senate Bill S4909B

2011-2012 Legislative Session

Establishes the health care practitioner hygienic dress code program within the department of health to address clothing that may cause infections

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Archive: Last Bill Status - In Committee


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

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Actions

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Assembly Actions - Lowercase
Senate Actions - UPPERCASE
May 29, 2012 print number 4909b
amend and recommit to health
Jan 31, 2012 print number 4909a
amend and recommit to health
Jan 04, 2012 referred to health
Apr 29, 2011 referred to health

Bill Amendments

Original
A
B (Active)
Original
A
B (Active)

Co-Sponsors

S4909 - Bill Details

See Assembly Version of this Bill:
A7845C
Current Committee:
Law Section:
Public Health Law
Laws Affected:
Add Art 2 Title 6 §266, Pub Health L; amd §6507, Ed L; amd §§2343, 3436 & 5505, Ins L

S4909 - Bill Texts

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Establishes the health care practitioner hygienic dress code program within the department of health to address clothing, jewelry and identification tags worn by health care professionals that may cause infection, disease and bacteria in patients, visitors and the general public.

view sponsor memo
BILL NUMBER:S4909

TITLE OF BILL:
An act
to amend the public health law, the education law and the insurance law,
in relation to establishing a health care practitioner hygienic dress
code; and providing for the repeal of certain
provisions upon expiration
thereof

PURPOSE:
The purpose of this bill is to help reduce the rate of patient injury
due to the inadvertent spread of infections, bacteria, and diseases
by health care practitioners due to the clothes and other items that
they wear. Further, it is to help reduce the rising cost of medical
malpractice insurance faced by health care practitioners due to the
increased damages from injuries caused by such infections.

SUMMARY OF PROVISIONS:
Section 1: Amends Article 2 of the Public Health Law by adding new
title 6, "Health Care Practitioner Hygienic Dress Code". This section
creates a State health care practitioner hygienic dress code council
comprised of twenty-five members appointed by the commissioner of
health with the advice of the commissioner of education and financial
services. This council is to advise the health and education
commissioners on (i) the best practices for mitigating and
eliminating the spread of disease and other infections via
practitioner clothing, jewelry, and facility identification tags (ii)
the promotion of better coordinated interdisciplinary policies to
ensure hygienic practices, (iii) establish materials and curricula to
be used in continuing education programs related to hygienic dress
codes.

This council also may provide guidance to practitioners and health
care facilities on the best practices to mitigate and eliminate the
spread of infection and disease by vectors related to health care
practitioners' clothes and identification tags.

The council should examine and consider the adoption of rules and
regulations including a bare below the elbow policy, no necktie
policy, education and instruction to patients and practitioners,
provision of clean scrubs and uniforms, and prohibition of wearing
clothing worn during treatment of patients outside of the health care
facility.

This section also creates Health care practitioner hygienic resource
centers as the commissioner may designate. These centers shall act as
a source of support and information for practitioners in the area of
sanitary and hygienic conditions for patient treatment. These centers
may be contracted for with not-for-profit organizations at the
discretion of the Health Department and with the council's
consultation.

The council, in consultation with the health and education
departments, as well as practitioner professional organizations, is
to develop course materials on sanitary dress code policies and


practices and, within two years, make recommendations for inclusions
into the continuing education curriculum of such policies or practices.

Lastly, every other year, the council shall submit a report on
activities or accomplishments on sanitary and hygienic conditions
recommended by the council in health care facilities, including
legislative proposals.

Section 2: Amends section 6507 of the education law and adds new
paragraph d to subdivision 3. It establishes standards for continuing
education for health care practitioners on the best practices and
approaches for mitigating and eliminating the spread of disease by
health care practitioners by implementing to the extent practicable
the recommendations of the state health care practitioner hygienic
dress code council.

Section 3: Amends 2343 of the insurance law by adding
subsection(f)which instructs the superintendent to approve and
implement programs to encourage health care facilities and
practitioners to adopt hygienic dress codes to obtain better or
cheaper medical malpractice coverage. Such programs can include
enhanced coverage levels, lower deductibles, or an actuarially
appropriate premium reduction for facilities and health care
providers which have implemented a successful practitioner dress code.

Section 4: Amends 3436 of the insurance law by adding subsection (f)
to chapter 266 which instructs insurers to provide for actuarially
appropriate premium reductions or other medical malpractice insurance
enhancements such as enhanced coverage levels and lower deductibles
for health care providers and facilities which implement a successful
practitioner dress code.

Section 5: Amends section 5505 of the insurance law by adding
subsection e which provides for an actuarially appropriate premium
discounts or other medical malpractice insurance enhancements such as
enhanced coverage levels and lower deductibles by the association for
facilities and practitioners which implement a successful
practitioner dress code.

Section 6: This act is effective on the first on January next
succeeding date on which is shall have become law and section one
expires January 1, 2020.

JUSTIFICATION:
New York is facing a crisis with regard to the availability and
affordability of medical liability insurance coverage. New York
health care providers pay the highest premium rates in the country
for their medical liability insurance and those rates continue to rise.

Approaches to improve patient safety have been increasingly researched
for their effects on curtailing medical malpractice liability costs.
Malpractice claims that involve preventable injuries often result in
large jury awards. Information indicates that, rather than increased
frequency of claims, the soaring amount of individual malpractice
awards accounts for increasing malpractice costs. Therefore, it is
logical to reduce, and when possible, eliminate preventable injuries
to curtail medical malpractice costs and accompanying premium rates.


In a report issued by Senator Klein, it was found that while other
methods and avenues for addressing rising medical malpractice costs
and overall health care costs, such as attempting to cap damages in
medical malpractice suits or other methods of tort reform, there were
other ways to address the underlying causes of increased insurance
rates. Namely, that by addressing some of the underlying causes of
injury rates in patients such as the spread of infections, such as
nosocomial infections like methicillin resistant staphylococcus
aureus (MRSA), that these reduced incidence rates would necessarily
reduce the number of claims and thus the rising costs of medical
malpractice insurance.

One major way of curtailing the number of these infections involves
avoiding having to treat drug-resistant afflictions altogether and
work to mitigate their initial spread. That is, mitigating the spread
of these infections is an effective method of combating them. Thus,
as research indicates that the health care practitioners themselves
may be unwitting agents of these infections, examining how they are
being spread and then addressing that cause may be an effective tool.

Exploring and possibly implementing all or some of a health care
practitioner dress code may lead to fewer injuries to patients as
well as lowered insurance premiums. Further, this can lessen the
practice of defensive medicine-that is, care tailored toward
preventing lawsuits and not carefully planned to a patient's needs
which also drives up the cost of care.

PRIOR LEGISLATIVE HISTORY:
New Bill.

FISCAL IMPLICATIONS:
This bill is designed to lower rising medical malpractice costs by
targeting some of the underlying causes such as the spread of several
types of infection. Lowering such rates should also lead to fewer
claims and less time in the hospital, thus alleviating associated
health care costs to all parties involved, including the state.

EFFECTIVE DATE:
This act shall take effect on the first of January next succeeding the
date on which it shall have become law and section one of this act
shall expire and be deemed repealed January 1, 2020.

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

                                  4909

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                             April 29, 2011
                               ___________

Introduced  by  Sen.  KLEIN  -- read twice and ordered printed, and when
  printed to be committed to the Committee on Health

AN ACT to amend the public health law, the education law and the  insur-
  ance  law,  in  relation  to  establishing  a health care practitioner
  hygienic  dress  code;  and  providing  for  the  repeal  of   certain
  provisions upon expiration thereof

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

  Section 1. Article 2 of the public health law is amended by  adding  a
new title 6 to read as follows:
                                 TITLE 6
                    HEALTH CARE PRACTITIONER HYGIENIC
                               DRESS CODE
SECTION 266. HEALTH CARE PRACTITIONER HYGIENIC DRESS CODE.
  S  266.  HEALTH CARE PRACTITIONER HYGIENIC DRESS CODE. 1. DEFINITIONS.
THE FOLLOWING WORDS OR PHRASES AS USED IN  THIS  TITLE  SHALL  HAVE  THE
FOLLOWING MEANINGS:
  (A)  "CONTINUING  EDUCATION"  SHALL  MEAN  ALL PROFESSIONAL CONTINUING
EDUCATION PROGRAMS REQUIRED EITHER BY  STATE  LAW,  OR  BY  PROFESSIONAL
ASSOCIATIONS  AUTHORIZED  BY  THE  EDUCATION  DEPARTMENT  TO MONITOR THE
REQUIREMENTS OF LICENSURE OR CERTIFICATION  AND  TO  CONDUCT  CONTINUING
EDUCATION REQUIRED TO BE COMPLETED BY A HEALTH CARE PRACTITIONER.
  (B)  "COUNCIL"  SHALL MEAN THE STATE HEALTH CARE PRACTITIONER HYGIENIC
DRESS CODE COUNCIL ESTABLISHED BY SUBDIVISION TWO OF THIS SECTION.
  (C) "HEALTH CARE FACILITY" SHALL MEAN AND INCLUDE A HOSPITAL AND RESI-
DENTIAL HEALTH CARE FACILITY AS DEFINED IN SECTION TWENTY-EIGHT  HUNDRED
ONE OF THIS CHAPTER, AND ANY SETTING IN WHICH A HEALTH CARE PRACTITIONER
REGULARLY PRACTICES HIS OR HER PROFESSION.
  (D)  "HEALTH  CARE  PRACTITIONER"  SHALL MEAN ANY PERSON LICENSED AS A
PHYSICIAN PURSUANT TO ARTICLE ONE HUNDRED THIRTY-ONE  OF  THE  EDUCATION
LAW, PHYSICIAN ASSISTANT OR SPECIALIST ASSISTANT PURSUANT TO ARTICLE ONE

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD10964-03-1

S. 4909                             2

HUNDRED THIRTY-ONE-B OF THE EDUCATION LAW, NURSE PURSUANT TO ARTICLE ONE
HUNDRED THIRTY-NINE OF THE EDUCATION LAW, OR MIDWIFE PURSUANT TO ARTICLE
ONE HUNDRED FORTY OF THE EDUCATION LAW.
  2. STATE HEALTH CARE PRACTITIONER HYGIENIC DRESS CODE COUNCIL. (A) THE
STATE  HEALTH  CARE  PRACTITIONER  HYGIENIC DRESS CODE COUNCIL IS HEREBY
ESTABLISHED IN THE DEPARTMENT TO  BE  AN  EXPERT  PANEL  TO  ADVISE  THE
COMMISSIONER  AND  THE  COMMISSIONER OF EDUCATION ON: (I) THE BEST PRAC-
TICES RELATED TO MITIGATING  AND  ELIMINATING  THE  SPREAD  OF  DISEASE,
INFECTION  AND  BACTERIA TO PATIENTS, VISITORS AND THE GENERAL PUBLIC IN
HEALTH CARE FACILITIES BY MEANS OF THE UNHYGIENIC CLOTHING, JEWELRY  AND
HEALTH CARE FACILITY IDENTIFICATION TAGS WORN BY HEALTH CARE PRACTITION-
ERS AND THE CLEANING PERSONNEL OF SUCH FACILITIES, (II) THE PROMOTION OF
BETTER  AND  COORDINATED POLICIES TO ENSURE BETTER HYGIENIC PRACTICES IN
HEALTH CARE FACILITIES, AND  (III)  THE  DEVELOPMENT  OF  GUIDELINES  TO
ASSIST  THE EDUCATION DEPARTMENT IN ESTABLISHING MATERIALS AND CURRICULA
TO BE USED IN PROVIDING CONTINUING EDUCATION  PROGRAMS  TO  HEALTH  CARE
PRACTITIONERS ON THE USE OF A HYGIENIC DRESS CODE TO MINIMIZE THE SPREAD
OF DISEASE, INFECTION AND BACTERIA TO PATIENTS, VISITORS AND THE GENERAL
PUBLIC.
  (B)  THE COUNCIL SHALL BE COMPOSED OF TWENTY-FIVE MEMBERS APPOINTED BY
THE  COMMISSIONER.  THE  COMMISSIONER  SHALL  SEEK  RECOMMENDATIONS  FOR
APPOINTMENTS  FROM  THE COMMISSIONER OF EDUCATION AND THE SUPERINTENDENT
OF FINANCIAL SERVICES. THE  MEMBERSHIP  OF  THE  COUNCIL  SHALL  INCLUDE
REPRESENTATIVES  OF  THE  VARIOUS  PROFESSIONS  WITHIN THE DEFINITION OF
HEALTH CARE PRACTITIONER, THE VARIOUS FACILITIES AND SETTINGS WITHIN THE
DEFINITION OF HEALTH CARE FACILITY, EDUCATORS OF HEALTH CARE PRACTITION-
ERS, CLEANING AND STERILIZATION SERVICES  FOR  HEALTH  CARE  FACILITIES,
PHARMACEUTICAL COMPANIES, AND INSURERS AND CORPORATIONS PROVIDING HEALTH
CARE COVERAGE.  THE CHAIR OF THE COUNCIL SHALL BE A MEMBER THEREOF AS IS
SO DESIGNATED BY THE COMMISSIONER.
  (C) THE MEMBERS OF THE COUNCIL SHALL HAVE EXPERTISE IN THE MAINTENANCE
AND  CREATION  OF  SANITARY  AND HYGIENIC CONDITIONS IN THE TREATMENT OF
PATIENTS BY HEALTH CARE PRACTITIONERS AND IN HEALTH CARE FACILITIES. THE
TERM OF OFFICE OF SUCH MEMBERS SHALL BE FOUR YEARS. THE MEMBERS  OF  THE
COUNCIL  SHALL  RECEIVE NO COMPENSATION FOR THEIR SERVICES, BUT SHALL BE
ALLOWED THEIR ACTUAL AND NECESSARY EXPENSES IN THE PERFORMANCE OF  THEIR
DUTIES.
  (D)  THE  COUNCIL  SHALL MEET UPON THE CALL OF THE COMMISSIONER OR THE
CHAIR. THE COUNCIL MAY ADOPT REGULATIONS CONSISTENT WITH THIS SECTION.
  (E) THE COMMISSIONER SHALL DESIGNATE SUCH  EMPLOYEE  AND  PROVIDE  FOR
OTHER  RESOURCES  OF  THE  DEPARTMENT  AS MAY BE REASONABLY NECESSARY TO
PROVIDE SUPPORT AND SERVICES FOR THE WORK OF THE COUNCIL.
  (F) THE COUNCIL MAY PROVIDE  TECHNICAL  INFORMATION  AND  GUIDANCE  TO
HEALTH  CARE  PRACTITIONERS AND HEALTH CARE FACILITIES ON THE LATEST AND
BEST PRACTICES AND STRATEGIES RELATED TO MITIGATING AND ELIMINATING  THE
SPREAD OF DISEASE, INFECTION AND BACTERIA DURING THE COURSE OF TREATMENT
OF PATIENTS AS IT RELATES TO THE USE OF HYGIENIC HEALTH CARE PRACTITION-
ER CLOTHING, ATTIRE AND A DRESS CODE.
  3.  POLICIES  TO  BE CONSIDERED, EXAMINED AND POSSIBLY ADVANCED BY THE
COUNCIL. THE COUNCIL SHALL CONSIDER AND EXAMINE THE  FOLLOWING  POLICIES
AND GUIDELINES IN THE ADOPTION OF RULES AND REGULATIONS:
  (A) THE ADOPTION OF A BARE BELOW THE ELBOW POLICY OF HEALTH CARE PRAC-
TITIONERS,  WHICH  SHALL  INCLUDE, BUT NOT BE LIMITED TO, THE WEARING OF
SHORT SLEEVE SHIRTS, A PROHIBITION ON THE WEARING  OF  WRISTWATCHES  AND
OTHER  JEWELRY,  AND  A  PROHIBITION  ON THE WEARING OF COATS OR JACKETS
WHILE PROVIDING TREATMENT TO PATIENTS;

S. 4909                             3

  (B) THE ADOPTION OF A NO NECKTIES POLICY;
  (C)  THE PROVISION OF EDUCATION AND INSTRUCTION TO PATIENTS AND HEALTH
CARE PRACTITIONERS ON  HOW  ENHANCED  SANITARY  AND  HYGIENIC  POLICIES,
INCLUDING  THE  USE OF HYGENIC HEALTH CARE PRACTITIONER CLOTHING, ATTIRE
AND A DRESS CODE, CAN HELP TO REDUCE THE RISK OF CROSS-INFECTION;
  (D) ENCOURAGING HEALTH CARE FACILITIES TO PROVIDE ADEQUATE SUPPLIES OF
CLEAN SCRUBS, OTHER ARTICLES OF CLOTHING AND HEALTH CARE FACILITY  IDEN-
TIFICATION  TAGS TO HEALTH CARE PRACTITIONERS TO ENSURE FREQUENT CHANGES
THEREOF;
  (E) ENCOURAGING HEALTH CARE  FACILITIES  TO  PROVIDE  ON-SITE  LAUNDRY
SERVICES  AND    CHANGING ROOMS, AND INSTRUCTION ON HOW TO APPROPRIATELY
WASH CLOTHING WORN BY HEALTH CARE PRACTITIONERS;
  (F) THE WEARING OF PLASTIC APRONS AND DOUBLE  GLOVES  BY  HEALTH  CARE
PRACTITIONERS DURING THE TREATMENT OF PATIENTS;
  (G)  THE  ADOPTION OF A PROHIBITION ON THE WEARING OUTSIDE OF A HEALTH
CARE FACILITY BY HEALTH  CARE  PRACTITIONERS  OF  CLOTHING  WORN  DURING
TREATMENT OF PATIENTS; AND
  (H)  CONSIDERATION  OF  ALTERATIONS  IN  MEDICAID  AND  PRIVATE  PAYOR
REIMBURSEMENT RATES AND PRACTICES TO ENCOURAGE MORE OPTIMUM SANITARY AND
HYGIENIC CONDITIONS IN HEALTH CARE FACILITIES.
  4. HEALTH CARE PRACTITIONER HYGIENIC RESOURCE CENTERS. THE COMMISSION-
ER, IN CONSULTATION WITH THE COUNCIL, MAY DESIGNATE A HEALTH CARE  PRAC-
TITIONER  HYGIENIC  RESOURCE CENTER OR CENTERS. SUCH RESOURCE CENTER MAY
BE STATEWIDE OR REGIONAL,  AND  SHALL  ACT  AS  A  SOURCE  OF  TECHNICAL
SUPPORT,  INFORMATION  AND  GUIDANCE  FOR  HEALTH CARE PRACTITIONERS AND
HEALTH CARE FACILITIES ON THE LATEST STRATEGIES AND BEST PRACTICES  WITH
REGARD  TO  ESTABLISHING SANITARY AND HYGIENIC CONDITIONS FOR THE TREAT-
MENT OF PATIENTS. THE DEPARTMENT, IN CONSULTATION WITH THE COUNCIL,  MAY
CONTRACT  WITH NOT-FOR-PROFIT ORGANIZATIONS OR ASSOCIATIONS TO ESTABLISH
AND MANAGE SUCH RESOURCE CENTERS. SUCH RESOURCE CENTERS MAY CHARGE A FEE
TO HELP OFFSET THE COST OF PROVIDING SUCH SERVICES.
  5. CONTINUING EDUCATION FOR HEALTH CARE PRACTITIONERS. THE COUNCIL, IN
CONSULTATION WITH THE DEPARTMENT, THE EDUCATION  DEPARTMENT  AND  HEALTH
CARE PRACTITIONER PROFESSIONAL ORGANIZATIONS, SHALL DEVELOP, COMPILE AND
PUBLISH  INFORMATION AND COURSE MATERIALS ON SANITARY AND HYGIENIC PRAC-
TICES THAT SHOULD BE FOLLOWED BY HEALTH CARE  PRACTITIONERS  AND  HEALTH
CARE  FACILITIES  TO  MITIGATE  AND  ELIMINATE  THE  SPREAD  OF DISEASE,
INFECTION AND BACTERIA TO PATIENTS, VISITORS AND THE GENERAL  PUBLIC  BY
MEANS  OF  THE CLOTHING, JEWELRY AND HEALTH CARE FACILITY IDENTIFICATION
TAGS WORN BY HEALTH CARE PRACTITIONERS AND  THE  CLEANING  PERSONNEL  OF
SUCH  FACILITIES. IN ADDITION, WITHIN TWO YEARS OF THE EFFECTIVE DATE OF
THIS TITLE, THE COUNCIL SHALL  MAKE  RECOMMENDATIONS  TO  THE  EDUCATION
DEPARTMENT  FOR  THE COURSE WORK, TRAINING AND CURRICULUM TO BE INCLUDED
IN THE CONTINUING  EDUCATION  ON  THE  BEST  PRACTICES,  STRATEGIES  AND
APPROACHES  RELATED TO MITIGATING AND ELIMINATING THE SPREAD OF DISEASE,
INFECTION AND BACTERIA TO PATIENTS, VISITORS AND THE GENERAL  PUBLIC  IN
HEALTH CARE FACILITIES BY MEANS OF THE CLOTHING, JEWELRY AND HEALTH CARE
FACILITY  IDENTIFICATION  TAGS WORN BY HEALTH CARE PRACTITIONERS AND THE
CLEANING PERSONNEL OF SUCH FACILITIES.
  6. REPORT. ON OR BEFORE MARCH FIRST OF EACH  ODD  NUMBERED  YEAR,  THE
COUNCIL SHALL SUBMIT TO THE GOVERNOR, THE COMMISSIONER, THE COMMISSIONER
OF  EDUCATION, THE TEMPORARY PRESIDENT OF THE SENATE, THE SPEAKER OF THE
ASSEMBLY, THE MINORITY LEADER OF THE SENATE, THE MINORITY LEADER OF  THE
ASSEMBLY, AND THE CHAIRS OF THE SENATE AND ASSEMBLY COMMITTEES ON HEALTH
A  REPORT ON ITS ACTIVITIES AND ACCOMPLISHMENTS PURSUANT TO THIS ARTICLE
RELATING TO SANITARY AND HYGIENIC CONDITIONS IN HEALTH CARE  FACILITIES.

S. 4909                             4

SUCH  REPORT  MAY  ALSO  INCLUDE  SUCH LEGISLATIVE PROPOSALS AS IT DEEMS
NECESSARY TO MORE EFFECTIVELY IMPLEMENT THE PROVISIONS OF THIS TITLE.
  S 2. Paragraphs b and c of subdivision 3 of section 6507 of the educa-
tion law, as added by chapter 987 of the laws of 1971, are amended and a
new paragraph d is added to read as follows:
  b.  Review  qualifications  in connection with licensing requirements;
[and]
  c. Provide for licensing examinations and reexaminations[.]; AND
  D. (I) ESTABLISH STANDARDS FOR CONTINUING EDUCATION  FOR  HEALTH  CARE
PRACTITIONERS  ON  THE BEST PRACTICES, STRATEGIES AND APPROACHES RELATED
TO MITIGATING AND ELIMINATING  THE  SPREAD  OF  DISEASE,  INFECTION  AND
BACTERIA  TO  PATIENTS,  VISITORS  AND THE GENERAL PUBLIC IN HEALTH CARE
FACILITIES BY MEANS OF THE CLOTHING, JEWELRY AND  HEALTH  CARE  FACILITY
IDENTIFICATION  TAGS  WORN BY HEALTH CARE PRACTITIONERS AND THE CLEANING
PERSONNEL OF SUCH FACILITIES.  IN PROMULGATION OF  SUCH  STANDARDS,  THE
DEPARTMENT  AND  THE  APPROPRIATE  BOARD  OF  EACH SUCH PROFESSION SHALL
CONSIDER AND, TO THE EXTENT PRACTICABLE, IMPLEMENT  THE  RECOMMENDATIONS
OF THE STATE HEALTH CARE PRACTITIONER HYGIENIC DRESS CODE COUNCIL.
  (II) FOR THE PURPOSES OF THIS PARAGRAPH:
  (A)  "HEALTH  CARE  FACILITY"  SHALL MEAN AND INCLUDE A HOSPITAL AND A
RESIDENTIAL HEALTH CARE FACILITY  AS  DEFINED  IN  SECTION  TWENTY-EIGHT
HUNDRED  ONE OF THE PUBLIC HEALTH LAW, AND ANY SETTING IN WHICH A HEALTH
CARE PRACTITIONER REGULARLY PRACTICES HIS OR HER PROFESSION.
  (B) "HEALTH CARE PRACTITIONER" SHALL MEAN ANY  PERSON  LICENSED  AS  A
PHYSICIAN  PURSUANT  TO  ARTICLE  ONE  HUNDRED THIRTY-ONE OF THIS TITLE,
PHYSICIAN ASSISTANT OR SPECIALIST  ASSISTANT  PURSUANT  TO  ARTICLE  ONE
HUNDRED  THIRTY-ONE-B  OF  THIS  TITLE,  NURSE  PURSUANT  TO ARTICLE ONE
HUNDRED THIRTY-NINE OF THIS TITLE, OR MIDWIFE PURSUANT  TO  ARTICLE  ONE
HUNDRED FORTY OF THIS TITLE.
  S  3.  Section  2343  of  the insurance law is amended by adding a new
subsection (f) to read as follows:
  (F) THE SUPERINTENDENT SHALL APPROVE AND IMPLEMENT PROGRAMS TO ENCOUR-
AGE HEALTH CARE PROVIDERS, HEALTH CARE FACILITIES AND  MEDICAL  MALPRAC-
TICE INSURERS TO PARTICIPATE IN HEALTH CARE PROVIDER HYGIENIC DRESS CODE
PROGRAMS.  SUCH  PROGRAMS MAY INCLUDE, BUT SHALL BE LIMITED TO, ENHANCED
COVERAGE LEVELS, REDUCTIONS IN DEDUCTIBLE LEVELS OR  ACTUARIALLY  APPRO-
PRIATE  PREMIUM  REDUCTION  FOR INSURED HEALTH CARE PROVIDERS AND HEALTH
CARE FACILITIES WHICH HAVE IMPLEMENTED A SUCCESSFUL HEALTH CARE  PRACTI-
TIONER  DRESS  CODE PROGRAM, PURSUANT TO TITLE SIX OF ARTICLE TWO OF THE
PUBLIC HEALTH LAW, WHICH IS APPROVED BY THE COMMISSIONER OF HEALTH.
  S 4. Section 3436 of the insurance law, as added by chapter 266 of the
laws of 1986, is amended by adding a  new  subsection  (f)  to  read  as
follows:
  (F)  AN  INSURER  WHICH  ISSUES POLICIES FOR PRIMARY LEVELS OF MEDICAL
MALPRACTICE INSURANCE  SHALL  UPON  THE  ISSUANCE  OR  RENEWAL  THEREOF,
PROVIDE  FOR  PROGRAMS  TO  ENCOURAGE HEALTH CARE PROVIDERS, HEALTH CARE
FACILITIES AND MEDICAL MALPRACTICE INSURERS  TO  PARTICIPATE  IN  HEALTH
CARE  PROVIDER  HYGIENIC DRESS CODE PROGRAMS. SUCH PROGRAMS MAY INCLUDE,
BUT SHALL BE LIMITED TO, ENHANCED COVERAGE LEVELS, REDUCTIONS IN DEDUCT-
IBLE LEVELS OR ACTUARIALLY APPROPRIATE  PREMIUM  REDUCTION  FOR  INSURED
HEALTH  CARE PROVIDERS AND HEALTH CARE FACILITIES WHICH HAVE IMPLEMENTED
A SUCCESSFUL HEALTH CARE PRACTITIONER DRESS CODE  PROGRAM,  PURSUANT  TO
TITLE  SIX OF ARTICLE TWO OF THE PUBLIC HEALTH LAW, WHICH IS APPROVED BY
THE COMMISSIONER OF HEALTH.
  S 5. Section 5505 of the insurance law is  amended  by  adding  a  new
subsection (e) to read as follows:

S. 4909                             5

  (E)  THE  ASSOCIATION'S RATES, RATING PLANS AND RATING CLASSIFICATIONS
SHALL PROVIDE FOR PROGRAMS TO ENCOURAGE HEALTH  CARE  PROVIDERS,  HEALTH
CARE  FACILITIES  AND  MEDICAL  MALPRACTICE  INSURERS  TO PARTICIPATE IN
HEALTH CARE PROVIDER HYGIENIC DRESS CODE  PROGRAMS.  SUCH  PROGRAMS  MAY
INCLUDE,  BUT  SHALL BE LIMITED TO, ENHANCED COVERAGE LEVELS, REDUCTIONS
IN DEDUCTIBLE LEVELS OR ACTUARIALLY APPROPRIATE  PREMIUM  DISCOUNTS  FOR
HEALTH  CARE PROVIDERS AND HEALTH CARE FACILITIES WHICH HAVE IMPLEMENTED
A SUCCESSFUL HEALTH CARE PRACTITIONER DRESS CODE  PROGRAM,  PURSUANT  TO
TITLE  SIX OF ARTICLE TWO OF THE PUBLIC HEALTH LAW, WHICH IS APPROVED BY
THE COMMISSIONER OF HEALTH.
  S 6. This act shall take effect on the first of January next  succeed-
ing the date on which it shall have become a law and section one of this
act shall expire and be deemed repealed January 1, 2020.

Co-Sponsors

S4909A - Bill Details

See Assembly Version of this Bill:
A7845C
Current Committee:
Law Section:
Public Health Law
Laws Affected:
Add Art 2 Title 6 §266, Pub Health L; amd §6507, Ed L; amd §§2343, 3436 & 5505, Ins L

S4909A - Bill Texts

view summary

Establishes the health care practitioner hygienic dress code program within the department of health to address clothing, jewelry and identification tags worn by health care professionals that may cause infection, disease and bacteria in patients, visitors and the general public.

view sponsor memo
BILL NUMBER:S4909A

TITLE OF BILL:
An act
to amend the public health law, the education law and the insurance law,
in relation to establishing a health care practitioner hygienic dress
code; and providing for the repeal of certain
provisions upon expiration
thereof

PURPOSE:
The purpose of this bill is to help reduce the rate of patient injury
due to the inadvertent spread of infections, bacteria, and diseases
by health care practitioners due to the clothes and other items that
they wear. Further, it is to help reduce the rising cost of medical
malpractice insurance faced by health care practitioners due to the
increased damages from injuries caused by such infections.

SUMMARY OF PROVISIONS:
Section 1: Amends Article 2 of the Public Health Law by adding new
title 6, "Health Care Practitioner Hygienic Dress Code". This section
creates a State health care practitioner hygienic dress code council
comprised of twenty-five members appointed by the commissioner of
health with the advice of the commissioner of education and financial
services. This council is to advise the health and education
commissioners on (i) the best practices for mitigating and
eliminating the spread of disease and other infections via
practitioner clothing, jewelry, and facility identification tags (ii)
the promotion of better coordinated interdisciplinary policies to
ensure hygienic practices, (iii) establish materials and curricula to
be used in continuing education programs related to hygienic dress
codes.

This council also may provide guidance to practitioners and health
care facilities on the best practices to mitigate and eliminate the
spread of infection and disease by vectors related to health care
practitioners' clothes and identification tags.

The council should examine and consider the adoption of rules and
regulations including a bare below the elbow policy, no necktie
policy, education and instruction to patients and practitioners,
provision of clean scrubs and uniforms, and prohibition of wearing
clothing worn during treatment of patients outside of the health care
facility.

This section also creates Health care practitioner hygienic resource
centers as the commissioner may designate. These centers shall act as
a source of support and information for practitioners in the area of
sanitary and hygienic conditions for patient treatment. These centers
may be contracted for with not-for-profit organizations at the

discretion of
the Health Department and with the council's consultation.

The council, in consultation with the health and education
departments, as well as practitioner professional organizations, is
to develop course materials on sanitary dress code policies and
practices and, within two years, make recommendations for inclusions
into the continuing education curriculum of such policies or practices.

Lastly, every other year, the council shall submit a report on
activities or accomplishments on sanitary and hygienic conditions
recommended
by the council in health care facilities, including legislative
proposals.

Section 2: Amends section 6507 of the education law and adds new
paragraph d to subdivision 3. It establishes standards for continuing
education for health care practitioners on the best practices and
approaches for mitigating and eliminating the spread of disease by
health care practitioners by implementing to the extent practicable
the recommendations of the state health care practitioner hygienic
dress code council.

Section 3: Amends 2343 of the insurance law by adding
subsection (f} which instructs the superintendent to approve and
implement programs to encourage health care facilities and
practitioners to adopt hygienic dress codes to obtain better or
cheaper medical malpractice coverage. Such programs can include
enhanced coverage levels, lower deductibles, or an actuarially
appropriate premium reduction for facilities and health care
providers which have implemented a successful practitioner dress code.

Section 4: Amends 3436 of the insurance law by adding subsection (f)
to chapter 266 which instructs insurers to provide for actuarially
appropriate premium reductions or other medical malpractice insurance
enhancements such as enhanced coverage levels and lower deductibles
for health care providers and facilities which implement a successful
practitioner dress code.

Section 5: Amends section 5505 of the insurance law by adding
subsection e which provides for an actuarially appropriate premium
discounts or other medical malpractice insurance enhancements such as
enhanced coverage levels and lower deductibles by the association for
facilities and practitioners which implement a successful
practitioner dress code.

Section 6: This act is effective on the first on January next
succeeding date on which is shall have become law and section one
expires January 1, 2020.

JUSTIFICATION:

New York is facing a crisis with regard to the availability and
affordability of medical liability insurance coverage. New York
health care providers pay the highest premium rates in the country
for their medical liability insurance and those rates continue to rise.

Approaches to improve patient safety have been increasingly researched
for their effects on curtailing medical malpractice liability costs.
Malpractice claims that involve preventable injuries often result in
large jury awards. Information indicates that, rather than increased
frequency of claims, the Soaring amount of individual malpractice
awards accounts for increasing malpractice costs. Therefore, it is
logical to reduce, and when Possible, eliminate preventable injuries
to Curtail medical malpractice costs and accompanying premium rates.

In a report issued by Senator Klein, it was found that while other
methods and avenues for addressing rising medical malpractice costs
and overall health care costs, such as attempting to cap damages in
medical malpractice suits or other methods of tort reform, there were
other ways to address the underlying causes of increased insurance
rates. Namely, that by addressing some of the underlying causes of
injury rates in patients such as the spread of infections, Such as
nosocomial infections like methicillin resistant staphylococcus
aureus (MRSA), that these reduced incidence rates would necessarily
reduce the number of claims and thus the rising costs of medical
malpractice insurance.

One major way of curtailing the number of these infections involves
avoiding having to treat drug-resistant afflictions altogether and
work to mitigate their initial spread. That is, mitigating the spread
of these infections is an effective method of Combating them. Thus,
as research indicates that the health care practitioners themselves
may be unwitting agents of these infections, examining how they are
being spread and then addressing that cause may be an effective tool.

Exploring and possibly implementing all or some of a health care
practitioner dress code may lead to fewer injuries to patients as
well as lowered insurance premiums. Further, this can lessen the
practice of defensive medicine-that is, care tailored toward
preventing lawsuits and not carefully planned to a patient's needs
which also drives up the cost of care.

PRIOR LEGISLATIVE HISTORY:
New Bill.

FISCAL IMPLICATIONS:
This bill is designed to lower rising medical malpractice costs by
targeting some of the underlying causes such as the spread of several
types of infection. Lowering such rates should also lead to fewer
claims and less time in the hospital, thus alleviating associated
health care costs to all parties involved, including the state.

EFFECTIVE DATE:

This act shall take effect on the first of January next Succeeding the
date on which it shall have become law and section one of this act
shall expire and be deemed repealed January 1, 2021.

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

                                 4909--A

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                             April 29, 2011
                               ___________

Introduced  by  Sens. KLEIN, CARLUCCI, SAVINO, VALESKY -- read twice and
  ordered printed, and when printed to be committed to the Committee  on
  Health  --  recommitted  to the Committee on Health in accordance with
  Senate Rule 6, sec. 8 -- committee discharged, bill  amended,  ordered
  reprinted as amended and recommitted to said committee

AN  ACT to amend the public health law, the education law and the insur-
  ance law, in relation  to  establishing  a  health  care  practitioner
  hygienic   dress  code;  and  providing  for  the  repeal  of  certain
  provisions upon expiration thereof

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

  Section  1.  Article 2 of the public health law is amended by adding a
new title 6 to read as follows:
                                 TITLE 6
                    HEALTH CARE PRACTITIONER HYGIENIC
                               DRESS CODE
SECTION 266. HEALTH CARE PRACTITIONER HYGIENIC DRESS CODE.
  S 266. HEALTH CARE PRACTITIONER HYGIENIC DRESS CODE.  1.  DEFINITIONS.
THE  FOLLOWING  WORDS  OR  PHRASES  AS USED IN THIS TITLE SHALL HAVE THE
FOLLOWING MEANINGS:
  (A) "CONTINUING EDUCATION"  SHALL  MEAN  ALL  PROFESSIONAL  CONTINUING
EDUCATION  PROGRAMS  REQUIRED  EITHER  BY  STATE LAW, OR BY PROFESSIONAL
ASSOCIATIONS AUTHORIZED BY  THE  EDUCATION  DEPARTMENT  TO  MONITOR  THE
REQUIREMENTS  OF  LICENSURE  OR  CERTIFICATION AND TO CONDUCT CONTINUING
EDUCATION REQUIRED TO BE COMPLETED BY A HEALTH CARE PRACTITIONER.
  (B) "COUNCIL" SHALL MEAN THE STATE HEALTH CARE  PRACTITIONER  HYGIENIC
DRESS CODE COUNCIL ESTABLISHED BY SUBDIVISION TWO OF THIS SECTION.
  (C) "HEALTH CARE FACILITY" SHALL MEAN AND INCLUDE A HOSPITAL AND RESI-
DENTIAL  HEALTH CARE FACILITY AS DEFINED IN SECTION TWENTY-EIGHT HUNDRED
ONE OF THIS CHAPTER, AND ANY SETTING IN WHICH A HEALTH CARE PRACTITIONER
REGULARLY PRACTICES HIS OR HER PROFESSION.

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD10964-06-2

S. 4909--A                          2

  (D) "HEALTH CARE PRACTITIONER" SHALL MEAN ANY  PERSON  LICENSED  AS  A
PHYSICIAN  PURSUANT  TO  ARTICLE ONE HUNDRED THIRTY-ONE OF THE EDUCATION
LAW, PHYSICIAN ASSISTANT OR SPECIALIST ASSISTANT PURSUANT TO ARTICLE ONE
HUNDRED THIRTY-ONE-B OF THE EDUCATION LAW, NURSE PURSUANT TO ARTICLE ONE
HUNDRED THIRTY-NINE OF THE EDUCATION LAW, OR MIDWIFE PURSUANT TO ARTICLE
ONE HUNDRED FORTY OF THE EDUCATION LAW.
  2. STATE HEALTH CARE PRACTITIONER HYGIENIC DRESS CODE COUNCIL. (A) THE
STATE  HEALTH  CARE  PRACTITIONER  HYGIENIC DRESS CODE COUNCIL IS HEREBY
ESTABLISHED IN THE DEPARTMENT TO  BE  AN  EXPERT  PANEL  TO  ADVISE  THE
COMMISSIONER  AND  THE  COMMISSIONER OF EDUCATION ON: (I) THE BEST PRAC-
TICES RELATED TO MITIGATING  AND  ELIMINATING  THE  SPREAD  OF  DISEASE,
INFECTION  AND  BACTERIA TO PATIENTS, VISITORS AND THE GENERAL PUBLIC IN
HEALTH CARE FACILITIES BY MEANS OF THE UNHYGIENIC CLOTHING, JEWELRY  AND
HEALTH CARE FACILITY IDENTIFICATION TAGS WORN BY HEALTH CARE PRACTITION-
ERS AND THE CLEANING PERSONNEL OF SUCH FACILITIES, (II) THE PROMOTION OF
BETTER  AND  COORDINATED POLICIES TO ENSURE BETTER HYGIENIC PRACTICES IN
HEALTH CARE FACILITIES, AND  (III)  THE  DEVELOPMENT  OF  GUIDELINES  TO
ASSIST  THE EDUCATION DEPARTMENT IN ESTABLISHING MATERIALS AND CURRICULA
TO BE USED IN PROVIDING CONTINUING EDUCATION  PROGRAMS  TO  HEALTH  CARE
PRACTITIONERS ON THE USE OF A HYGIENIC DRESS CODE TO MINIMIZE THE SPREAD
OF DISEASE, INFECTION AND BACTERIA TO PATIENTS, VISITORS AND THE GENERAL
PUBLIC.
  (B)  THE COUNCIL SHALL BE COMPOSED OF TWENTY-FIVE MEMBERS APPOINTED BY
THE  COMMISSIONER.  THE  COMMISSIONER  SHALL  SEEK  RECOMMENDATIONS  FOR
APPOINTMENTS  FROM  THE COMMISSIONER OF EDUCATION AND THE SUPERINTENDENT
OF FINANCIAL SERVICES. THE  MEMBERSHIP  OF  THE  COUNCIL  SHALL  INCLUDE
REPRESENTATIVES  OF  THE  VARIOUS  PROFESSIONS  WITHIN THE DEFINITION OF
HEALTH CARE PRACTITIONER, THE VARIOUS FACILITIES AND SETTINGS WITHIN THE
DEFINITION OF HEALTH CARE FACILITY, EDUCATORS OF HEALTH CARE PRACTITION-
ERS, CLEANING AND STERILIZATION SERVICES  FOR  HEALTH  CARE  FACILITIES,
PHARMACEUTICAL COMPANIES, AND INSURERS AND CORPORATIONS PROVIDING HEALTH
CARE COVERAGE.  THE CHAIR OF THE COUNCIL SHALL BE A MEMBER THEREOF AS IS
SO DESIGNATED BY THE COMMISSIONER.
  (C) THE MEMBERS OF THE COUNCIL SHALL HAVE EXPERTISE IN THE MAINTENANCE
AND  CREATION  OF  SANITARY  AND HYGIENIC CONDITIONS IN THE TREATMENT OF
PATIENTS BY HEALTH CARE PRACTITIONERS AND IN HEALTH CARE FACILITIES. THE
TERM OF OFFICE OF SUCH MEMBERS SHALL BE FOUR YEARS. THE MEMBERS  OF  THE
COUNCIL  SHALL  RECEIVE NO COMPENSATION FOR THEIR SERVICES, BUT SHALL BE
ALLOWED THEIR ACTUAL AND NECESSARY EXPENSES IN THE PERFORMANCE OF  THEIR
DUTIES.
  (D)  THE  COUNCIL  SHALL MEET UPON THE CALL OF THE COMMISSIONER OR THE
CHAIR. THE COUNCIL MAY ADOPT REGULATIONS CONSISTENT WITH THIS SECTION.
  (E) THE COMMISSIONER SHALL DESIGNATE SUCH  EMPLOYEE  AND  PROVIDE  FOR
OTHER  RESOURCES  OF  THE  DEPARTMENT  AS MAY BE REASONABLY NECESSARY TO
PROVIDE SUPPORT AND SERVICES FOR THE WORK OF THE COUNCIL.
  (F) THE COUNCIL MAY PROVIDE  TECHNICAL  INFORMATION  AND  GUIDANCE  TO
HEALTH  CARE  PRACTITIONERS AND HEALTH CARE FACILITIES ON THE LATEST AND
BEST PRACTICES AND STRATEGIES RELATED TO MITIGATING AND ELIMINATING  THE
SPREAD OF DISEASE, INFECTION AND BACTERIA DURING THE COURSE OF TREATMENT
OF PATIENTS AS IT RELATES TO THE USE OF HYGIENIC HEALTH CARE PRACTITION-
ER CLOTHING, ATTIRE AND A DRESS CODE.
  3.  POLICIES  TO  BE CONSIDERED, EXAMINED AND POSSIBLY ADVANCED BY THE
COUNCIL. THE COUNCIL SHALL CONSIDER AND EXAMINE THE  FOLLOWING  POLICIES
AND GUIDELINES IN THE ADOPTION OF RULES AND REGULATIONS:
  (A) THE ADOPTION OF A BARE BELOW THE ELBOW POLICY OF HEALTH CARE PRAC-
TITIONERS,  WHICH  SHALL  INCLUDE, BUT NOT BE LIMITED TO, THE WEARING OF

S. 4909--A                          3

SHORT SLEEVE SHIRTS, A PROHIBITION ON THE WEARING  OF  WRISTWATCHES  AND
OTHER  JEWELRY,  AND  A  PROHIBITION  ON THE WEARING OF COATS OR JACKETS
WHILE PROVIDING TREATMENT TO PATIENTS;
  (B) THE ADOPTION OF A NO NECKTIES POLICY;
  (C)  THE PROVISION OF EDUCATION AND INSTRUCTION TO PATIENTS AND HEALTH
CARE PRACTITIONERS ON  HOW  ENHANCED  SANITARY  AND  HYGIENIC  POLICIES,
INCLUDING  THE USE OF HYGIENIC HEALTH CARE PRACTITIONER CLOTHING, ATTIRE
AND A DRESS CODE, CAN HELP TO REDUCE THE RISK OF CROSS-INFECTION;
  (D) ENCOURAGING HEALTH CARE FACILITIES TO PROVIDE ADEQUATE SUPPLIES OF
CLEAN SCRUBS, OTHER ARTICLES OF CLOTHING AND HEALTH CARE FACILITY  IDEN-
TIFICATION  TAGS TO HEALTH CARE PRACTITIONERS TO ENSURE FREQUENT CHANGES
THEREOF;
  (E) ENCOURAGING HEALTH CARE  FACILITIES  TO  PROVIDE  ON-SITE  LAUNDRY
SERVICES  AND    CHANGING ROOMS, AND INSTRUCTION ON HOW TO APPROPRIATELY
WASH CLOTHING WORN BY HEALTH CARE PRACTITIONERS;
  (F) THE WEARING OF PLASTIC APRONS AND DOUBLE  GLOVES  BY  HEALTH  CARE
PRACTITIONERS DURING THE TREATMENT OF PATIENTS;
  (G)  THE  ADOPTION OF A PROHIBITION ON THE WEARING OUTSIDE OF A HEALTH
CARE FACILITY BY HEALTH  CARE  PRACTITIONERS  OF  CLOTHING  WORN  DURING
TREATMENT OF PATIENTS; AND
  (H)  CONSIDERATION  OF  ALTERATIONS  IN  MEDICAID  AND  PRIVATE  PAYOR
REIMBURSEMENT RATES AND PRACTICES TO ENCOURAGE MORE OPTIMUM SANITARY AND
HYGIENIC CONDITIONS IN HEALTH CARE FACILITIES.
  4. HEALTH CARE PRACTITIONER HYGIENIC RESOURCE CENTERS. THE COMMISSION-
ER, IN CONSULTATION WITH THE COUNCIL, MAY DESIGNATE A HEALTH CARE  PRAC-
TITIONER  HYGIENIC  RESOURCE CENTER OR CENTERS. SUCH RESOURCE CENTER MAY
BE STATEWIDE OR REGIONAL,  AND  SHALL  ACT  AS  A  SOURCE  OF  TECHNICAL
SUPPORT,  INFORMATION  AND  GUIDANCE  FOR  HEALTH CARE PRACTITIONERS AND
HEALTH CARE FACILITIES ON THE LATEST STRATEGIES AND BEST PRACTICES  WITH
REGARD  TO  ESTABLISHING SANITARY AND HYGIENIC CONDITIONS FOR THE TREAT-
MENT OF PATIENTS. THE DEPARTMENT, IN CONSULTATION WITH THE COUNCIL,  MAY
CONTRACT  WITH NOT-FOR-PROFIT ORGANIZATIONS OR ASSOCIATIONS TO ESTABLISH
AND MANAGE SUCH RESOURCE CENTERS. SUCH RESOURCE CENTERS MAY CHARGE A FEE
TO HELP OFFSET THE COST OF PROVIDING SUCH SERVICES.
  5. CONTINUING EDUCATION FOR HEALTH CARE PRACTITIONERS. THE COUNCIL, IN
CONSULTATION WITH THE DEPARTMENT, THE EDUCATION  DEPARTMENT  AND  HEALTH
CARE PRACTITIONER PROFESSIONAL ORGANIZATIONS, SHALL DEVELOP, COMPILE AND
PUBLISH  INFORMATION AND COURSE MATERIALS ON SANITARY AND HYGIENIC PRAC-
TICES THAT SHOULD BE FOLLOWED BY HEALTH CARE  PRACTITIONERS  AND  HEALTH
CARE  FACILITIES  TO  MITIGATE  AND  ELIMINATE  THE  SPREAD  OF DISEASE,
INFECTION AND BACTERIA TO PATIENTS, VISITORS AND THE GENERAL  PUBLIC  BY
MEANS  OF  THE CLOTHING, JEWELRY AND HEALTH CARE FACILITY IDENTIFICATION
TAGS WORN BY HEALTH CARE PRACTITIONERS AND  THE  CLEANING  PERSONNEL  OF
SUCH  FACILITIES. IN ADDITION, WITHIN TWO YEARS OF THE EFFECTIVE DATE OF
THIS TITLE, THE COUNCIL SHALL  MAKE  RECOMMENDATIONS  TO  THE  EDUCATION
DEPARTMENT  FOR  THE COURSE WORK, TRAINING AND CURRICULUM TO BE INCLUDED
IN THE CONTINUING  EDUCATION  ON  THE  BEST  PRACTICES,  STRATEGIES  AND
APPROACHES  RELATED TO MITIGATING AND ELIMINATING THE SPREAD OF DISEASE,
INFECTION AND BACTERIA TO PATIENTS, VISITORS AND THE GENERAL  PUBLIC  IN
HEALTH CARE FACILITIES BY MEANS OF THE CLOTHING, JEWELRY AND HEALTH CARE
FACILITY  IDENTIFICATION  TAGS WORN BY HEALTH CARE PRACTITIONERS AND THE
CLEANING PERSONNEL OF SUCH FACILITIES.
  6. REPORT. ON OR BEFORE MARCH FIRST OF EACH EVEN  NUMBERED  YEAR,  THE
COUNCIL SHALL SUBMIT TO THE GOVERNOR, THE COMMISSIONER, THE COMMISSIONER
OF  EDUCATION, THE TEMPORARY PRESIDENT OF THE SENATE, THE SPEAKER OF THE
ASSEMBLY, THE MINORITY LEADER OF THE SENATE, THE MINORITY LEADER OF  THE

S. 4909--A                          4

ASSEMBLY, AND THE CHAIRS OF THE SENATE AND ASSEMBLY COMMITTEES ON HEALTH
A  REPORT ON ITS ACTIVITIES AND ACCOMPLISHMENTS PURSUANT TO THIS ARTICLE
RELATING TO SANITARY AND HYGIENIC CONDITIONS IN HEALTH CARE  FACILITIES.
SUCH  REPORT  MAY  ALSO  INCLUDE  SUCH LEGISLATIVE PROPOSALS AS IT DEEMS
NECESSARY TO MORE EFFECTIVELY IMPLEMENT THE PROVISIONS OF THIS TITLE.
  S 2. Paragraphs b and c of subdivision 3 of section 6507 of the educa-
tion law, as added by chapter 987 of the laws of 1971, are amended and a
new paragraph d is added to read as follows:
  b. Review qualifications in connection  with  licensing  requirements;
[and]
  c. Provide for licensing examinations and reexaminations[.]; AND
  D.  (I)  ESTABLISH  STANDARDS FOR CONTINUING EDUCATION FOR HEALTH CARE
PRACTITIONERS ON THE BEST PRACTICES, STRATEGIES AND  APPROACHES  RELATED
TO  MITIGATING  AND  ELIMINATING  THE  SPREAD  OF DISEASE, INFECTION AND
BACTERIA TO PATIENTS, VISITORS AND THE GENERAL  PUBLIC  IN  HEALTH  CARE
FACILITIES  BY  MEANS  OF THE CLOTHING, JEWELRY AND HEALTH CARE FACILITY
IDENTIFICATION TAGS WORN BY HEALTH CARE PRACTITIONERS AND  THE  CLEANING
PERSONNEL  OF  SUCH FACILITIES.   IN PROMULGATION OF SUCH STANDARDS, THE
DEPARTMENT AND THE APPROPRIATE  BOARD  OF  EACH  SUCH  PROFESSION  SHALL
CONSIDER  AND,  TO THE EXTENT PRACTICABLE, IMPLEMENT THE RECOMMENDATIONS
OF THE STATE HEALTH CARE PRACTITIONER HYGIENIC DRESS CODE COUNCIL.
  (II) FOR THE PURPOSES OF THIS PARAGRAPH:
  (A) "HEALTH CARE FACILITY" SHALL MEAN AND INCLUDE  A  HOSPITAL  AND  A
RESIDENTIAL  HEALTH  CARE  FACILITY  AS  DEFINED IN SECTION TWENTY-EIGHT
HUNDRED ONE OF THE PUBLIC HEALTH LAW, AND ANY SETTING IN WHICH A  HEALTH
CARE PRACTITIONER REGULARLY PRACTICES HIS OR HER PROFESSION.
  (B)  "HEALTH  CARE  PRACTITIONER"  SHALL MEAN ANY PERSON LICENSED AS A
PHYSICIAN PURSUANT TO ARTICLE ONE  HUNDRED  THIRTY-ONE  OF  THIS  TITLE,
PHYSICIAN  ASSISTANT  OR  SPECIALIST  ASSISTANT  PURSUANT TO ARTICLE ONE
HUNDRED THIRTY-ONE-B OF  THIS  TITLE,  NURSE  PURSUANT  TO  ARTICLE  ONE
HUNDRED  THIRTY-NINE  OF  THIS TITLE, OR MIDWIFE PURSUANT TO ARTICLE ONE
HUNDRED FORTY OF THIS TITLE.
  S 3. Section 2343 of the insurance law is  amended  by  adding  a  new
subsection (f) to read as follows:
  (F) THE SUPERINTENDENT SHALL APPROVE AND IMPLEMENT PROGRAMS TO ENCOUR-
AGE  HEALTH  CARE PROVIDERS, HEALTH CARE FACILITIES AND MEDICAL MALPRAC-
TICE INSURERS TO PARTICIPATE IN HEALTH CARE PROVIDER HYGIENIC DRESS CODE
PROGRAMS. SUCH PROGRAMS MAY INCLUDE, BUT SHALL BE LIMITED  TO,  ENHANCED
COVERAGE  LEVELS,  REDUCTIONS IN DEDUCTIBLE LEVELS OR ACTUARIALLY APPRO-
PRIATE PREMIUM REDUCTION FOR INSURED HEALTH CARE  PROVIDERS  AND  HEALTH
CARE  FACILITIES WHICH HAVE IMPLEMENTED A SUCCESSFUL HEALTH CARE PRACTI-
TIONER DRESS CODE PROGRAM, PURSUANT TO TITLE SIX OF ARTICLE TWO  OF  THE
PUBLIC HEALTH LAW, WHICH IS APPROVED BY THE COMMISSIONER OF HEALTH.
  S 4. Section 3436 of the insurance law, as added by chapter 266 of the
laws  of  1986,  is  amended  by  adding a new subsection (f) to read as
follows:
  (F) AN INSURER WHICH ISSUES POLICIES FOR  PRIMARY  LEVELS  OF  MEDICAL
MALPRACTICE  INSURANCE  SHALL  UPON  THE  ISSUANCE  OR  RENEWAL THEREOF,
PROVIDE FOR PROGRAMS TO ENCOURAGE HEALTH  CARE  PROVIDERS,  HEALTH  CARE
FACILITIES  AND  MEDICAL  MALPRACTICE  INSURERS TO PARTICIPATE IN HEALTH
CARE PROVIDER HYGIENIC DRESS CODE PROGRAMS. SUCH PROGRAMS  MAY  INCLUDE,
BUT SHALL BE LIMITED TO, ENHANCED COVERAGE LEVELS, REDUCTIONS IN DEDUCT-
IBLE  LEVELS  OR  ACTUARIALLY  APPROPRIATE PREMIUM REDUCTION FOR INSURED
HEALTH CARE PROVIDERS AND HEALTH CARE FACILITIES WHICH HAVE  IMPLEMENTED
A  SUCCESSFUL  HEALTH  CARE PRACTITIONER DRESS CODE PROGRAM, PURSUANT TO

S. 4909--A                          5

TITLE SIX OF ARTICLE TWO OF THE PUBLIC HEALTH LAW, WHICH IS APPROVED  BY
THE COMMISSIONER OF HEALTH.
  S  5.  Section  5505  of  the insurance law is amended by adding a new
subsection (e) to read as follows:
  (E) THE ASSOCIATION'S RATES, RATING PLANS AND  RATING  CLASSIFICATIONS
SHALL  PROVIDE  FOR  PROGRAMS TO ENCOURAGE HEALTH CARE PROVIDERS, HEALTH
CARE FACILITIES AND  MEDICAL  MALPRACTICE  INSURERS  TO  PARTICIPATE  IN
HEALTH  CARE  PROVIDER  HYGIENIC  DRESS CODE PROGRAMS. SUCH PROGRAMS MAY
INCLUDE, BUT SHALL BE LIMITED TO, ENHANCED COVERAGE  LEVELS,  REDUCTIONS
IN  DEDUCTIBLE  LEVELS  OR ACTUARIALLY APPROPRIATE PREMIUM DISCOUNTS FOR
HEALTH CARE PROVIDERS AND HEALTH CARE FACILITIES WHICH HAVE  IMPLEMENTED
A  SUCCESSFUL  HEALTH  CARE PRACTITIONER DRESS CODE PROGRAM, PURSUANT TO
TITLE SIX OF ARTICLE TWO OF THE PUBLIC HEALTH LAW, WHICH IS APPROVED  BY
THE COMMISSIONER OF HEALTH.
  S  6. This act shall take effect on the first of January next succeed-
ing the date on which it shall have become a law and section one of this
act shall expire and be deemed repealed January 1, 2021.

Co-Sponsors

S4909B (ACTIVE) - Bill Details

See Assembly Version of this Bill:
A7845C
Current Committee:
Law Section:
Public Health Law
Laws Affected:
Add Art 2 Title 6 §266, Pub Health L; amd §6507, Ed L; amd §§2343, 3436 & 5505, Ins L

S4909B (ACTIVE) - Bill Texts

view summary

Establishes the health care practitioner hygienic dress code program within the department of health to address clothing, jewelry and identification tags worn by health care professionals that may cause infection, disease and bacteria in patients, visitors and the general public.

view sponsor memo
BILL NUMBER:S4909B

TITLE OF BILL:
An act
to amend the public health law, the education law and the insurance law,
in relation to establishing a health care practitioner hygienic dress
code; and providing for the repeal of certain
provisions upon expiration
thereof

PURPOSE:
The purpose of this bill is to help reduce the rate of practitioner
and patient injury due to the inadvertent spread of infections,
bacteria, and diseases due to cross-infections via clothes and other
items. Further, it is to help reduce the rising cost of medical
malpractice insurance faced by health care practitioners due to the
increased damages from injuries caused by such infections.

SUMMARY OF PROVISIONS:
Section 1: Amends Article 2 of the Public Health Law by adding new
title 6, "Health Care Practitioner Hygienic Dress Code." This section
creates a State health care practitioner hygienic dress code council
comprised of twenty-five members appointed by the commissioner of
health with the advice of the commissioner of education and financial
services. This council is to advise the health and education
commissioners on (i) the best practices for mitigating and
eliminating the spread of disease among the health-care practitioner
community and to their patients via garments and accessories, (ii)
the promotion of better coordinated interdisciplinary policies to
ensure hygienic practices, (iii) establish materials and curricula to
be used in continuing education programs related to hygienic dress
codes.

This council also may provide guidance to practitioners and health
care facilities on the best practices to mitigate and eliminate the
spread of infection and disease by vectors related to health care
practitioners' clothes and identification tags.

The council should examine and consider the adoption of rules and
regulations including education and instruction to patients and
practitioners, provision of clean scrubs and uniforms, implementation
of best-practices dress codes, and prohibition of wearing clothing
worn during treatment outside of the health care facility.

This section also creates Health care practitioner hygienic resource
centers as the commissioner may designate. These centers shall act as
a source of support and information for practitioners in the area of
sanitary and hygienic conditions for patient treatment. These centers
may be contracted for with not-for-profit organizations at the
discretion of the Health Department and with the council's consultation.

The council, in consultation with the health and education
departments, as well as practitioner professional organizations, is
to develop course materials on sanitary dress code policies and
practices and, within two years, make recommendations for inclusions
into the continuing education curriculum of such policies or practices.


Lastly, every other year, the council shall submit a report on
activities or accomplishments on sanitary and hygienic conditions
recommended by the council in health care facilities, including
legislative proposals.

Section 2: Amends section 6507 of the education law and adds new
paragraph d to subdivision 3. It establishes standards for continuing
education for health care practitioners on the best practices and
approaches for mitigating and eliminating the spread of disease by
health care practitioners by implementing to the extent practicable
the recommendations of the state health care practitioner hygienic
dress code council.

Section 3: Amends 2343 of the insurance law by adding subsection (f)
which instructs the superintendent to approve and implement programs
to encourage health care facilities and practitioners to adopt
hygienic dress codes to obtain better or cheaper medical malpractice
coverage. Such programs can include enhanced coverage levels, lower
deductibles, or an actuarially appropriate premium reduction for
facilities and health care providers which have implemented a
successful practitioner dress code.

Section 4: Amends 3436 of the insurance law by adding subsection (f)
to chapter 266 which instructs insurers to provide for actuarially
appropriate premium reductions or other medical malpractice insurance
enhancements such as enhanced coverage levels and lower deductibles
for health care providers and facilities which implement a
successful practitioner dress code.

Section 5: Amends section 5505 of the insurance law by adding
subsection e which provides for an actuarially appropriate premium
discounts or other medical malpractice insurance enhancements such as
enhanced coverage levels and lower deductibles by the association for
facilities and practitioners which implement a successful
practitioner dress code.

Section 6: This act is effective on the first on January next
succeeding date on which is shall have become law and section one
expires January 1, 2021.

JUSTIFICATION:
Approaches to improve patient and practitioner safety have been
increasingly researched for curtailing medical malpractice liability
costs. Addressing the issue of costs through the lens of infection
rates not only is a viable method of combating an underlying cause of
increases, but also enhances practitioner and patient safety.

New York is facing a crisis with regard to the availability and
affordability of medical liability insurance coverage. New York
health care providers pay the highest premium rates in the country
for their medical liability insurance and those rates continue to rise.

Malpractice claims that involve preventable injuries often result in
large jury awards. Information indicates that, rather than increased
frequency of claims, the soaring amount of individual malpractice
awards accounts for increasing malpractice costs. Therefore, it is


logical to reduce, and, when possible, eliminate preventable injuries
to curtail medical malpractice costs and accompanying premium rates.

In a report issued by Senator Klein, it was found that while other
methods and avenues for addressing rising medical malpractice costs
and overall health care costs, such as attempting to cap damages in
medical malpractice suits or other methods of tort reform, there were
other ways to address the underlying causes of increased insurance
rates. Namely, that by addressing some of the underlying causes of
injury rates in patients such as the spread of infections, such as
nosocomial infections like methicillin resistant staphylococcus
aureus (MRSA), that these reduced incidence rates would necessarily
reduce the number of claims and thus the rising costs of medical
malpractice insurance.

One major way of curtailing the number of these infections among
patients and practitioners alike involves avoiding having to treat
drug-resistant afflictions altogether and work to mitigate their
initial spread. That is, mitigating the spread of these infections
is an effective method of Combating them. Thus, as research indicates
that the health care practitioners themselves may be unwitting agents
of these infections, examining how they are being spread and then
addressing that cause may be an effective tool.

Exploring and possibly implementing all or some of a health care
practitioner dress code may lead to fewer injuries to practitioners
and patients as well as lowered insurance premiums. Further, this can
lessen the practice of defensive medicine-that is, care tailored
toward preventing lawsuits and not carefully planned to a patient's
needs which also drives up the cost of care.

PRIOR LEGISLATIVE HISTORY:
New Bill.

FISCAL IMPLICATIONS:
This bill is designed to lower rising medical malpractice costs by
targeting some of the underlying causes such as the spread of several
types of infection. Lowering such rates should also lead to fewer
claims and less time in the hospital, thus alleviating associated
health care costs to all parties involved, including the state.

EFFECTIVE DATE:
This act shall take effect on the first of January next succeeding the
date on which it shall have become law and section one of this act
shall expire and be deemed repealed January 1, 2021.

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

                                 4909--B

                       2011-2012 Regular Sessions

                            I N  S E N A T E

                             April 29, 2011
                               ___________

Introduced  by  Sens. KLEIN, CARLUCCI, SAVINO, VALESKY -- read twice and
  ordered printed, and when printed to be committed to the Committee  on
  Health  --  recommitted  to the Committee on Health in accordance with
  Senate Rule 6, sec. 8 -- committee discharged, bill  amended,  ordered
  reprinted  as  amended  and recommitted to said committee -- committee
  discharged, bill amended, ordered reprinted as amended and recommitted
  to said committee

AN ACT to amend the public health law, the education law and the  insur-
  ance  law,  in  relation  to  establishing  a health care practitioner
  hygienic  dress  code;  and  providing  for  the  repeal  of   certain
  provisions upon expiration thereof

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

  Section 1. Article 2 of the public health law is amended by  adding  a
new title 6 to read as follows:
                                 TITLE 6
                    HEALTH CARE PRACTITIONER HYGIENIC
                               DRESS CODE
SECTION 266. HEALTH CARE PRACTITIONER HYGIENIC DRESS CODE.
  S  266.  HEALTH CARE PRACTITIONER HYGIENIC DRESS CODE. 1. DEFINITIONS.
THE FOLLOWING WORDS OR PHRASES AS USED IN  THIS  TITLE  SHALL  HAVE  THE
FOLLOWING MEANINGS:
  (A)  "CONTINUING  EDUCATION"  SHALL  MEAN  ALL PROFESSIONAL CONTINUING
EDUCATION PROGRAMS REQUIRED EITHER BY  STATE  LAW,  OR  BY  PROFESSIONAL
ASSOCIATIONS  AUTHORIZED  BY  THE  EDUCATION  DEPARTMENT  TO MONITOR THE
REQUIREMENTS OF LICENSURE OR CERTIFICATION  AND  TO  CONDUCT  CONTINUING
EDUCATION REQUIRED TO BE COMPLETED BY A HEALTH CARE PRACTITIONER.
  (B)  "COUNCIL"  SHALL MEAN THE STATE HEALTH CARE PRACTITIONER HYGIENIC
DRESS CODE COUNCIL ESTABLISHED BY SUBDIVISION TWO OF THIS SECTION.
  (C) "HEALTH CARE FACILITY" SHALL MEAN AND INCLUDE A HOSPITAL AND RESI-
DENTIAL HEALTH CARE FACILITY AS DEFINED IN SECTION TWENTY-EIGHT  HUNDRED

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD10964-08-2

S. 4909--B                          2

ONE OF THIS CHAPTER, AND ANY SETTING IN WHICH A HEALTH CARE PRACTITIONER
REGULARLY PRACTICES HIS OR HER PROFESSION.
  (D)  "HEALTH  CARE  PRACTITIONER"  SHALL MEAN ANY PERSON LICENSED AS A
PHYSICIAN PURSUANT TO ARTICLE ONE HUNDRED THIRTY-ONE  OF  THE  EDUCATION
LAW, PHYSICIAN ASSISTANT OR SPECIALIST ASSISTANT PURSUANT TO ARTICLE ONE
HUNDRED THIRTY-ONE-B OF THE EDUCATION LAW, NURSE PURSUANT TO ARTICLE ONE
HUNDRED THIRTY-NINE OF THE EDUCATION LAW, OR MIDWIFE PURSUANT TO ARTICLE
ONE HUNDRED FORTY OF THE EDUCATION LAW.
  2. STATE HEALTH CARE PRACTITIONER HYGIENIC DRESS CODE COUNCIL. (A) THE
STATE  HEALTH  CARE  PRACTITIONER  HYGIENIC DRESS CODE COUNCIL IS HEREBY
ESTABLISHED IN THE DEPARTMENT TO  BE  AN  EXPERT  PANEL  TO  ADVISE  THE
COMMISSIONER  AND  THE  COMMISSIONER OF EDUCATION ON: (I) THE BEST PRAC-
TICES RELATED TO MITIGATING  AND  ELIMINATING  THE  SPREAD  OF  DISEASE,
INFECTION  AND  BACTERIA TO PATIENTS, VISITORS AND THE GENERAL PUBLIC IN
HEALTH CARE FACILITIES BY MEANS OF THE UNHYGIENIC CLOTHING, JEWELRY  AND
HEALTH CARE FACILITY IDENTIFICATION TAGS WORN BY HEALTH CARE PRACTITION-
ERS AND THE CLEANING PERSONNEL OF SUCH FACILITIES, (II) THE PROMOTION OF
BETTER  AND  COORDINATED POLICIES TO ENSURE BETTER HYGIENIC PRACTICES IN
HEALTH CARE FACILITIES, AND  (III)  THE  DEVELOPMENT  OF  GUIDELINES  TO
ASSIST  THE EDUCATION DEPARTMENT IN ESTABLISHING MATERIALS AND CURRICULA
TO BE USED IN PROVIDING CONTINUING EDUCATION  PROGRAMS  TO  HEALTH  CARE
PRACTITIONERS ON THE USE OF A HYGIENIC DRESS CODE TO MINIMIZE THE SPREAD
OF DISEASE, INFECTION AND BACTERIA TO PATIENTS, VISITORS AND THE GENERAL
PUBLIC.
  (B)  THE COUNCIL SHALL BE COMPOSED OF TWENTY-FIVE MEMBERS APPOINTED BY
THE  COMMISSIONER.  THE  COMMISSIONER  SHALL  SEEK  RECOMMENDATIONS  FOR
APPOINTMENTS  FROM  THE COMMISSIONER OF EDUCATION AND THE SUPERINTENDENT
OF FINANCIAL SERVICES. THE  MEMBERSHIP  OF  THE  COUNCIL  SHALL  INCLUDE
REPRESENTATIVES  OF  THE  VARIOUS  PROFESSIONS  WITHIN THE DEFINITION OF
HEALTH CARE PRACTITIONER, THE VARIOUS FACILITIES AND SETTINGS WITHIN THE
DEFINITION OF HEALTH CARE FACILITY, EDUCATORS OF HEALTH CARE PRACTITION-
ERS, CLEANING AND STERILIZATION SERVICES  FOR  HEALTH  CARE  FACILITIES,
PHARMACEUTICAL COMPANIES, AND INSURERS AND CORPORATIONS PROVIDING HEALTH
CARE COVERAGE.  THE CHAIR OF THE COUNCIL SHALL BE A MEMBER THEREOF AS IS
SO DESIGNATED BY THE COMMISSIONER.
  (C) THE MEMBERS OF THE COUNCIL SHALL HAVE EXPERTISE IN THE MAINTENANCE
AND  CREATION  OF  SANITARY  AND HYGIENIC CONDITIONS IN THE TREATMENT OF
PATIENTS BY HEALTH CARE PRACTITIONERS AND IN HEALTH CARE FACILITIES. THE
TERM OF OFFICE OF SUCH MEMBERS SHALL BE FOUR YEARS. THE MEMBERS  OF  THE
COUNCIL  SHALL  RECEIVE NO COMPENSATION FOR THEIR SERVICES, BUT SHALL BE
ALLOWED THEIR ACTUAL AND NECESSARY EXPENSES IN THE PERFORMANCE OF  THEIR
DUTIES.
  (D)  THE  COUNCIL  SHALL MEET UPON THE CALL OF THE COMMISSIONER OR THE
CHAIR. THE COUNCIL MAY ADOPT REGULATIONS CONSISTENT WITH THIS SECTION.
  (E) THE COMMISSIONER SHALL DESIGNATE SUCH  EMPLOYEE  AND  PROVIDE  FOR
OTHER  RESOURCES  OF  THE  DEPARTMENT  AS MAY BE REASONABLY NECESSARY TO
PROVIDE SUPPORT AND SERVICES FOR THE WORK OF THE COUNCIL.
  (F) THE COUNCIL MAY PROVIDE  TECHNICAL  INFORMATION  AND  GUIDANCE  TO
HEALTH  CARE  PRACTITIONERS AND HEALTH CARE FACILITIES ON THE LATEST AND
BEST PRACTICES AND STRATEGIES RELATED TO MITIGATING AND ELIMINATING  THE
SPREAD OF DISEASE, INFECTION AND BACTERIA DURING THE COURSE OF TREATMENT
OF PATIENTS AS IT RELATES TO THE USE OF HYGIENIC HEALTH CARE PRACTITION-
ER CLOTHING, ATTIRE AND A DRESS CODE.
  3.  POLICIES  TO  BE  CONSIDERED, EXAMINED AND POSSIBLY ADVANCED AFTER
EVIDENCE-BASED REVIEW BY THE COUNCIL. THE  COUNCIL  SHALL  CONSIDER  AND

S. 4909--B                          3

EXAMINE  THE  FOLLOWING POLICIES AND GUIDELINES IN THE ADOPTION OF RULES
AND REGULATIONS:
  (A)  THE PROVISION OF EDUCATION AND INSTRUCTION TO PATIENTS AND HEALTH
CARE PRACTITIONERS ON  HOW  ENHANCED  SANITARY  AND  HYGIENIC  POLICIES,
INCLUDING  THE USE OF HYGIENIC HEALTH CARE PRACTITIONER CLOTHING, ATTIRE
AND A DRESS CODE, CAN HELP TO REDUCE THE RISK OF CROSS-INFECTION;
  (B) ENCOURAGING HEALTH CARE FACILITIES TO PROVIDE ADEQUATE SUPPLIES OF
CLEAN SCRUBS, OTHER ARTICLES OF CLOTHING AND HEALTH CARE FACILITY  IDEN-
TIFICATION  TAGS TO HEALTH CARE PRACTITIONERS TO ENSURE FREQUENT CHANGES
THEREOF;
  (C) ENCOURAGING HEALTH CARE FACILITIES TO PROVIDE CHANGING ROOMS,  AND
INSTRUCTION  ON  HOW  TO APPROPRIATELY WASH CLOTHING WORN BY HEALTH CARE
PRACTITIONERS;
  (D) THE WEARING OF PATHOGEN-RESISTANT  SCRUBS  AND  COATS,  APRONS  OR
SLIPS MADE OF PLASTIC OR WICKING MATERIALS, AND DOUBLE GLOVES;
  (E)  THE  ADOPTION OF A PROHIBITION ON THE WEARING OUTSIDE OF A HEALTH
CARE FACILITY BY HEALTH  CARE  PRACTITIONERS  OF  CLOTHING  WORN  DURING
TREATMENT OF PATIENTS; AND
  (F)  CONSIDERATION  OF  ALTERATIONS  IN  MEDICAID  AND  PRIVATE  PAYOR
REIMBURSEMENT RATES AND PRACTICES TO ENCOURAGE MORE OPTIMUM SANITARY AND
HYGIENIC CONDITIONS IN HEALTH CARE FACILITIES.
  4. HEALTH CARE PRACTITIONER HYGIENIC RESOURCE CENTERS. THE COMMISSION-
ER, IN CONSULTATION WITH THE COUNCIL, MAY DESIGNATE A HEALTH CARE  PRAC-
TITIONER  HYGIENIC  RESOURCE CENTER OR CENTERS. SUCH RESOURCE CENTER MAY
BE STATEWIDE OR REGIONAL,  AND  SHALL  ACT  AS  A  SOURCE  OF  TECHNICAL
SUPPORT,  INFORMATION  AND  GUIDANCE  FOR  HEALTH CARE PRACTITIONERS AND
HEALTH CARE FACILITIES ON THE LATEST STRATEGIES AND BEST PRACTICES  WITH
REGARD  TO  ESTABLISHING SANITARY AND HYGIENIC CONDITIONS FOR THE TREAT-
MENT OF PATIENTS. THE DEPARTMENT, IN CONSULTATION WITH THE COUNCIL,  MAY
CONTRACT  WITH NOT-FOR-PROFIT ORGANIZATIONS OR ASSOCIATIONS TO ESTABLISH
AND MANAGE SUCH RESOURCE CENTERS. SUCH RESOURCE CENTERS MAY CHARGE A FEE
TO HELP OFFSET THE COST OF PROVIDING SUCH SERVICES.
  5. CONTINUING EDUCATION FOR HEALTH CARE PRACTITIONERS. THE COUNCIL, IN
CONSULTATION WITH THE DEPARTMENT, THE EDUCATION  DEPARTMENT  AND  HEALTH
CARE PRACTITIONER PROFESSIONAL ORGANIZATIONS, SHALL DEVELOP, COMPILE AND
PUBLISH  INFORMATION AND COURSE MATERIALS ON SANITARY AND HYGIENIC PRAC-
TICES THAT SHOULD BE FOLLOWED BY HEALTH CARE  PRACTITIONERS  AND  HEALTH
CARE  FACILITIES  TO  MITIGATE  AND  ELIMINATE  THE  SPREAD  OF DISEASE,
INFECTION AND BACTERIA TO PATIENTS, VISITORS AND THE GENERAL  PUBLIC  BY
MEANS  OF  THE CLOTHING, JEWELRY AND HEALTH CARE FACILITY IDENTIFICATION
TAGS WORN BY HEALTH CARE PRACTITIONERS AND  THE  CLEANING  PERSONNEL  OF
SUCH  FACILITIES. IN ADDITION, WITHIN TWO YEARS OF THE EFFECTIVE DATE OF
THIS TITLE, THE COUNCIL SHALL  MAKE  RECOMMENDATIONS  TO  THE  EDUCATION
DEPARTMENT  FOR  THE COURSE WORK, TRAINING AND CURRICULUM TO BE INCLUDED
IN THE CONTINUING  EDUCATION  ON  THE  BEST  PRACTICES,  STRATEGIES  AND
APPROACHES  RELATED TO MITIGATING AND ELIMINATING THE SPREAD OF DISEASE,
INFECTION AND BACTERIA TO PATIENTS, VISITORS AND THE GENERAL  PUBLIC  IN
HEALTH CARE FACILITIES BY MEANS OF THE CLOTHING, JEWELRY AND HEALTH CARE
FACILITY  IDENTIFICATION  TAGS WORN BY HEALTH CARE PRACTITIONERS AND THE
CLEANING PERSONNEL OF SUCH FACILITIES.
  6. REPORT. ON OR BEFORE MARCH FIRST OF EACH EVEN  NUMBERED  YEAR,  THE
COUNCIL SHALL SUBMIT TO THE GOVERNOR, THE COMMISSIONER, THE COMMISSIONER
OF  EDUCATION, THE TEMPORARY PRESIDENT OF THE SENATE, THE SPEAKER OF THE
ASSEMBLY, THE MINORITY LEADER OF THE SENATE, THE MINORITY LEADER OF  THE
ASSEMBLY, AND THE CHAIRS OF THE SENATE AND ASSEMBLY COMMITTEES ON HEALTH
A  REPORT ON ITS ACTIVITIES AND ACCOMPLISHMENTS PURSUANT TO THIS ARTICLE

S. 4909--B                          4

RELATING TO SANITARY AND HYGIENIC CONDITIONS IN HEALTH CARE  FACILITIES.
SUCH  REPORT  MAY  ALSO  INCLUDE  SUCH LEGISLATIVE PROPOSALS AS IT DEEMS
NECESSARY TO MORE EFFECTIVELY IMPLEMENT THE PROVISIONS OF THIS TITLE.
  S 2. Paragraphs b and c of subdivision 3 of section 6507 of the educa-
tion law, as added by chapter 987 of the laws of 1971, are amended and a
new paragraph d is added to read as follows:
  b.  Review  qualifications  in connection with licensing requirements;
[and]
  c. Provide for licensing examinations and reexaminations[.]; AND
  D. (I) ESTABLISH STANDARDS FOR CONTINUING EDUCATION  FOR  HEALTH  CARE
PRACTITIONERS  ON  THE BEST PRACTICES, STRATEGIES AND APPROACHES RELATED
TO MITIGATING AND ELIMINATING  THE  SPREAD  OF  DISEASE,  INFECTION  AND
BACTERIA  TO  PATIENTS,  VISITORS  AND THE GENERAL PUBLIC IN HEALTH CARE
FACILITIES BY MEANS OF THE CLOTHING, JEWELRY AND  HEALTH  CARE  FACILITY
IDENTIFICATION  TAGS  WORN BY HEALTH CARE PRACTITIONERS AND THE CLEANING
PERSONNEL OF SUCH FACILITIES.  IN PROMULGATION OF  SUCH  STANDARDS,  THE
DEPARTMENT  AND  THE  APPROPRIATE  BOARD  OF  EACH SUCH PROFESSION SHALL
CONSIDER AND, TO THE EXTENT PRACTICABLE, IMPLEMENT  THE  RECOMMENDATIONS
OF THE STATE HEALTH CARE PRACTITIONER HYGIENIC DRESS CODE COUNCIL.
  (II) FOR THE PURPOSES OF THIS PARAGRAPH:
  (A)  "HEALTH  CARE  FACILITY"  SHALL MEAN AND INCLUDE A HOSPITAL AND A
RESIDENTIAL HEALTH CARE FACILITY  AS  DEFINED  IN  SECTION  TWENTY-EIGHT
HUNDRED  ONE OF THE PUBLIC HEALTH LAW, AND ANY SETTING IN WHICH A HEALTH
CARE PRACTITIONER REGULARLY PRACTICES HIS OR HER PROFESSION.
  (B) "HEALTH CARE PRACTITIONER" SHALL MEAN ANY  PERSON  LICENSED  AS  A
PHYSICIAN  PURSUANT  TO  ARTICLE  ONE  HUNDRED THIRTY-ONE OF THIS TITLE,
PHYSICIAN ASSISTANT OR SPECIALIST  ASSISTANT  PURSUANT  TO  ARTICLE  ONE
HUNDRED  THIRTY-ONE-B  OF  THIS  TITLE,  NURSE  PURSUANT  TO ARTICLE ONE
HUNDRED THIRTY-NINE OF THIS TITLE, OR MIDWIFE PURSUANT  TO  ARTICLE  ONE
HUNDRED FORTY OF THIS TITLE.
  S  3.  Section  2343  of  the insurance law is amended by adding a new
subsection (f) to read as follows:
  (F) THE SUPERINTENDENT SHALL APPROVE AND IMPLEMENT PROGRAMS TO ENCOUR-
AGE HEALTH CARE PROVIDERS, HEALTH CARE FACILITIES AND  MEDICAL  MALPRAC-
TICE INSURERS TO PARTICIPATE IN HEALTH CARE PROVIDER HYGIENIC DRESS CODE
PROGRAMS.  SUCH  PROGRAMS MAY INCLUDE, BUT SHALL BE LIMITED TO, ENHANCED
COVERAGE LEVELS, REDUCTIONS IN DEDUCTIBLE LEVELS OR  ACTUARIALLY  APPRO-
PRIATE  PREMIUM  REDUCTION  FOR INSURED HEALTH CARE PROVIDERS AND HEALTH
CARE FACILITIES WHICH HAVE IMPLEMENTED A SUCCESSFUL HEALTH CARE  PRACTI-
TIONER  DRESS  CODE PROGRAM, PURSUANT TO TITLE SIX OF ARTICLE TWO OF THE
PUBLIC HEALTH LAW, WHICH IS APPROVED BY THE COMMISSIONER OF HEALTH.
  S 4. Section 3436 of the insurance law, as added by chapter 266 of the
laws of 1986, is amended by adding a  new  subsection  (f)  to  read  as
follows:
  (F)  AN  INSURER  WHICH  ISSUES POLICIES FOR PRIMARY LEVELS OF MEDICAL
MALPRACTICE INSURANCE  SHALL  UPON  THE  ISSUANCE  OR  RENEWAL  THEREOF,
PROVIDE  FOR  PROGRAMS  TO  ENCOURAGE HEALTH CARE PROVIDERS, HEALTH CARE
FACILITIES AND MEDICAL MALPRACTICE INSURERS  TO  PARTICIPATE  IN  HEALTH
CARE  PROVIDER  HYGIENIC DRESS CODE PROGRAMS. SUCH PROGRAMS MAY INCLUDE,
BUT SHALL BE LIMITED TO, ENHANCED COVERAGE LEVELS, REDUCTIONS IN DEDUCT-
IBLE LEVELS OR ACTUARIALLY APPROPRIATE  PREMIUM  REDUCTION  FOR  INSURED
HEALTH  CARE PROVIDERS AND HEALTH CARE FACILITIES WHICH HAVE IMPLEMENTED
A SUCCESSFUL HEALTH CARE PRACTITIONER DRESS CODE  PROGRAM,  PURSUANT  TO
TITLE  SIX OF ARTICLE TWO OF THE PUBLIC HEALTH LAW, WHICH IS APPROVED BY
THE COMMISSIONER OF HEALTH.

S. 4909--B                          5

  S 5. Section 5505 of the insurance law is  amended  by  adding  a  new
subsection (e) to read as follows:
  (E)  THE  ASSOCIATION'S RATES, RATING PLANS AND RATING CLASSIFICATIONS
SHALL PROVIDE FOR PROGRAMS TO ENCOURAGE HEALTH  CARE  PROVIDERS,  HEALTH
CARE  FACILITIES  AND  MEDICAL  MALPRACTICE  INSURERS  TO PARTICIPATE IN
HEALTH CARE PROVIDER HYGIENIC DRESS CODE  PROGRAMS.  SUCH  PROGRAMS  MAY
INCLUDE,  BUT  SHALL BE LIMITED TO, ENHANCED COVERAGE LEVELS, REDUCTIONS
IN DEDUCTIBLE LEVELS OR ACTUARIALLY APPROPRIATE  PREMIUM  DISCOUNTS  FOR
HEALTH  CARE PROVIDERS AND HEALTH CARE FACILITIES WHICH HAVE IMPLEMENTED
A SUCCESSFUL HEALTH CARE PRACTITIONER DRESS CODE  PROGRAM,  PURSUANT  TO
TITLE  SIX OF ARTICLE TWO OF THE PUBLIC HEALTH LAW, WHICH IS APPROVED BY
THE COMMISSIONER OF HEALTH.
  S 6. This act shall take effect on the first of January next  succeed-
ing the date on which it shall have become a law and section one of this
act shall expire and be deemed repealed January 1, 2021.

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