S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   5161
 
                        2017-2018 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             February 6, 2017
                                ___________
 
 Introduced by M. of A. CRESPO -- read once and referred 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 smoking restrictions in  certain
   outdoor  areas  (Part  E);  to amend the education law, in relation to
   requiring all teachers to be trained in identifying and responding  to
   asthma  emergencies  (Part  F);  to  amend  the  real property law, in
   relation to residential rental property smoking policies (Part G);  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 H); to amend the
   education law, in relation to the use of inhalers and nebulizers (Part
   I); to amend the environmental conservation law, in relation to pesti-
   cide alternatives used at schools and day care centers (Part  J);  and
   to  amend  the public buildings law, in relation to curtailing the use
   of cleaning materials that induce or trigger asthma episodes (Part K)
 
   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 K. 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
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD08181-01-7

 A. 5161                             2
 
 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.
   § 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.
   § 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.
   § 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

 A. 5161                             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.
   §  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.

 A. 5161                             4
 
   § 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 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.
   § 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.
   § 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.
   § 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.
   § 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.

 A. 5161                             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.
   § 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.
   §  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.
   § 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

 A. 5161                             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.
   § 2. This act shall take effect immediately.
 
                                  PART E
 
   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.
   §  2.  Section  1399-o-1 of the public health law, as added by chapter
 102 of the laws of 2013, is amended to read as follows:
   § 1399-o-1. Smoking restrictions; certain outdoor areas. 1.  A.  Smok-
 ing  shall  not  be permitted and no person shall smoke during the hours
 between sunrise and sunset, when one or more persons under  the  age  of

 A. 5161                             7
 
 twelve are present at any playground. For the purposes of this [section]
 SUBDIVISION,  the  term  "playground"  means  an improved area designed,
 equipped, and set aside for play of six or more children  which  is  not
 intended  for  use  as  an athletic playing field or athletic court, and
 shall include any play equipment, surfacing,  fencing,  signs,  internal
 pathways, internal land forms, vegetation, and related structures. Play-
 grounds  or playground equipment constructed upon one, two and three-fa-
 mily residential real property are exempt from the requirements of  this
 [section]  SUBDIVISION.    This [section] SUBDIVISION shall not apply to
 any playground located within the city of New York.
   [2.] B. No police officer, peace officer, regulatory  officer  or  law
 enforcement  official  may  arrest,  ticket, stop or question any person
 based solely or in part on an alleged violation of PARAGRAPH A  OF  THIS
 subdivision [one of this section], nor may an alleged violation of PARA-
 GRAPH A OF THIS subdivision [one of this section] support probable cause
 to  conduct  any  search  or  limited search of any person or his or her
 immediate surroundings.
   2. A. 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
 FACILITIES FOR ELEMENTARY OR SECONDARY SCHOOL STUDENTS.   SUCH  DISTANCE
 SHALL BECOME A DESIGNATED NO SMOKING ZONE.
   B. LOCAL HEALTH DEPARTMENTS ARE AUTHORIZED TO ADOPT REGULATIONS AS ARE
 REQUIRED  TO IMPLEMENT THIS SUBDIVISION. ANY PENALTY ASSESSED AND RECOV-
 ERED IN AN ACTION BROUGHT UNDER THIS SUBDIVISION SHALL BE  PAID  TO  AND
 USED BY THE MUNICIPALITY BRINGING THE ACTION.
   C. THIS SUBDIVISION 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.
   D.  ANY  PERSON  VIOLATING THE PROVISIONS OF THIS SUBDIVISION SHALL BE
 GUILTY OF A VIOLATION, AND IS SUBJECT TO A FINE OF THIRTY-FIVE DOLLARS.
   E. 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."
   F. NOTHING CONTAINED IN THIS SUBDIVISION IS INTENDED TO REGULATE SMOK-
 ING  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.
   § 3. This act shall take effect on the one hundred twentieth day after
 it shall have become a law.
 
                                  PART F
 
   Section 1. The education law is amended by adding a new section 3001-e
 to read as follows:
   § 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-

 A. 5161                             8
 
 ING TO BE GIVEN BY PERSONS OR ORGANIZATIONS DEEMED QUALIFIED TO DO SO BY
 THE COMMISSIONER.
   §  2. This act shall take effect one year after it shall have become a
 law.
 
                                  PART G
 
   Section 1. The real property law is amended by adding  a  new  section
 235-h to read as follows:
   §  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.
   § 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 H
 
   Section 1. The education law is amended by adding a new section 1527-a
 to read as follows:
   §  1527-A.  IDLING  MOTOR  VEHICLES ON SCHOOL GROUNDS. 1. ON OR BEFORE
 SEPTEMBER FIRST, TWO THOUSAND NINETEEN 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.
   § 2. This act shall take effect immediately.
 
                                  PART I
 
   Section 1.  The education law is amended by adding a new  section  923
 to read as follows:
   § 923. 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. 5161                             9
 
 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.
   § 2. 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 J
 
   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.
   § 2. This act shall take effect immediately.
 
                                  PART K

   Section 1.   The public buildings law  is  amended  by  adding  a  new
 section 144 to read as follows:
   § 144. 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.
   § 2. This act shall take effect on the one hundred eightieth day after
 it shall have become a law.
   §  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. 5161                            10
 
 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.
   §  4.  This  act shall take effect immediately provided, however, that
 the applicable effective date of Parts A through K of this act shall  be
 as specifically set forth in the last section of such Parts.