Senate Bill S2374A

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

                                 2374--A

                       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 -- recommitted
  to the Committee on Agriculture 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, 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  (Part
  A);  to  amend the public health law, in relation to in-utero exposure
  to tobacco smoke prevention (Part B); to amend the public health  law,
  in  relation  to  including  certain  respiratory diseases and obesity
  within disease management demonstration programs (Part  C);  to  amend
  the  public  health  law,  in  relation to the reduction of emphysema,
  chronic bronchitis and other chronic respiratory diseases in  children
  (Part  D);  to  amend  the  public  health  law,  in  relation  to the
  collection and reporting of obesity data (Part E); 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 F); to amend the public health law, in
  relation to breastfeeding of  infants  and  the  adolescent  pregnancy
  nutrition  counseling program (Part G); to amend the education law, in
  relation to the use of inhalers and nebulizers (Part H); to amend  the
  real  property law, in relation to residential rental property smoking
  policies (Part I); to amend the state  finance  law,  in  relation  to
  establishing  the  obesity and respiratory disease research and educa-
  tion fund (Part J); to amend the social services law, in  relation  to
  child  day  care  facilities  (Part K); to amend the education law, in
  relation to use of school facilities by not-for-profit and  charitable
  organizations  for after-school programs (Part L); to amend the educa-
  tion law, in relation to screening for childhood obesity and promotion
  of the availability of certain foods and beverages  in  schools  (Part
  M);  to  amend the education law, in relation to restricting the sale,
  lease, transfer or authorization of open-air  schoolhouse  playgrounds

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

                                                           LBD06771-05-4

S. 2374--A                          2

  for  certain uses (Part N); to amend the education law, in relation to
  instruction in good health and reducing the incidence of obesity (Part
  O); to amend the public buildings law, in relation to  bicycle  access
  to  public  office  buildings  (Part  P); to amend the agriculture and
  markets law and the education law, in relation to  authorizing  school
  districts  and  institutions of higher education to donate excess food
  to local voluntary food assistance programs (Part Q); and to amend the
  insurance law and the public health law, in relation to making actuar-
  ially appropriate reductions in health insurance  premiums  in  return
  for  an  enrollee's or insured's participation in a qualified wellness
  program (Part R)

  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  R.  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.  Subdivision  1 of section 206 of the public health law is
amended by adding two new paragraphs (u) and (v) to read as follows:
  (U) (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 ESTABLISH A VOLUNTARY ARTIFICIAL TRANS FAT
REDUCTION PROGRAM. SUCH PROGRAM MAY CONSIST OF, BUT SHALL NOT BE LIMITED

S. 2374--A                          3

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.
  (V)  (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" MAY INCLUDE THE FOLLOWING, PER  STANDARD
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. 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 B

  Section 1. The public health law is amended by adding  a  new  article
13-I to read as follows:
                              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 IS ENCOURAGED TO 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 DEVELOPMENTAL 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. 2374--A                          4

  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 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 C

  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-
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

S. 2374--A                          5

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 D

  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
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-

S. 2374--A                          6

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.

                                 PART E

  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;

S. 2374--A                          7

  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 F

  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
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

S. 2374--A                          8

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
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

S. 2374--A                          9

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 G

  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
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

S. 2374--A                         10

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.
  *  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.

S. 2374--A                         11

  * 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
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:

S. 2374--A                         12

  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 H

  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
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-

S. 2374--A                         13

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 I

  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
TWENTY  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 J

  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".
  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.

S. 2374--A                         14

  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 K

  Section  1.    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
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 2. 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  3. 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.

                                 PART L

  Section 1. Subdivision 1 of  section  414  of  the  education  law  is
amended by adding a new paragraph (l) to read as follows:
  (L)  FOR  BONA FIDE AFTER-SCHOOL PROGRAMS OPERATED BY A NOT-FOR-PROFIT
OR CHARITABLE ORGANIZATION. SUCH PROGRAMS SHALL  PRESENT  SOME  FORM  OF
EDUCATIONAL INSTRUCTION OR ACADEMIC MATERIAL, OR PROMOTE PHYSICAL EDUCA-
TION.
  S  2. Subdivision 2 of section 414 of the education law, as amended by
chapter 513 of the laws of 2005, is amended to read as follows:
  2. The trustees or board of education shall determine  the  terms  and
conditions  for  such use which may include rental at least in an amount
sufficient to cover all resulting expenses for  the  purposes  of  para-

S. 2374--A                         15

graphs (a), (b), (c), (d), (e), (g), (i), (j) and (k) of subdivision one
of this section. FOR THE PURPOSES OF PARAGRAPH (1) OF SUBDIVISION ONE OF
THIS SECTION, THE TRUSTEES OR BOARD OF EDUCATION MAY PROVIDE THAT EITHER
NO FEE OR A MINIMAL FEE BE IMPOSED UPON THE NOT-FOR-PROFIT OR CHARITABLE
ORGANIZATION. Any such use, pursuant to [paragraphs] PARAGRAPH (a), (c),
(d), (h) [and], (j) OR (L) of subdivision one of this section, shall not
allow  the  exclusion of any district child solely because said child is
not attending a district school or not  attending  the  district  school
which is sponsoring such use or on which grounds the use is to occur.
  S 3. Subdivision 27 of section 2590-h of the education law, as amended
by chapter 345 of the laws of 2009, is amended to read as follows:
  27.  Promulgate regulations, in conjunction with each community super-
intendent, establishing a plan for providing access to school facilities
in each community school district, when not in use for school  purposes,
in  accordance  with  the provisions of section four hundred fourteen of
this chapter. Such plan shall set forth a reasonable system of fees  not
to  exceed  the  actual  costs and specify that no part of any fee shall
directly or indirectly benefit or be deposited  into  an  account  which
inures  to  the  benefit  of  the  custodians  or  custodial  engineers.
NOTWITHSTANDING ANY OTHER PROVISION OF LAW, RULE OR  REGULATION  TO  THE
CONTRARY,  SUCH  PLAN    MAY PROVIDE THAT EITHER NO FEE OR A MINIMAL FEE
SHALL BE CHARGED FOR THE USE OF SCHOOL FACILITIES BY A NOT-FOR-PROFIT OR
CHARITABLE ORGANIZATION. THE USE OF SUCH FACILITIES SHALL  ONLY  BE  FOR
BONA  FIDE  AFTER-SCHOOL  PROGRAMS THAT PRESENT SOME FORM OF EDUCATIONAL
INSTRUCTION OR ACADEMIC MATERIAL, OR PROMOTE PHYSICAL EDUCATION.
  S 4. Subdivision 27 of section 2590-h of the education law, as amended
by chapter 720 of the laws of 1996, is amended to read as follows:
  27. Develop, in conjunction with each community superintendent, a plan
for providing access to  school  facilities  in  each  community  school
district,  when  not  in use for school purposes, in accordance with the
provisions of section four hundred fourteen of this chapter.  Such  plan
shall  set  forth  a  reasonable system of fees not to exceed the actual
costs and specify that no part of any fee shall directly  or  indirectly
benefit  or  be deposited into an account which inures to the benefit of
the custodians  or  custodial  engineers.    NOTWITHSTANDING  ANY  OTHER
PROVISION  OF  LAW,  RULE  OR  REGULATION TO THE CONTRARY, SUCH PLAN MAY
PROVIDE THAT EITHER NO FEE OR A MINIMAL FEE SHALL BE CHARGED FOR THE USE
OF SCHOOL FACILITIES BY A NOT-FOR-PROFIT OR CHARITABLE ORGANIZATION. THE
USE OF SUCH FACILITIES SHALL ONLY BE FOR BONA FIDE AFTER-SCHOOL PROGRAMS
THAT PRESENT SOME FORM OF EDUCATIONAL INSTRUCTION OR ACADEMIC  MATERIAL,
OR PROMOTE PHYSICAL EDUCATION.
  S 5. This act shall take effect on the one hundred eightieth day after
it  shall have become a law; provided that the amendments to subdivision
27 of section 2590-h of the education law, made by section three of this
act, shall be subject to the expiration and reversion of  such  section,
pursuant  to  subdivision 12 of section 17 of chapter 345 of the laws of
2009, as amended, when upon such date the provisions of section four  of
this act shall take effect.

                                 PART M

  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

S. 2374--A                         16

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
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

S. 2374--A                         17

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.
  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

S. 2374--A                         18

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
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

S. 2374--A                         19

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
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 N

  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

S. 2374--A                         20

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, 2015; 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 O

  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.
  (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, OR 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.

S. 2374--A                         21

  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, OR 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 P

  Section 1. Section 11 of the public buildings law, as added by chapter
819 of the laws of 1987 and subdivision 2 as amended by chapter  126  of
the laws of 1988, is amended to read as follows:
  S 11. Pilot  program  of  bicycle parking facilities.   1. Legislative
finding. In recognition of the role which bicycles can serve as a  valu-
able  transportation  mode  with  energy  conservation, health, PHYSICAL
FITNESS and environmental benefits, it is  hereby  declared  to  be  the
policy of the state that provision for adequate and safe bicycle facili-
ties including the use of present facilities for safe and secure bicycle
parking  AND  STORAGE  be  included  in the planning [and], development,
CONSTRUCTION OR RECONSTRUCTION of all state facilities.
  2. (a) The commissioner of general services shall undertake a  [pilot]
program for THE provision and promotion of safe and secure bicycle park-
ing  facilities  at state office buildings FOR STATE EMPLOYEES AND VISI-
TORS AT SUCH BUILDINGS. The commissioner[, within one year of the enact-
ment of this  section,]  OF  GENERAL  SERVICES  shall  provide,  at  the
principal  office  buildings  under  his  OR  HER superintendence at the
Nelson A. Rockefeller Empire State Plaza in Albany[, New  York],  secure
bicycle parking facilities for use by employees and visitors.  PROVIDED,
FURTHER,  THAT THE COMMISSIONER OF GENERAL SERVICES SHALL MAKE AN INVEN-
TORY OF ALL EXISTING BICYCLE PARKING AND STORAGE FACILITIES AT ALL STATE
OFFICE BUILDINGS AND OFFICE BUILDINGS IN WHICH THE STATE LEASES OR OCCU-
PIES SPACE. SUCH INVENTORY SHALL BE MADE ONLY OF STATE OWNED  OR  LEASED
BUILDINGS  OR  OFFICES  WHICH HAVE OVER FIFTY STATE EMPLOYEES LOCATED AT

S. 2374--A                         22

SUCH SITE OR IN WHICH THE VISITATION RATE BY THE GENERAL PUBLIC IS  OVER
FIVE HUNDRED VISITORS, ON AVERAGE, EACH MONTH. SUCH INVENTORY OF BICYCLE
PARKING  AND  STORAGE  FACILITIES SHALL BE COMPLETED WITHIN TWO YEARS OF
THE  EFFECTIVE  DATE OF THE CHAPTER OF THE LAWS OF TWO THOUSAND FOURTEEN
WHICH AMENDED THIS SECTION.
  (b) The commissioner OF GENERAL SERVICES is also authorized, within  a
reasonable period and where feasible, to provide suitable support facil-
ities  including  clothing lockers, showers and changing facilities, and
to charge a reasonable use fee.
  (c) For the purpose of this section, the term "bicycle parking facili-
ty" means a device or enclosure, located within a building or  installa-
tion,  or  conveniently  adjacent  thereto,  that  is easily accessible,
clearly visible and so located as to minimize the  danger  of  theft  of
bicycles.  Such  a  device  shall  consist of a parking rack, locker, or
other device constructed to enable the frame and both wheels of a  bicy-
cle  to  be  secured with ease by use of a padlock in a manner that will
minimize the risk of theft, or an enclosure which limits access  to  the
bicycles and is under observation by an attendant.
  3.  UPON  COMPLETION  OF  A  STATE OFFICE BUILDING BICYCLE PARKING AND
STORAGE FACILITIES INVENTORY PROVIDED FOR IN PARAGRAPH (A)  OF  SUBDIVI-
SION  TWO  OF  THIS  SECTION, THE COMMISSIONER OF GENERAL SERVICES SHALL
DEVELOP A PLAN TO EXPAND  BICYCLE  PARKING  AND  STORAGE  FACILITIES  TO
ENCOURAGE  THE USE OF SUCH FACILITIES BY STATE EMPLOYEES AND THE GENERAL
PUBLIC THAT PATRONIZE SUCH FACILITIES TO CONDUCT PUBLIC  BUSINESS.  SUCH
PLAN SHALL BE COMPLETED WITHIN EIGHTEEN MONTHS AFTER FINALIZATION OF THE
PARKING  AND  STORAGE  FACILITIES INVENTORY. SUCH PLAN SHALL CONTAIN AND
ADDRESS THE FOLLOWING ELEMENTS TO  ENCOURAGE  STATE  EMPLOYEES  AND  THE
GENERAL  PUBLIC  TO  USE  BICYCLES  MORE FREQUENTLY AT EACH STATE OFFICE
BUILDING FACILITY OR LEASED PREMISE:
  (A) THE INVENTORY OF BICYCLE PARKING AND STORAGE FACILITIES  SHALL  BE
RANKED  FROM  HIGHEST TO LOWEST BASED ON THE EXISTING UNFULFILLED DEMAND
FOR SUCH FACILITIES AT STATE OFFICE BUILDINGS. SUCH RANKING  SHALL  ALSO
CONSIDER  INCREASED  FUTURE DEMAND OR THE POTENTIAL FOR INCREASED FUTURE
DEMAND OF SUCH PARKING AND STORAGE FACILITIES;
  (B) IN URBAN SETTINGS, THERE SHALL BE  A  PLAN  TO  DEVELOP  AN  AMPLE
SUPPLY  OF  SECURE  COVERED AND UNCOVERED OFF-STREET BICYCLE PARKING AND
STORAGE OR ALTERNATE INDOOR PARKING OR STORAGE FOR SUCH BICYCLES;
  (C) ADEQUATE POSTING OF SUCH BICYCLE PARKING  AND  STORAGE  FACILITIES
SHALL  BE  PROVIDED  FOR  AND  PLACED  AROUND SUCH STATE OFFICE BUILDING
FACILITY TO ENCOURAGE UTILIZATION OF SUCH PARKING AND STORAGE FACILITIES
BY STATE EMPLOYEES AND THE GENERAL PUBLIC;
  (D) A MARKETING PLAN AND COMMUNITY OUTREACH EFFORT SHALL  PROVIDE  FOR
THE  DISSEMINATION  OF INFORMATION TO STATE EMPLOYEES, VISITORS TO STATE
OFFICE BUILDINGS, AND TO THE GENERAL PUBLIC TO ENCOURAGE INDIVIDUALS  TO
USE BICYCLES WHEN TRAVELING TO SUCH BUILDINGS OR FACILITIES; AND
  (E) THE COMMISSIONER OF GENERAL SERVICES SHALL INCLUDE AND ADDRESS ANY
OTHER ELEMENT IN THE PLAN AS HE OR SHE DEEMS APPROPRIATE.
  4. In undertaking such [pilot] program, the office OF GENERAL SERVICES
shall:    (a) Consult with and cooperate with (i) [the statewide bicycle
advisory council, (ii)] the [New York state] department  of  transporta-
tion  regional bicycle coordinator[, (iii)]; (II) local bicycle planning
groups[,]; and [(iv)] (III) persons, organizations,  and  groups  served
by, interested in, or concerned with the area under study.
  (b)  Request and receive from any department, division, board, bureau,
commission or other agency of the state  or  any  political  subdivision
thereof  or  any  public  authority,  any  assistance and data as may be

S. 2374--A                         23

necessary to enable the office OF GENERAL  SERVICES  to  carry  out  its
responsibilities under this section.
  [(c)  On  or before the first day of January, nineteen hundred eighty-
nine, a report shall be submitted to the governor  and  the  legislature
which shall include a determination of usage levels, a statement outlin-
ing  first  year  progress  and the elements of a statewide plan for the
provision of such facilities.]
  5. NOTHING IN THIS SECTION SHALL BE CONSTRUED TO REQUIRE THE STATE  OR
THE OWNER, LESSEE, MANAGER OR OTHER PERSON WHO IS IN CONTROL OF A BUILD-
ING  GOVERNED  BY  THIS  SECTION TO PROVIDE SPACE FOR STORED BICYCLES AT
SUCH BUILDING OR BROUGHT INTO SUCH BUILDING OR TO PERMIT A BICYCLE TO BE
PARKED IN A MANNER THAT VIOLATES BUILDING OR FIRE  CODES  OR  ANY  OTHER
APPLICABLE  LAW,  RULE  OR  CODE,  OR WHICH OTHERWISE IMPEDES INGRESS OR
EGRESS TO SUCH BUILDING.
  6. THERE IS HEREBY ESTABLISHED  A  TEMPORARY  BICYCLE  COMMUTING  TASK
FORCE  TO EXAMINE THE DEVELOPMENT OF SHELTERED BICYCLE PARKING IN PUBLIC
SPACES.
  (A) SUCH TASK FORCE SHALL BE COMPRISED OF NINE MEMBERS, INCLUDING  THE
COMMISSIONER  OF  GENERAL  SERVICES, THE COMMISSIONER OF TRANSPORTATION,
THE COMMISSIONER OF MOTOR VEHICLES, THE COMMISSIONER OF BUILDINGS OF THE
CITY OF NEW YORK AND THE COMMISSIONER  OF  PARKS  AND  RECREATION  OR  A
DESIGNEE  OF  ANY  SUCH  COMMISSIONERS. THE REMAINING FOUR MEMBERS SHALL
CONSIST OF A GROUP OF MUNICIPAL PLANNERS, BICYCLE ASSOCIATION  REPRESEN-
TATIVES, BUILDING CONTRACTORS AND ENGINEERS.  THEY SHALL BE APPOINTED AS
FOLLOWS: ONE MEMBER SHALL BE APPOINTED BY THE TEMPORARY PRESIDENT OF THE
SENATE;  ONE  MEMBER  SHALL  BE  APPOINTED BY THE MINORITY LEADER OF THE
SENATE; ONE MEMBER SHALL BE APPOINTED BY THE SPEAKER  OF  THE  ASSEMBLY;
AND  ONE  MEMBER SHALL BE APPOINTED BY THE MINORITY LEADER OF THE ASSEM-
BLY.
  (B) THE CHAIR OF THE TEMPORARY BICYCLE COMMUTING TASK FORCE  SHALL  BE
THE  COMMISSIONER  OF GENERAL SERVICES. MEMBERS OF THE TEMPORARY BICYCLE
COMMUTING TASK FORCE SHALL SERVE WITHOUT  COMPENSATION  AND  SHALL  MEET
WHEN DEEMED NECESSARY BY THE CHAIR.
  (C)  WITHIN  EIGHTEEN  MONTHS  OF THE TEMPORARY BICYCLE COMMUTING TASK
FORCE'S ESTABLISHMENT, SUCH TASK FORCE  SHALL  ISSUE  A  REPORT  TO  THE
GOVERNOR  AND  THE  LEGISLATURE.  SUCH  REPORT SHALL INCLUDE, BUT NOT BE
LIMITED TO (I) AN ASSESSMENT OF THE DEMAND FOR SHELTERED BICYCLE PARKING
IN PUBLIC SPACES; (II) AN EXAMINATION OF  THE  MARKETING  AND  COMMUNITY
OUTREACH  EFFORTS  NEEDED TO ENCOURAGE THE USE OF BICYCLES; (III) RECOM-
MENDATIONS ON ESTABLISHING PARTNERSHIPS WITH ENTITIES TO  DEVELOP  SHEL-
TERED  BICYCLE STORAGE AND PARKING FACILITIES IN PUBLIC SPACES; AND (IV)
SUGGESTIONS ON EXPANDING THE OFFICE OF GENERAL SERVICES TO LOCAL MUNICI-
PAL AND PRIVATE OFFICE BUILDINGS. SUCH REPORT SHALL  BE  POSTED  ON  THE
WEBSITE OF EACH STATE AGENCY THAT WAS A MEMBER OF SUCH TASK FORCE WITHIN
TWENTY  DAYS  FROM ITS SUBMISSION TO THE GOVERNOR. THE TEMPORARY BICYCLE
COMMUTING TASK FORCE SHALL CEASE TO EXIST THREE MONTHS AFTER  THE  ISSU-
ANCE OF ITS REPORT.
  S 2. This act shall take effect on the one hundred eightieth day after
it shall have become a law.

                                 PART Q

  Section 1. Section 16 of the agriculture and markets law is amended by
adding a new subdivision 5-c to read as follows:
  5-C.  COOPERATE WITH THE COMMISSIONER OF EDUCATION, PURSUANT TO SUBDI-
VISION THIRTY-TWO OF SECTION THREE HUNDRED FIVE OF THE EDUCATION LAW, TO

S. 2374--A                         24

DEVELOP GUIDELINES FOR THE VOLUNTARY IMPLEMENTATION BY SCHOOL  DISTRICTS
AND INSTITUTIONS OF HIGHER EDUCATION, AS DEFINED IN SUBDIVISION EIGHT OF
SECTION  TWO  OF  THE  EDUCATION  LAW,  OF  PROGRAMS WHICH ENCOURAGE THE
DONATION OF EXCESS, UNUSED, EDIBLE FOOD FROM MEALS SERVED AT SUCH EDUCA-
TIONAL FACILITIES TO LOCAL VOLUNTARY FOOD ASSISTANCE PROGRAMS.
  S  2.  Section  305  of  the  education law is amended by adding a new
subdivision 32 to read as follows:
  32. THE COMMISSIONER, IN CONSULTATION AND COOPERATION WITH THE COMMIS-
SIONER OF AGRICULTURE AND MARKETS, SHALL DEVELOP VOLUNTARY GUIDELINES TO
ENCOURAGE AND FACILITATE THE ABILITY  OF  SCHOOL  DISTRICTS  AND  INSTI-
TUTIONS  OF  HIGHER EDUCATION TO DONATE EXCESS, UNUSED, EDIBLE FOOD FROM
MEALS SERVED AT SUCH EDUCATIONAL  FACILITIES  TO  LOCAL  VOLUNTARY  FOOD
ASSISTANCE  PROGRAMS  INCLUDING,  BUT  NOT  LIMITED  TO,  COMMUNITY FOOD
PANTRIES, SOUP KITCHENS, AND OTHER COMMUNITY AND  NOT-FOR-PROFIT  ORGAN-
IZATIONS THAT DISTRIBUTE FOOD TO THE POOR AND DISADVANTAGED.
  SUCH GUIDELINES MAY INCLUDE, BUT NEED NOT BE LIMITED TO:
  A.  A  METHODOLOGY  TO PROVIDE INFORMATION TO EDUCATIONAL INSTITUTIONS
AND LOCAL VOLUNTARY FOOD ASSISTANCE PROGRAMS OF THE PROVISIONS  OF  SUCH
GUIDELINES;
  B.  A  MEANS  BY  WHICH EDUCATIONAL INSTITUTIONS ARE PROVIDED WITH THE
NAMES AND ADDRESSES  OF  ALL  NEARBY  LOCAL  VOLUNTARY  FOOD  ASSISTANCE
PROGRAMS;
  C.  A  MEANS  BY  WHICH  LOCAL  VOLUNTARY FOOD ASSISTANCE PROGRAMS ARE
PROVIDED WITH THE NAMES AND ADDRESSES OF NEARBY EDUCATIONAL INSTITUTIONS
WHICH SERVE MEALS UPON THEIR PREMISES;
  D. NOTIFICATION TO EDUCATIONAL INSTITUTIONS OF THEIR ABILITY TO  ELECT
TO DONATE EXCESS, UNUSED, EDIBLE FOOD TO LOCAL VOLUNTARY FOOD ASSISTANCE
PROGRAMS; AND
  E. THE PROVISION OF INFORMATION AND TECHNICAL ASSISTANCE ON THE MANNER
OF HOW TO BEST DONATE EXCESS FOOD IN A SAFE AND SANITARY MANNER.
  THE  COMMISSIONER  SHALL  COORDINATE THE IMPLEMENTATION OF SUCH GUIDE-
LINES WITH THE FARM-TO-SCHOOL PROGRAM AND THE NEW YORK HARVEST  FOR  NEW
YORK  KIDS  WEEK  PROGRAM  ESTABLISHED PURSUANT TO SUBDIVISION FIVE-B OF
SECTION SIXTEEN OF THE AGRICULTURE AND MARKETS LAW.
  S 3. This act shall take effect on the one hundred eightieth day after
it shall have become a law.

                                 PART R

  Section 1. Section 3231 of the insurance law, as added by chapter  501
of the laws of 1992, is amended by adding a new subsection (c-1) to read
as follows:
  (C-1)  SUBJECT  TO  THE  APPROVAL OF THE SUPERINTENDENT, AN INSURER OR
HEALTH MAINTENANCE ORGANIZATION ISSUING AN INDIVIDUAL  OR  GROUP  HEALTH
INSURANCE POLICY PURSUANT TO THIS SECTION MAY PROVIDE FOR AN ACTUARIALLY
APPROPRIATE REDUCTION IN PREMIUM RATES OR OTHER BENEFITS OR ENHANCEMENTS
APPROVED  BY  THE SUPERINTENDENT TO ENCOURAGE AN ENROLLEE'S OR INSURED'S
ACTIVE PARTICIPATION IN A QUALIFIED WELLNESS PROGRAM. A QUALIFIED  WELL-
NESS  PROGRAM  CAN  BE  A RISK MANAGEMENT SYSTEM THAT IDENTIFIES AT-RISK
POPULATIONS OR ANY OTHER SYSTEMATIC PROGRAM OR COURSE OF MEDICAL CONDUCT
WHICH HELPS TO PROMOTE PHYSICAL AND MENTAL FITNESS, HEALTH AND  WELL-BE-
ING,  HELPS  TO  PREVENT  OR MITIGATE THE CONDITIONS OF ACUTE OR CHRONIC
SICKNESS, DISEASE OR PAIN, OR  WHICH  MINIMIZES  ADVERSE  HEALTH  CONSE-
QUENCES  DUE TO LIFESTYLE.  SUCH A WELLNESS PROGRAM MAY HAVE SOME OR ALL
OF THE FOLLOWING ELEMENTS TO ADVANCE  THE  PHYSICAL  HEALTH  AND  MENTAL
WELL-BEING OF ITS PARTICIPANTS:

S. 2374--A                         25

  (1)  AN  EDUCATION  PROGRAM  TO  INCREASE THE AWARENESS OF AND DISSEM-
INATION OF INFORMATION ABOUT PURSUING HEALTHIER  LIFESTYLES,  AND  WHICH
WARNS  ABOUT  RISKS  OF  PURSUING ENVIRONMENTAL OR BEHAVIORAL ACTIVITIES
THAT ARE DETRIMENTAL TO HUMAN HEALTH. IN ADDITION,  INFORMATION  ON  THE
AVAILABILITY  OF HEALTH SCREENING TESTS TO ASSIST IN THE EARLY IDENTIFI-
CATION AND TREATMENT OF DISEASES SUCH AS CANCER, HEART  DISEASE,  HYPER-
TENSION, DIABETES, ASTHMA, OBESITY OR OTHER ADVERSE HEALTH AFFLICTIONS;
  (2) A PROGRAM THAT ENCOURAGES BEHAVIORAL PRACTICES THAT EITHER ENCOUR-
AGES  HEALTHY  LIVING  ACTIVITIES OR DISCOURAGES UNHEALTHY LIVING ACTIV-
ITIES. SUCH ACTIVITIES OR PRACTICES MAY INCLUDE  WELLNESS  PROGRAMS,  AS
PROVIDED  UNDER  SECTION  THREE THOUSAND TWO HUNDRED THIRTY-NINE OF THIS
ARTICLE; AND
  (3) THE MONITORING OF THE PROGRESS OF EACH COVERED PERSON TO TRACK HIS
OR HER ADHERENCE TO SUCH WELLNESS PROGRAM AND TO PROVIDE ASSISTANCE  AND
MORAL  SUPPORT TO SUCH COVERED PERSON TO ASSIST HIM OR HER TO ATTAIN THE
GOALS OF THE COVERED PERSON'S WELLNESS PROGRAM.
  SUCH WELLNESS PROGRAM SHALL DEMONSTRATE ACTUARIALLY THAT IT ENCOURAGES
THE GENERAL GOOD HEALTH AND WELL-BEING OF THE  COVERED  POPULATION.  THE
INSURER  OR  HEALTH  MAINTENANCE ORGANIZATION SHALL NOT REQUIRE SPECIFIC
OUTCOMES AS A RESULT OF AN ENROLLEE'S  OR  INSURED'S  ADHERENCE  TO  THE
APPROVED WELLNESS PROGRAM.
  S  2. Subsections (b) and (c) of section 3239 of the insurance law, as
added by chapter 592 of  the  laws  of  2008,  paragraphs  6  and  7  of
subsection  (b)  and  subparagraphs  (C)  and  (D)  of  paragraph  2  of
subsection (c) as amended, and paragraph 8 of subsection (b) and subpar-
agraphs (E) and (F) of paragraph 2 of subsection (c) as added by chapter
519 of the laws of 2013, are amended to read as follows:
  (b) A wellness program may include, but is not limited to, the follow-
ing programs or services:
  (1) the use of a health risk assessment tool;
  (2) a smoking cessation program;
  (3) a weight management program;
  (4) a stress AND/OR HYPERTENSION management program;
  (5) a worker injury prevention program;
  (6) a nutrition education program;
  (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[.];
  (9) A SUBSTANCE OR ALCOHOL ABUSE CESSATION PROGRAM; AND
  (10) A PROGRAM TO MANAGE AND COPE WITH CHRONIC PAIN.
  (c)(1) A wellness program may use rewards and incentives  for  partic-
ipation  provided  that  where  the  group  health  insurance  policy or
subscriber contract is required to be community-rated, the  rewards  and
incentives  shall  not  include a discounted premium rate or a rebate or
refund of premium, EXCEPT AS PROVIDED  IN  SECTION  THREE  THOUSAND  TWO
HUNDRED THIRTY-ONE OF THIS ARTICLE, OR SECTION FOUR THOUSAND TWO HUNDRED
THIRTY-FIVE,  FOUR  THOUSAND  THREE  HUNDRED  SEVENTEEN OR FOUR THOUSAND
THREE HUNDRED TWENTY-SIX OF THIS CHAPTER, OR SECTION FORTY-FOUR  HUNDRED
FIVE OF THE PUBLIC HEALTH LAW.
  (2) Permissible rewards and incentives MAY include:
  (A)  full  or  partial  reimbursement  of the cost of participating in
smoking cessation [or], weight management, STRESS  AND/OR  HYPERTENSION,
WORKER  INJURY  PREVENTION,  NUTRITION  EDUCATION,  SUBSTANCE OR ALCOHOL
ABUSE CESSATION, OR CHRONIC PAIN MANAGEMENT AND COPING programs;

S. 2374--A                         26

  (B) full or partial reimbursement of  the  cost  of  membership  in  a
health club or fitness center;
  (C) the waiver or reduction of copayments, coinsurance and deductibles
for  preventive  services  covered  under the group policy or subscriber
contract;
  (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.
  (3)  Where  the  reward  involves a group member's meeting a specified
standard based on a health condition, the wellness program must meet the
requirements of 45 CFR Part 146.
  (4) A reward or incentive which involves a discounted premium rate  or
a  rebate or refund of premium shall be based on actuarial demonstration
that the wellness program can reasonably be expected to  result  in  the
overall  good  health and well being of the group AS PROVIDED IN SECTION
THREE THOUSAND TWO HUNDRED THIRTY-ONE OF  THIS  ARTICLE,  SECTIONS  FOUR
THOUSAND  TWO HUNDRED THIRTY-FIVE, FOUR THOUSAND THREE HUNDRED SEVENTEEN
AND FOUR THOUSAND THREE HUNDRED TWENTY-SIX OF THIS CHAPTER, AND  SECTION
FORTY-FOUR HUNDRED FIVE OF THE PUBLIC HEALTH LAW.
  S 3. Subsection (h) of section 4235 of the insurance law is amended by
adding a new paragraph 5 to read as follows:
  (5)  EACH  INSURER  DOING BUSINESS IN THIS STATE, WHEN FILING WITH THE
SUPERINTENDENT ITS SCHEDULES OF PREMIUM RATES, RULES AND  CLASSIFICATION
OF  RISKS  FOR  USE  IN  CONNECTION WITH THE ISSUANCE OF ITS POLICIES OF
GROUP ACCIDENT, GROUP HEALTH OR GROUP ACCIDENT AND HEALTH INSURANCE, MAY
PROVIDE FOR AN ACTUARIALLY APPROPRIATE REDUCTION  IN  PREMIUM  RATES  OR
OTHER BENEFITS OR ENHANCEMENTS APPROVED BY THE SUPERINTENDENT TO ENCOUR-
AGE AN ENROLLEE'S OR INSURED'S ACTIVE PARTICIPATION IN A QUALIFIED WELL-
NESS  PROGRAM.  A  QUALIFIED  WELLNESS  PROGRAM CAN BE A RISK MANAGEMENT
SYSTEM THAT IDENTIFIES  AT-RISK  POPULATIONS  OR  ANY  OTHER  SYSTEMATIC
PROGRAM OR COURSE OF MEDICAL CONDUCT WHICH HELPS TO PROMOTE PHYSICAL AND
MENTAL  FITNESS, HEALTH AND WELL-BEING, HELPS TO PREVENT OR MITIGATE THE
CONDITIONS OF ACUTE OR CHRONIC SICKNESS, DISEASE OR PAIN, OR WHICH MINI-
MIZES ADVERSE HEALTH CONSEQUENCES DUE TO LIFESTYLE.    SUCH  A  WELLNESS
PROGRAM  MAY  HAVE  SOME OR ALL OF THE FOLLOWING ELEMENTS TO ADVANCE THE
PHYSICAL HEALTH AND MENTAL WELL-BEING OF ITS PARTICIPANTS:
  (A) AN EDUCATION PROGRAM TO INCREASE  THE  AWARENESS  OF  AND  DISSEM-
INATION  OF  INFORMATION  ABOUT PURSUING HEALTHIER LIFESTYLES, AND WHICH
WARNS ABOUT RISKS OF PURSUING  ENVIRONMENTAL  OR  BEHAVIORAL  ACTIVITIES
THAT  ARE  DETRIMENTAL  TO HUMAN HEALTH. IN ADDITION, INFORMATION ON THE
AVAILABILITY OF HEALTH SCREENING TESTS TO ASSIST IN THE EARLY  IDENTIFI-
CATION  AND  TREATMENT OF DISEASES SUCH AS CANCER, HEART DISEASE, HYPER-
TENSION, DIABETES, ASTHMA, OBESITY OR OTHER ADVERSE HEALTH AFFLICTIONS;
  (B) A PROGRAM THAT ENCOURAGES BEHAVIORAL PRACTICES THAT EITHER ENCOUR-
AGES HEALTHY LIVING ACTIVITIES OR DISCOURAGES  UNHEALTHY  LIVING  ACTIV-
ITIES.    SUCH ACTIVITIES OR PRACTICES MAY INCLUDE WELLNESS PROGRAMS, AS
PROVIDED UNDER SECTION THREE THOUSAND TWO HUNDRED  THIRTY-NINE  OF  THIS
CHAPTER; AND
  (C) THE MONITORING OF THE PROGRESS OF EACH COVERED PERSON TO TRACK HIS
OR  HER ADHERENCE TO SUCH WELLNESS PROGRAM AND TO PROVIDE ASSISTANCE AND

S. 2374--A                         27

MORAL SUPPORT TO SUCH COVERED PERSON TO ASSIST HIM OR HER TO ATTAIN  THE
GOALS OF THE COVERED PERSON'S WELLNESS PROGRAM.
  SUCH WELLNESS PROGRAM SHALL DEMONSTRATE ACTUARIALLY THAT IT ENCOURAGES
THE  GENERAL  GOOD  HEALTH AND WELL-BEING OF THE COVERED POPULATION. THE
INSURER OR HEALTH MAINTENANCE ORGANIZATION SHALL  NOT  REQUIRE  SPECIFIC
OUTCOMES  AS  A  RESULT  OF  AN ENROLLEE'S OR INSURED'S ADHERENCE TO THE
APPROVED WELLNESS PROGRAM.
  S 4. Section 4317 of the insurance law is  amended  by  adding  a  new
subsection (c-1) to read as follows:
  (C-1)  SUBJECT  TO  THE  APPROVAL OF THE SUPERINTENDENT, AN INSURER OR
HEALTH MAINTENANCE ORGANIZATION ISSUING AN INDIVIDUAL  OR  GROUP  HEALTH
INSURANCE  CONTRACT PURSUANT TO THIS SECTION MAY PROVIDE FOR AN ACTUARI-
ALLY APPROPRIATE  REDUCTION  IN  PREMIUM  RATES  OR  OTHER  BENEFITS  OR
ENHANCEMENTS  APPROVED  BY THE SUPERINTENDENT TO ENCOURAGE AN ENROLLEE'S
OR INSURED'S ACTIVE PARTICIPATION IN A  QUALIFIED  WELLNESS  PROGRAM.  A
QUALIFIED  WELLNESS PROGRAM CAN BE A RISK MANAGEMENT SYSTEM THAT IDENTI-
FIES AT-RISK POPULATIONS OR ANY OTHER SYSTEMATIC PROGRAM  OR  COURSE  OF
MEDICAL  CONDUCT  WHICH  HELPS  TO  PROMOTE PHYSICAL AND MENTAL FITNESS,
HEALTH AND WELL-BEING, HELPS TO PREVENT OR MITIGATE  THE  CONDITIONS  OF
ACUTE  OR  CHRONIC SICKNESS, DISEASE OR PAIN, OR WHICH MINIMIZES ADVERSE
HEALTH CONSEQUENCES DUE TO LIFESTYLE.  SUCH A WELLNESS PROGRAM MAY  HAVE
SOME OR ALL OF THE FOLLOWING ELEMENTS TO ADVANCE THE PHYSICAL HEALTH AND
MENTAL WELL-BEING OF ITS PARTICIPANTS:
  (1)  AN  EDUCATION  PROGRAM  TO  INCREASE THE AWARENESS OF AND DISSEM-
INATION OF INFORMATION ABOUT PURSUING HEALTHIER  LIFESTYLES,  AND  WHICH
WARNS  ABOUT  RISKS  OF  PURSUING ENVIRONMENTAL OR BEHAVIORAL ACTIVITIES
THAT ARE DETRIMENTAL TO HUMAN HEALTH. IN ADDITION,  INFORMATION  ON  THE
AVAILABILITY  OF HEALTH SCREENING TESTS TO ASSIST IN THE EARLY IDENTIFI-
CATION AND TREATMENT OF DISEASES SUCH AS CANCER, HEART  DISEASE,  HYPER-
TENSION, DIABETES, ASTHMA, OBESITY OR OTHER ADVERSE HEALTH AFFLICTIONS;
  (2) A PROGRAM THAT ENCOURAGES BEHAVIORAL PRACTICES THAT EITHER ENCOUR-
AGES  HEALTHY  LIVING  ACTIVITIES OR DISCOURAGES UNHEALTHY LIVING ACTIV-
ITIES. SUCH ACTIVITIES OR PRACTICES MAY INCLUDE  WELLNESS  PROGRAMS,  AS
PROVIDED  UNDER  SECTION  THREE THOUSAND TWO HUNDRED THIRTY-NINE OF THIS
CHAPTER; AND
  (3) THE MONITORING OF THE PROGRESS OF EACH COVERED PERSON TO TRACK HIS
OR HER ADHERENCE TO SUCH WELLNESS PROGRAM AND TO PROVIDE ASSISTANCE  AND
MORAL  SUPPORT TO SUCH COVERED PERSON TO ASSIST HIM OR HER TO ATTAIN THE
GOALS OF THE COVERED PERSON'S WELLNESS PROGRAM.
  SUCH WELLNESS PROGRAM SHALL DEMONSTRATE ACTUARIALLY THAT IT ENCOURAGES
THE GENERAL GOOD HEALTH AND WELL-BEING OF THE  COVERED  POPULATION.  THE
INSURER  OR  HEALTH  MAINTENANCE ORGANIZATION SHALL NOT REQUIRE SPECIFIC
OUTCOMES AS A RESULT OF AN ENROLLEE'S  OR  INSURED'S  ADHERENCE  TO  THE
APPROVED WELLNESS PROGRAM.
  S 5. Subsection (m) of section 4326 of the insurance law is amended by
adding a new paragraph 4 to read as follows:
  (4)  APPROVAL  OF THE SUPERINTENDENT, AN INSURER OR HEALTH MAINTENANCE
ORGANIZATION ISSUING A CONTRACT FOR QUALIFYING SMALL EMPLOYERS OR  INDI-
VIDUALS  PURSUANT  TO THIS SECTION MAY PROVIDE FOR AN ACTUARIALLY APPRO-
PRIATE REDUCTION IN PREMIUM RATES  OR  OTHER  BENEFITS  OR  ENHANCEMENTS
APPROVED  BY  THE SUPERINTENDENT TO ENCOURAGE AN ENROLLEE'S OR INSURED'S
ACTIVE PARTICIPATION IN A QUALIFIED WELLNESS PROGRAM. A QUALIFIED  WELL-
NESS  PROGRAM  CAN  BE  A RISK MANAGEMENT SYSTEM THAT IDENTIFIES AT-RISK
POPULATIONS OR ANY OTHER SYSTEMATIC PROGRAM OR COURSE OF MEDICAL CONDUCT
WHICH HELPS TO PROMOTE PHYSICAL AND MENTAL FITNESS, HEALTH AND  WELL-BE-
ING,  HELPS  TO  PREVENT  OR MITIGATE THE CONDITIONS OF ACUTE OR CHRONIC

S. 2374--A                         28

SICKNESS, DISEASE OR PAIN, OR  WHICH  MINIMIZES  ADVERSE  HEALTH  CONSE-
QUENCES  DUE TO LIFESTYLE.  SUCH A WELLNESS PROGRAM MAY HAVE SOME OR ALL
OF THE FOLLOWING ELEMENTS TO ADVANCE  THE  PHYSICAL  HEALTH  AND  MENTAL
WELL-BEING OF ITS PARTICIPANTS:
  (1)  AN  EDUCATION  PROGRAM  TO  INCREASE THE AWARENESS OF AND DISSEM-
INATION OF INFORMATION ABOUT PURSUING HEALTHIER  LIFESTYLES,  AND  WHICH
WARNS  ABOUT  RISKS  OF  PURSUING ENVIRONMENTAL OR BEHAVIORAL ACTIVITIES
THAT ARE DETRIMENTAL TO HUMAN HEALTH. IN ADDITION,  INFORMATION  ON  THE
AVAILABILITY  OF HEALTH SCREENING TESTS TO ASSIST IN THE EARLY IDENTIFI-
CATION AND TREATMENT OF DISEASES SUCH AS CANCER, HEART  DISEASE,  HYPER-
TENSION, DIABETES, ASTHMA, OBESITY OR OTHER ADVERSE HEALTH AFFLICTIONS;
  (2) A PROGRAM THAT ENCOURAGES BEHAVIORAL PRACTICES THAT EITHER ENCOUR-
AGES  HEALTHY  LIVING  ACTIVITIES OR DISCOURAGES UNHEALTHY LIVING ACTIV-
ITIES. SUCH ACTIVITIES OR PRACTICES MAY INCLUDE  WELLNESS  PROGRAMS,  AS
PROVIDED  UNDER  SECTION  THREE THOUSAND TWO HUNDRED THIRTY-NINE OF THIS
CHAPTER; AND
  (3) THE MONITORING OF THE PROGRESS OF EACH COVERED PERSON TO TRACK HIS
OR HER ADHERENCE TO SUCH WELLNESS PROGRAM AND TO PROVIDE ASSISTANCE  AND
MORAL  SUPPORT TO SUCH COVERED PERSON TO ASSIST HIM OR HER TO ATTAIN THE
GOALS OF THE COVERED PERSON'S WELLNESS PROGRAM.
  SUCH WELLNESS PROGRAM SHALL DEMONSTRATE ACTUARIALLY THAT IT ENCOURAGES
THE GENERAL GOOD HEALTH AND WELL-BEING OF THE  COVERED  POPULATION.  THE
INSURER  OR  HEALTH  MAINTENANCE ORGANIZATION SHALL NOT REQUIRE SPECIFIC
OUTCOMES AS A RESULT OF AN ENROLLEE'S  OR  INSURED'S  ADHERENCE  TO  THE
APPROVED WELLNESS PROGRAM.
  S  6. Section 4405 of the public health law is amended by adding a new
subdivision 5-a to read as follows:
  5-A. SUBJECT TO  THE  APPROVAL  OF  THE  SUPERINTENDENT  OF  FINANCIAL
SERVICES, THE POSSIBLE PROVIDING OF AN ACTUARIALLY APPROPRIATE REDUCTION
IN  PREMIUM  RATES  OR  OTHER  BENEFITS  OR ENHANCEMENTS APPROVED BY THE
SUPERINTENDENT OF FINANCIAL SERVICES TO ENCOURAGE AN  ENROLLEE'S  ACTIVE
PARTICIPATION  IN  A  QUALIFIED  WELLNESS  PROGRAM. A QUALIFIED WELLNESS
PROGRAM CAN BE A RISK MANAGEMENT SYSTEM THAT  IDENTIFIES  AT-RISK  POPU-
LATIONS  OR  ANY  OTHER  SYSTEMATIC PROGRAM OR COURSE OF MEDICAL CONDUCT
WHICH HELPS TO PROMOTE PHYSICAL AND MENTAL FITNESS, HEALTH AND  WELL-BE-
ING,  HELPS  TO  PREVENT  OR MITIGATE THE CONDITIONS OF ACUTE OR CHRONIC
SICKNESS, DISEASE OR PAIN, OR  WHICH  MINIMIZES  ADVERSE  HEALTH  CONSE-
QUENCES  DUE TO LIFESTYLE.  SUCH A WELLNESS PROGRAM MAY HAVE SOME OR ALL
OF THE FOLLOWING ELEMENTS TO ADVANCE  THE  PHYSICAL  HEALTH  AND  MENTAL
WELL-BEING OF ITS PARTICIPANTS:
  (1)  AN  EDUCATION  PROGRAM  TO  INCREASE THE AWARENESS OF AND DISSEM-
INATION OF INFORMATION ABOUT PURSUING HEALTHIER  LIFESTYLES,  AND  WHICH
WARNS  ABOUT  RISKS  OF  PURSUING ENVIRONMENTAL OR BEHAVIORAL ACTIVITIES
THAT ARE DETRIMENTAL TO HUMAN HEALTH. IN ADDITION,  INFORMATION  ON  THE
AVAILABILITY  OF HEALTH SCREENING TESTS TO ASSIST IN THE EARLY IDENTIFI-
CATION AND TREATMENT OF DISEASES SUCH AS CANCER, HEART  DISEASE,  HYPER-
TENSION, DIABETES, ASTHMA, OBESITY OR OTHER ADVERSE HEALTH AFFLICTIONS;
  (2) A PROGRAM THAT ENCOURAGES BEHAVIORAL PRACTICES THAT EITHER ENCOUR-
AGES  HEALTHY  LIVING  ACTIVITIES OR DISCOURAGES UNHEALTHY LIVING ACTIV-
ITIES. SUCH ACTIVITIES OR PRACTICES MAY INCLUDE  WELLNESS  PROGRAMS,  AS
PROVIDED  UNDER  SECTION  THREE  THOUSAND TWO HUNDRED THIRTY-NINE OF THE
INSURANCE LAW; AND
  (3) THE MONITORING OF THE PROGRESS OF EACH COVERED PERSON TO TRACK HIS
OR HER ADHERENCE TO SUCH WELLNESS PROGRAM AND TO PROVIDE ASSISTANCE  AND
MORAL  SUPPORT TO SUCH COVERED PERSON TO ASSIST HIM OR HER TO ATTAIN THE
GOALS OF THE COVERED PERSON'S WELLNESS PROGRAM.

S. 2374--A                         29

  SUCH WELLNESS PROGRAM SHALL DEMONSTRATE ACTUARIALLY THAT IT ENCOURAGES
THE GENERAL GOOD HEALTH AND WELL-BEING OF THE  COVERED  POPULATION.  THE
HEALTH MAINTENANCE ORGANIZATION SHALL NOT REQUIRE SPECIFIC OUTCOMES AS A
RESULT OF AN ENROLLEE'S ADHERENCE TO THE APPROVED WELLNESS PROGRAM;
  S 7. This act shall take effect on the one hundred eightieth day 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 added, amended
and/or repealed 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 R of this act shall be
as specifically set forth in the last section of such Parts.