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

                                 2417--A

                       2013-2014 Regular Sessions

                          I N  A S S E M B L Y

                            January 15, 2013
                               ___________

Introduced by M. of A. CRESPO, RODRIGUEZ, CASTRO, ARROYO, RIVERA, RAMOS,
  ESPINAL,  MOYA, ORTIZ, SEPULVEDA, PRETLOW -- read once and referred to
  the Committee on Health -- committee discharged, bill amended, ordered
  reprinted as amended and recommitted to said committee

AN ACT to amend the public health law, in relation to  establishing  the
  asthma  prevention and education program (Part A); to amend the public
  health  law,  in  relation  to  in-utero  exposure  to  tobacco  smoke
  prevention  (Part  B);  to amend the public health law, in relation to
  reporting on the incidence of asthma (Part C);  to  amend  the  public
  health  law,  in  relation  to  including certain respiratory diseases
  within disease management demonstration programs (Part  D);  to  amend
  the  public  health  law,  in  relation to 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:

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD00970-03-3

A. 2417--A                          2
              

  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
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

A. 2417--A                          3

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
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

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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 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

A. 2417--A                          5

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.
  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:

A. 2417--A                          6

  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, 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

A. 2417--A                          7

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  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

A. 2417--A                          8

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.
  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:

A. 2417--A                          9

  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-
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

A. 2417--A                         10

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,
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-

A. 2417--A                         11

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.