIGHT BABIES TO HIS OR HER DESIGNEES, INCLUD-
ING PERSONS OR ENTITIES UNDER CONTRACT WITH  THE  DEPARTMENT  TO  REVIEW
QUALITY  OF  CARE  ISSUES, AS RELATED TO THE PROVISIONS OF THIS SECTION,
AND TO CONDUCT QUALITY IMPROVEMENT INITIATIVES  AS  NEEDED  TO  MONITOR,
EVALUATE  AND IMPROVE PATIENT CARE AND OUTCOMES. SUCH DESIGNEE OR PERSON
OR ENTITY UNDER CONTRACT WITH THE DEPARTMENT TO REVIEW QUALITY  OF  CARE

S. 2374                            20

ISSUES  SHALL  MAINTAIN  THE CONFIDENTIALITY OF ALL SUCH INFORMATION AND
SHALL USE IT ONLY TO IMPROVE QUALITY OF CARE, AS APPROVED BY THE DEPART-
MENT, AND TO IMPLEMENT THE PROVISIONS OF TITLE FIVE OF  ARTICLE  TWO  OF
THIS  CHAPTER, AS ADDED BY CHAPTER FIVE HUNDRED THIRTY-EIGHT OF THE LAWS
OF TWO THOUSAND TWO.
  6. THE DEPARTMENT MAY PRODUCE AND DISTRIBUTE EDUCATIONAL MATERIALS  ON
CHILDHOOD  OBESITY  AND ASTHMA RISKS AND PRECAUTIONS. SUCH MATERIALS MAY
BE MADE AVAILABLE TO CHILD  CARE  CENTERS,  PEDIATRICIANS  AND  NURSERY,
ELEMENTARY AND SECONDARY SCHOOLS FOR DISTRIBUTION TO PERSONS IN PARENTAL
RELATION  TO  CHILDREN,  AND  TO  HOSPITALS,  BIRTHING CENTERS AND OTHER
APPROPRIATE  HEALTH  CARE  PROVIDERS  FOR  DISTRIBUTION   TO   MATERNITY
PATIENTS.  IN  ADDITION,  SUCH  MATERIALS MAY BE PROVIDED TO HEALTH CARE
PROFESSIONALS ENGAGED IN THE CARE AND TREATMENT OF CHILDREN FOR DISTRIB-
UTION TO SUCH CHILDREN AND PERSONS IN PARENTAL RELATION. THE  DEPARTMENT
MAY  ALSO  PROVIDE INFORMATION ON CHILDHOOD OBESITY AND ASTHMA RISKS AND
PRECAUTIONS ON THE DEPARTMENT'S INTERNET WEBSITE. NO PROVISION  OF  THIS
SUBDIVISION SHALL BE DEEMED TO PROHIBIT THE UTILIZATION AND DISTRIBUTION
OF  EDUCATIONAL  MATERIALS  RELATING  THERETO  PRODUCED  BY  ANY PUBLIC,
PRIVATE OR GOVERNMENTAL ENTITY, IN LIEU OF THE  DEPARTMENT'S  PRODUCTION
OF SUCH MATERIALS.
  7.  THE DEPARTMENT SHALL PERIODICALLY REVIEW AVAILABLE DATA ON OBESITY
AND ASTHMA IN CHILDREN AND UPDATE THE INFORMATION ON  CHILDHOOD  OBESITY
AND  ASTHMA RISKS AND PRECAUTIONARY MEASURES PROVIDED IN ITS EDUCATIONAL
MATERIALS AND ON ITS INTERNET WEBSITE, AS APPROPRIATE.
  S 4. This act shall take effect immediately.

                                 PART K

  Section 1.  Section 2505-a of the public health law, as added by chap-
ter 292 of the laws of 2009, is amended to read as follows:
  S 2505-a. Rights of breastfeeding mothers. 1. The  principles  enunci-
ated  in subdivision three of this section are declared to be the public
policy of the state and a copy of such  statement  of  rights  shall  be
posted  conspicuously  in  a  public  place in each maternal health care
facility AND CHILD DAY CARE FACILITY.   For purposes  of  this  section,
"maternal  health  care  provider"  means a physician, midwife, or other
authorized practitioner attending a pregnant woman; and "maternal health
care facility" includes  hospitals  and  freestanding  birthing  centers
providing  perinatal services in accordance with article twenty-eight of
this chapter and applicable regulations.
  2. The commissioner shall make available to every maternal health care
provider [and], maternal health care facility AND CHILD DAY CARE FACILI-
TY, on the health department's website for the purpose  of  health  care
facilities  to  include such rights in the maternity information leaflet
as described in section twenty-eight hundred three-j of this chapter,  a
copy  of  the  statement of rights provided in subdivision three of this
section in the top six languages other than English spoken in the  state
according  to  the latest available data from the U.S. Bureau of Census,
and shall adopt any rules and regulations necessary to ensure that  such
patients  are  treated  in accordance with the provisions of such state-
ment.
  3. The statement of rights shall consist of the following:
                 "Breastfeeding Mothers' Bill of Rights"
  Choosing the way you will feed your new baby is one of  the  important
decisions  you will make in preparing for your infant's arrival. Doctors
agree that for most women breastfeeding is the safest and  most  healthy

S. 2374                            21

choice.  It  is  your right to be informed about the benefits of breast-
feeding and have your health care provider [and], maternal  health  care
facility  AND  CHILD DAY CARE FACILITY encourage and support breastfeed-
ing.  You  have  the  right to make your own choice about breastfeeding.
Whether you choose to breastfeed or not you  have  the  following  basic
rights  regardless  of  your race, creed, national origin, sexual orien-
tation, gender identity or expression, or source  of  payment  for  your
health  care.  Maternal  health care facilities have a responsibility to
ensure that you understand these rights. They must provide this informa-
tion clearly for you and must provide an interpreter if necessary. These
rights may only be limited in cases where your health or the  health  of
your  baby requires it. If any of the following things are not medically
right for you or your baby, you should be fully informed  of  the  facts
and be consulted.
(1)  Before  You  Deliver,  if  you attend prenatal childbirth education
classes provided by the maternal health care facility and  all  hospital
clinics and diagnostic and treatment centers providing prenatal services
in  accordance with article 28 of the public health law you must receive
the breastfeeding mothers' bill of rights.  Each  maternal  health  care
facility  shall provide the maternity information leaflet, including the
Breastfeeding Mothers' Bill of Rights, in accordance with section  twen-
ty-eight  hundred  three-i  of  this  chapter  to each patient or to the
appointed personal representative at the time of prebooking or  time  of
admission  to a maternal health care facility. Each maternal health care
provider shall give a copy of the Breastfeeding Mothers' Bill of  Rights
to each patient at or prior to the medically appropriate time.
  You  have  the  right  to  complete  information about the benefits of
breastfeeding for yourself and your baby. This will  help  you  make  an
informed choice on how to feed your baby.
  You  have  the right to receive information that is free of commercial
interests and includes:
  *  How  breastfeeding  benefits  you  and  your  baby   nutritionally,
medically and emotionally;
  * How to prepare yourself for breastfeeding;
  * How to understand some of the problems you may face and how to solve
them.
(2) In The Maternal Health Care Facility:
  * You have the right to have your baby stay with you right after birth
whether you deliver vaginally or by cesarean section. You have the right
to begin breastfeeding within one hour after birth.
  *  You  have  the right to have someone trained to help you in breast-
feeding give you information and help you when you need it.
  * You have the right to have your baby not receive any bottle  feeding
or pacifiers.
  *  You  have the right to know about and refuse any drugs that may dry
up your milk.
  * You have the right to have your baby in your room with you 24  hours
a day.
  * You have the right to breastfeed your baby at any time day or night.
  *  You  have the right to know if your doctor or your baby's pediatri-
cian is advising against breastfeeding before any feeding decisions  are
made.
  *  You have the right to have a sign on your baby's crib clearly stat-
ing that your baby is breastfeeding and that no bottle  feeding  of  any
type is to be offered.

S. 2374                            22

  *  You  have  the  right to receive full information about how you are
doing with breastfeeding and get help on how to improve.
  * You have the right to breastfeed your baby in the neonatal intensive
care  unit.  If  nursing  is not possible, every attempt will be made to
have your baby receive your pumped or expressed milk.
  * If you, or your baby, are re-hospitalized in a maternal care facili-
ty after the initial delivery stay, the hospital will make every  effort
to continue to support breastfeeding, to provide hospital grade electric
pumps and rooming in facilities.
  *  You  have  the right to have help from someone specially trained in
breastfeeding support and  expressing  breast  milk  if  your  baby  has
special needs.
  * You have the right to have a family member or friend receive breast-
feeding information from a staff member if you request it.
(3) When You Leave The Maternal Health Care Facility:
  *  You  have  the  right  to printed breastfeeding information free of
commercial material.
  * You have the right, unless specifically requested by you, and avail-
able at the  facility,  to  be  discharged  from  the  facility  without
discharge  packs  containing  infant  formula, or formula coupons unless
ordered by your baby's health care provider.
  * You have the right to get information about breastfeeding  resources
in your community including information on availability of breastfeeding
consultants, support groups and breast pumps.
  * You have the right to have the facility give you information to help
choose a medical provider for your baby and understand the importance of
a follow-up appointment.
  *  You  have  the right to receive information about safely collecting
and storing your breast milk.
  * You have the right to breastfeed your baby in any  location,  public
or  private, where you are otherwise authorized to be. Complaints can be
directed to the New York State Division of Human Rights.
  * YOU HAVE A RIGHT TO BREASTFEED YOUR BABY AT YOUR PLACE OF EMPLOYMENT
OR CHILD DAY CARE CENTER IN AN  ENVIRONMENT  THAT  DOES  NOT  DISCOURAGE
BREASTFEEDING OR THE PROVISION OF BREAST MILK.
  All  the  above  are your rights. If the maternal health care facility
does not honor these rights you can seek help by contacting the New York
state department of health  or  by  contacting  the  hospital  complaint
hotline or via email.
  4.  The  commissioner  shall  make regulations reasonably necessary to
implement this section.
  S 2. Section 2505 of the public health law, as added by chapter 479 of
the laws of 1980, is amended to read as follows:
  S 2505. Human  breast  milk;  collection,  storage  and  distribution;
general  powers  of  the  commissioner.    The  commissioner  is  hereby
empowered to:
  (a) adopt regulations and guidelines including,  but  not  limited  to
donor  standards,  methods of collection, and standards for storage, and
distribution of human breast milk;
  (b) conduct educational activities to inform  the  public  and  health
care  providers  of  the  availability  of human breast milk for infants
determined to require such milk and to inform potential  donors  of  the
opportunities for proper donation;
  (c)  ADOPT  REGULATIONS  AND  GUIDELINES  TO  ENCOURAGE AND FACILITATE
EMPLOYERS AND CHILD DAY CARE CENTERS TO ESTABLISH ENVIRONMENTS  THAT  DO
NOT  DISCOURAGE  BREASTFEEDING  AND  THE  PROVISION OF BREAST MILK. SUCH

S. 2374                            23

ENVIRONMENTS SHALL INCLUDE SANITARY LOCATIONS FOR BREASTFEEDING,  REFRI-
GERATORS,  AND  TRAINED  STAFF  TO  ASSIST  IN BREASTFEEDING AND FEEDING
BABIES WITH EXPRESSED BREAST MILK;
  (D) COLLECT AND COMPILE DATA ON THE PREVALENCE OF BREASTFEEDING IN THE
STATE AND THE HEALTH CONDITION OF CHILDREN FED BREAST MILK IN COMPARISON
TO THOSE WHO WERE NOT; AND
  (E)  establish  rules  and regulations to effectuate the provisions of
this section.
  S 3. Subdivision 2 of section 2515 of the public health law, as  added
by section 20 of part A of chapter 58 of the laws of 2008, is amended to
read as follows:
  2. "Services for eligible adolescents" means those services, including
but  not  limited  to: vocational and educational counseling, job skills
training, family life and parenting education, life skills  development,
coordination, case management, primary preventive health care, PREGNANCY
AND  CHILD  NUTRITION COUNSELING FOR EXPECTANT MOTHERS TO CURB THE INCI-
DENCE OF CHILDHOOD OBESITY, family  planning,  social  and  recreational
programs, child care, outreach and advocacy, follow-up on service utili-
zation, crisis intervention, and efforts to stimulate community interest
and involvement.
  S  4.  Paragraph  (c) of subdivision 2 of section 2515-a of the public
health law, as added by section 20 of part A of chapter 58 of  the  laws
of 2008, is amended to read as follows:
  (c)  serve  a geographic area where the incidence of infant mortality,
LOW BIRTH WEIGHT INFANTS, CHILDHOOD OBESITY and the prevalence  of  low-
income  families are high and where the availability or accessibility of
services for eligible adolescents is low;
  S 5. Subdivision (b) of section 2522 of  the  public  health  law,  as
amended  by chapter 484 of the laws of 2009, is amended and a new subdi-
vision (e-1) is added to read as follows:
  (b) promotion of community awareness of the benefits TO THE MOTHER AND
CHILD of preconception health and early and continuous prenatal care;
  (E-1) HEALTH AND NUTRITIONAL EDUCATION AND SERVICES FOR BOTH  PARENTS,
REGARDING  CHILDHOOD AND ADULT OBESITY AND ASTHMA, AND THE PREVENTION OR
MITIGATION THEREOF;
  S 6. This act shall take effect immediately.

                                 PART L

  Section 1. Section 916 of the education law, as amended by chapter 524
of the laws of 2006, is amended to read as follows:
  S 916. Pupils afflicted with asthma OR OTHER POTENTIALLY  LIFE-THREAT-
ENING RESPIRATORY ILLNESSES.  The board of education or trustees of each
school  district  and  board  of  cooperative educational services shall
allow pupils who have been  diagnosed  by  a  physician  or  other  duly
authorized health care provider with a severe OR MODERATELY SEVERE asth-
matic   condition  OR  OTHER  POTENTIALLY  LIFE-THREATENING  RESPIRATORY
ILLNESS to carry and use a prescribed inhaler  during  the  school  day,
with  the  written  permission  of  a physician or other duly authorized
health care provider, and parental consent, based on such physician's or
provider's determination that such pupil is subject to sudden  asthmatic
attacks  [severe  enough to] THAT CAN debilitate such pupil. A record of
such permission shall be maintained in the school office.  In  addition,
upon the written request of a parent or person in parental relation, the
board of education or trustees of a school district and board of cooper-
ative  educational services shall allow such pupils to maintain an extra

S. 2374                            24

such inhaler in the care and custody of a registered professional  nurse
OR  OTHER  DESIGNATED  RESPONSIBLE  PERSON  employed by such district or
board of cooperative educational services.    Nothing  in  this  section
shall  require  a  school  district  or board of cooperative educational
services to retain a school nurse  solely  for  the  purpose  of  taking
custody  of a spare inhaler, or require that a school nurse be available
at all times in a school building for such purpose.
  S 2. The education law is amended by adding a new section 921 to  read
as follows:
  S 921. USE OF NEBULIZER. 1. EVERY SCHOOL DISTRICT AND BOARD OF COOPER-
ATIVE  EDUCATIONAL SERVICES IN THIS STATE MAY MAINTAIN ONE OR MORE NEBU-
LIZERS IN THE OFFICE OF THE SCHOOL NURSE  OR  IN  A  SIMILAR  ACCESSIBLE
LOCATION.
  2.  THE COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONER OF HEALTH,
MAY PROMULGATE REGULATIONS FOR THE ADMINISTRATION OF  ASTHMA  MEDICATION
THROUGH  THE USE OF A NEBULIZER BY THE SCHOOL NURSE OR PERSON AUTHORIZED
BY REGULATION. THE REGULATIONS MAY INCLUDE:
  A. A REQUIREMENT THAT EACH CERTIFIED NURSE OR OTHER PERSON  AUTHORIZED
TO  ADMINISTER  ASTHMA  MEDICATION IN SCHOOLS RECEIVE TRAINING IN AIRWAY
MANAGEMENT AND IN THE USE OF NEBULIZERS  AND  INHALERS  CONSISTENT  WITH
NATIONALLY RECOGNIZED STANDARDS; AND
  B.  A  REQUIREMENT THAT EACH PUPIL AUTHORIZED TO USE ASTHMA MEDICATION
PURSUANT TO SECTION NINE HUNDRED SIXTEEN OF THIS ARTICLE OR A  NEBULIZER
HAVE  AN  ASTHMA  TREATMENT PLAN PREPARED BY THE PHYSICIAN OF THE PUPIL,
WHICH IDENTIFY, AT A MINIMUM, ASTHMA TRIGGERS, THE TREATMENT  PLAN,  AND
SUCH OTHER ELEMENTS AS SHALL BE DETERMINED BY THE REGENTS.
  S 3. This act shall take effect on the one hundred eightieth day after
it shall have become a law; provided, however, that effective immediate-
ly  the  commissioner of education is authorized to promulgate rules and
regulations for the implementation of this act on such effective date.

                                 PART M

  Section 1. The real property law is amended by adding  a  new  section
235-h to read as follows:
  S  235-H.  RESIDENTIAL  RENTAL PROPERTY SMOKING POLICIES. EVERY RENTAL
AGREEMENT FOR A DWELLING UNIT, IN A MULTIPLE DWELLING BUILDING WITH FOUR
OR MORE UNITS, SHALL INCLUDE A DISCLOSURE OF THE SMOKING POLICY FOR  THE
PREMISES  ON  WHICH  THE  DWELLING  UNIT IS LOCATED. THE DISCLOSURE MUST
STATE WHETHER SMOKING IS PROHIBITED ON  THE  PREMISES,  ALLOWED  ON  THE
ENTIRE  PREMISES  OR  ALLOWED  IN  LIMITED AREAS ON THE PREMISES. IF THE
SMOKING POLICY ALLOWS SMOKING IN LIMITED  AREAS  ON  THE  PREMISES,  THE
DISCLOSURE  MUST  IDENTIFY  THE  AREAS  ON THE PREMISES WHERE SMOKING IS
ALLOWED.
  S 2. This act shall take effect on the first of January next  succeed-
ing the date on which it shall have become a law.

                                 PART N

  Section  1.   The state finance law is amended by adding a new section
91-h to read as follows:
  S 91-H. OBESITY AND RESPIRATORY DISEASE RESEARCH AND  EDUCATION  FUND.
1.  THERE IS HEREBY ESTABLISHED IN THE JOINT CUSTODY OF THE COMMISSIONER
OF TAXATION AND FINANCE AND THE COMPTROLLER, A SPECIAL FUND TO BE  KNOWN
AS THE "OBESITY AND RESPIRATORY DISEASE RESEARCH AND EDUCATION FUND".

S. 2374                            25

  2.  SUCH  FUND  SHALL  CONSIST  OF ALL REVENUE RECEIVED PURSUANT TO AN
APPROPRIATION THERETO, AND ALL OTHER MONEYS  APPROPRIATED,  CREDITED  OR
TRANSFERRED  THERETO  FROM  ANY  OTHER  FUND  OR SOURCE PURSUANT TO LAW.
NOTHING IN THIS SECTION SHALL  BE  DEEMED  TO  PREVENT  THE  STATE  FROM
RECEIVING  GRANTS,  GIFTS  OR  BEQUESTS FOR THE PURPOSES OF THE FUND AND
DEPOSITING THEM INTO THE FUND ACCORDING TO LAW.
  3. MONIES OF THE FUND SHALL BE EXPENDED ONLY FOR ADULT  AND  CHILDHOOD
OBESITY, ASTHMA, CHRONIC BRONCHITIS OR OTHER CHRONIC RESPIRATORY DISEASE
RESEARCH  AND  EDUCATIONAL PROJECTS CONDUCTED PURSUANT TO SECTIONS TWEN-
TY-FOUR HUNDRED ELEVEN, TWENTY-FIVE HUNDRED AND TWENTY-FIVE HUNDRED-K OF
THE PUBLIC HEALTH LAW.
  4. MONIES SHALL BE PAYABLE FROM THE FUND ON THE AUDIT AND  WARRANT  OF
THE COMPTROLLER ON VOUCHERS APPROVED OR CERTIFIED BY THE COMMISSIONER OF
HEALTH.
  S 2. This act shall take effect immediately.

                                 PART O

  Section 1. Paragraphs 6 and 7 of subsection (b) of section 3239 of the
insurance  law, as added by chapter 592 of the laws of 2008, are amended
and a new paragraph 8 is added to read as follows:
  (6) a nutrition education program; [and]
  (7) health or fitness incentive programs[.]; AND
  (8) A COORDINATED WEIGHT MANAGEMENT, NUTRITION, STRESS MANAGEMENT  AND
PHYSICAL  FITNESS  PROGRAM  TO  COMBAT  THE  HIGH INCIDENCE OF ADULT AND
CHILDHOOD OBESITY, ASTHMA AND OTHER CHRONIC RESPIRATORY CONDITIONS.
  S 2. Subparagraphs (C) and (D) of paragraph 2  of  subsection  (c)  of
section  3239  of the insurance law, as added by chapter 592 of the laws
of 2008, are amended and two new subparagraphs (E) and (F) are added  to
read as follows:
  (C) the waiver or reduction of copayments, coinsurance and deductibles
for  preventive  services  covered  under the group policy or subscriber
contract; [and]
  (D) monetary rewards in the form of gift cards or  gift  certificates,
so  long  as the recipient of the reward is encouraged to use the reward
for a product or a service that promotes good health,  such  as  healthy
cook books, over the counter vitamins or exercise equipment[.];
  (E)  FULL  OR  PARTIAL REIMBURSEMENT OF THE COST OF PARTICIPATING IN A
STRESS MANAGEMENT PROGRAM OR ACTIVITY; AND
  (F) FULL OR PARTIAL REIMBURSEMENT OF THE COST OF  PARTICIPATING  IN  A
HEALTH OR FITNESS PROGRAM.
  S 3. This act shall take effect immediately.

                                 PART P

  Section  1.    Subparagraph  4  of  paragraph  (o) of subdivision 4 of
section 366 of the social services law is amended by adding a new clause
(vi-a) to read as follows:
  (VI-A) HEALTH AND NUTRITIONAL EDUCATION AND SERVICES FOR BOTH PARENTS,
REGARDING CHILDHOOD AND ADULT OBESITY, ASTHMA AND THE MITIGATION  THERE-
OF;
  S  2.  Paragraph  (a)  of subdivision 2-a of section 390 of the social
services law, as added by chapter 416 of the laws of 2000, is amended to
read as follows:
  (a) The office of children and family services shall promulgate  regu-
lations   which  establish  minimum  quality  program  requirements  for

S. 2374                            26

licensed and registered child day care homes, programs  and  facilities.
Such  requirements  shall include but not be limited to (i) the need for
age appropriate activities, materials and equipment  to  promote  cogni-
tive,  educational,  social, cultural, physical, emotional, language and
recreational development of children in care  in  a  safe,  healthy  and
caring environment (ii) principles of childhood development (iii) appro-
priate  staff/child  ratios  for family day care homes, group family day
care homes, school age day care programs and day care centers,  provided
however  that  such  staff/child ratios shall not be less stringent than
applicable staff/child ratios as set forth in part  four  hundred  four-
teen, four hundred sixteen, four hundred seventeen or four hundred eigh-
teen  of title eighteen of the New York code of rules and regulations as
of January first, two thousand (iv) appropriate levels of supervision of
children in care (v) APPROPRIATE PHYSICAL ACTIVITY,  NUTRITIONAL  OFFER-
INGS,  AND LOW CALORIE AND LOW SUGAR BEVERAGES TO LOWER THE INCIDENCE OF
CHILDHOOD  OBESITY  (VI)  minimum  standards  for  sanitation,   health,
infection  control, nutrition, buildings and equipment, safety, security
procedures, first aid, fire prevention, fire  safety,  evacuation  plans
and drills, prevention of child abuse and maltreatment, staff qualifica-
tions and training, record keeping, and child behavior management.
  S  3.  Section 390-a of the social services law is amended by adding a
new subdivision 6 to read as follows:
  6. NO FAMILY DAY CARE HOME, GROUP FAMILY DAY  CARE  HOME,  SCHOOL  AGE
CHILD  CARE  PROGRAM OR CHILD DAY CARE CENTER SHALL DISCRIMINATE AGAINST
ANY CHILD WHO IS BREAST FED OR WHO IS FED WITH EXPRESSED BREAST MILK.
  S 4. Subdivision 1 of section 224-b of the county  law,  as  added  by
chapter 575 of the laws of 1989, is amended to read as follows:
  1.  Agreements to employ and manage area program specialists. Notwith-
standing the provisions of subdivision  eight  of  section  two  hundred
twenty-four  of  this  article, two or more county cooperative extension
associations may enter into a separate agreement with Cornell university
to employ area program specialists.   Examples of  program  areas  which
could  be funded and delivered through the Cornell cooperative extension
system could include but not be limited to water  quality,  solid  waste
management,  commercial  and alternative agricultural technologies inte-
grated pest management, nutrition, diet and health, ADULT AND  CHILDHOOD
OBESITY,  ASTHMA  AND  CHRONIC RESPIRATORY ILLNESS PREVENTION, community
and rural development, housing availability  and  affordability,  family
and economic well being, and the complex problems of youth at risk. Such
annual  agreements  shall  identify  the  titles  of the positions to be
supported and the program areas for which they will provide  leadership.
Standards  for  the  employment  of  area program specialists, including
salaries, shall be established by Cornell university, through the direc-
tor of extension in consultation with county cooperative extension asso-
ciations, apart from standards for the employment of professional  staff
under  section  two  hundred  twenty-four  of this article. Area program
specialists shall, for administrative purposes, receive salary  payments
through  the  Cornell  university payroll and for such purposes shall be
deemed employees of Cornell university; provided,  however,  that  their
program  activities shall be directed and managed jointly by the partic-
ipating associations and Cornell university under the terms of the annu-
al memorandum of agreement. Area program specialists shall  be  eligible
to  receive  the  same  state or federal fringe benefits as professional
staff employed by the cooperative extension associations under the terms
of section two hundred twenty-four of this article.

S. 2374                            27

  S 5. This act shall take effect on the first of January next  succeed-
ing  the date on which it shall have become a law; provided that, effec-
tive immediately, any rules and regulations necessary to  implement  the
provisions of this act on its effective date are authorized and directed
to be completed on or before such date.
  S  3.  Severability clause. If any clause, sentence, paragraph, subdi-
vision, section or part of this act shall be adjudged by  any  court  of
competent  jurisdiction  to  be invalid, such judgment shall not affect,
impair, or invalidate the remainder thereof, but shall  be  confined  in
its  operation  to the clause, sentence, paragraph, subdivision, section
or part thereof directly involved in the controversy in which such judg-
ment shall have been rendered. It is hereby declared to be the intent of
the legislature that this act would  have  been  enacted  even  if  such
invalid provisions had not been included herein.
  S  4.  This  act shall take effect immediately provided, however, that
the applicable effective date of Parts A through P of this act shall  be
as specifically set forth in the last section of such Parts.

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