S T A T E O F N E W Y O R K ________________________________________________________________________ 6505--A 2015-2016 Regular Sessions I N A S S E M B L Y March 25, 2015 ___________ Introduced by M. of A. CRESPO, PICHARDO, RIVERA, COOK, CROUCH, FINCH, RAIA, DILAN -- Multi-Sponsored by -- M. of A. LUPINACCI -- read once and referred to the Committee on Health -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said commit- tee 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. LBD03883-04-5 A. 6505--A 2 1 Section 1. This act enacts into law major components of legislation 2 which combat the incidence of asthma and other respiratory diseases such 3 as emphysema and chronic bronchitis. Each component is wholly contained 4 within a Part identified as Parts A through L. The effective date for 5 each particular provision contained within such Part is set forth in the 6 last section of such Part. Any provision in any section contained within 7 a Part, including the effective date of the Part, which makes a refer- 8 ence to a section "of this act", when used in connection with that 9 particular component, shall be deemed to mean and refer to the corre- 10 sponding section of the Part in which it is found. Section four of this 11 act sets forth the general effective date of this act. 12 S 2. Legislative findings and purpose. The legislature finds that 13 asthma is a chronic, potentially life-threatening, respiratory illness 14 that affects over a million New Yorkers, including thousands of children 15 and adolescents. Asthma is the leading cause of school absences attri- 16 buted to chronic conditions. Asthma is also directly linked to large and 17 growing inpatient bills for medicaid and other health care payers. 18 Therefore, the legislature finds that establishing a comprehensive 19 statewide asthma prevention management and control program which coordi- 20 nates the efforts of individuals, families, health care providers, 21 schools and community-based organizations is in the public interest and 22 would benefit the people of the state of New York. 23 PART A 24 Section 1. The public health law is amended by adding a new article 25 27-BB to read as follows: 26 ARTICLE 27-BB 27 ASTHMA DISEASE MANAGEMENT AND CONTROL 28 SECTION 2725. ASTHMA DISEASE MANAGEMENT AND CONTROL PROGRAM. 29 2726. STUDY OF ASTHMA INCIDENCE AND PREVALENCE. 30 2727. ANNUAL REPORT. 31 S 2725. ASTHMA DISEASE MANAGEMENT AND CONTROL PROGRAM. 1. THERE IS 32 HEREBY CREATED WITHIN THE DEPARTMENT THE ASTHMA DISEASE MANAGEMENT AND 33 CONTROL PROGRAM (HEREINAFTER REFERRED TO IN THIS ARTICLE AS THE 34 "PROGRAM"). THE PURPOSE OF THE PROGRAM IS TO PROMOTE ASTHMA DISEASE 35 MANAGEMENT AND EDUCATION AND OUTREACH ABOUT ASTHMA TO PEOPLE WHO SUFFER 36 FROM ASTHMA AND THEIR FAMILIES, HEALTH CARE PROVIDERS, AND THE GENERAL 37 PUBLIC. 38 2. SERVICES TO BE PROVIDED BY THE PROGRAM MAY INCLUDE: 39 (A) ASTHMA DISEASE MANAGEMENT AND CASE MANAGEMENT FOR PATIENTS AND 40 THEIR FAMILIES; 41 (B) ASTHMA OUTREACH AND SCREENING; 42 (C) THE PROMOTION OF AWARENESS OF THE CAUSES OF ASTHMA; 43 (D) EDUCATION ON PREVENTION STRATEGIES; 44 (E) EDUCATION ON PROPER DISEASE MANAGEMENT PRACTICES; AND 45 (F) EDUCATION ON AVAILABLE TREATMENT MODALITIES. 46 3. THE COMMISSIONER SHALL MAKE GRANTS WITHIN THE AMOUNTS APPROPRIATED 47 THEREFOR TO LOCAL HEALTH AGENCIES, HEALTH CARE PROVIDERS, SCHOOLS, 48 SCHOOL BASED HEALTH CENTERS AND COMMUNITY-BASED ORGANIZATIONS, AND OTHER 49 ORGANIZATIONS WITH DEMONSTRATED INTEREST AND EXPERTISE IN SERVING 50 PERSONS WITH ASTHMA TO PROVIDE THE SERVICES SET OUT IN THIS SECTION. 51 GRANT RECIPIENTS SHALL BE GOVERNMENT ENTITIES OR NOT-FOR-PROFIT ORGAN- 52 IZATIONS. 53 THE COMMISSIONER MAY COORDINATE GRANTS UNDER THIS SUBDIVISION WITH THE 54 AVAILABILITY OF GRANTS FROM OTHER SOURCES. THE COMMISSIONER MAY ALSO A. 6505--A 3 1 ACCEPT OR SEEK GRANTS FROM OTHER SOURCES TO ENHANCE THE AMOUNTS APPRO- 2 PRIATED TO THE PROGRAM. 3 S 2726. STUDY OF ASTHMA INCIDENCE AND PREVALENCE. 1. THE DEPARTMENT 4 SHALL STUDY THE INCIDENCE AND PREVALENCE OF ASTHMA IN THE STATE'S POPU- 5 LATION AND CURRENT DISEASE MANAGEMENT PRACTICES. SUCH STUDY SHALL 6 UTILIZE INFORMATION OBTAINED PURSUANT TO ARTICLE TWENTY-FOUR-F OF THIS 7 CHAPTER, AND INCLUDE: 8 (A) THE CAUSE AND NATURE OF THE DISEASE; 9 (B) BEHAVIORAL AND ENVIRONMENTAL TRIGGERS; 10 (C) AN ASSESSMENT OF THE NEED FOR PATIENT-CENTERED CASE MANAGEMENT TO 11 MEET SPECIFIC PHYSICAL AND ENVIRONMENTAL NEEDS OF PATIENTS; 12 (D) OUTCOME EVALUATIONS, INCLUDING, BUT NOT LIMITED TO, PATIENT 13 PERCEPTIONS OF IMPROVEMENT, SIGNS AND SYMPTOMS OF ASTHMA, PULMONARY 14 FUNCTION, HISTORY OF ASTHMA EXACERBATIONS, PHARMACOTHERAPY, ASSESSMENT 15 OF HOSPITAL EMERGENCY ROOM VISITS FOR ASTHMA, AND PATIENT-PROVIDER 16 COMMUNICATION; AND 17 (E) AN ASSESSMENT OF THE ABILITY OF PROVIDERS, INCLUDING NON-PROFES- 18 SIONALS AND HEALTH CARE PROFESSIONALS SUCH AS PHYSICIANS, NURSES, PHAR- 19 MACISTS AND RESPIRATORY THERAPISTS, TO SYSTEMICALLY INSTRUCT AND DEVELOP 20 ASTHMA MANAGEMENT PLANS FOR PATIENTS AND FREQUENTLY REVIEW WITH PATIENTS 21 AND THEIR FAMILIES HOW TO MANAGE AND CONTROL THEIR ASTHMA. 22 2. THE DEPARTMENT SHALL GATHER DATA FOR MONITORING THE OCCURRENCE, 23 FREQUENCY, INCIDENCE, CAUSE, EFFECT AND SEVERITY OF ASTHMA. 24 (A) THE DEPARTMENT MAY REQUIRE THE FOLLOWING TO REPORT DATA UNDER THIS 25 SUBDIVISION: 26 I. THE STATEWIDE PLANNING AND RESEARCH COOPERATIVE SYSTEM (SPARCS); 27 II. HEALTH MAINTENANCE ORGANIZATIONS LICENSED PURSUANT TO ARTICLE 28 FORTY-THREE OF THE INSURANCE LAW OR CERTIFIED PURSUANT TO THIS CHAPTER 29 OR AN INDEPENDENT PRACTICE ASSOCIATION CERTIFIED OR RECOGNIZED PURSUANT 30 TO THIS CHAPTER; 31 III. OTHER INSURERS; 32 IV. THE MEDICAID (TITLE XIX OF THE FEDERAL SOCIAL SECURITY ACT) 33 PROGRAM; 34 V. HEALTH FACILITIES; 35 VI. HEALTH CARE PRACTITIONERS; 36 VII. PATIENTS: SELF REPORTING; 37 VIII. THE DEPARTMENT OF ENVIRONMENTAL CONSERVATION; AND 38 IX. ANY OTHER SOURCE THE COMMISSIONER DEEMS APPROPRIATE. 39 (B) THE DEPARTMENT SHALL COMPILE AND ANALYZE DATA GATHERED UNDER PARA- 40 GRAPH (A) OF THIS SUBDIVISION AND ARTICLE TWENTY-FOUR-F OF THIS CHAPTER, 41 AND CORRELATE IT WITH DATA AS TO PLACES OF EMPLOYMENT, AREAS OF RESI- 42 DENCE, SCHOOLS ATTENDED, AGES OF THOSE AFFLICTED, ENVIRONMENTAL FACTORS 43 INCLUDING PROXIMITY TO SOURCE OF POLLUTION AND SUCH OTHER DATA AS THE 44 DEPARTMENT DEEMS APPROPRIATE. 45 (C) THE DEPARTMENT SHALL MAINTAIN AND COMPILE REPORTED DATA IN A 46 MANNER SUITABLE FOR RESEARCH PURPOSES AND SHALL COLLECT AND MAKE SUCH 47 DATA AVAILABLE TO PERSONS IN THE MANNER SET FORTH IN SUBDIVISION THREE 48 OF THIS SECTION. 49 3. ANY DATA COLLECTED OR REPORTED SHALL NOT CONTAIN THE NAME OF ANY 50 PATIENT, HIS OR HER SOCIAL SECURITY NUMBER, OR ANY OTHER INFORMATION 51 WHICH WOULD PERMIT A PATIENT TO BE IDENTIFIED. THE DEPARTMENT SHALL 52 DEVELOP A UNIQUE, CONFIDENTIAL IDENTIFIER TO BE USED IN THE COLLECTION 53 OF PATIENT INFORMATION AS REQUIRED BY THIS SECTION. 54 S 2727. ANNUAL REPORT. ON OR BEFORE THE FIRST OF JANUARY DURING THE 55 TWO CALENDAR YEARS NEXT SUCCEEDING THE EFFECTIVE DATE OF THIS SECTION 56 AND BIENNIALLY THEREAFTER, THE COMMISSIONER SHALL SUBMIT A REPORT A. 6505--A 4 1 REGARDING THE STATUS AND ACCOMPLISHMENTS OF THE PROGRAM AND PROVIDE 2 RECOMMENDATIONS TO THE GOVERNOR, THE TEMPORARY PRESIDENT AND THE MINORI- 3 TY LEADER OF THE SENATE, AND THE SPEAKER AND THE MINORITY LEADER OF THE 4 ASSEMBLY. SUCH REPORT MAY BE SUBMITTED IN CONJUNCTION WITH THE REPORT 5 REQUIRED BY ARTICLE TWENTY-FOUR-F OF THIS CHAPTER. 6 S 2. This act shall take effect on the one hundred eightieth day after 7 it shall have become law. Effective immediately the commissioner of 8 health is authorized to promulgate any and all rules and regulations and 9 take any other measures necessary to implement the provisions of this 10 act on its effective date. 11 PART B 12 Section 1. The public health law is amended by adding a new article 13 13-I to read as follows: 14 ARTICLE 13-I 15 IN-UTERO EXPOSURE TO TOBACCO SMOKE PREVENTION 16 SECTION 1399-XX. IN-UTERO EXPOSURE PREVENTION. 17 1399-YY. PROGRAMS. 18 S 1399-XX. IN-UTERO EXPOSURE PREVENTION. 1. EVERY HEALTHCARE PROVIDER, 19 HEALTHCARE INSURER AND PREGNANCY PROGRAM SHALL DISTRIBUTE INFORMATION ON 20 THE ADVERSE EFFECTS OF SMOKING DURING PREGNANCY FOR BOTH FIRSTHAND AND 21 SECONDHAND SMOKE. SUCH ADVERSE EFFECTS TO THE INFANT INCLUDE LOWER BIRTH 22 RATES, HIGHER INCIDENCE OF ASTHMA AND OBESITY, AND COGNITIVE AND DEVEL- 23 OPMENTAL DAMAGE. 24 2. EVERY HEALTHCARE PROVIDER SHALL MONITOR EXPECTANT MOTHERS' SMOKING 25 STATUSES AND OFFER CONTINUOUS TAILORED DISCUSSION OF QUITTING SMOKING 26 WITH EXPECTANT MOTHERS DURING THEIR PRENATAL CARE. 27 S 1399-YY. PROGRAMS. THE FOLLOWING PROGRAMS SHALL BE ADDED TO EXISTING 28 TOBACCO CONTROL PROGRAMS FOR PREGNANT WOMEN OR TO OTHER PREGNANCY 29 RELATED PROGRAMS: 30 1. CARBON MONOXIDE MONITORING; 31 2. DEPRESSION, SOCIAL SUPPORT AND DOMESTIC VIOLENCE SCREENING AND 32 REFERRALS; 33 3. REFERRALS FOR SMOKING CESSATION FOR HOUSEHOLD MEMBERS; 34 4. ONGOING SUPPORT BY COUNSELING AND EDUCATIONAL MATERIALS; AND 35 5. FINANCIAL INCENTIVES SUCH AS SHIPPING VOUCHER OR DIAPER COUPONS FOR 36 QUITTING FOR MORE THAN FOUR WEEKS. 37 S 2. This act shall take effect on the one hundred eightieth day after 38 it shall have become a law. Provided, that effective immediately the 39 commissioner of health is authorized and directed to promulgate any and 40 all rules and regulations, and take any other measures necessary to 41 implement the provisions of this act on its effective date. 42 PART C 43 Section 1. The public health law is amended by adding a new article 44 24-F to read as follows: 45 ARTICLE 24-F 46 ASTHMA REPORTING 47 SECTION 2499-B. ASTHMA; DUTY TO REPORT. 48 2499-C. REPORTING. 49 2499-D. ASTHMA; REPORTS CONFIDENTIAL. 50 S 2499-B. ASTHMA; DUTY TO REPORT. 1. EVERY PHYSICIAN AND OTHER HEALTH 51 CARE PROVIDER SHALL GIVE NOTICE TO THE DEPARTMENT WITHIN THIRTY DAYS OF A. 6505--A 5 1 EVERY INCIDENT OF AN ASTHMA ATTACK COMING UNDER HIS OR HER CARE, EXCEPT 2 AS OTHERWISE PROVIDED. 3 2. THE PERSON IN CHARGE OF EVERY ASTHMA REPORTING FACILITY SHALL GIVE 4 NOTICE TO THE DEPARTMENT WITHIN THIRTY DAYS OF EVERY INCIDENT OF AN 5 ASTHMA ATTACK COMING UNDER THE CARE OF SUCH FACILITY. 6 3. THE DEPARTMENT SHALL ESTABLISH REGULATIONS DESIGNATING WHICH 7 SPECIFIC INFORMATION SHALL BE REPORTED TO THE DEPARTMENT PURSUANT TO 8 THIS SECTION. 9 4. A PHYSICIAN OR HEALTH CARE PROVIDER OR ASTHMA REPORTING FACILITY 10 WHICH VIOLATES ANY PROVISION OF THIS SECTION SHALL BE SUBJECT TO A CIVIL 11 PENALTY PURSUANT TO SECTION TWELVE OF THIS CHAPTER. 12 5. THE NOTICES REQUIRED BY THIS SECTION SHALL BE UPON FORMS SUPPLIED 13 BY THE COMMISSIONER AND SHALL CONTAIN SUCH INFORMATION AS SHALL BE 14 REQUIRED BY THE COMMISSIONER. 15 6. FOR THE PURPOSES OF THIS SECTION, AN "ASTHMA REPORTING FACILITY" 16 MEANS A HOSPITAL AS DEFINED IN ARTICLE TWENTY-EIGHT OF THIS CHAPTER, 17 CLINIC, ANY ORGANIZATION CERTIFIED PURSUANT TO ARTICLE FORTY-FOUR OF 18 THIS CHAPTER, OR OTHER SIMILAR PUBLIC OR PRIVATE INSTITUTION. 19 S 2499-C. REPORTING. 1. THE COMMISSIONER SHALL SUBMIT BIENNIAL REPORTS 20 TO THE GOVERNOR, THE TEMPORARY PRESIDENT OF THE SENATE, THE SPEAKER OF 21 THE ASSEMBLY, THE MINORITY LEADER OF THE SENATE AND THE MINORITY LEADER 22 OF THE ASSEMBLY. THE REPORTS SHALL INCLUDE AN EVALUATION OF THE ASTHMA 23 REGISTRY AS IT RELATES TO TIMELINESS, QUALITY AND COMPLETENESS; AN EVAL- 24 UATION OF THE UTILITY OF THE REGISTRY FOR SCIENTIFIC RESEARCH; AN EVALU- 25 ATION OF THE ACCESS, TIMELINESS AND QUALITY OF REPORTING INFORMATION TO 26 RESEARCHERS AND OTHER SIMILAR INDIVIDUALS; AN EVALUATION OF THE REGIS- 27 TRY'S DATA ELEMENTS, INCLUDING TREATMENT, SEVERITY OF DISEASE, OCCUPA- 28 TION, AGE AND RESIDENCE; AN EVALUATION OF THE FEASIBILITY AND UTILITY OF 29 INCLUSION OF OCCUPATIONAL HISTORY AND RESIDENCE HISTORY; AND AN EVALU- 30 ATION OF INTEGRATING THE REGISTRY WITH OTHER DATABASES MAINTAINED BY 31 STATE AGENCIES AND DEPARTMENTS, INCLUDING THE STATEWIDE PLANNING AND 32 RESEARCH COOPERATIVE SYSTEM. 33 2. THE COMMISSIONER SHALL SUBMIT AN ANNUAL REPORT TO THE GOVERNOR, THE 34 TEMPORARY PRESIDENT OF THE SENATE, THE SPEAKER OF THE ASSEMBLY, THE 35 MINORITY LEADER OF THE SENATE AND THE MINORITY LEADER OF THE ASSEMBLY. 36 SUCH REPORT SHALL INCLUDE AN EVALUATION OF WHETHER THE REGISTRY IS 37 ACHIEVING ASTHMA INCIDENCE REGISTRY GOALS ESTABLISHED BY A NATIONALLY 38 RECOGNIZED ASTHMA REGISTRY ORGANIZATION, INCLUDING NUMERICAL GOALS 39 CONCERNING TIMELINESS, QUALITY, AND COMPLETENESS. 40 S 2499-D. ASTHMA; REPORTS CONFIDENTIAL. THE REPORTS OF ASTHMA ATTACKS 41 MADE PURSUANT TO THE PROVISIONS OF THIS ARTICLE SHALL NOT BE DIVULGED OR 42 MADE PUBLIC BY ANY PERSON SO AS TO DISCLOSE THE IDENTITY OF ANY PERSON 43 TO WHOM THEY RELATE, EXCEPT IN SO FAR AS MAY BE AUTHORIZED IN THE SANI- 44 TARY CODE. 45 S 2. This act shall take effect on the one hundred eightieth day after 46 it shall have become a law. Effective immediately, the commissioner of 47 health is authorized to promulgate any and all rules and regulations and 48 take any other measures necessary to implement this act on its effective 49 date on or before such date. 50 PART D 51 Section 1. Subdivisions 2 and 4 of section 2111 of the public health 52 law, as added by section 21 of part C of chapter 58 of the laws of 2004, 53 are amended to read as follows: A. 6505--A 6 1 2. The department shall establish the criteria by which individuals 2 will be identified as eligible for enrollment in the demonstration 3 programs. Persons eligible for enrollment in the disease management 4 demonstration program shall be limited to individuals who: receive 5 medical assistance pursuant to title eleven of article five of the 6 social services law and may be eligible for benefits pursuant to title 7 18 of the social security act (Medicare); are not enrolled in a Medicaid 8 managed care plan, including individuals who are not required or not 9 eligible to participate in Medicaid managed care programs pursuant to 10 section three hundred sixty-four-j of the social services law; are diag- 11 nosed with chronic health problems as may be specified by the entity 12 undertaking the demonstration program, including, but not limited to one 13 or more of the following: congestive heart failure, chronic obstructive 14 pulmonary disease, asthma, EMPHYSEMA, CHRONIC BRONCHITIS, OTHER RESPIR- 15 ATORY DISEASES, diabetes or other chronic health conditions as may be 16 specified by the department; or have experienced or are likely to expe- 17 rience one or more hospitalizations or are otherwise expected to incur 18 excessive costs and high utilization of health care services. 19 4. The demonstration program shall offer evidence-based services and 20 interventions designed to ensure that the enrollees receive high quali- 21 ty, preventative and cost-effective care, aimed at reducing the necessi- 22 ty for hospitalization or emergency room care or at reducing lengths of 23 stay when hospitalization is necessary. The demonstration program may 24 include screening of eligible enrollees, developing an individualized 25 care management plan for each enrollee and implementing that plan. 26 Disease management demonstration programs that utilize information tech- 27 nology systems that allow for continuous application of evidence-based 28 guidelines to medical assistance claims data and other available data to 29 identify specific instances in which clinical interventions are justi- 30 fied and communicate indicated interventions to physicians, health care 31 providers and/or patients, and monitor physician and health care provid- 32 er response to such interventions, shall have the enrollees, or groups 33 of enrollees, approved by the department for participation. The services 34 provided by the demonstration program as part of the care management 35 plan may include, but are not limited to, case management, social work, 36 individualized health counselors, multi-behavioral goals plans, claims 37 data management, health and self-care education, drug therapy management 38 and oversight, personal emergency response systems and other monitoring 39 technologies, SYSTEMATIC CHRONIC HEALTH CONDITIONS IDENTIFIED FOR MONI- 40 TORING, telehealth services and similar services designed to improve the 41 quality and cost-effectiveness of health care services. 42 S 2. This act shall take effect immediately. 43 PART E 44 Section 1. Subdivision 1 of section 2599-b of the public health law, 45 as amended by section 88 of part B of chapter 58 of the laws of 2005, is 46 amended to read as follows: 47 1. The program shall be designed to prevent and reduce the incidence 48 and prevalence of obesity in children and adolescents, especially among 49 populations with high rates of obesity and obesity-related health 50 complications including, but not limited to, diabetes, heart disease, 51 cancer, osteoarthritis, asthma, EMPHYSEMA, CHRONIC BRONCHITIS, OTHER 52 CHRONIC RESPIRATORY DISEASES and other conditions. The program shall use 53 recommendations and goals of the United States departments of agricul- 54 ture and health and human services, the surgeon general and centers for A. 6505--A 7 1 disease control in developing and implementing guidelines for nutrition 2 education and physical activity projects as part of obesity prevention 3 efforts. The content and implementation of the program shall stress the 4 benefits of choosing a balanced, healthful diet from the many options 5 available to consumers, without specifically targeting the elimination 6 of any particular food group, food product or food-related industry. 7 S 2. Paragraphs (f) and (g) of subdivision 2 of section 2599-b of the 8 public health law, as amended by section 88 of part B of chapter 58 of 9 the laws of 2005, are amended and a new paragraph (h) is added to read 10 as follows: 11 (f) developing training programs for medical and other health profes- 12 sionals to teach practical skills in nutrition and exercise education to 13 children and their parents and caregivers; [and] 14 (g) developing screening programs in coordination with health care 15 providers and institutions including but not limited to day care centers 16 and schools for overweight and obesity for children aged two through 17 eighteen years, using body mass index (BMI) appropriate for age and 18 gender, and notification, in a manner protecting the confidentiality of 19 such children and their families, of parents of BMI status, and explana- 20 tion of the consequences of such status, including recommended actions 21 parents may need to take and information about resources and referrals 22 available to families to enhance nutrition and physical activity to 23 reduce and prevent obesity[.]; AND 24 (H) COORDINATING WITH THE EDUCATION DEPARTMENT, OFFICE OF TEMPORARY 25 AND DISABILITY ASSISTANCE, OFFICE OF CHILDREN AND FAMILY SERVICES AND 26 OTHER FEDERAL, STATE AND LOCAL AGENCIES TO INCORPORATE STRATEGIES TO 27 CURTAIL THE INCIDENCE OF ASTHMA, EMPHYSEMA, CHRONIC BRONCHITIS AND OTHER 28 CHRONIC RESPIRATORY DISEASES TO ENABLE ADULTS AND CHILDREN TO SAFELY 29 INCREASE PHYSICAL ACTIVITY TO HELP CURB THE INCIDENCE OF OBESITY. 30 S 3. This act shall take effect immediately. 31 PART F 32 Section 1. Legislative intent. The legislature recognizes that expo- 33 sure to second-hand smoke is known to cause cancer, pneumonia, asthma, 34 bronchitis and heart disease in humans, and to trigger asthma attacks. 35 The legislature finds that prohibiting smoking within a presumptively 36 reasonable minimum distance of fifteen feet from entrances and exits 37 that serve enclosed areas where smoking is prohibited is consistent with 38 such prohibition. This legislation will apply to any individual occupy- 39 ing such area with the purpose of smoking, but provides exceptions for 40 individuals passing through such area. Therefore, the legislature finds 41 that smoking in such area shall be prohibited and owners and other indi- 42 viduals in control of such area are recommended to post signs indicating 43 no smoking areas and providing for fines for violations. 44 S 2. Section 1399-o-1 of the public health law, as added by chapter 45 102 of the laws of 2013, is amended to read as follows: 46 S 1399-o-1. Smoking restrictions; certain outdoor areas. 1. A. Smok- 47 ing shall not be permitted and no person shall smoke during the hours 48 between sunrise and sunset, when one or more persons under the age of 49 twelve are present at any playground. For the purposes of this [section] 50 SUBDIVISION, the term "playground" means an improved area designed, 51 equipped, and set aside for play of six or more children which is not 52 intended for use as an athletic playing field or athletic court, and 53 shall include any play equipment, surfacing, fencing, signs, internal 54 pathways, internal land forms, vegetation, and related structures. Play- A. 6505--A 8 1 grounds or playground equipment constructed upon one, two and three-fa- 2 mily residential real property are exempt from the requirements of this 3 [section] SUBDIVISION. This [section] SUBDIVISION shall not apply to 4 any playground located within the city of New York. 5 [2.] B. No police officer, peace officer, regulatory officer or law 6 enforcement official may arrest, ticket, stop or question any person 7 based solely or in part on an alleged violation of PARAGRAPH A OF THIS 8 subdivision [one of this section], nor may an alleged violation of PARA- 9 GRAPH A OF THIS subdivision [one of this section] support probable cause 10 to conduct any search or limited search of any person or his or her 11 immediate surroundings. 12 2. A. SMOKING IS PROHIBITED WITHIN A PRESUMPTIVELY REASONABLE MINIMUM 13 DISTANCE OF FIFTEEN FEET FROM ENTRANCES OR EXITS OF PUBLIC BUILDINGS OR 14 PRIVATE BUILDINGS THAT CONTAIN STATE OR MUNICIPAL OFFICES OR EDUCATIONAL 15 FACILITIES FOR ELEMENTARY OR SECONDARY SCHOOL STUDENTS. SUCH DISTANCE 16 SHALL BECOME A DESIGNATED NO SMOKING ZONE. 17 B. LOCAL HEALTH DEPARTMENTS ARE AUTHORIZED TO ADOPT REGULATIONS AS ARE 18 REQUIRED TO IMPLEMENT THIS SUBDIVISION. ANY PENALTY ASSESSED AND RECOV- 19 ERED IN AN ACTION BROUGHT UNDER THIS SUBDIVISION SHALL BE PAID TO AND 20 USED BY THE MUNICIPALITY BRINGING THE ACTION. 21 C. THIS SUBDIVISION SHALL NOT APPLY TO INDIVIDUALS WALKING THROUGH THE 22 DESIGNATED NO SMOKING ZONE OF SUCH AREA FOR THE PURPOSE OF GETTING TO 23 ANOTHER DESTINATION, BUT SHALL ONLY APPLY TO INDIVIDUALS OCCUPYING THE 24 DESIGNATED NO SMOKING ZONE FOR THE PURPOSE OF SMOKING. 25 D. ANY PERSON VIOLATING THE PROVISIONS OF THIS SUBDIVISION SHALL BE 26 GUILTY OF A VIOLATION, AND IS SUBJECT TO A FINE OF THIRTY-FIVE DOLLARS. 27 E. THE COMMISSIONER MAY RECOMMEND DESIGNS FOR SIGNS WHICH MAY BE USED 28 BY THE OWNERS, OPERATORS, MANAGERS, EMPLOYERS OR OTHER PERSONS, AT THEIR 29 OPTION, WHO CONTROL AREAS WHERE SMOKING IS PROHIBITED PURSUANT TO 30 SECTION THIRTEEN HUNDRED NINETY-NINE-O OF THIS ARTICLE. SUCH SIGNS SHALL 31 INCLUDE THE WARNING THAT "SMOKING IN THIS AREA IS PUNISHABLE BY LAW AND 32 ALL VIOLATORS SHALL BE SUBJECT TO A FINE OF THIRTY-FIVE DOLLARS." 33 F. NOTHING CONTAINED IN THIS SUBDIVISION IS INTENDED TO REGULATE SMOK- 34 ING IN A PRIVATE RESIDENCE OR IN THE GENERAL PUBLIC OUTDOORS, EXCEPTING 35 PLACES IN WHICH SMOKING IS PROHIBITED THROUGH THE LOCAL FIRE DEPARTMENT, 36 OR BY OTHER LAW, ORDINANCE OR REGULATION. 37 S 3. This act shall take effect on the one hundred twentieth day after 38 it shall have become a law. 39 PART G 40 Section 1. The education law is amended by adding a new section 3001-e 41 to read as follows: 42 S 3001-E. ASTHMA EMERGENCIES; TRAINING IN IDENTIFICATION AND RESPONSE. 43 THE COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONER OF HEALTH, SHALL 44 ESTABLISH STANDARDS FOR THE TRAINING OF TEACHERS AND OTHER APPROPRIATE 45 PERSONNEL IN IDENTIFYING AND RESPONDING TO ASTHMA EMERGENCIES IN PUPILS 46 AND OTHER PERSONS. SUCH STANDARDS SHALL SPECIFY MINIMUM LEVELS OF KNOW- 47 LEDGE AND PROCEDURES TO BE FOLLOWED. SUCH STANDARDS SHALL PERMIT TRAIN- 48 ING TO BE GIVEN BY PERSONS OR ORGANIZATIONS DEEMED QUALIFIED TO DO SO BY 49 THE COMMISSIONER. 50 S 2. This act shall take effect one year after it shall have become a 51 law. 52 PART H A. 6505--A 9 1 Section 1. The real property law is amended by adding a new section 2 235-h to read as follows: 3 S 235-H. RESIDENTIAL RENTAL PROPERTY SMOKING POLICIES. EVERY RENTAL 4 AGREEMENT FOR A DWELLING UNIT, IN A MULTIPLE DWELLING BUILDING WITH FOUR 5 OR MORE UNITS, SHALL INCLUDE A DISCLOSURE OF THE SMOKING POLICY FOR THE 6 PREMISES ON WHICH THE DWELLING UNIT IS LOCATED. THE DISCLOSURE MUST 7 STATE WHETHER SMOKING IS PROHIBITED ON THE PREMISES, ALLOWED ON THE 8 ENTIRE PREMISES OR ALLOWED IN LIMITED AREAS ON THE PREMISES. IF THE 9 SMOKING POLICY ALLOWS SMOKING IN LIMITED AREAS ON THE PREMISES, THE 10 DISCLOSURE MUST IDENTIFY THE AREAS ON THE PREMISES WHERE SMOKING IS 11 ALLOWED. 12 S 2. This act shall take effect on the first of January next succeed- 13 ing the date on which it shall have become a law. 14 PART I 15 Section 1. The education law is amended by adding a new section 1527-a 16 to read as follows: 17 S 1527-A. IDLING MOTOR VEHICLES ON SCHOOL GROUNDS. 1. ON OR BEFORE 18 SEPTEMBER FIRST, TWO THOUSAND SEVENTEEN AND CONSISTENT WITH THE COMMIS- 19 SIONER'S REGULATIONS, ADOPTED PURSUANT TO SECTION THIRTY-SIX HUNDRED 20 THIRTY-SEVEN OF THIS CHAPTER, THE BOARD OF EDUCATION OR BOARD OF TRUS- 21 TEES OF EVERY SCHOOL DISTRICT AND THE GOVERNING BODY OF EVERY PRIVATE 22 ELEMENTARY OR SECONDARY SCHOOL IN THE STATE SHALL PROMULGATE AND IMPLE- 23 MENT RULES PROHIBITING THE ENGINE OF ANY MOTOR VEHICLE, AS DEFINED IN 24 SECTION ONE HUNDRED TWENTY-FIVE OF THE VEHICLE AND TRAFFIC LAW, TO 25 REMAIN IDLING FOR MORE THAN ONE MINUTE WHILE SUCH VEHICLE IS PARKED OR 26 STANDING ON SCHOOL GROUNDS, ADJACENT TO SCHOOL GROUNDS, OR IN FRONT OF 27 ANY SCHOOL WHILE LOADING OR OFF LOADING PASSENGERS. 28 2. EACH SCHOOL DISTRICT AND PRIVATE ELEMENTARY AND SECONDARY SCHOOL 29 SHALL CONSPICUOUSLY POST SIGNS UPON, ADJACENT AND IN FRONT OF SCHOOL 30 GROUNDS ADVISING OPERATORS OF MOTOR VEHICLES OF THE PROVISIONS OF THE 31 RULES ADOPTED PURSUANT TO SUBDIVISION ONE OF THIS SECTION. 32 S 2. This act shall take effect immediately. 33 PART J 34 Section 1. The education law is amended by adding a new section 922 35 to read as follows: 36 S 922. USE OF NEBULIZER. 1. EVERY SCHOOL DISTRICT AND BOARD OF COOPER- 37 ATIVE EDUCATIONAL SERVICES IN THIS STATE MAY MAINTAIN ONE OR MORE NEBU- 38 LIZERS IN THE OFFICE OF THE SCHOOL NURSE OR IN A SIMILAR ACCESSIBLE 39 LOCATION. 40 2. THE COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONER OF HEALTH, 41 MAY PROMULGATE REGULATIONS FOR THE ADMINISTRATION OF ASTHMA MEDICATION 42 THROUGH THE USE OF A NEBULIZER BY THE SCHOOL NURSE OR PERSON AUTHORIZED 43 BY REGULATION. THE REGULATIONS MAY INCLUDE: 44 A. A REQUIREMENT THAT EACH CERTIFIED NURSE OR OTHER PERSON AUTHORIZED 45 TO ADMINISTER ASTHMA MEDICATION IN SCHOOLS RECEIVE TRAINING IN AIRWAY 46 MANAGEMENT AND IN THE USE OF NEBULIZERS AND INHALERS CONSISTENT WITH 47 NATIONALLY RECOGNIZED STANDARDS; AND 48 B. A REQUIREMENT THAT EACH PUPIL AUTHORIZED TO USE ASTHMA MEDICATION 49 PURSUANT TO SUBDIVISION ONE OF SECTION NINE HUNDRED SIXTEEN OF THIS 50 ARTICLE OR A NEBULIZER HAVE AN ASTHMA TREATMENT PLAN PREPARED BY THE 51 PHYSICIAN OF THE PUPIL, WHICH IDENTIFY, AT A MINIMUM, ASTHMA TRIGGERS, A. 6505--A 10 1 THE TREATMENT PLAN, AND SUCH OTHER ELEMENTS AS SHALL BE DETERMINED BY 2 THE REGENTS. 3 S 2. This act shall take effect on the one hundred eightieth day after 4 it shall have become a law; provided, however, that effective immediate- 5 ly the commissioner of education is authorized to promulgate rules and 6 regulations for the implementation of this act on such effective date. 7 PART K 8 Section 1. Subdivision 7 of section 33-0303 of the environmental 9 conservation law, as added by chapter 85 of the laws of 2010, is amended 10 to read as follows: 11 7. The commissioner, in consultation with the commissioner of educa- 12 tion and the commissioner of health, shall develop guidance AND REGU- 13 LATIONS on pesticide alternatives to facilitate compliance with section 14 four hundred nine-k of the education law and three hundred ninety-g of 15 the social services law. PROVIDED, FURTHER, THAT SUCH PESTICIDE ALTERNA- 16 TIVES SHALL HELP TO MINIMIZE THE INCIDENCE OF ASTHMA ATTACKS IN PUBLIC 17 AND PRIVATE BUILDINGS AND RESIDENCES, WHILE STILL EFFECTIVELY CONTROL- 18 LING THE TARGETED PEST OR ORGANISM. SUCH REGULATIONS SHALL PROVIDE FOR 19 THE USE OF THE LEAST TOXIC PESTICIDE OR PESTICIDES, WHICH EFFECTIVELY 20 ERADICATES THE TARGETED PEST OR ORGANISM. 21 S 2. This act shall take effect immediately. 22 PART L 23 Section 1. The public buildings law is amended by adding a new 24 section 143 to read as follows: 25 S 143. CURTAIL USE OF CHEMICALS THAT INDUCE OR TRIGGER ASTHMA ATTACKS. 26 1. NOTWITHSTANDING ANY OTHER PROVISION OF LAW TO THE CONTRARY, THE 27 SUPERINTENDENT OF EVERY STATE PUBLIC BUILDING, AND OF EVERY TRANSPORTA- 28 TION FACILITY OPERATED BY A PUBLIC AUTHORITY, PUBLIC BENEFIT CORPORATION 29 OR MUNICIPALITY SHALL TO THE BEST OF HIS OR HER ABILITY CURTAIL THE USE 30 OF CLEANING MATERIALS OR CHEMICALS, EXPOSURE TO WHICH MAY CAUSE EITHER 31 THE BUILDING CLEANING STAFF OR OTHER PERSONS WHO ENTER SUCH BUILDING TO 32 DEVELOP THE DISEASE OF ASTHMA, OR WHICH MAY EXACERBATE OR TRIGGER AN 33 ASTHMA ATTACK. 34 2. A DETERMINATION OF WHICH OR THE QUANTITY OR CONCENTRATION OF SUCH 35 CLEANING MATERIALS OR CHEMICALS EXPOSURE TO WHICH MAY CAUSE PERSONS TO 36 DEVELOP THE DISEASE OF ASTHMA, OR WHICH MAY EXACERBATE OR TRIGGER AN 37 ASTHMA ATTACK, SHALL BE MADE BY THE COMMISSIONER OF HEALTH WHO SHALL 38 PROMULGATE A LIST OF SUCH CLEANING MATERIALS OR CHEMICALS. 39 S 2. This act shall take effect on the one hundred eightieth day after 40 it shall have become a law. 41 S 3. Severability clause. If any clause, sentence, paragraph, subdi- 42 vision, section or part of this act shall be adjudged by any court of 43 competent jurisdiction to be invalid, such judgment shall not affect, 44 impair, or invalidate the remainder thereof, but shall be confined in 45 its operation to the clause, sentence, paragraph, subdivision, section 46 or part thereof directly involved in the controversy in which such judg- 47 ment shall have been rendered. It is hereby declared to be the intent of 48 the legislature that this act would have been enacted even if such 49 invalid provisions had not been included herein. 50 S 4. This act shall take effect immediately provided, however, that 51 the applicable effective date of Parts A through L of this act shall be 52 as specifically set forth in the last section of such Parts.