senate Bill S2363

2013-2014 Legislative Session

Enacts comprehensive provisions to curtail the incidence of asthma and other respiratory diseases

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Archive: Last Bill Status - In Committee


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

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Actions

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Assembly Actions - Lowercase
Senate Actions - UPPERCASE
Jan 08, 2014 referred to health
Jan 16, 2013 referred to health

Co-Sponsors

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S2363 - Bill Details

See Assembly Version of this Bill:
A2417A
Current Committee:
Law Section:
Public Health Law
Laws Affected:
Add Art 27-BB §§2725 - 2727, Art 13-I §§1399-xx & 1399-yy, Art 24-F §§2499-b - 2499-d, 1399-o-1, amd §§2111 & 2599-b, Pub Health L; add §§3001-e, 1527-a & 921, amd §916, Ed L; add §235-h, RP L; amd §33-0303, En Con L; add §143, Pub Bldg L
Versions Introduced in 2011-2012 Legislative Session:
S5863, A9485

S2363 - Bill Texts

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Enacts comprehensive provisions to curtail the incidence of asthma and other respiratory diseases; requires teachers in public and non-public school systems to be trained in identifying and responding to asthma emergencies in accordance with standards to be prescribed by the commissioner of education in consultation with the commissioner of health; provides for a program of asthma disease management and control within the department of health; program shall provide various services to health care providers, patients, and others; authorizes the commissioner of health to make grants; provides for a study of asthma incidence and prevalence; provides for an annual report on the program; requires health care providers to provide pregnant women with information on in-utero exposure to tobacco smoke; requires residential leases to include information on the smoking restrictions for the leased premises and in common ares; prohibits idling of motor vehicle engines upon school grounds; authorizes school boards to allow certain students to use inhalers or nebulizers; requires the school that authorizes the use of an inhaler to prepare an asthma treatment plan for the student; ensures safety of all students who suffer from respiratory illnesses in New York; requires reporting of cases of asthma; provides for the curtailing of the use of chemicals which may trigger asthma episodes; provides for the use of the least toxic pesticides which effectively eradicate the targeted organism; includes certain respiratory diseases within the disease management demonstration program; provides for the reduction of emphysema, chronic bronchitis and other chronic respiratory diseases in children; relates to smoking restrictions in certain outdoor areas.

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BILL NUMBER:S2363

TITLE OF BILL: An act to amend the public health law, in relation to
establishing the asthma prevention and education program (Part A); to
amend the public health law, in relation to in-utero exposure to
tobacco smoke prevention (Part B); to amend the public health law, in
relation to reporting on the incidence of asthma (Part C); to amend
the public health law, in relation to including certain respiratory
diseases within disease management demonstration programs (Part D); to
amend the public health law, in relation to the reduction of
emphysema, chronic bronchitis and other chronic respiratory diseases
in children (Part E); to amend the public health law, in relation to
smoking restrictions in certain outdoor areas (Part F); to amend the
education law, in relation to requiring all teachers to be trained in
identifying and responding to asthma emergencies (Part G); to amend
the real property law, in relation to residential rental property
smoking policies (Part H); to amend the education law, in relation to
requiring school districts and private elementary and secondary
schools to establish and implement rules prohibiting the engine of any
motor vehicle to remain idling while parked or standing on school
grounds (Part I); to amend the education law, in relation to the use
of inhalers and nebulizers (Part J); to amend the environmental
conservation law, in relation to pesticide alternatives used at
schools and day care centers (Part K); and to amend the public
buildings law, in relation to curtailing the use of cleaning materials
that induce or trigger asthma episodes (Part L)

PURPOSE: To establish a comprehensive statewide asthma management and
control program which coordinates the efforts of individuals,
families, health care providers, schools and community-based
organizations to benefit the people of the State of New York at many
levels.

SUMMARY OF PROVISIONS:

Section 1: Legislative Intent.

Section 2: (Part A) Adds a new Public Health Law Article 27-BB as
follows:

Creates a new Public Health Law section 2725 to create an Asthma
disease management and control program. The purpose of the program is
to promote asthma disease management and education and outreach about
asthma to people who suffer from asthma and their families, health
care providers, and the general public.

Creates a new Public Health Law (PHL) section 2726 to require the
Department of Health (DOH) to study the incidence and prevalence of
asthma in New York state including current disease management
practices. Such study shall include the cause and nature of the
disease, behavioral and environmental triggers, an assessment of the
need for patient-centered case management to meet specific physical
and environmental needs of patients, outcome evaluations and an
assessment of the ability of providers to systemically instruct and
develop asthma management plans for patients and frequently review
with patients and their families how to manage and control their


asthma. DOH shall also gather demographic information for monitoring
the occurrence, frequency, incidence, cause, effect and severity of
asthma. The gathered data can be used for research purposes and the
Department of Health will develop a unique and confidential identifier
to be used in the collection of patient information for the purposes
described above. Information gathered pursuant to the Asthma incident
reporting provisions of PHL Article 24-F can be used for the
preparation of any reports contained in this Part A of this bill.

Creates a new PHL section § 2727 to require the Commissioner to submit
an annual report, commencing January first, after the bill is enacted
and continue annually thereafter. The report shall include the status
and accomplishments of the program and provide recommendations to the
governor, the temporary president and the minority leader of the
senate, and the speaker and the minority leader of the assembly.

Section 3: (Part B) Adds a new Article 13-I to the Public Health Law
to establish a program to prevent in-utero exposure to tobacco smoke.
Under this program, health care providers, health insurers, and
pregnancy programs shall distribute information on the adverse effects
of smoking during pregnancy, both first hand and second hand smoke.
In-utero exposure to tobacco smoke leads to lower birth rates, higher
incidences of asthma and childhood obesity, and can lead to cognitive
and developmental damage to the child. Under this article,
individualized smoking cessation programs would be established to
increase the success rates for mothers who smoke tobacco or live in
households where others smoke tobacco. This program will help to
reduce the incidence of asthma.

Section 4: (Part C) Adds a new Public Health Law Article 24-F to
establish an Asthma Incidence Reporting program that is similar to one
that already exists to map the incidence of cancer in New York. The
bill defines asthma attacks as a reportable disease that physicians,
other health care providers, hospitals, and other health care
facilities are required to report to the Health Department

(DOH). The Department shall establish what constitutes a reportable
event, so that information received by DOH can be used to track where
and who is affected by asthma attacks. Among the demographic
information to be collected and sorted for those afflicted with asthma
includes by age, residence, location, proximity to industrial and
transportation sites, race, and by school.

Section 5: (Part D) Amends Public Health Law section 2111 to expand
the scope of disease management demonstration programs administered by
DOH to enhance the quality and cost-effectiveness of care rendered to
Medicaid-eligible persons who do not participate in Medicaid Managed
Care who have chronic health problems. Under current law,
demonstration programs can include chronic conditions related to
congestive heart failure, chronic obstructive pulmonary disease,
asthma and diabetes. This provision expands the scope of demonstration
programs to include chronic conditions related to emphysema, chronic
bronchitis, and other respiratory diseases.

Section 6: (Part E) Amends Public Health Law section 2599-b to expand
the scope of programs administered by DOH to reduce the incidence and
prevalence of obesity in children and adolescents, especially among


populations with high rates of obesity. Under current law, the program
looks to address obesity related health complications such as
diabetes, heart disease, cancer, osteoarthritis, and asthma. This bill
would expand such programs to include obesity-related health
complications such as emphysema, chronic bronchitis, and other chronic
respiratory diseases.

Section 7: (Part F) Adds a new Public Health Law section 1399-0-1 to
expand the provisions of the law that regulates smoking in certain
indoor areas open to the public to also include certain outdoor areas
open to the public. Under this provision, it is prohibited to smoke
within 15 feet from the entrance or exit of public buildings or
private buildings that contain state or municipal offices or
educational facilities. The underlying purpose of this provision is to
ensure that a person who needs to conduct public business or students
who enter into elementary and secondary schools, that are located in
private buildings, are not exposed to second-hand tobacco smoke that
may trigger an asthma episode or attack.

Section 8: (Part G) Adds a new Education Law section 3001-e to require
the Education Commissioner, in consultation with the Commissioner of
Health, to establish standards for the training of teachers and other
appropriate personnel in identifying and responding to asthma
emergencies.

Section 9: (Part H) Adds Real Property Law section 235-h to require
that every rental agreement for an apartment in a building that has
four units or more must disclose the smoking policy of such building,
The landlord is still free to either fully ban, partially ban, or
generally permit smoking in such building's apartments and common
areas. It is the purpose of this section to encourage landlords to
think about the building's smoking policy and to give tenants notice
of such policies. This in turn may encourage non-smoker tenants to
seek out apartment buildings that have a no smoking policy and
encourage landlords to at least minimize smoke exposure to those
tenants who do not smoke to increase the marketability of their
apartments.While this bill is a comprehensive bill to address asthma
issues, there is a correlation between those who are exposed, either
voluntary or otherwise, to first and second hand tobacco smoke, and
asthma. It would be difficult to address asthma issues without looking
at the incidence of tobacco smoking and exposing, particularly
children, to such conditions that can trigger asthma attacks and
increase the incidence of asthma conditions generally.

Section 10: (Part I) Adds a new Education Law section 1527-a to expand
the concept and provisions contained in Chapter 670 of the Laws of
2007 which mandated that the Department of Education promulgate rules
and regulations to minimize the discharge of school bus exhaust on
school grounds when such vehicles were loading and unloading students.
The underlying purpose of this law was to minimize diesel exhaust from
idling school busses to help lower the incidence of asthma and reduce
the number of asthma attacks sustained by school children. This bill
proposes to expand the prohibition on idling school busses to include
all other private vehicles that deliver or discharge students on
school grounds. While many students are transported to and from school
by school busses, many others are transported by family members
individually to school. The standard operating procedure for most


schools is that a separate line of cars is established and the
students must remain in those private vehicles until a designated
time, at which time the students are discharged or picked up. During
the wait time, many private vehicles continue to operate and discharge
emissions which can lead to an increased incidence of asthma
conditions or a full fledged asthma attack. This provision encourages
such private vehicles to turn off their engines to reduce the amount
of emissions and triggers for asthma attacks.

Section 11: (Part J) Amends Education Law section 916 to expand the
number of students who can have and use an inhaler at school to
maintain appropriate airflow to their lungs or suppress an asthmatic
attack.The medical community maintains that it is better to monitor
and address those who are susceptible to asthma conditions and treat
such conditions before an asthmatic attack occurs, This bill increases
the number of persons who can have and use an inhaler at school to
include not only those who have a 'severe asthmatic condition", to
also include those who have a "moderately severe asthmatic condition"
or have other potentially life-threatening respiratory illnesses".

Section 2 of this Part J also adds a new Education Law section 921 to
authorize school districts to posses and use nebulizers for those
students that need such treatments. As the number and severity asthma
attacks increases in the student body, it is important that such
students have access not only to their inhalers, but nebulizers as
well.The bill provides safeguards to ensure that only students that
have a physician's treatment plan can use such nebulizers on school
grounds.Further, such nebulizer treatment must be monitored by the
school nurse or other person authorized by regulation.

Section 12: (Part K) Amends Environmental Conservation Law section
33-0303 (7) to expand the scope of this section of law which empowers
the Commissioner of Environmental Conservation (DEC) to promulgate
rules and guidance on the use pesticide alternatives to minimize
pesticide applications in day care centers and in schools. This
proposed provision allows DEC to identify pesticide alternatives that
can help to minimize the incidence of asthma attacks in public
buildings and homes, while still effectively controlling the targeted
pest or organization. Studies have shown that higher levels of
cockroach and mouse allergens can increase the incidence of asthma
episodes or attacks.To control these conditions, the heightened use of
pesticides is generally required to keep such pests under control.
However, the application of pesticides also, can increase the
incidence of asthma episodes or attacks.Hence, lower levels of
pesticide applications are a desired to minimize asthma conditions.
This provision asks DEC, in consultation with DOH, to advise those who
apply pesticides in homes and public buildings to use pesticides that
can help to minimize targeted pests, but also which does not, as best
as possible, heighten the incidence of asthma conditions or attacks.
It is important to embody in the law the conflicting goals of
pesticide use, while still considering its effect asthma conditions.

Section 13: (Part L) Adds a new Public Buildings Law section 143 to
curtail the use of cleaning materials or chemicals that can induce or
trigger asthma attacks. The superintendent of every state public
building and every public transportation facility operated by a public
authority, public benefit corporation or municipality shall curtail,


to the best of their ability, the use of cleaning materials or
chemicals that may cause their the building's cleaning staff or the
general public to have an asthma attack or increase the incidence of
such an asthma condition. In determining which cleaning products and
concentration of cleaning chemicals that may trigger an asthma attack
or increase the incidence of an asthmatic condition for cleaning staff
or the general public, DOH shall promulgate a list of such chemicals
to guide the actions of building superintendents.

JUSTIFICATION: Asthma is a chronic, potentially life-threatening,
respiratory illness that affects over a million New Yorkers, including
many who are children and adolescents. Asthma is also directly linked
to large and growing inpatient and outpatient bills paid for by
Medicaid and other health care payers, which in most cases could be
avoided through early education and treatment of this condition.
Asthma is the most common chronic disorder in children and adolescents
and is responsible for approximately 10 million missed school days
each year which is three times the amount for children without this
debilitating ailment. In recent years, asthma has become the leading
cause of hospitalization among children in New York and since 1980,
the death rate among sufferers has increased a staggering 50%. In one
area of the Bronx known as ".Asthma Alley" the rate of asthma
sufferers is 7 1/2 times that of the national average.

Research and preventive efforts need to be increased. This is because
numerous studies show that early education, screening, and treatment
is a very cost effective method to address this growing public health
problem. Establishing a comprehensive statewide asthma management
program which coordinates the efforts of individuals, families, health
care providers, schools and community-based organizations would help
New York track the disease, better understand its causes and triggers,
and direct asthma education and preventive care to the children and
families who need it the most.

LEGISLATIVE HISTORY: 2012- S. 5863 - Referred to Health

FISCAL IMPLICATIONS: Some of the provisions of this bill may be
subject to fiscal appropriation.

EFFECTIVE DATE: See the individual effective dates for each Part of
this bill.

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

                                  2363

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                            January 16, 2013
                               ___________

Introduced  by Sens. KLEIN, CARLUCCI, GRISANTI, SAVINO -- read twice and
  ordered printed, and when printed to be committed to the Committee  on
  Health

AN  ACT  to amend the public health law, in relation to establishing the
  asthma prevention and education program (Part A); to amend the  public
  health  law,  in  relation  to  in-utero  exposure  to  tobacco  smoke
  prevention (Part B); to amend the public health law,  in  relation  to
  reporting  on  the  incidence  of asthma (Part C); to amend the public
  health law, in relation  to  including  certain  respiratory  diseases
  within  disease  management  demonstration programs (Part D); to amend
  the public health law, in relation  to  the  reduction  of  emphysema,
  chronic  bronchitis and other chronic respiratory diseases in children
  (Part E); to amend the public  health  law,  in  relation  to  smoking
  restrictions in certain outdoor areas (Part F); to amend the education
  law,  in relation to requiring all teachers to be trained in identify-
  ing and responding to asthma emergencies (Part G); to amend  the  real
  property law, in relation to residential rental property smoking poli-
  cies  (Part  H);  to amend the education law, in relation to requiring
  school districts and  private  elementary  and  secondary  schools  to
  establish  and  implement  rules  prohibiting  the engine of any motor
  vehicle to remain idling while parked or standing  on  school  grounds
  (Part I); to amend the education law, in relation to the use of inhal-
  ers  and  nebulizers (Part J); to amend the environmental conservation
  law, in relation to pesticide alternatives used  at  schools  and  day
  care  centers  (Part  K);  and  to  amend the public buildings law, in
  relation to curtailing the use of cleaning materials  that  induce  or
  trigger asthma episodes (Part L)

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

  Section 1. This act enacts into law major  components  of  legislation
which combat the incidence of asthma and other respiratory diseases such
as  emphysema and chronic bronchitis. Each component is wholly contained
within a Part identified as Parts A through L. The  effective  date  for
each particular provision contained within such Part is set forth in the

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD00970-02-3

S. 2363                             2

last section of such Part. Any provision in any section contained within
a  Part,  including the effective date of the Part, which makes a refer-
ence to a section "of this act",  when  used  in  connection  with  that
particular  component,  shall  be deemed to mean and refer to the corre-
sponding section of the Part in which it is found. Section four of  this
act sets forth the general effective date of this act.
  S  2.  Legislative  findings  and  purpose. The legislature finds that
asthma is a chronic, potentially life-threatening,  respiratory  illness
that affects over a million New Yorkers, including thousands of children
and  adolescents.  Asthma is the leading cause of school absences attri-
buted to chronic conditions. Asthma is also directly linked to large and
growing inpatient bills for  medicaid  and  other  health  care  payers.
Therefore,  the  legislature  finds  that  establishing  a comprehensive
statewide asthma prevention management and control program which coordi-
nates the efforts  of  individuals,  families,  health  care  providers,
schools  and community-based organizations is in the public interest and
would benefit the people of the state of New York.

                                 PART A

  Section 1. The public health law is amended by adding  a  new  article
27-BB to read as follows:
                               ARTICLE 27-BB
                  ASTHMA DISEASE MANAGEMENT AND CONTROL
SECTION 2725. ASTHMA DISEASE MANAGEMENT AND CONTROL PROGRAM.
        2726. STUDY OF ASTHMA INCIDENCE AND PREVALENCE.
        2727. ANNUAL REPORT.
  S  2725.  ASTHMA  DISEASE  MANAGEMENT AND CONTROL PROGRAM. 1. THERE IS
HEREBY CREATED WITHIN THE DEPARTMENT THE ASTHMA DISEASE  MANAGEMENT  AND
CONTROL  PROGRAM  (HEREINAFTER  REFERRED  TO  IN  THIS  ARTICLE  AS  THE
"PROGRAM"). THE PURPOSE OF THE PROGRAM  IS  TO  PROMOTE  ASTHMA  DISEASE
MANAGEMENT  AND EDUCATION AND OUTREACH ABOUT ASTHMA TO PEOPLE WHO SUFFER
FROM ASTHMA AND THEIR FAMILIES, HEALTH CARE PROVIDERS, AND  THE  GENERAL
PUBLIC.
  2. SERVICES TO BE PROVIDED BY THE PROGRAM MAY INCLUDE:
  (A)  ASTHMA  DISEASE  MANAGEMENT  AND CASE MANAGEMENT FOR PATIENTS AND
THEIR FAMILIES;
  (B) ASTHMA OUTREACH AND SCREENING;
  (C) THE PROMOTION OF AWARENESS OF THE CAUSES OF ASTHMA;
  (D) EDUCATION ON PREVENTION STRATEGIES;
  (E) EDUCATION ON PROPER DISEASE MANAGEMENT PRACTICES; AND
  (F) EDUCATION ON AVAILABLE TREATMENT MODALITIES.
  3. THE COMMISSIONER SHALL MAKE GRANTS WITHIN THE AMOUNTS  APPROPRIATED
THEREFOR  TO  LOCAL  HEALTH  AGENCIES,  HEALTH  CARE PROVIDERS, SCHOOLS,
SCHOOL BASED HEALTH CENTERS AND COMMUNITY-BASED ORGANIZATIONS, AND OTHER
ORGANIZATIONS  WITH  DEMONSTRATED  INTEREST  AND  EXPERTISE  IN  SERVING
PERSONS  WITH  ASTHMA  TO  PROVIDE THE SERVICES SET OUT IN THIS SECTION.
GRANT RECIPIENTS SHALL BE GOVERNMENT ENTITIES OR  NOT-FOR-PROFIT  ORGAN-
IZATIONS.
  THE COMMISSIONER MAY COORDINATE GRANTS UNDER THIS SUBDIVISION WITH THE
AVAILABILITY  OF  GRANTS  FROM  OTHER SOURCES. THE COMMISSIONER MAY ALSO
ACCEPT OR SEEK GRANTS FROM OTHER SOURCES TO ENHANCE THE  AMOUNTS  APPRO-
PRIATED TO THE PROGRAM.
  S  2726.  STUDY  OF ASTHMA INCIDENCE AND PREVALENCE. 1. THE DEPARTMENT
SHALL STUDY THE INCIDENCE AND PREVALENCE OF ASTHMA IN THE STATE'S  POPU-
LATION  AND  CURRENT  DISEASE  MANAGEMENT  PRACTICES.  SUCH  STUDY SHALL

S. 2363                             3

UTILIZE INFORMATION OBTAINED PURSUANT TO ARTICLE TWENTY-FOUR-F  OF  THIS
CHAPTER, AND INCLUDE:
  (A) THE CAUSE AND NATURE OF THE DISEASE;
  (B) BEHAVIORAL AND ENVIRONMENTAL TRIGGERS;
  (C)  AN ASSESSMENT OF THE NEED FOR PATIENT-CENTERED CASE MANAGEMENT TO
MEET SPECIFIC PHYSICAL AND ENVIRONMENTAL NEEDS OF PATIENTS;
  (D) OUTCOME  EVALUATIONS,  INCLUDING,  BUT  NOT  LIMITED  TO,  PATIENT
PERCEPTIONS  OF  IMPROVEMENT,  SIGNS  AND  SYMPTOMS OF ASTHMA, PULMONARY
FUNCTION, HISTORY OF ASTHMA EXACERBATIONS,  PHARMACOTHERAPY,  ASSESSMENT
OF  HOSPITAL  EMERGENCY  ROOM  VISITS  FOR  ASTHMA, AND PATIENT-PROVIDER
COMMUNICATION; AND
  (E) AN ASSESSMENT OF THE ABILITY OF PROVIDERS,  INCLUDING  NON-PROFES-
SIONALS  AND HEALTH CARE PROFESSIONALS SUCH AS PHYSICIANS, NURSES, PHAR-
MACISTS AND RESPIRATORY THERAPISTS, TO SYSTEMICALLY INSTRUCT AND DEVELOP
ASTHMA MANAGEMENT PLANS FOR PATIENTS AND FREQUENTLY REVIEW WITH PATIENTS
AND THEIR FAMILIES HOW TO MANAGE AND CONTROL THEIR ASTHMA.
  2. THE DEPARTMENT SHALL GATHER DATA  FOR  MONITORING  THE  OCCURRENCE,
FREQUENCY, INCIDENCE, CAUSE, EFFECT AND SEVERITY OF ASTHMA.
  (A) THE DEPARTMENT MAY REQUIRE THE FOLLOWING TO REPORT DATA UNDER THIS
SUBDIVISION:
  I. THE STATEWIDE PLANNING AND RESEARCH COOPERATIVE SYSTEM (SPARCS);
  II.  HEALTH  MAINTENANCE  ORGANIZATIONS  LICENSED  PURSUANT TO ARTICLE
FORTY-THREE OF THE INSURANCE LAW OR CERTIFIED PURSUANT TO  THIS  CHAPTER
OR  AN INDEPENDENT PRACTICE ASSOCIATION CERTIFIED OR RECOGNIZED PURSUANT
TO THIS CHAPTER;
  III. OTHER INSURERS;
  IV. THE MEDICAID (TITLE  XIX  OF  THE  FEDERAL  SOCIAL  SECURITY  ACT)
PROGRAM;
  V. HEALTH FACILITIES;
  VI. HEALTH CARE PRACTITIONERS;
  VII. PATIENTS: SELF REPORTING;
  VIII. THE DEPARTMENT OF ENVIRONMENTAL CONSERVATION; AND
  IX. ANY OTHER SOURCE THE COMMISSIONER DEEMS APPROPRIATE.
  (B) THE DEPARTMENT SHALL COMPILE AND ANALYZE DATA GATHERED UNDER PARA-
GRAPH (A) OF THIS SUBDIVISION AND ARTICLE TWENTY-FOUR-F OF THIS CHAPTER,
AND  CORRELATE  IT  WITH DATA AS TO PLACES OF EMPLOYMENT, AREAS OF RESI-
DENCE, SCHOOLS ATTENDED, AGES OF THOSE AFFLICTED, ENVIRONMENTAL  FACTORS
INCLUDING  PROXIMITY  TO  SOURCE OF POLLUTION AND SUCH OTHER DATA AS THE
DEPARTMENT DEEMS APPROPRIATE.
  (C) THE DEPARTMENT SHALL MAINTAIN  AND  COMPILE  REPORTED  DATA  IN  A
MANNER  SUITABLE  FOR  RESEARCH PURPOSES AND SHALL COLLECT AND MAKE SUCH
DATA AVAILABLE TO PERSONS IN THE MANNER SET FORTH IN  SUBDIVISION  THREE
OF THIS SECTION.
  3.  ANY  DATA  COLLECTED OR REPORTED SHALL NOT CONTAIN THE NAME OF ANY
PATIENT, HIS OR HER SOCIAL SECURITY NUMBER,  OR  ANY  OTHER  INFORMATION
WHICH  WOULD  PERMIT  A  PATIENT  TO BE IDENTIFIED. THE DEPARTMENT SHALL
DEVELOP A UNIQUE, CONFIDENTIAL IDENTIFIER TO BE USED IN  THE  COLLECTION
OF PATIENT INFORMATION AS REQUIRED BY THIS SECTION.
  S  2727.  ANNUAL  REPORT. ON OR BEFORE THE FIRST OF JANUARY DURING THE
TWO CALENDAR YEARS NEXT SUCCEEDING THE EFFECTIVE DATE  OF  THIS  SECTION
AND  BIENNIALLY  THEREAFTER,  THE  COMMISSIONER  SHALL  SUBMIT  A REPORT
REGARDING THE STATUS AND ACCOMPLISHMENTS  OF  THE  PROGRAM  AND  PROVIDE
RECOMMENDATIONS TO THE GOVERNOR, THE TEMPORARY PRESIDENT AND THE MINORI-
TY  LEADER OF THE SENATE, AND THE SPEAKER AND THE MINORITY LEADER OF THE
ASSEMBLY. SUCH REPORT MAY BE SUBMITTED IN CONJUNCTION  WITH  THE  REPORT
REQUIRED BY ARTICLE TWENTY-FOUR-F OF THIS CHAPTER.

S. 2363                             4

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

                                 PART C

  Section  1.  The  public health law is amended by adding a new article
24-F to read as follows:
                              ARTICLE 24-F
                            ASTHMA REPORTING
SECTION 2499-B. ASTHMA; DUTY TO REPORT.
        2499-C. REPORTING.
        2499-D. ASTHMA; REPORTS CONFIDENTIAL.
  S 2499-B. ASTHMA; DUTY TO REPORT. 1. EVERY PHYSICIAN AND OTHER  HEALTH
CARE  PROVIDER SHALL GIVE NOTICE TO THE DEPARTMENT WITHIN THIRTY DAYS OF
EVERY INCIDENT OF AN ASTHMA ATTACK COMING UNDER HIS OR HER CARE,  EXCEPT
AS OTHERWISE PROVIDED.
  2.  THE PERSON IN CHARGE OF EVERY ASTHMA REPORTING FACILITY SHALL GIVE
NOTICE TO THE DEPARTMENT WITHIN THIRTY DAYS  OF  EVERY  INCIDENT  OF  AN
ASTHMA ATTACK COMING UNDER THE CARE OF SUCH FACILITY.

S. 2363                             5

  3.  THE  DEPARTMENT  SHALL  ESTABLISH  REGULATIONS  DESIGNATING  WHICH
SPECIFIC INFORMATION SHALL BE REPORTED TO  THE  DEPARTMENT  PURSUANT  TO
THIS SECTION.
  4.  A  PHYSICIAN  OR HEALTH CARE PROVIDER OR ASTHMA REPORTING FACILITY
WHICH VIOLATES ANY PROVISION OF THIS SECTION SHALL BE SUBJECT TO A CIVIL
PENALTY PURSUANT TO SECTION TWELVE OF THIS CHAPTER.
  5. THE NOTICES REQUIRED BY THIS SECTION SHALL BE UPON  FORMS  SUPPLIED
BY  THE  COMMISSIONER  AND  SHALL  CONTAIN  SUCH INFORMATION AS SHALL BE
REQUIRED BY THE COMMISSIONER.
  6. FOR THE PURPOSES OF THIS SECTION, AN  "ASTHMA  REPORTING  FACILITY"
MEANS  A  HOSPITAL  AS  DEFINED IN ARTICLE TWENTY-EIGHT OF THIS CHAPTER,
CLINIC, ANY ORGANIZATION CERTIFIED PURSUANT  TO  ARTICLE  FORTY-FOUR  OF
THIS CHAPTER, OR OTHER SIMILAR PUBLIC OR PRIVATE INSTITUTION.
  S 2499-C. REPORTING. 1. THE COMMISSIONER SHALL SUBMIT BIENNIAL REPORTS
TO  THE  GOVERNOR, THE TEMPORARY PRESIDENT OF THE SENATE, THE SPEAKER OF
THE ASSEMBLY, THE MINORITY LEADER OF THE SENATE AND THE MINORITY  LEADER
OF  THE ASSEMBLY.  THE REPORTS SHALL INCLUDE AN EVALUATION OF THE ASTHMA
REGISTRY AS IT RELATES TO TIMELINESS, QUALITY AND COMPLETENESS; AN EVAL-
UATION OF THE UTILITY OF THE REGISTRY FOR SCIENTIFIC RESEARCH; AN EVALU-
ATION OF THE ACCESS, TIMELINESS AND QUALITY OF REPORTING INFORMATION  TO
RESEARCHERS  AND  OTHER SIMILAR INDIVIDUALS; AN EVALUATION OF THE REGIS-
TRY'S DATA ELEMENTS, INCLUDING TREATMENT, SEVERITY OF  DISEASE,  OCCUPA-
TION, AGE AND RESIDENCE; AN EVALUATION OF THE FEASIBILITY AND UTILITY OF
INCLUSION  OF  OCCUPATIONAL HISTORY AND RESIDENCE HISTORY; AND AN EVALU-
ATION OF INTEGRATING THE REGISTRY WITH  OTHER  DATABASES  MAINTAINED  BY
STATE  AGENCIES  AND  DEPARTMENTS,  INCLUDING THE STATEWIDE PLANNING AND
RESEARCH COOPERATIVE SYSTEM.
  2. THE COMMISSIONER SHALL SUBMIT AN ANNUAL REPORT TO THE GOVERNOR, THE
TEMPORARY PRESIDENT OF THE SENATE, THE  SPEAKER  OF  THE  ASSEMBLY,  THE
MINORITY  LEADER  OF THE SENATE AND THE MINORITY LEADER OF THE ASSEMBLY.
SUCH REPORT SHALL INCLUDE AN  EVALUATION  OF  WHETHER  THE  REGISTRY  IS
ACHIEVING  ASTHMA  INCIDENCE  REGISTRY GOALS ESTABLISHED BY A NATIONALLY
RECOGNIZED  ASTHMA  REGISTRY  ORGANIZATION,  INCLUDING  NUMERICAL  GOALS
CONCERNING TIMELINESS, QUALITY, AND COMPLETENESS.
  S  2499-D. ASTHMA; REPORTS CONFIDENTIAL. THE REPORTS OF ASTHMA ATTACKS
MADE PURSUANT TO THE PROVISIONS OF THIS ARTICLE SHALL NOT BE DIVULGED OR
MADE PUBLIC BY ANY PERSON SO AS TO DISCLOSE THE IDENTITY OF  ANY  PERSON
TO  WHOM THEY RELATE, EXCEPT IN SO FAR AS MAY BE AUTHORIZED IN THE SANI-
TARY CODE.
  S 2. This act shall take effect on the one hundred eightieth day after
it shall have become a law. Effective immediately, the  commissioner  of
health is authorized to promulgate any and all rules and regulations and
take any other measures necessary to implement this act on its effective
date on or before such date.

                                 PART D

  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

S. 2363                             6

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, EMPHYSEMA, CHRONIC BRONCHITIS, OTHER RESPIR-
ATORY DISEASES, diabetes or other chronic health conditions  as  may  be
specified  by the department; or have experienced or are likely to expe-
rience 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
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 E

  Section 1.  Subdivision 1 of 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:
  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,  EMPHYSEMA,  CHRONIC BRONCHITIS, OTHER
CHRONIC RESPIRATORY DISEASES and other conditions. The program shall use
recommendations and goals of the United States departments  of  agricul-
ture  and health and human services, the surgeon general and centers for
disease control in developing and implementing guidelines for  nutrition
education  and  physical activity projects as part of obesity prevention
efforts. The content and implementation 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.

S. 2363                             7

  S  2. Paragraphs (f) and (g) of subdivision 2 of section 2599-b of the
public health law, as amended by section 88 of part B of chapter  58  of
the  laws  of 2005, are amended and a new paragraph (h) is added to read
as follows:
  (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  coordination  with  health  care
providers and institutions including but not limited to day care centers
and  schools  for  overweight  and obesity for children aged two through
eighteen 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 explana-
tion 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, EMPHYSEMA, CHRONIC BRONCHITIS AND OTHER
CHRONIC RESPIRATORY DISEASES TO ENABLE ADULTS  AND  CHILDREN  TO  SAFELY
INCREASE PHYSICAL ACTIVITY TO HELP CURB THE INCIDENCE OF OBESITY.
  S 3. This act shall take effect immediately.

                                 PART F

  Section  1. Legislative intent.  The legislature recognizes that expo-
sure to second-hand smoke is known to cause cancer,  pneumonia,  asthma,
bronchitis  and  heart disease in humans, and to trigger asthma attacks.
The legislature finds that prohibiting smoking  within  a  presumptively
reasonable  minimum  distance  of  fifteen feet from entrances and exits
that serve enclosed areas where smoking is prohibited is consistent with
such prohibition.  This legislation will apply to any individual occupy-
ing such area with the purpose of smoking, but provides  exceptions  for
individuals  passing through such area. Therefore, the legislature finds
that smoking in such area shall be prohibited and owners and other indi-
viduals in control of such area are recommended to post signs indicating
no smoking areas and providing for fines for violations.
  S 2. The public health law is amended by adding a new section 1399-o-1
to read as follows:
  S 1399-O-1. SMOKING RESTRICTIONS; CERTAIN OUTDOOR AREAS.   1.  SMOKING
IS  PROHIBITED  WITHIN  A  PRESUMPTIVELY  REASONABLE MINIMUM DISTANCE OF
FIFTEEN FEET FROM ENTRANCES OR EXITS  OF  PUBLIC  BUILDINGS  OR  PRIVATE
BUILDINGS THAT CONTAIN STATE OR MUNICIPAL OFFICES OR EDUCATIONAL FACILI-
TIES  FOR  ELEMENTARY OR SECONDARY SCHOOL STUDENTS.  SUCH DISTANCE SHALL
BECOME A DESIGNATED NO SMOKING ZONE.
  2. LOCAL HEALTH DEPARTMENTS ARE AUTHORIZED TO ADOPT REGULATIONS AS ARE
REQUIRED TO IMPLEMENT THIS SECTION. ANY PENALTY ASSESSED  AND  RECOVERED
IN AN ACTION BROUGHT UNDER THIS SECTION SHALL BE PAID TO AND USED BY THE
MUNICIPALITY BRINGING THE ACTION.
  3.  THIS  SECTION  SHALL  NOT APPLY TO INDIVIDUALS WALKING THROUGH THE
DESIGNATED NO SMOKING ZONE OF SUCH AREA FOR THE PURPOSE  OF  GETTING  TO
ANOTHER  DESTINATION,  BUT SHALL ONLY APPLY TO INDIVIDUALS OCCUPYING THE
DESIGNATED NO SMOKING ZONE FOR THE PURPOSE OF SMOKING.

S. 2363                             8

  4. ANY PERSON VIOLATING THE PROVISIONS OF THIS SECTION SHALL BE GUILTY
OF A VIOLATION, AND IS SUBJECT TO A FINE OF THIRTY-FIVE DOLLARS.
  5.  THE COMMISSIONER MAY RECOMMEND DESIGNS FOR SIGNS WHICH MAY BE USED
BY THE OWNERS, OPERATORS, MANAGERS, EMPLOYERS OR OTHER PERSONS, AT THEIR
OPTION, WHO CONTROL  AREAS  WHERE  SMOKING  IS  PROHIBITED  PURSUANT  TO
SECTION THIRTEEN HUNDRED NINETY-NINE-O OF THIS ARTICLE. SUCH SIGNS SHALL
INCLUDE  THE WARNING THAT "SMOKING IN THIS AREA IS PUNISHABLE BY LAW AND
ALL VIOLATORS SHALL BE SUBJECT TO A FINE OF THIRTY-FIVE DOLLARS."
  6. NOTHING CONTAINED IN THIS SECTION IS INTENDED TO  REGULATE  SMOKING
IN  A  PRIVATE  RESIDENCE  OR  IN THE GENERAL PUBLIC OUTDOORS, EXCEPTING
PLACES IN WHICH SMOKING IS PROHIBITED THROUGH THE LOCAL FIRE DEPARTMENT,
OR BY OTHER LAW, ORDINANCE, OR REGULATION.
  S 3. This act shall take effect on the one hundred twentieth day after
it shall have become a law.

                                 PART G

  Section 1. The education law is amended by adding a new section 3001-e
to read as follows:
  S 3001-E. ASTHMA EMERGENCIES; TRAINING IN IDENTIFICATION AND RESPONSE.
THE COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONER OF HEALTH, SHALL
ESTABLISH STANDARDS FOR THE TRAINING OF TEACHERS AND  OTHER  APPROPRIATE
PERSONNEL  IN IDENTIFYING AND RESPONDING TO ASTHMA EMERGENCIES IN PUPILS
AND OTHER PERSONS. SUCH STANDARDS SHALL SPECIFY MINIMUM LEVELS OF  KNOW-
LEDGE  AND PROCEDURES TO BE FOLLOWED. SUCH STANDARDS SHALL PERMIT TRAIN-
ING TO BE GIVEN BY PERSONS OR ORGANIZATIONS DEEMED QUALIFIED TO DO SO BY
THE COMMISSIONER.
  S 2. This act shall take effect one year after it shall have become  a
law.

                                 PART H

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

                                 PART I

  Section 1. The education law is amended by adding a new section 1527-a
to read as follows:
  S 1527-A. IDLING MOTOR VEHICLES ON SCHOOL GROUNDS.  1.  ON  OR  BEFORE
SEPTEMBER  FIRST,  TWO  THOUSAND FIFTEEN AND CONSISTENT WITH THE COMMIS-
SIONER'S REGULATIONS, ADOPTED PURSUANT  TO  SECTION  THIRTY-SIX  HUNDRED
THIRTY-SEVEN  OF  THIS CHAPTER, THE BOARD OF EDUCATION OR BOARD OF TRUS-
TEES OF EVERY SCHOOL DISTRICT AND THE GOVERNING BODY  OF  EVERY  PRIVATE
ELEMENTARY  OR SECONDARY SCHOOL IN THE STATE SHALL PROMULGATE AND IMPLE-

S. 2363                             9

MENT RULES PROHIBITING THE ENGINE OF ANY MOTOR VEHICLE,  AS  DEFINED  IN
SECTION  ONE  HUNDRED  TWENTY-FIVE  OF  THE  VEHICLE AND TRAFFIC LAW, TO
REMAIN IDLING FOR MORE THAN ONE MINUTE WHILE SUCH VEHICLE IS  PARKED  OR
STANDING  ON  SCHOOL GROUNDS, ADJACENT TO SCHOOL GROUNDS, OR IN FRONT OF
ANY SCHOOL WHILE LOADING OR OFF LOADING PASSENGERS.
  2. EACH SCHOOL DISTRICT AND PRIVATE ELEMENTARY  AND  SECONDARY  SCHOOL
SHALL  CONSPICUOUSLY  POST  SIGNS  UPON, ADJACENT AND IN FRONT OF SCHOOL
GROUNDS ADVISING OPERATORS OF MOTOR VEHICLES OF THE  PROVISIONS  OF  THE
RULES ADOPTED PURSUANT TO SUBDIVISION ONE OF THIS SECTION.
  S 2. This act shall take effect immediately.

                                 PART J

  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-
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  SUBDIVISION  ONE  OF  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,

S. 2363                            10

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 K

  Section 1. Subdivision 7  of  section  33-0303  of  the  environmental
conservation law, as added by chapter 85 of the laws of 2010, is amended
to read as follows:
  7.  The  commissioner, in consultation with the commissioner of educa-
tion and the commissioner of health, shall develop  guidance  AND  REGU-
LATIONS  on pesticide alternatives to facilitate compliance with section
four hundred nine-k of the education law and three hundred  ninety-g  of
the social services law. PROVIDED, FURTHER, THAT SUCH PESTICIDE ALTERNA-
TIVES  SHALL  HELP TO MINIMIZE THE INCIDENCE OF ASTHMA ATTACKS IN PUBLIC
AND PRIVATE BUILDINGS AND RESIDENCES, WHILE STILL  EFFECTIVELY  CONTROL-
LING  THE TARGETED PEST OR ORGANISM.  SUCH REGULATIONS SHALL PROVIDE FOR
THE USE OF THE LEAST TOXIC PESTICIDE OR  PESTICIDES,  WHICH  EFFECTIVELY
ERADICATES THE TARGETED PEST OR ORGANISM.
  S 2. This act shall take effect immediately.

                                 PART L

  Section  1.    The  public  buildings  law  is amended by adding a new
section 143 to read as follows:
  S 143. CURTAIL USE OF CHEMICALS THAT INDUCE OR TRIGGER ASTHMA ATTACKS.
1.  NOTWITHSTANDING ANY OTHER PROVISION OF  LAW  TO  THE  CONTRARY,  THE
SUPERINTENDENT  OF EVERY STATE PUBLIC BUILDING, AND OF EVERY TRANSPORTA-
TION FACILITY OPERATED BY A PUBLIC AUTHORITY, PUBLIC BENEFIT CORPORATION
OR MUNICIPALITY SHALL TO THE BEST OF HIS OR HER ABILITY CURTAIL THE  USE
OF  CLEANING  MATERIALS OR CHEMICALS, EXPOSURE TO WHICH MAY CAUSE EITHER
THE BUILDING CLEANING STAFF OR OTHER PERSONS WHO ENTER SUCH BUILDING  TO
DEVELOP  THE  DISEASE  OF  ASTHMA, OR WHICH MAY EXACERBATE OR TRIGGER AN
ASTHMA ATTACK.
  2. A DETERMINATION OF WHICH OR THE QUANTITY OR CONCENTRATION  OF  SUCH
CLEANING  MATERIALS  OR CHEMICALS EXPOSURE TO WHICH MAY CAUSE PERSONS TO
DEVELOP THE DISEASE OF ASTHMA, OR WHICH MAY  EXACERBATE  OR  TRIGGER  AN
ASTHMA  ATTACK,  SHALL  BE  MADE BY THE COMMISSIONER OF HEALTH WHO SHALL
PROMULGATE A LIST OF SUCH CLEANING MATERIALS OR CHEMICALS.
  S 2. This act shall take effect on the one hundred eightieth day after
it shall have become a law.
  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 L of this act shall be
as specifically set forth in the last section of such Parts.

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