This bill has been amended

Bill S2374-2013

Enacts the "omnibus obesity and respiratory illness reduction act"

Enacts the "omnibus obesity and respiratory illness reduction act"; establishes a community gardens task force and provides for direct marketing of fresh vegetables and fruits in areas with a high incidence of adult and child obesity; provides for the screening for childhood obesity by elementary and secondary schools and promotes the availability of certain healthy foods and beverages; provides for the regulation of the use of trans fats and requires the provision of nutritional information by food service facilities; restricts the sale, lease, transfer or authorization of open-air schoolhouse playgrounds for certain uses; requires instruction in schools on good health practices; includes certain respiratory diseases and obesity in disease management demonstration programs; enacts provisions to reduce the incidence of certain respiratory diseases; enacts provisions to prevent in-utero exposure to tobacco smoke; provides for the use of inhalers and nebulizers by certain students; provides for residential real property smoking policies; adds weight control and schools to the health care and wellness education and outreach program; expands the collection and reporting of data on obesity in the state; directs the health research science board to study obesity and respiratory diseases; provides for expanded obesity prevention and screening; expands ease of breast feeding in child day care centers and at work; provides for nutrition counseling to pregnant teenagers; establishes the obesity and respiratory disease research and education fund; includes weight management and physical fitness in wellness programs; provides for health and nutritional education and services to teen parents; requires day care centers to provide healthy foods and exercise; directs cooperative extension to offer obesity and respiratory disease prevention programs.

Details

Actions

  • Jan 8, 2014: REFERRED TO AGRICULTURE
  • Jan 16, 2013: REFERRED TO AGRICULTURE

Memo

BILL NUMBER:S2374

TITLE OF BILL: An act to amend the agriculture and markets law, in relation to combating the incidence of adult and child obesity, establishing a community gardens task force and encouraging direct marketing of fresh fruits and vegetables in areas with a high incidence of adult and child obesity (Part A); to amend the education law, in relation to screening for childhood obesity and promotion of the availability of certain foods and beverages in schools (Part B); to amend the public health law, in relation to regulating the use of artificial trans fats and requiring food service facilities to post or provide nutritional information on the food products served, and the inclusion of weight control in the health care and wellness education and outreach program (Part C); to amend the education law, in relation to restricting the sale, lease, transfer or authorization of open-air schoolhouse playgrounds for certain uses (Part D); to amend the education law, in relation to instruction in good health and reducing the incidence of obesity (Part E); to amend the public health law, in relation to in-utero exposure to tobacco smoke prevention (Part F); to amend the public health law, in relation to including certain respiratory diseases and obesity within disease management demonstration programs (Part G); to amend the public health law, in relation to the reduction of emphysema, chronic bronchitis and other chronic respiratory diseases in children (Part H); to amend the public health law, in relation to the collection and reporting of obesity data (Part I); to amend the public health law, in relation to directing the health research science board to study respiratory diseases and obesity, and childhood obesity prevention and screening (Part J); to amend the public health law, in relation to breastfeeding of infants and the adolescent pregnancy nutrition counseling program (Part K); to amend the education law, in relation to the use of inhalers and nebulizers (Part L); to amend the real property law, in relation to residential rental property smoking policies (Part M); to amend the state finance law, in relation to establishing the obesity and respiratory disease research and education fund (Part N); to amend the insurance law, in relation to wellness programs (Part O); to amend the social services law, in relation to health and nutritional education and services and child day care facilities; and to amend the county law, in relation to the Cornell cooperative extension system relating to adult and childhood obesity, asthma, and respiratory illness prevention (Part P)

PURPOSE OR GENERAL IDEA OF BILL: The purpose of this bill is to establish a comprehensive inter-disciplinary program to combat childhood obesity. The incidence of childhood obesity is a rapidly growing public health, social, and economic concern that is adversely affecting the overall health and wellbeing of our next generation of New Yorkers. in fact, acute and chronic adverse health conditions such as diabetes, chronic coronary conditions, and respiratory illnesses caused by obesity conditions is about to overtake those acute and chronic adverse health conditions caused by smoking tobacco. This hill attempts to better integrate current programs and laws that relate to combating childhood obesity.

Further, this bill attempts to integrate activities to be conducted by: A) the Department of Agriculture and Markets to facilitate the increased availability and affordability of locally produced fresh produce to areas of the state that have a high incidence of childhood obesity. Such initiatives to increase the volume, availability and consumption of more fresh produce in at-risk targeted areas that have a high incidence of obese individuals could be supplied by locally producing community gardens and by the shipment of fresh produce by commercial growers into such targeted areas. The rational being that increasing the availability of fresh fruits and vegetables to underserved areas will increase the consumption of such foods because they are tastier and more likely to be consumed by at-risk populations.

B) the Education Department to better educate students and parents on the important economic and health reasons for consuming a balanced and nutritious diet. In addition to teaching such subjects in Health class, the scientific reasons for the importance of having a balanced diet should be presented in science classes such as biology and chemistry. Further, the Department will more actively provide for more opportunities for physical recreational activities to foster physical fitness and create an environment so that students are more capable to learn because they have "burned off" energy during recess,

C) the Department of Health will be encouraged to better track areas of the state that have high incidences of childhood obesity and encourage health care facilities and health care providers to identify and treat such conditions at an earlier time of a patient's life.

D) the Insurance Department, will encourage health insurers and their insureds to more actively participate in Wellness Programs that combat the high incidence of adult and childhood obesity. Further, altering the eating and exercise habits of parents can have positive effects on the eating and exercise habits of their children,

E) the Office of Children and Family Services with regard to its regulatory powers over the provision of child care by child day care centers should become more proactive in encouraging such centers to provide more low calorie foods to children and encourage more physical activity. In addition, help to increase the awareness of the problem of childhood obesity by teenage mothers will go a long way to help reduce the incidence of childhood obesity, and

E) better integrate the work of the Departments of Agriculture & Markets, Education, and Health, and the Office of Children & Family Services with activities conducted by local volunteer groups, health care providers, local governments, schools and cooperative Extension Services.

SUMMARY OF PROVISIONS: This bill is a comprehensive inter-disciplinary approach to address the high incidence of childhood obesity in New York State. Further, this bill amends many sections of law, so it is broken down into Parts A through P, depending on the laws to be amended.

PART A:

Section 1: Amends Agriculture & Markets Law (Ag. & Markets Law) Section 3 to expand the Declaration of Policy and purposes of the Department to improve the overall health of New yorkers and to help combat the increasing incidence of adult and childhood obesity. The Department already is charged with the duty to encourage the production of fresh farm products in this State, this provision merely encourages the Department to also encourage the consumption of such products by persons who are obese and in those areas of the State that have a high incidence of childhood obesity.

Section 2: Amends Ag. & Markets Law section 16 (5-b) which outlines the General powers and Duties of the Department to also cooperate with the Health Department in implementing the Childhood Obesity Program pursuant to Article 25 of the public Health Law (PHL) and with the Commissioner of Education to encourage the production and consumption of fresh locally produced fruits and vegetables by primary and secondary school students to help combat the increasing incidence of childhood obesity. In addition, the Department is to cooperate with other federal, state and local agencies to encourage the expansion of community gardens so as to increase the availability and affordability of locally grown produce, to help combat adult and childhood obesity, especially in areas of the state that have a high incidence of obesity.

Section 3: Adds a new Ag. & Markets Law section 31-f to establish legislative findings that community gardens provide significant health, educational, and social benefits to the general public, especially for those who reside in urban and suburban areas of this State. Community gardens help to provide low cost nutritious and fresh foods to the general public, especially to the disadvantaged and poor; promotes health and healthier lifestyles by encouraging better eating habits and increased physical activity, fosters the retention of open spaces in urban areas of our state's cities and villages, provides inexpensive community building activities, helps to reduce the incidence of crime, and engenders a closer relationship between urban residents and nature and their local environment. This provision is needed so that the Office of Community Gardens has a mission statement so that it can more effectively work with other federal, state, and local agencies to help promote the concept of community gardens and do what it can to help combat the high incidence of childhood and adult obesity.

Section 4: Amends Ag. & Markets Law section 31-g to expand the duties of the Office of Community Gardens. In the definitional section, it expands what types of activities are considered to be "garden" activities, expands the definition of "municipality", and adds a new definition for "state agency" to reduce the verbiage in this Article 2-C.

Section 5: Amend Ag. & Markets Law section 31-h to expand the number of activities that the Office of Community Gardens may engage in if they choose to do so. Among the new types of activities that the Office may participate in, if the Office wishes to do so, are the following:

-To assist groups that wish to establish community gardens, the Office can help to develop a single recommended application form to request a state agency or municipality to use certain vacant lands for community garden purposes.

-assist community garden groups in their activities and encourage the better coordination of activities between such groups and school garden programs and local voluntary food assistance programs, such as food pantry's and soup kitchens that provide food for the poor and disadvantaged, hospitals, other health care facilities, and educational facilities.

- encourage better communication between and sharing of resources between community garden groups and the New York Kids Week Program provided for under the Ag. & Markets Law, and individual farm-to-school and school garden programs. The purpose of this section is to make a better connection between the activities of community gardens and the educational activities of existing school programs, if such schools wish to do so.

-support efforts by the Departments of Health and Education to combat the high incidence of adult and childhood obesity by encouraging the consumption of community garden produced fruits and vegetables.

Section 6: Amend Ag. & Markets Law section 31-i to include municipal vacant land in addition to state agency controlled vacant land to be used for community gardens.

Section 7: Adds Ag. & Markets Law section 31-j to allow the Office of Community Gardens, at their own option, to convene a Community Gardens Task Force if authorized by the commissioner of Ag. & Markets. The membership of the Task Force must be no more than 25 members. Further the Task Force can utilize the opinions of various state agencies such as education, health, environmental conservation, corrections, and the office of state parks. In addition, the various state-wide municipal associations can have input into the activities of the task force. The task force is to look into encouraging the establishment and expansion of community gardens, encourage cooperation between community gardens and voluntary food assistance programs, and increase the benefits provided by community gardens.

Section 8: Amends Ag & Markets Law section 281, the Declaration of Legislative Findings for Article 23, which relates to the Department's powers to encourage the direct marketing of New York

agricultural products. This provision encourages the Department to also help to encourage the consumption of such locally produced products in a manner that helps to combat the high incidence of adult and childhood obesity.

Section 9: Amends Ag. & Markets Law section 283 (5) and creates a new (8-a) which relates to the Department's powers and duties to promote the direct sale of farm and food products produced in New York to increase the supply of fresh wholesome foods that can be obtained more inexpensively. Doing so, may help to increase the consumption of foods that can help to combat the high incidence of childhood obesity. Under this provision, the Department is encouraged to develop direct marketing programs for the provision of fresh fruits and vegetables in areas designated by DOH as having a high incidence of childhood obesity.

Section 10: Effective date. This Part shall take effect immediately.

PART B:

Section 1: Amends Education Law section 901 which relates to school health services to be provided. This section expands the types of services that can be provided by school health services to include examining students for the existence, in addition to diseases or disabilities, to include childhood obesity as defined pursuant to existing Education Law standards contained in section 904.

Section 2: Amends Education Law section 903 to add that school health exams may include a diabetes risk analysis if such child has risk factors for type 1 or type 2 diabetes, such as obesity, family history of type 2 diabetes, or other factors that heighten the risk of diabetes. section 3: Amends Education Law section 904 which relates to examinations by health appraisal to include obesity.

Section 4: Amends Education Law section 912 which relates to health and welfare services to all children, may also include childhood obesity screening.

Section 5: Amends Education Law section 918 (4)and(5)which relates to the formation of school district nutrition advisory committees. Under this provision, such advisory committees can study and make recommendations on current nutritional policies of the school district to reduce the incidence of childhood obesity. Further, such advisory committees can make recommendations on educational information that can be provided to parents and guardians of students regarding healthy nutrition and health risks associated with asthma, chronic bronchitis, and other chronic respiratory diseases. Provided further, make recommendations to teachers and other staff as to the dangers of childhood obesity.

Section 6: This Part B shall take effect 2 years after it shall have become law.

PART C:

Section 1: Amends Public Health Law section 206 (1) which relates to the general powers and duties of the Commissioner of Health. This provision adds a new subdivision to authorize that the Department of Health may promulgate rules and regulations to restrict the use of artificial trans fats in the preparation of certain foods served by food service establishments that offer the immediate sale of food to the general public. Foods that DOH could regulate that have trans fat include those prepared foods that contain vegetable shortening, margarine, or partially hydro-genated vegetable oil in quantities above .5 grams per serving. Such regulations cannot apply to foods that are served to the public in packages sealed by the manufacturer. Further such regulations cannot apply to the City of New York or any other municipality that has adopted a local law to regulate such products. This bill provision does not mandate DOH to promulgate such rules, but establishes a framework should the Department deem it appropriate to promulgate such regulations.

This section also authorizes DOH to mandate that food service establishments may require that warning signs be placed in such establishments to inform the public about the health risks associated with the over consumption of foods made with artificial trans fats.

This section also authorizes DOH to establish a voluntary artificial trans fat reduction or program. Such a program can include a public information dissemination program to inform the public about the health risks associated with the over consumption of foods that have significant amounts of artificial trans fats.

This section also authorizes DOH to require chain owned food service establishments that have over 25 sites to disclose on their product offerings the total number of calories, grams of carbohydrates, saturated fats, and milligrams of sodium contained in each food offered for sale at such establishment. Such information may, in the discretion of the Department, be offered to the public upon request.

Section 2: Amends Public Health Law section 207 which relates to the Health Care and Wellness Education and Outreach Program. This provision expands the ability of DOH to conduct wellness education and outreach programs to elementary and secondary school educators. Further, such education and outreach programs can provide information about the adverse health risks to adults and children who become obese or underweight.

Section 3: Amends Public Health Law section 207 to provide that the Department's education and outreach programs may also talk about the short term and long term adverse health risks to adults and children who become overweight, obese or underweight.

Section 4: This Part C shall take effect one year after this bill shall have become law.

PART D:

Section 1: Amends Education Law section 2556(5) to add a new sentence to encourage certain secondary and primary schools in New York City to provide for other types of recreational play spaces if existing

playgrounds are subsequently used for school construction or siting of temporary classroom units. Under current law, Section 2556(5) requires open-air playgrounds be attached to all schoolhouses constructed in the city of New York. The purpose of this provision is to encourage the retention of adequate outdoor playground space for New York City school children. Further, that if existing playgrounds are sold, leased, transferred or used for school building construction in a way that eliminates such playground space, that the school establish a plan to secure suitable and adequate playground space for the physical recreation needs of such pupils.

PART E:

Section 1: Amends Education Law section 803 (1) and (5) which relates to the instruction of physical education in all elementary and secondary schools to foster the increased overall physical fitness and good health of its students and to foster a reduction in the incidence of childhood obesity. Further, it encourages the regents to ensure that all students in elementary and secondary schools have daily physical activity to increase their physical wellbeing and to increase their ability to absorb what is being taught in school.

Section 2: Amends Education Law section 804(1) to alter the material taught in health, physical education, and appropriate science classes to include information on the health risks associated with childhood obesity and ways to combat the incidence of childhood obesity.

Section 3: Amends Education Law section 804-a which relates to the comprehensive School Health Education Demonstration Program. These demonstration programs can be established by individual schools for the development, implementation, evaluation, validation, and replication of exemplary comprehensive health education programs. This bill expands this demonstration program to include conveying knowledge to students on a host of social conditions to include in addition to adolescent pregnancy, alcohol abuse, truancy, suicide, and substance abuse to also include obesity, asthma, or other chronic respiratory diseases.

Section 4: Amends Education Law section 813 to ensure that during a primary and secondary student's lunch period that ample time is devoted so that such student can consume his lunch and have time to engage in physical exercise or recreation.

PART F:

Section 1: Adds a new Article 13-I to the Public Health Law to establish a program to prevent in-utero exposure to tobacco smoke. Under this program, health care providers, health insurers, and pregnancy programs shall distribute information on the adverse effects of smoking during pregnancy, both first hand and second hand smoke. In-utero exposure to tobacco smoke leads to lower birth rates, higher incidences of asthma and childhood obesity, and can lead to cognitive and developmental damage to the child. Under this article, individualized smoking cessation programs would be established to help increase the success rates for mothers who smoke tobacco or live in households where others smoke tobacco. This program will help to reduce the incidence of asthma.

Section 2: The effective date for this provision is 180 days after it shall have become law.

PART G:

Section 1: Amends Public Health Law section 2111 to expand the scope of disease management demonstration programs administered by DOH to enhance the quality and cost-effectiveness of care rendered to Medicaid-eligible persons who do not participate in Medicaid Managed Care who have chronic health problems. Under current law, demonstration programs can include chronic conditions related to congestive heart failure, chronic obstructive pulmonary disease, asthma and diabetes. This provision expands the scope of demonstration programs to include obesity, chronic bronchitis, and other chronic respiratory diseases.

PART H:

Section 1: Amends Public Health Law section 2599-b to expand the scope of programs administered by DOH to reduce the incidence and prevalence of obesity in children and adolescents, especially among populations with high rates of obesity. Under current law, the program looks to address obesity related health complications such as diabetes, heart disease, cancer, osteoarthritis, and asthma. This bill would expand such programs to include obesity-related health complications such as chronic bronchitis, and other chronic respiratory diseases.

In addition a new paragraph (h)is added to encourage DOH to coordinate 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, and chronic respiratory diseases to enable adults and children to safely increase physical activity to help curb the incidence of obesity.

Section 2: Amends Public Health Law section 2599-c that relates to the Department's role in encouraging more school-based childhood obesity prevention and physical activity programs. This bill adds that the Department in advancing school-based childhood obesity prevention and physical activity programs should cooperate with the Commissioners of Agriculture & Markets and Education, and county boards of cooperative extension.

PART I:

Section 1: Amends Public Health Law section 263 that relates to an already authorized obesity study. This provision cross references a new Public Health Law section 2500-k and the information received from the childhood obesity prevention and screening program established pursuant to that section of the law.

PART J:

Section 1: Amends Public Health Law section 2411 which relates to the powers and duties of the Commissioner. This provision authorizes the Commissioner to act in an advisory and supervisory capacity with

regard to the Health Research Science Board as it relates to childhood obesity, asthma, and chronic bronchitis or other respiratory diseases. Further it expands the jurisdiction of such Board to research issues related to childhood obesity, asthma, and other respiratory diseases in addition to already being authorized to research breast, prostate or testicular cancer.

Section 2: Amends Public Health Law section 2500 (1) which relates to the Commissioner's duties as it relates to maternal and child health to also include childhood obesity.

Section 3: Amends Public Health Law section 2500-k to establish a childhood obesity prevention and screening program. This provision authorizes the Department to establish a childhood obesity prevention and screening program so that trends may be ascertained with regard to the incidence and location of populations that have childhood obesity conditions. This research information may be shared with hospitals that provide obstetric services and pediatric primary care providers. Ultimately, this information can be used to review and improve quality of care provided by such health care providers.

PART K:

Section 1: Amends Public Health Law section 2505-a to add child day care facilities to the list of facilities that must post the "statement of rights of breast feeding mothers". The goal of this provision is to disseminate the statement of rights of breastfeeding mothers to places where such mothers may frequent. Studies have shown that encouraging the breast feeding of children reduces the risk that such infants become obese later on in life.

Section 2: Amends Public Health Law section 2505, which relates to the general powers of the Commissioner to regulate the collection, storage and distribution of human breast milk. This provision authorizes the Commissioner to adopt regulations or guidelines to encourage and facilitate employers and child day care centers to establish environments that do not discourage the practice of breast feeding.

Section 3: Amends Public Health Law section 2515 (2) that relates to Adolescent Pregnancy Prevention and Services Program to add to "services for eligible adolescents" vocational and education counseling on pregnancy and child nutrition counseling for expectant mothers to help curtail the incidence of childhood obesity.

Section 4: Amends Public Health Law section 2515-a(2) that relates to the administration of community service project plans. The purpose of these demonstration plans is to develop new methodologies to advance the provision of health care that reduces adolescent pregnancy and provide services to assist teenage mothers. These demonstration programs tend to be located in geographical areas where there is a high incidence of infant mortality and low income families. This provision expands the demonstration program areas to also include geographical areas that have low birth weight babies or childhood Obesity.

Section 5: Amends Public Health Law section 2522 to empower the Health Department to provide funds, if it deems appropriate, to finance health and nutritional education and services to both parents regarding childhood and adult obesity and asthma, and the prevention or mitigation thereof.

PART L:

Section 1: Amends Education Law section 916 to expand the number of students who can have and use an inhaler at school to maintain appropriate airflow to their lungs or suppress an asthmatic attack. The medical community maintains that it is better to monitor and address those who are susceptible to asthma conditions and treat such conditions before an asthmatic attack occurs, This bill increases the number of persons who can have and use an inhaler at school to include not only those who have a "severe asthmatic condition", to also include those who have a "moderately severe asthmatic condition" or have other potentially life-threatening respiratory illnesses".

Section 2: Adds a new Education Law section 921 to authorize school districts to posses and use nebulizers for those students that need such treatments. As the number and severity asthma attacks increases in the student body, it is important that such students have access not only to their inhalers, but nebulizers as well. The bill provides safeguards to ensure that only students that have a physician's treatment plan can use such nebulizers on school grounds. Further, such nebulizer treatment must be monitored by the school nurse or other person authorized by regulation. The underlying justification to enact the provisions of Part I is that if students are not able to engage in physical activity because of restricted breathing patterns and asthma, any treatment that encourages such students to maintain physical activity may help to reduce the incidence of childhood obesity.

PART M:

Section 1: Adds Real Property Law section 235-h to require that every rental agreement for an apartment in a building that has four units or more must disclose the smoking policy of such building. The landlord is still free to either fully ban, partially ban, or generally permit smoking in such building's apartments and common areas. It is the purpose of this section to encourage landlords to think about the building's smoking policy and to give tenants notice of such policies. This in turn may encourage non-smoker tenants to seek out apartment buildings that have a no smoking policy and encourage landlords to at least minimize smoke exposure to those tenants who do not smoke to increase the marketability of their apartments. While this bill is a comprehensive bill to address adult and childhood obesity issues, there is a correlation between those who are exposed, either voluntary or otherwise, to first and second hand tobacco smoke, and asthma and the incidence of obesity. It would be difficult to address obesity and asthma issues without looking at the incidence of tobacco smoking and exposing, particularly children, to such conditions that can trigger asthma attacks and increase the incidence of obesity conditions generally because

children are not able to conduct physical activity to maintain a proper weight.

PART N:

Section 1: Adds a new State Finance Law section 91-h to establish the Obesity and Respiratory Disease Research Fund. This fund is established to support the financing of projects and research provided for in PHL sections 2411, 2500, and 2500-k.

PART O:

Sections 1 and 2: Amends Insurance Law section 3239 that relates to Wellness Programs that can be sponsored by health insurers or HMOs to help promote the health and wellbeing of their insureds or subscribers. This provision expands the types of wellness programs that can sponsored by such carriers to include coordinated weight management, nutrition, stress management and physical fitness programs to combat the high incidence of adult and child obesity, asthma, and other chronic respiratory conditions. This section also, allows for the full or partial reimbursement of the cost of participating in stress management programs or activities.

PART P:

Section 1: Amends Social Services Law sections 366(4) to encourage both parents to obtain health and nutritional education and services regarding childhood and adult obesity, asthma, and the mitigation thereof.

Section 2: Amends Social Services Law section 390(2-a) to authorize the Office of Children and Family Services may promulgate rules and regulations on appropriate physical activity, nutritional offerings, and low calorie foods and beverages to lower the incidence of childhood obesity for child day care homes, programs, and facilities.

Section 3: Amends Social Services Law.section 390-a to prohibit any family day care home, group family day care home, or school age child care program or child day care center to discriminate against any child who is breast fed or who is fed with expressed breast milk.

Section 4: Amends County Law section 224-b to authorize cooperative extension services to provide in a coordinated manner a local or statewide program specialist that relates to adult and childhood obesity, asthma, or chronic respiratory illness prevention.

JUSTIFICATION: The growing prevalence of overweight and obese children is a crisis that is facing the entire nation. Obesity related health care expenditures in New York are some of the highest in the nation. Further, contrary to the lower prevalence of obesity among adults, children in New York are more likely to be obese or overweight when compared to national trends. Obesity and overweight conditions in individuals are leading to higher incidences of life threatening conditions and substantial economic costs both to the State of New York for health care costs and to employers in lost work time and

higher health care costs. Obesity in children tends to manifest itself more widely among poorer children and children whose parents have lower education levels.

The rising incidence of childhood obesity is a serious medical problem that continues to grow, especially among poorer and minority communities. Further, obesity is known to cause or exacerbate a number of serious chronic medical disorders including hypertension, dyslipidemia, cardiovascular disease, diabetes, and respiratory dysfunction. Nearly 80%' of patients with diabetes mellitus are obese, while nearly 7090- of diagnosed cases of cardiovascular disease are related to obesity. Obesity ranks only second to smoking as a preventable cause of death. Unfortunately, preventable deaths caused by obesity conditions is rapidly approaching and will surpass those deaths caused by smoking tobacco.

While the high prevalence of obesity and overweight conditions is an important public health concern when it affects adults. It should be of heightened concern that this adult affliction is now becoming more common among children. When obesity conditions afflict children this poses, significant quality of life detriments to such persons, reduces the productivity of such individuals over a longer time of their life, and hastens the onset of many chronic conditions that can hurt the quality of life of such persons and their families.

The provisions of this bill are derived from a report by the Independent Democratic Conference entitled "Childhood Obesity: Mitigation and Prevention in the State of New York". This report outlines the trends of the increasing incidence of childhood obesity, some of the causes of this increase, and suggested courses of action that can be taken to help reduce this ever increasing public health problem. It is important for state agencies such as the Departments of Health, Education, Agriculture & Markets, and Insurance, the Office of Children and Family Services coordinate their current activities to curb this problem. Further, once New York's state agencies have a more coordinated approach to curb childhood obesity, then other public stakeholders such as school educators and BOCES can combine forces with such state agencies and with private stakeholders such as health care providers, health care facilities, child day care centers, insurers, and community groups to provide a coordinated way to address this problem.

PRIOR LEGISLATIVE HISTORY: 2012 - S. 6423 - Referred to Agriculture

EFFECTIVE DATE: See relevant sections at the end of each Part of this bill.


Text

STATE OF NEW YORK ________________________________________________________________________ 2374 2013-2014 Regular Sessions IN SENATE January 16, 2013 ___________
Introduced by Sens. KLEIN, ADDABBO, CARLUCCI, HANNON, HASSELL-THOMPSON, PARKER, SAVINO, STAVISKY -- read twice and ordered printed, and when printed to be committed to the Committee on Agriculture AN ACT to amend the agriculture and markets law, in relation to combat- ing the incidence of adult and child obesity, establishing a community gardens task force and encouraging direct marketing of fresh fruits and vegetables in areas with a high incidence of adult and child obesity (Part A); to amend the education law, in relation to screening for childhood obesity and promotion of the availability of certain foods and beverages in schools (Part B); to amend the public health law, in relation to regulating the use of artificial trans fats and requiring food service facilities to post or provide nutritional information on the food products served, and the inclusion of weight control in the health care and wellness education and outreach program (Part C); to amend the education law, in relation to restricting the sale, lease, transfer or authorization of open-air schoolhouse play- grounds for certain uses (Part D); to amend the education law, in relation to instruction in good health and reducing the incidence of obesity (Part E); to amend the public health law, in relation to in-utero exposure to tobacco smoke prevention (Part F); to amend the public health law, in relation to including certain respiratory diseases and obesity within disease management demonstration programs (Part G); to amend the public health law, in relation to the reduction of emphysema, chronic bronchitis and other chronic respiratory diseases in children (Part H); to amend the public health law, in relation to the collection and reporting of obesity data (Part I); to amend the public health law, in relation to directing the health research science board to study respiratory diseases and obesity, and childhood obesity prevention and screening (Part J); to amend the public health law, in relation to breastfeeding of infants and the adolescent pregnancy nutrition counseling program (Part K); to amend the education law, in relation to the use of inhalers and nebulizers (Part L); to amend the real property law, in relation to residential rental property smoking policies (Part M); to amend the state finance EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD06771-01-3 S. 2374 2 law, in relation to establishing the obesity and respiratory disease research and education fund (Part N); to amend the insurance law, in relation to wellness programs (Part O); to amend the social services law, in relation to health and nutritional education and services and child day care facilities; and to amend the county law, in relation to the Cornell cooperative extension system relating to adult and child- hood obesity, asthma, and respiratory illness prevention (Part P) THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Short title. This act shall be known and may be cited as the "omnibus obesity and respiratory illness reduction act". S 2. This act enacts into law major components of legislation which combat the incidence of adult and child obesity and respiratory diseases, and encourage the production and consumption of fresh fruits and vegetables. Each component is wholly contained within a Part identi- fied as Parts A through P. The effective date for each particular provision contained within such Part is set forth in the last section of such Part. Any provision in any section contained within a Part, includ- ing the effective date of the Part, which makes a reference to a section "of this act", when used in connection with that particular component, shall be deemed to mean and refer to the corresponding section of the Part in which it is found. Section four of this act sets forth the general effective date of this act. PART A Section 1. Section 3 of the agriculture and markets law, as amended by chapter 651 of the laws of 1946, is amended to read as follows: S 3. Declaration of policy and purposes. The agricultural industry is basic to the life of our state. It vitally concerns and affects the welfare, health, economic well-being and productive and industrial capa- bilities of all our people. It is the policy and duty of the state to promote, foster, and encourage the agricultural industry, with proper standards of living for those engaged therein; to design and establish long-range programs for its stabilization and profitable operation; to increase through education, research, regulation, and scientific means, the quantity, quality, and efficiency of its production; to improve its marketing system; to encourage adequate and skilled assistance for agri- cultural enterprises; to maintain at fair prices uncontrolled by specu- lation the instrumentalities and products of agriculture; to remove unnecessary or unfair costs and obstacles in the [transporation] TRANS- PORTATION, storage, processing, distribution, marketing, and sale of agricultural products; to prevent frauds in the traffic therein; to promote an expanded demand for the state's agricultural products and the intelligent uses thereof by consumers as pure and wholesome food; to protect the public health and to eliminate the evils of under-nourish- ment; to encourage the selection and consumption of food according to sound dietary and nutritional principles; TO IMPROVE OUR CITIZENS' OVER- ALL HEALTH AND TO COMBAT THE INCREASING INCIDENCE OF ADULT AND CHILDHOOD OBESITY; and to make our people conscious of the bond of mutual self-in- terest between our urban and our rural populations. Accordingly, all laws enacted concerning the agricultural industry and its allied subjects, whether included in this chapter or not, are to be
deemed an exercise of the police power of the state and a discharge of its obligations for the promotion of the general welfare through state- wide laws and regulations, local initiative and government, cooperative action between groups and localities, home-rule measures, individual enterprise, civic consciousness, and appropriate coordination with the federal government and as between educational research institutions within the state. Such laws and all governmental measures adopted pursuant thereto should receive a liberal interpretation and application in furtherance of the aforesaid policy and purposes. S 2. Subdivision 5-b of section 16 of the agriculture and markets law, as added by chapter 2 of the laws of 2001, is amended to read as follows: 5-b. (A) Establish, in cooperation with the commissioner of education, a farm-to-school program to facilitate and promote the purchase of New York farm products by schools, universities and other educational insti- tutions under the jurisdiction of the education department. The depart- ment shall solicit information from the education department regarding school districts and other educational institutions interested in purchasing New York farm products, including but not limited to, the type and amount of such products schools wish to purchase and the name of the appropriate contact person from the interested school district. The department shall make this information readily available to inter- ested New York farmers, farm organizations and businesses that market New York farm products. The department shall provide information to the education department and interested school districts and other educa- tional institutions about the availability of New York farm products, including but not limited to, the types and amount of products, and the names and contact information of farmers, farm organizations and busi- nesses marketing such products. The commissioner shall report to the legislature on the need for changes in law to facilitate the purchases of such products by schools and educational institutions. The department shall also coordinate with the education department, and school food service, education, health and nutrition, farm, and other interested organizations in establishing a promotional event, to be known as New York Harvest For New York Kids Week, in early October each year, that will promote New York agriculture and foods to children through school meal programs and the classroom, at farms and farmers' markets and other locations in the community. (B) COOPERATE WITH THE DEPARTMENT OF HEALTH IN IMPLEMENTING THE CHILD- HOOD OBESITY PREVENTION PROGRAM PURSUANT TO TITLE EIGHT OF ARTICLE TWEN- TY-FIVE OF THE PUBLIC HEALTH LAW AND WITH THE COMMISSIONER OF EDUCATION TO ENCOURAGE THE PRODUCTION AND CONSUMPTION OF FRESH LOCALLY PRODUCED FRUITS AND VEGETABLES BY ELEMENTARY AND SECONDARY SCHOOL AGED CHILDREN PURSUANT TO PARAGRAPH (A) OF THIS SUBDIVISION TO HELP COMBAT THE INCREASING INCIDENCE OF CHILDHOOD OBESITY. (C) COOPERATE WITH FEDERAL, OTHER STATE AND MUNICIPAL AGENCIES TO ENCOURAGE THE EXPANSION OF COMMUNITY GARDENS PURSUANT TO ARTICLE TWO-C OF THIS CHAPTER TO HELP ENCOURAGE THE PRODUCTION AND CONSUMPTION OF FRESH LOCALLY PRODUCED FRUITS AND VEGETABLES TO HELP COMBAT THE INCREAS- ING INCIDENCE OF ADULT AND CHILD OBESITY. S 3. Article 2-C of the agriculture and markets law is amended by adding a new section 31-f to read as follows: S 31-F. LEGISLATIVE FINDINGS. THE LEGISLATURE HEREBY FINDS AND DECLARES THAT COMMUNITY GARDENS PROVIDE SIGNIFICANT HEALTH, EDUCATIONAL AND SOCIAL BENEFITS TO THE GENERAL PUBLIC, ESPECIALLY FOR THOSE WHO
RESIDE IN URBAN AND SUBURBAN AREAS OF THIS STATE. FURTHERMORE, IT IS THE ARTICULATED PUBLIC POLICY OF THIS STATE TO PROMOTE AND FOSTER GROWTH IN THE NUMBER OF COMMUNITY GARDENS AND THE ACREAGE OF SUCH GARDENS. THE COMMUNITY GARDEN MOVEMENT CONTINUES TO PROVIDE LOW COST FOOD THAT IS FRESH AND NUTRITIOUS FOR THOSE WHO MAY BE UNABLE TO READILY AFFORD FRESH FRUITS AND VEGETABLES FOR THEMSELVES OR THEIR FAMILIES, PROMOTES PUBLIC HEALTH AND HEALTHIER INDIVIDUAL LIFESTYLES BY ENCOURAGING BETTER EATING HABITS AND INCREASED PHYSICAL ACTIVITY BY GROWING THEIR OWN FOOD, FOSTERS THE RETENTION AND EXPANSION OF OPEN SPACES, PARTICULARLY IN URBAN ENVIRONMENTS, ENHANCES URBAN AND SUBURBAN ENVIRONMENTAL QUALITY AND COMMUNITY BEAUTIFICATION, PROVIDES INEXPENSIVE COMMUNITY BUILDING ACTIVITIES, RECREATION AND PHYSICAL EXERCISE FOR ALL AGE GROUPS, ESTAB- LISHES A SAFE PLACE FOR COMMUNITY INVOLVEMENT AND HELPS TO REDUCE THE INCIDENCE OF CRIME, ENGENDERS A CLOSER RELATIONSHIP BETWEEN URBAN RESI- DENTS, NATURE AND THEIR LOCAL ENVIRONMENT, AND FOSTERS GREEN JOB TRAIN- ING AND ECOLOGICAL EDUCATION AT ALL LEVELS. FURTHER, THE PROMOTION OF COMMUNITY GARDENS CAN HELP THE COMMUNITY TO CONDUCT ACTIVITIES FOR ITSELF TO COMBAT CHILDHOOD AND ADULT OBESITY TO ADVANCE THE OVERALL HEALTH OF COMMUNITY MEMBERS. IT IS THEREFORE THE INTENT OF THE LEGIS- LATURE AND THE PURPOSE OF THIS ARTICLE TO FOSTER GROWTH IN THE NUMBER, SIZE AND SCOPE OF COMMUNITY GARDENS IN THIS STATE BY ENCOURAGING STATE AGENCIES, MUNICIPALITIES AND PRIVATE PARTIES IN THEIR EFFORTS TO PROMOTE COMMUNITY GARDENS. S 4. Subdivisions 2 and 3 of section 31-g of the agriculture and markets law, as added by chapter 862 of the laws of 1986, are amended and a new subdivision 4-a is added to read as follows: 2. "Garden" shall mean a piece OR PARCEL of land appropriate for THE cultivation of herbs, fruits, flowers, NUTS, HONEY, POULTRY FOR EGG PRODUCTION, MAPLE SYRUP, ORNAMENTAL OR VEGETABLE PLANTS, NURSERY PRODUCTS, or vegetables. 3. "Municipality" shall mean any county, town, village, city, school district [or], BOARD OF COOPERATIVE EDUCATIONAL SERVICES, other special district, OR ANY OFFICE OR AGENCY THEREOF. 4-A. "STATE AGENCY" SHALL MEAN ANY DEPARTMENT, BUREAU, COMMISSION, BOARD, PUBLIC AUTHORITY OR OTHER AGENCY OF THE STATE, INCLUDING ANY PUBLIC BENEFIT CORPORATION OF WHICH ANY MEMBER OF WHOSE BOARD IS APPOINTED BY THE GOVERNOR. S 5. Section 31-h of the agriculture and markets law, as added by chapter 862 of the laws of 1986, is amended to read as follows: S 31-h. Office of community gardens; powers; duties. 1. The commis- sioner shall establish within the department an office of community gardens which shall have the authority and responsibility for carrying out the provisions of this article in cooperation with the [state] department of environmental conservation, the [state] education depart- ment, THE DEPARTMENT OF HEALTH, the department of state, cooperative extensions and other state agencies and municipalities. 2. The duties of the office shall include: a. Upon request, the office shall assist in the identification of vacant public land within a given geographical location and provide information regarding agency jurisdiction and the relative suitability of such lands for community gardening purposes; b. Serve as a coordinator on behalf of interested community groups and the appropriate state or local agencies to facilitate the use of vacant public lands for community garden use for not less than one growing season by receiving and forwarding with recommendation completed appli- cations to the appropriate STATE OR MUNICIPAL agency. PROVIDED, FURTHER,
THAT THE OFFICE MAY DEVELOP A SINGLE RECOMMENDED APPLICATION FORM TO BE USED BY COMMUNITY GROUPS WHEN APPLYING TO STATE AGENCIES OR MUNICI- PALITIES FOR USE OF VACANT PUBLIC LAND FOR COMMUNITY GARDEN PURPOSES; c. Support and encourage contact between community garden programs already in existence and those programs in the initial stages of devel- opment; [and] d. Seek and provide such assistance, to the extent funds or grants may become available, for the purposes identified in this article[.]; E. ASSIST, SUPPORT AND ENCOURAGE CONTACT AND COOPERATION BETWEEN, AND THE COOPERATIVE SHARING OF RESOURCES BETWEEN COMMUNITY GARDEN GROUPS, SCHOOL GARDEN PROGRAMS AND LOCAL VOLUNTARY FOOD ASSISTANCE PROGRAMS, SUCH AS COMMUNITY FOOD PANTRIES, SOUP KITCHENS, OTHER COMMUNITY AND NOT-FOR-PROFIT ORGANIZATIONS THAT PROVIDE OR DISTRIBUTE FOOD TO THE POOR AND DISADVANTAGED, HOSPITALS, OTHER HEALTH CARE FACILITIES AND EDUCA- TIONAL FACILITIES. SUCH SUPPORT CAN INCLUDE THE PROVISION OF SURPLUS COMMUNITY GARDEN FOOD OR OTHER AGRICULTURAL PRODUCTS TO SUCH LOCAL VOLUNTARY FOOD ASSISTANCE PROGRAMS; F. ASSIST, SUPPORT AND ENCOURAGE COMMUNICATION, AND THE SHARING OF RESOURCES BETWEEN COMMUNITY GARDEN ORGANIZATIONS AND THE NEW YORK HARVEST FOR NEW YORK KIDS WEEK PROGRAM ESTABLISHED BY THE DEPARTMENT PURSUANT TO SUBDIVISION FIVE-B OF SECTION SIXTEEN OF THIS CHAPTER, AND INDIVIDUAL FARM-TO-SCHOOL AND SCHOOL GARDEN PROGRAMS; G. SUPPORT EFFORTS BY THE DEPARTMENTS OF HEALTH AND EDUCATION TO COMBAT ADULT AND CHILDHOOD OBESITY BY ENCOURAGING THE CONSUMPTION OF COMMUNITY GARDEN PRODUCED FRUITS AND VEGETABLES; AND H. ESTABLISH A COMMUNITY GARDENS TASK FORCE PURSUANT TO SECTION THIR- TY-ONE-J OF THIS ARTICLE. S 6. Section 31-i of the agriculture and markets law, as added by chapter 862 of the laws of 1986, is amended to read as follows: S 31-i. Use of state OR MUNICIPALLY owned land for community gardens. 1. Any state agency[, department, board, public benefit corporation, public authority] or [commission] MUNICIPALITY with title to vacant public land may permit community organizations to use such lands for community gardening purposes. Such use of vacant public land may be conditioned on the community organization possessing liability insurance and accepting liability for injury or damage resulting from use of the vacant public land for community gardening purposes. 2. State agencies AND MUNICIPALITIES which have received an applica- tion for use of public lands for community garden purposes shall respond to the applicant within thirty days and make a final determination with- in one hundred eighty days. S 7. The agriculture and markets law is amended by adding a new section 31-j to read as follows: S 31-J. COMMUNITY GARDENS TASK FORCE. 1. THE OFFICE MAY CONVENE A COMMUNITY GARDENS TASK FORCE TO IDENTIFY AND DEVELOP WAYS TO ENCOURAGE STATE AGENCIES, MUNICIPALITIES AND PRIVATE PARTIES TO ESTABLISH AND EXPAND COMMUNITY GARDENS AND THE ACTIVITIES CONDUCTED BY SUCH GARDENS. 2. THE TASK FORCE SHALL BE CHAIRED BY THE COMMISSIONER, OR BY SUCH OFFICER OR EMPLOYEE OF THE DEPARTMENT AS SHALL BE DESIGNATED BY THE COMMISSIONER. THE MEMBERSHIP OF THE TASK FORCE MAY INCLUDE REPRESEN- TATION FROM THE EDUCATION DEPARTMENT, DEPARTMENT OF ENVIRONMENTAL CONSERVATION, DEPARTMENT OF HEALTH, DEPARTMENT OF STATE, OFFICE OF PARKS, RECREATION AND HISTORIC PRESERVATION, AND OFFICE OF GENERAL SERVICES. SUCH TASK FORCE SHALL INCLUDE MEMBERS THAT REPRESENT COUNTIES, CITIES, TOWNS, VILLAGES, SCHOOL DISTRICTS, OTHER SPECIAL USE DISTRICTS, PUBLIC AUTHORITIES AND COOPERATIVE EXTENSION SERVICES.
3. THE TASK FORCE SHALL HAVE NOT MORE THAN TWENTY-FIVE MEMBERS. 4. THE OFFICE, MAY REQUEST THE ASSISTANCE OF STATE AGENCIES INCLUDING, BUT NOT LIMITED TO THE EDUCATION DEPARTMENT, DEPARTMENT OF ENVIRONMENTAL CONSERVATION, DEPARTMENT OF HEALTH, DEPARTMENT OF STATE, DEPARTMENT OF CORRECTIONS AND COMMUNITY SUPERVISION, OFFICE OF STATE PARKS, RECREATION AND HISTORIC PRESERVATION, AND OFFICE OF GENERAL SERVICES TO CARRY OUT THE WORK OF THE TASK FORCE. 5. THE TASK FORCE MAY ONLY ACT WHEN THREE-FIFTHS OF ITS MEMBERSHIP ARE PRESENT. ALL ACTION OF THE TASK FORCE SHALL REQUIRE AN AFFIRMATIVE VOTE OF ITS MEMBERSHIP. THE TASK FORCE SHALL CONVENE AT THE CALL OF THE OFFICE. 6. THE MEMBERS OF THE TASK FORCE SHALL RECEIVE NO COMPENSATION FOR THEIR SERVICES, BUT SHALL BE ALLOWED THEIR ACTUAL AND NECESSARY EXPENSES INCURRED IN THE PERFORMANCE OF THEIR DUTIES PURSUANT TO THIS SECTION. 7. (A) THE GOALS OF THE TASK FORCE MAY INCLUDE, BUT ARE NOT LIMITED TO, THE STUDY, EVALUATION AND DEVELOPMENT OF RECOMMENDATIONS: (I) TO ENCOURAGE THE ESTABLISHMENT AND EXPANSION OF COMMUNITY GARDENS BY STATE AGENCIES, MUNICIPAL GOVERNMENTS, EDUCATIONAL FACILITIES AND PRIVATE PARTIES, SUCH AS HOSPITALS, OTHER HEALTH CARE FACILITIES AND OTHER HEALTH CARE PROVIDERS, (II) TO ENCOURAGE COOPERATION BETWEEN THE ACTIV- ITIES AND OPERATIONS OF COMMUNITY GARDENS AND PROVISION OF DONATED FOOD TO LOCAL VOLUNTARY FOOD ASSISTANCE PROGRAMS FOR THE POOR AND DISADVAN- TAGED, (III) TO ENCOURAGE THE PRODUCTION AND CONSUMPTION OF FRESH FRUITS AND VEGETABLES TO HELP COMBAT THE INCREASING PREVALENCE OF ADULT AND CHILDHOOD OBESITY, AND (IV) TO INCREASE THE BENEFITS THAT COMMUNITY GARDENS MAY PROVIDE TO THE LOCAL COMMUNITY IN WHICH THEY ARE LOCATED. (B) IN ACHIEVING THE GOALS OF THE TASK FORCE, THE TASK FORCE MAY CONSIDER RECOMMENDATIONS THAT: (I) ENCOURAGE THE EXECUTION OF CONSERVA- TION EASEMENTS BY STATE AGENCIES, MUNICIPALITIES, EDUCATIONAL FACILITIES OR PRIVATE PARTIES TO ESTABLISH OR PROTECT COMMUNITY GARDENS, (II) ENCOURAGE THE CREATION OF MECHANISMS TO TRANSFER DEVELOPMENT RIGHTS TO PROTECT COMMUNITY GARDENS OR ENCOURAGE THE DONATION OR LEASE OF LANDS FOR COMMUNITY GARDENS, (III) DEVELOPMENT OF MODEL ZONING CODES, LOCAL LAND USE LAWS OR OTHER MUNICIPAL POLICIES THAT COULD ENCOURAGE THE ESTABLISHMENT OR RETENTION OF COMMUNITY GARDENS, (IV) ENCOURAGE COOPER- ATIVE INITIATIVES BETWEEN HEALTH CARE FACILITIES, OTHER HEALTH CARE PROVIDERS AND COMMUNITY GROUPS TO ENCOURAGE THE PRODUCTION AND CONSUMP- TION OF FRESH FRUITS AND VEGETABLES TO COMBAT THE HIGH INCIDENCE OF ADULT AND CHILD OBESITY, AND (V) ANY OTHER ACTIVITY TO ACHIEVE THE GOALS DEEMED APPROPRIATE BY THE TASK FORCE ACCORDING TO THE PROVISIONS OF THIS ARTICLE. S 8. The opening paragraph of section 281 of the agriculture and markets law, as added by chapter 834 of the laws of 1981, is amended to read as follows: The legislature hereby finds that inflation has caused higher prices in all phases of farm and food production and farm and food products distribution; and that the demand, by consumers within the state, for increasing supplies of wholesome, fresh and nutritious farm and food products provides a significant opportunity for the development of alternative marketing structures for food grown within the state by which such products may be supplied directly to the consuming public. IN ADDITION, INCREASING THE SUPPLY OF WHOLESOME, FRESH, LOCALLY PRODUCED FRUITS AND VEGETABLES CAN HELP TO ENCOURAGE THE CONSUMPTION OF SUCH PRODUCE IN A MANNER THAT HELPS TO COMBAT THE INCREASING INCIDENCE OF ADULT AND CHILDHOOD OBESITY. REDUCING THE INCIDENCE OF OBESITY CAN HELP TO IMPROVE THE OVERALL HEALTH OF THE GENERAL PUBLIC, HELP TO REDUCE THE
COST OF PROVIDING HEALTH CARE AND REDUCE THE STATE'S COSTS OF PROVIDING SUCH CARE. S 9. Subdivision 5 of section 283 of the agriculture and markets law, as added by chapter 834 of the laws of 1981, is amended and a new subdi- vision 8-a is added to read as follows: 5. Provide assistance to consumer or non-profit organizations, PUBLIC OR PRIVATE AGENCIES, HOSPITALS AND OTHER HEALTH CARE FACILITIES seeking to purchase or facilitate the purchase of farm products directly from producers. 8-A. ENCOURAGE THE DEVELOPMENT OF DIRECT MARKETING PROGRAMS, WITHIN AREAS OF THE STATE DESIGNATED BY THE DEPARTMENT OF HEALTH AS HAVING A HIGH INCIDENCE OF CHILDHOOD OBESITY AND TO INCREASE THE CONSUMPTION OF FRESH FRUITS AND VEGETABLES TO HELP CURB THE INCIDENCE OF CHILDHOOD OBESITY. S 10. This act shall take effect immediately. PART B Section 1. Section 901 of the education law, as amended by chapter 477 of the laws of 2004, subdivision 1 as amended by section 57 of part A-1 of chapter 58 of the laws of 2006, is amended to read as follows: S 901. School health services to be provided. 1. School health services, as defined in subdivision two of this section, shall be provided by each school district for all students attending the public schools in this state, except in the city school district of the city of New York, as provided in this article. School health services shall include the services of a registered professional nurse, if one is employed, and shall also include such services as may be rendered as provided in this article in examining students for the existence of disease or disability, OR MAY INCLUDE SERVICES RELATED TO EXAMINING FOR CHILDHOOD OBESITY BASED UPON THE CALCULATION OF EACH STUDENT'S BODY MASS INDEX AND WEIGHT STATUS CATEGORY PURSUANT TO SECTION NINE HUNDRED FOUR OF THIS ARTICLE, and in testing the eyes and ears of such students. 2. School health services for the purposes of this article shall mean the several procedures, including, but not limited to, medical examina- tions, dental inspection and/or screening, scoliosis screening, vision screening [and], audiometer tests, AND CHILDHOOD OBESITY AS MEASURED BY BODY MASS INDEX AND WEIGHT STATUS CATEGORY, designed to determine the health status of the child; to inform parents or other persons in parental relation to the child, pupils and teachers of the individual child's health condition subject to federal and state confidentiality laws; to guide parents, children and teachers in procedures for prevent- ing and correcting defects [and], diseases AND CHILDHOOD OBESITY CONDI- TIONS; to instruct the school personnel in procedures to take in case of accident or illness; to survey and make necessary recommendations concerning the health and safety aspects of school facilities and the provision of health information. S 2. Subdivisions 1, 3 and 4 of section 903 of the education law, as amended by chapter 281 of the laws of 2007, subdivision 1 as separately amended by section 11 of part B of chapter 58 of the laws of 2007 and paragraph a of subdivision 3 as amended by section 28 of part A of chap- ter 58 of the laws of 2008, are amended to read as follows: 1. A health certificate shall be furnished by each student in the public schools upon his or her entrance in such schools and upon his or her entry into the grades prescribed by the commissioner in regulations, provided that such regulations shall require such certificates at least
twice during the elementary grades and twice in the secondary grades. An examination and health history of any child may be required by the local school authorities at any time in their discretion to promote the educa- tional interests of such child. Each certificate shall be signed by a duly licensed physician, physician assistant, or nurse practitioner, who is authorized by law to practice in this state, and consistent with any applicable written practice agreement, or by a duly licensed physician, physician assistant, or nurse practitioner, who is authorized to prac- tice in the jurisdiction in which the examination was given, provided that the commissioner has determined that such jurisdiction has stand- ards of licensure and practice comparable to those of New York. Each such certificate shall describe the condition of the student when the examination was made, which shall not be more than twelve months prior to the commencement of the school year in which the examination is required, and shall state whether such student is in a fit condition of health to permit his or her attendance at the public schools. THE EXAM- INATION MAY INCLUDE A DIABETES RISK ANALYSIS AND, IF NECESSARY, CHILDREN WITH RISK FACTORS FOR TYPE 1 DIABETES, OR RISK FACTORS ASSOCIATED WITH TYPE 2 DIABETES SUCH AS OBESITY, A FAMILY HISTORY OF TYPE 2 DIABETES, OR ANY OTHER FACTORS CONSISTENT WITH INCREASED RISK SHALL BE TESTED FOR DIABETES. Each such certificate shall also state the student's body mass index (BMI) and weight status category. For purposes of this section, BMI is computed as the weight in kilograms divided by the square of height in meters or the weight in pounds divided by the square of height in inches multiplied by a conversion factor of 703. Weight status cate- gories for children and adolescents shall be as defined by the commis- sioner of health. In all school districts such physician, physician assistant or nurse practitioner shall determine whether a one-time test for sickle cell anemia is necessary or desirable and he or she shall conduct such a test and the certificate shall state the results. 3. a. Within thirty days after the student's entrance in such schools or grades, the health certificate shall be submitted to the principal or his or her designee and shall be filed in the student's cumulative health record. If such student does not present a health certificate as required in this section, unless he or she has been accommodated on religious grounds, the principal or the principal's designee shall cause a notice to be sent to the parents or person in parental relationship to such student that if the required health certificate is not furnished within thirty days from the date of such notice, an examination will be made of such student, as provided in this article. Each school and school district [chosen as part of an appropriate sampling methodology] shall participate in surveys directed by the commissioner of health pursuant to the public health law in relation to students' BMI and weight status categories as reported on the school health certificate and which shall be subject to audit by the commissioner of health. Such surveys shall contain the information required pursuant to subdivision one of this section in relation to students' BMI and weight status cate- gories in aggregate. Parents or other persons in parental relation to a student may refuse to have the student's BMI and weight status category included in such survey. Each school and school district shall provide the commissioner of health with any information, records and reports he or she may require for the purpose of such audit. The BMI and weight status survey and audit as described in this subdivision shall be conducted consistent with confidentiality requirements imposed by feder- al law.
b. Within thirty days after the student's entrance in such schools or grades, the dental health certificate, if obtained, shall be filed in the student's cumulative health record. 4. Notwithstanding the provisions of subdivisions one, two and three of this section, no examinations for a health certificate or health history shall be required or dental certificate requested, and no screening examinations for sickle cell anemia OR CHILDHOOD OBESITY shall be required where a student or the parent or person in parental relation to such student objects thereto on the grounds that such examinations or health history conflict with their genuine and sincere religious beliefs. S 3. Subdivision 1 of section 904 of the education law, as amended by section 12 of part B of chapter 58 of the laws of 2007, is amended to read as follows: 1. Each principal of a public school, or his or her designee, shall report to the director of school health services having jurisdiction over such school, the names of all students who have not furnished health certificates as provided in section nine hundred three of this article, or who are children with disabilities, as defined by article eighty-nine of this chapter, and the director of school health services shall cause such students to be separately and carefully examined and tested to ascertain whether any student has defective sight or hearing, or any other physical disability which may tend to prevent him or her from receiving the full benefit of school work, or from requiring a modification of such work to prevent injury to the student or from receiving the best educational results. Each examination shall also include a calculation of the student's body mass index (BMI) and weight status category. For purposes of this section, BMI is computed as the weight in kilograms divided by the square of height in meters or the weight in pounds divided by the square of height in inches multiplied by a conversion factor of 703. Weight status categories for children and adolescents shall be as defined by the commissioner of health. In all school districts, such physician, physician assistant or nurse practi- tioner shall determine whether a one-time test for sickle cell anemia is necessary or desirable and he or she shall conduct such tests and the certificate shall state the results. If it should be ascertained, upon such test or examination, that any of such students have defective sight or hearing[,] or other physical disability, including sickle cell anemia, as above described, OR ARE OBESE, the principal or his or her designee shall notify the parents of, or other persons in parental relation to, the child as to the existence of such disability. If the parents or other persons in parental relation are unable or unwilling to provide the necessary relief and treatment for such students, such fact shall be reported by the principal or his or her designee to the direc- tor of school health services, whose duty it shall be to provide relief for such students. Each school and school district [chosen as part of an appropriate sampling methodology] shall participate in surveys directed by the commissioner of health pursuant to the public health law in relation to students' BMI and weight status categories as determined by the examination conducted pursuant to this section and which shall be subject to audit by the commissioner of health. Such surveys shall contain the information required pursuant to this subdivision in relation to students' BMI and weight status categories in aggregate. [Parents or other persons in parental relation to a student may refuse to have the student's BMI and weight status category included in such survey.] Each school and school district shall provide the commissioner
of health with any information, records and reports he or she may require for the purpose of such audit. The BMI and weight status survey and audit as described in this section shall be conducted consistent with confidentiality requirements imposed by federal law. [Data collection for such surveys shall commence on a voluntary basis at the beginning of the two thousand seven academic school year, and by all schools chosen as part of the sampling methodology at the beginning of the two thousand eight academic school year.] The department shall also utilize the collected data to develop a report of child obesity and obesity related diseases. S 4. Section 912 of the education law, as amended by chapter 477 of the laws of 2004, is amended to read as follows: S 912. Health and welfare services to all children. The voters and/or trustees or board of education of every school district shall, upon request of the authorities of a school other than public, provide resi- dent children who attend such school with any or all of the health and welfare services and facilities which are made available by such voters and/or trustees or board of education to or for children attending the public schools of the district. Such services may include, but are not limited to all services performed by a physician, physician assistant, dentist, dental hygienist, registered professional nurse, nurse practi- tioner, school psychologist, school social worker or school speech ther- apist, and may also include dental prophylaxis, vision and hearing screening examinations, CHILDHOOD OBESITY SCREENING, the taking of medical histories and the administration of health screening tests, the maintenance of cumulative health records and the administration of emer- gency care programs for ill or injured students. Any such services or facilities shall be so provided notwithstanding any provision of any charter or other provision of law inconsistent herewith. Where children residing in one school district attend a school other than public located in another school district, the school authorities of the district of residence shall contract with the school authorities of the district where such nonpublic school is located, for the provision of such health and welfare services and facilities to such children by the school district where such nonpublic school is located, for a consider- ation to be agreed upon between the school authorities of such districts, subject to the approval of the qualified voters of the district of residence when required under the provisions of this chap- ter. Every such contract shall be in writing and in the form prescribed by the commissioner, and before such contract is executed the same shall be submitted for approval to the superintendent of schools having juris- diction over such district of residence and such contract shall not become effective until approved by such superintendent. S 5. Subdivisions 4 and 5 of section 918 of the education law, as added by chapter 493 of the laws of 2004, are amended to read as follows: 4. The committee is encouraged to study AND MAKE RECOMMENDATIONS ON all facets of the current nutritional policies of the district includ- ing, but not limited to, the goals of the district to promote health and proper nutrition, REDUCE THE INCIDENCE OF CHILDHOOD OBESITY, vending machine sales, menu criteria, educational curriculum teaching healthy nutrition, AND educational information provided to parents or guardians regarding healthy nutrition and the health risks associated with obesi- ty, ASTHMA, CHRONIC BRONCHITIS AND OTHER CHRONIC RESPIRATORY DISEASES. PROVIDED, FURTHER, THE COMMITTEE MAY PROVIDE INFORMATION TO PERSONS IN PARENTAL RELATION ON opportunities offered to parents or guardians to
encourage healthier eating habits to students, and the education provided to teachers and other staff as to the importance of healthy nutrition AND ABOUT THE DANGERS OF CHILDHOOD OBESITY. In addition the committee shall consider recommendations and practices of other districts and nutrition studies. 5. The committee is encouraged to report periodically to the district regarding practices that will educate teachers, parents or guardians and children about healthy nutrition and raise awareness of the dangers of CHILDHOOD obesity, ASTHMA, CHRONIC BRONCHITIS AND OTHER CHRONIC RESPIR- ATORY DISEASES. The committee is encouraged also to provide any parent teacher associations in the district with such findings and recommenda- tions. S 6. This act shall take effect two years after it shall have become a law. PART C Section 1. Subdivision 1 of section 206 of the public health law is amended by adding two new paragraphs (s) and (t) to read as follows: (S) (I) BY RULE OR REGULATION, MAY REQUIRE FOOD SERVICE ESTABLISHMENTS INCLUDING, BUT NOT LIMITED TO RESTAURANTS, DINING ROOMS, DELIS, BAKER- IES, ELEMENTARY AND SECONDARY SCHOOLS, HOSPITALS, MOBILE FOOD SERVICE VEHICLES AND CARTS, AND CHILD CARE FACILITIES, THAT PREPARE, SELL OR SERVE FOOD FOR IMMEDIATE CONSUMPTION BY THE GENERAL PUBLIC, TO RESTRICT THE USE OF ARTIFICIAL TRANS FAT IN THE PREPARATION OF SUCH FOOD. FOR THE PURPOSES OF THIS PARAGRAPH, THE TERM "ARTIFICIAL TRANS FAT" MEANS ANY FOOD THAT IS LABELED, AND WHICH LISTS AS AN INGREDIENT OR CONTAINS VEGE- TABLE SHORTENING, MARGARINE OR ANY KIND OF PARTIALLY HYDROGENATED VEGE- TABLE OIL; PROVIDED, HOWEVER, THAT ANY FOOD WITH A NUTRITIONAL FACT LABEL OR OTHER DOCUMENTATION FROM A MANUFACTURER LIST STATING A TRANS FAT CONTENT OF LESS THAN .5 GRAMS PER SERVING SHALL NOT BE DEEMED TO CONTAIN ARTIFICIAL TRANS FAT. SUCH RULES AND REGULATIONS SHALL NOT APPLY TO ANY FOOD SERVED DIRECTLY TO THE GENERAL PUBLIC IN THE MANUFACTURER'S ORIGINAL SEALED PACKAGE. FURTHERMORE, SUCH RULES AND REGULATIONS SHALL NOT APPLY TO ANY FOOD SERVICE ESTABLISHMENT OR MOBILE FOOD COMMISSARY THAT IS SUBJECT TO ANY LOCAL LAW, ORDINANCE, CODE OR RULE THAT REGULATES THE USE OR DISCLOSURE OF ARTIFICIAL TRANS FATS BY FOOD SERVICE ESTAB- LISHMENTS. (II) THE COMMISSIONER MAY REQUIRE FOOD SERVICE ESTABLISHMENTS SERVING FOODS WITH ARTIFICIAL TRANS FAT TO POST WARNING SIGNS TO INFORM THE PUBLIC ABOUT THE HEALTH RISKS ASSOCIATED WITH THE OVER CONSUMPTION OF FOODS PREPARED WITH ARTIFICIAL TRANS FATS. SUCH WARNING SIGNS SHALL BE CONSPICUOUSLY POSTED IN AREAS WHERE FOOD MAY BE ORDERED FROM THE FOOD SERVICE ESTABLISHMENT AND SHALL BE IN SUBSTANTIALLY THE FOLLOWING FORM: "WARNING - THIS ESTABLISHMENT USES ARTIFICIAL TRANS FAT IN THE PREPARA- TION OF SOME OR ALL OF THE FOODS THAT ARE SOLD OR SERVED HERE. WHEN OVERCONSUMED, ARTIFICIAL TRANS FATS CAN LEAD TO INCREASES IN THE RISK OF HEART ATTACK, STROKE AND DEVELOPMENT OF TYPE 2 DIABETES." (III) THE COMMISSIONER MAY ESTABLISH A VOLUNTARY ARTIFICIAL TRANS FAT REDUCTION PROGRAM. SUCH PROGRAM MAY CONSIST OF, BUT SHALL NOT BE LIMITED TO, THE FOLLOWING COMPONENTS: (A) A PUBLIC INFORMATION DISSEMINATION PROGRAM TO INFORM THE PUBLIC OF THE HEALTH RISKS ASSOCIATED WITH THE OVERCONSUMPTION OF ARTIFICIAL TRANS FATS, AND (B) SUGGESTED FOOD PREPA- RATION METHODS THAT CAN BE FOLLOWED BY FOOD SERVICE ESTABLISHMENTS AND THE GENERAL PUBLIC TO REDUCE OR ELIMINATE THE USE OF ARTIFICIAL TRANS FATS.
(T) (I) FOR PURPOSES OF THIS PARAGRAPH, THE FOLLOWING DEFINITIONS SHALL APPLY: (A) "FOOD SERVICE FACILITY" MEANS A FOOD SERVICE ESTABLISHMENT, AS DEFINED IN THE STATE SANITARY CODE, THAT OPERATES UNDER COMMON OWNERSHIP OR CONTROL WITH AT LEAST TWENTY-FIVE OTHER FOOD SERVICE ESTABLISHMENTS WITH THE SAME NAME IN THE STATE THAT OFFER FOR SALE SUBSTANTIALLY THE SAME MENU ITEMS, OR OPERATES AS A FRANCHISED OUTLET OF A PARENT COMPANY WITH AT LEAST TWENTY-FIVE OTHER FRANCHISED OUTLETS WITH THE SAME NAME IN THE STATE THAT OFFER FOR SALE SUBSTANTIALLY THE SAME MENU ITEMS. (B) "NUTRITIONAL INFORMATION" INCLUDES ALL OF THE FOLLOWING, PER STAN- DARD MENU ITEM, AS THAT ITEM IS USUALLY PREPARED AND OFFERED FOR SALE: (I) TOTAL NUMBER OF CALORIES. (II) TOTAL NUMBER OF GRAMS OF CARBOHYDRATES. (III) TOTAL NUMBER OF GRAMS OF SATURATED FAT. (IV) TOTAL NUMBER OF MILLIGRAMS OF SODIUM. (C) "POINT OF SALE" MEANS THE LOCATION WHERE A CUSTOMER PLACES AN ORDER. (D) IN CALCULATING NUTRITIONAL INFORMATION, A FOOD SERVICE FACILITY MAY USE ANY REASONABLE MEANS RECOGNIZED BY THE FEDERAL FOOD AND DRUG ADMINISTRATION TO DETERMINE NUTRITIONAL INFORMATION FOR A STANDARD MENU ITEM, AS USUALLY PREPARED AND OFFERED FOR SALE INCLUDING, BUT NOT LIMIT- ED TO, NUTRIENT DATABASES AND LABORATORY ANALYSES. (II)(A) BY RULE OR REGULATION, MAY REQUIRE EVERY FOOD SERVICE FACILITY TO DISCLOSE THE NUTRITIONAL INFORMATION REQUIRED BY CLAUSE (B) OF THIS SUBPARAGRAPH. (B) A FOOD SERVICE FACILITY, BY RULE OR REGULATION, MAY BE REQUIRED TO DISCLOSE THE NUTRITIONAL INFORMATION IN A CLEAR AND CONSPICUOUS MANNER AT THE POINT OF SALE PRIOR TO OR DURING THE PLACEMENT OF AN ORDER. S 2. The opening paragraph of subdivision 1, and subdivisions 3, 4 and 6 of section 207 of the public health law, as amended by section 16 of part A of chapter 109 of the laws of 2010, are amended to read as follows: There is hereby created within the department the health care and wellness education and outreach program. The department may conduct education and outreach programs for consumers, patients, ELEMENTARY AND SECONDARY SCHOOL EDUCATORS, and health care providers relating to any health care matters the commissioner deems appropriate and: 3. The department may produce, make available to others for reprod- uction, or contract with others to develop such materials mentioned in this section as the commissioner deems appropriate. These materials shall be made available to the public AND TO ELEMENTARY AND SECONDARY SCHOOL EDUCATORS free of charge as appropriate or for a fee under certain circumstances. The commissioner may require where appropriate any health care provider to make these materials available to patients. 4. In exercising any of his or her powers under this section, the commissioner may consult with appropriate health care professionals, providers, consumers, EDUCATORS and patients or organizations represent- ing them. 6. The commissioner may appoint as appropriate advisory councils relating to various matters that are or are proposed to be the subjects of programs under this section. All such councils shall include repre- sentation of health care professionals, providers, EDUCATORS, consumers, patients and other appropriate interests. The members of the councils shall receive no compensation for their services, but shall be allowed their actual and necessary expenses incurred in performance of their duties.
S 3. Subdivision 1 of section 207 of the public health law is amended by adding a new paragraph (i) to read as follows: (I) ABOUT THE SHORT TERM AND LONG TERM ADVERSE HEALTH RISKS TO ADULTS AND CHILDREN WHO BECOME OVERWEIGHT, OBESE OR UNDERWEIGHT. THE INFORMA- TION SHALL INCLUDE, BUT NEED NOT BE LIMITED TO PROVIDING CITATIONS TO THE DEPARTMENT'S WEBSITE, AS WELL AS ANY OTHER WEBSITES PROVIDING INFOR- MATION ON THE SUBJECT. S 4. This act shall take effect one year after it shall have become a law, provided that, effective immediately, any rules and regulations necessary to implement the provisions of this act on its effective date are authorized and directed to be completed on or before such date. PART D Section 1. Subdivision 5 of section 2556 of the education law, such section as renumbered by chapter 762 of the laws of 1950, is amended to read as follows: 5. It shall be unlawful for a schoolhouse to be constructed in the city of New York without an open-air playground attached to or used in connection with the same. EXISTING PLAYGROUNDS SHALL NOT BE SOLD, LEASED OR TRANSFERRED, OR PERMANENTLY AUTHORIZED FOR OTHER USES SUCH AS SCHOOL BUILDING CONSTRUCTION, RENOVATION, PLACEMENT OR STORAGE OF BUILD- ING MATERIALS FOR SUCH WORK THAT WOULD ELIMINATE THE USE OF SUCH PLAY- GROUND SPACE FOR OUTDOOR RECREATIONAL ACTIVITIES UNLESS A PLAN IS ESTAB- LISHED AND IMPLEMENTED TO PROVIDE SUITABLE AND ADEQUATE PHYSICAL ACTIVITIES OR SPACE TO ACCOMMODATE THE PHYSICAL AND RECREATIONAL NEEDS OF THE PUPILS OF SUCH BUILDING. THE PROVISIONS OF THIS SUBDIVISION SHALL NOT APPLY TO SCHOOL CONSTRUCTION OR RENOVATION ACTIVITIES THAT OCCUR ON OR REQUIRE THE USE OF SUCH PLAYGROUNDS FOR A DURATION OF NO MORE THAN ONE YEAR. S 2. This act shall take effect July 1, 2013; provided however, that the commissioner of education is authorized and directed to promulgate any rules or regulations necessary for the timely implementation of this act on or before such date. PART E Section 1. Subdivisions 1 and 5 of section 803 of the education law, as amended by chapter 118 of the laws of 1957, are amended to read as follows: 1. All pupils above the age of eight years in all elementary and secondary schools, shall receive as part of the prescribed courses of instruction therein such physical education under the direction of the commissioner of education as the regents may determine. Such courses shall be designed to aid in the well-rounded education of pupils and in the development of character, citizenship, OVERALL physical fitness, GOOD health [and], the worthy use of leisure AND THE REDUCTION IN THE INCIDENCE OF CHILDHOOD OBESITY. Pupils above such age attending the public schools shall be required to attend upon such prescribed courses of instruction. 5. (A) It shall be the duty of the regents to adopt rules determining the subjects to be included in courses of physical education provided for in this section, the period of instruction in each of such courses, the qualifications of teachers, and the attendance upon such courses of instruction.
(B) NOTWITHSTANDING ANY OTHER PROVISION OF THIS SECTION, THE REGENTS MAY PROVIDE IN ITS RULES THAT THE PHYSICAL EDUCATION INSTRUCTION REQUIREMENT FOR ALL STUDENTS ENROLLED IN ELEMENTARY AND SECONDARY SCHOOL GRADES SHALL, WHERE FEASIBLE, INCLUDE DAILY PHYSICAL EXERCISE OR ACTIV- ITY, INCLUDING STUDENTS WITH DISABLING CONDITIONS AND THOSE IN ALTERNA- TIVE EDUCATION PROGRAMS. THE REGENTS MAY INCLUDE IN ITS RULES THAT STUDENTS ENROLLED IN SUCH ELEMENTARY AND SECONDARY SCHOOLS SHALL PARTIC- IPATE IN PHYSICAL EDUCATION, EXERCISE OR ACTIVITY FOR A MINIMUM OF ONE HUNDRED TWENTY MINUTES DURING EACH SCHOOL WEEK. THE REGENTS MAY PROVIDE FOR A TWO-YEAR PHASE-IN SCHEDULE FOR DAILY PHYSICAL EDUCATION IN ELEMEN- TARY SCHOOLS IN ITS RULES. S 2. The section heading and subdivision 1 of section 804 of the education law, the section heading as amended by chapter 401 of the laws of 1998 and subdivision 1 as added by chapter 982 of the laws of 1977, are amended and a new subdivision 3-b is added to read as follows: Health education regarding alcohol, drugs, tobacco abuse, THE REDUCTION IN THE INCIDENCE OF OBESITY, and the prevention and detection of certain cancers. 1. All schools shall include, as an integral part of health, SCIENCE AND PHYSICAL education, instruction so as to discourage the misuse and abuse of alcohol, tobacco[,] and other drugs, TO REDUCE THE INCIDENCE OF OBESITY, and promote attitudes and behavior that enhance health, well being, and human dignity. 3-B. INSTRUCTION REGARDING THE LONG TERM HEALTH RISKS ASSOCIATED WITH OBESITY AND METHODS OF PREVENTING AND REDUCING THE INCIDENCE OF OBESITY, INCLUDING GOOD NUTRITION AND REGULAR EXERCISE. SUCH INSTRUCTION MAY BE AN INTEGRAL PART OF REQUIRED HEALTH, SCIENCE AND PHYSICAL EDUCATION COURSES. S 3. Subdivision 1 of section 804-a of the education law, as added by chapter 730 of the laws of 1986, is amended to read as follows: 1. Within the amounts appropriated, the commissioner is hereby authorized to establish a demonstration program and to distribute state funds to local school districts, boards of cooperative educational services and in certain instances community school districts, for the development, implementation, evaluation, validation, demonstration and replication of exemplary comprehensive health education programs to assist the public schools in developing curricula, training staff, and addressing local health education needs of students, parents, and staff. SUCH PROGRAMS SHALL SERVE THE PURPOSE OF DEVELOPING AND ENHANCING PUPILS' HEALTH KNOWLEDGE, SKILLS, ATTITUDES AND BEHAVIORS, WHICH IS FUNDAMENTAL TO IMPROVING THEIR HEALTH STATUS AND ACADEMIC PERFORMANCE, AS WELL AS REDUCING THE INCIDENCE OF ADOLESCENT PREGNANCY, ALCOHOL ABUSE, TOBACCO ABUSE, TRUANCY, SUICIDE, SUBSTANCE ABUSE, OBESITY, ASTH- MA, OTHER CHRONIC RESPIRATORY DISEASES, AND OTHER PROBLEMS OF CHILDHOOD AND ADOLESCENCE. S 4. Section 813 of the education law, as added by chapter 296 of the laws of 1994, is amended to read as follows: S 813. School lunch period; scheduling. Each school shall schedule a reasonable time DURING EACH SCHOOL DAY for each full day pupil attending pre-kindergarten through grade twelve WITH AMPLE TIME to consume lunch AND TO ENGAGE IN PHYSICAL EXERCISE OR RECREATION. S 5. This act shall take effect immediately. PART F 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 G Section 1. Subdivisions 2 and 4 of section 2111 of the public health law, as added by section 21 of part C of chapter 58 of the laws of 2004, are amended to read as follows: 2. The department shall establish the criteria by which individuals will be identified as eligible for enrollment in the demonstration programs. Persons eligible for enrollment in the disease management demonstration program shall be limited to individuals who: receive medical assistance pursuant to title eleven of article five of the social services law and may be eligible for benefits pursuant to title 18 of the social security act (Medicare); are not enrolled in a Medicaid managed care plan, including individuals who are not required or not eligible to participate in Medicaid managed care programs pursuant to section three hundred sixty-four-j of the social services law; are diag- nosed with chronic health problems as may be specified by the entity undertaking the demonstration program, including, but not limited to one or more of the following: congestive heart failure, chronic obstructive pulmonary disease, asthma, CHRONIC BRONCHITIS, OTHER CHRONIC RESPIRATORY DISEASES, diabetes, ADULT AND CHILDHOOD OBESITY, or other chronic health conditions as may be specified by the department; or have experienced or are likely to experience one or more hospitalizations or are otherwise expected to incur excessive costs and high utilization of health care services. 4. The demonstration program shall offer evidence-based services and interventions designed to ensure that the enrollees receive high quali- ty, preventative and cost-effective care, aimed at reducing the necessi-
ty for hospitalization or emergency room care or at reducing lengths of stay when hospitalization is necessary. The demonstration program may include screening of eligible enrollees, developing an individualized care management plan for each enrollee and implementing that plan. Disease management demonstration programs that utilize information tech- nology systems that allow for continuous application of evidence-based guidelines to medical assistance claims data and other available data to identify specific instances in which clinical interventions are justi- fied and communicate indicated interventions to physicians, health care providers and/or patients, and monitor physician and health care provid- er response to such interventions, shall have the enrollees, or groups of enrollees, approved by the department for participation. The services provided by the demonstration program as part of the care management 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 H Section 1. Section 2599-b of the public health law, as amended by section 88 of part B of chapter 58 of the laws of 2005, is amended to read as follows: S 2599-b. Program development. 1. The program shall be designed to prevent and reduce the incidence and prevalence of obesity in children and adolescents, especially among populations with high rates of obesity and obesity-related health complications including, but not limited to, diabetes, heart disease, cancer, osteoarthritis, asthma, CHRONIC BRON- CHITIS, OTHER CHRONIC RESPIRATORY DISEASES and other conditions. The program shall use recommendations and goals of the United States depart- ments of agriculture and health and human services, the surgeon general and centers for disease control AND PREVENTION in developing and imple- menting guidelines for nutrition education and physical activity projects as part of obesity prevention efforts. The content and imple- mentation of the program shall stress the benefits of choosing a balanced, healthful diet from the many options available to consumers, without specifically targeting the elimination of any particular food group, food product or food-related industry. 2. The childhood obesity prevention program shall include, but not be limited to: (a) developing media health promotion campaigns, IN COORDINATION WITH THE PUBLIC INFORMATION PROVIDED PURSUANT TO SECTION TWENTY-FIVE HUNDRED-K OF THIS ARTICLE, targeted to children and adolescents and their parents and caregivers that emphasize increasing consumption of low-calorie, high-nutrient foods, decreasing consumption of high-calo- rie, low-nutrient foods and increasing physical activity designed to prevent or reduce obesity; (b) establishing school-based childhood obesity prevention nutrition education and physical activity programs including programs described in section twenty-five hundred ninety-nine-c of this article, as well as other programs with linkages to physical and health education courses, and which utilize the school health index of the National Center for
Chronic Disease Prevention and Health Promotion or other recognized school health assessment PURSUANT TO ARTICLE NINETEEN OF THE EDUCATION LAW; (c) establishing community-based childhood obesity prevention nutri- tion education and physical activity programs including programs which involve parents and caregivers, and which encourage communities, fami- lies, child care and other settings to provide safe and adequate space and time for physical activity and encourage a healthy diet, AND CAN BE IN COORDINATION WITH COUNTY COOPERATIVE EXTENSION PROGRAMS ESTABLISHED PURSUANT TO SECTION TWO HUNDRED TWENTY-FOUR-B OF THE COUNTY LAW; (d) coordinating with the state education department, department of agriculture and markets, office of parks, recreation and historic pres- ervation, office of temporary and disability assistance, office of chil- dren and family services and other federal, state and local agencies to incorporate strategies to prevent and reduce childhood obesity into government food assistance, health, education and recreation programs; (e) sponsoring periodic conferences or meetings to bring together experts in nutrition, exercise, public health, mental health, education, parenting, media, food marketing, food security, agriculture, community planning and other disciplines to examine societal-based solutions to the problem of childhood obesity and issue guidelines and recommenda- tions for New York state policy and programs; (f) developing training programs for medical and other health profes- sionals to teach practical skills in nutrition and exercise education to children and their parents and caregivers; [and] (g) developing screening programs, IN ACCORDANCE WITH SECTION TWENTY- FIVE HUNDRED-K OF THIS ARTICLE, in coordination with health care provid- ers and institutions including but not limited to day care centers and schools for overweight and obesity for children aged two through eigh- teen years, using body mass index (BMI) appropriate for age and gender, and notification, in a manner protecting the confidentiality of such children and their families, of parents of BMI status, and explanation of the consequences of such status, including recommended actions parents may need to take and information about resources and referrals available to families to enhance nutrition and physical activity to reduce and prevent obesity[.]; AND (H) COORDINATING WITH THE EDUCATION DEPARTMENT, OFFICE OF TEMPORARY AND DISABILITY ASSISTANCE, OFFICE OF CHILDREN AND FAMILY SERVICES AND OTHER FEDERAL, STATE AND LOCAL AGENCIES TO INCORPORATE STRATEGIES TO CURTAIL THE INCIDENCE OF ASTHMA, CHRONIC BRONCHITIS AND OTHER CHRONIC RESPIRATORY DISEASES TO ENABLE ADULTS AND CHILDREN TO SAFELY INCREASE PHYSICAL ACTIVITY TO HELP CURB THE INCIDENCE OF OBESITY. 3. The department, IN COOPERATION WITH THE EDUCATION DEPARTMENT, shall periodically collect and analyze information from schools, health and nutrition programs and other sources to determine the prevalence of childhood obesity in New York state, and to evaluate, to the extent possible, the effectiveness of the childhood obesity prevention program. S 2. The opening paragraph of section 2599-c of the public health law, as amended by section 88 of part B of chapter 58 of the laws of 2005, is amended to read as follows: The commissioner, IN COOPERATION WITH THE COMMISSIONERS OF EDUCATION AND AGRICULTURE AND MARKETS, AND COUNTY BOARDS OF COOPERATIVE EXTENSION, shall encourage the establishment of school-based childhood obesity prevention and physical activity programs that promote: S 3. This act shall take effect immediately.
PART I Section 1. Section 263 of the public health law, as added by chapter 538 of the laws of 2002, is amended to read as follows: S 263. Department authorized to study obesity - report. 1. The depart- ment is authorized to sample and collect data on individual cases where obesity is being actively treated AND DATA COLLECTED PURSUANT TO SECTION TWENTY-FIVE HUNDRED-K OF THIS CHAPTER, and to analyze such data in order to evaluate the impact of treating obesity. Such data collection and analysis shall include the following: a. The effectiveness of existing methods for treating or preventing obesity; b. The effectiveness of alternate methods for treating or preventing obesity; c. The fiscal impact of treating or preventing obesity; d. The compliance and cooperation of patients with various methods of treating or preventing obesity; or e. The reduction in serious medical problems associated with diabetes that results from treating or preventing obesity. 2. The department is authorized to fund the research authorized in subdivision one of this section AND SECTION TWENTY-FIVE HUNDRED-K OF THIS CHAPTER from gifts, grants, and donations from individuals, private organizations, foundations, or any governmental unit; except that no gift, grant, or donation may be accepted by the department if it is subject to conditions that are inconsistent with this title or any other laws of this state. The department shall have the power to direct the disposition of any such gift, grant, or donation for the purposes of this title. 3. After completion of the research authorized in subdivision one of this section, the department shall submit a report and supporting mate- rials to the governor and the legislature by June first of the following year AND UPDATE SUCH REPORT EVERY THREE YEARS. S 2. This act shall take effect immediately. PART J Section 1. Paragraphs (a), (b) and (c) of subdivision 1 of section 2411 of the public health law, as amended by chapter 219 of the laws of 1997, are amended to read as follows: (a) Survey state agencies, boards, programs and other state govern- mental entities to assess what, if any, relevant data has been or is being collected which may be of use to researchers engaged in breast, prostate or testicular cancer research, OR ADULT AND CHILDHOOD OBESITY, ASTHMA, CHRONIC BRONCHITIS OR OTHER CHRONIC RESPIRATORY DISEASE RESEARCH; (b) Consistent with the survey conducted pursuant to paragraph (a) of this subdivision, compile a list of data collected by state agencies which may be of assistance to researchers engaged in breast, prostate or testicular cancer research as established in section twenty-four hundred twelve of this title, AND ADULT AND CHILDHOOD OBESITY, ASTHMA, CHRONIC BRONCHITIS OR OTHER CHRONIC RESPIRATORY DISEASE RESEARCH; (c) Consult with the Centers for Disease Control and Prevention, the National Institutes of Health, the Federal Agency For Health Care Policy and Research, the National Academy of Sciences and other organizations or entities which may be involved in cancer research to solicit both information regarding breast, prostate and testicular cancer research
projects, AND ADULT AND CHILDHOOD OBESITY, ASTHMA, CHRONIC BRONCHITIS OR OTHER CHRONIC RESPIRATORY DISEASE RESEARCH PROJECTS that are currently being conducted and recommendations for future research projects; S 2. Subdivision 1 of section 2500 of the public health law, as amended by chapter 822 of the laws of 1987, is amended to read as follows: 1. The commissioner shall act in an advisory and supervisory capacity, in matters pertaining to the safeguarding of motherhood, the prevention of maternal, perinatal, infant and child mortality, the prevention of diseases, low birth weight, CHILDHOOD OBESITY, and defects of childhood and the promotion of maternal, prenatal and child health, including care in hospitals, and shall administer such services bearing on the health of mothers and children for which funds are or shall hereafter be made available. S 3. The public health law is amended by adding a new section 2500-k to read as follows: S 2500-K. CHILDHOOD OBESITY PREVENTION AND SCREENING. 1. LEGISLATIVE DECLARATION. THE LEGISLATURE HEREBY FINDS, DETERMINES AND DECLARES THAT OBESITY, PARTICULARLY CHILDHOOD OBESITY, IS A SERIOUS MEDICAL PROBLEM AND THAT THE HIGH INCIDENCE OF SUCH CONDITION NEEDS TO BE CURTAILED TO IMPROVE THE OVERALL HEALTH OF THE GENERAL PUBLIC AND TO HELP REDUCE THE COST OF PROVIDING HEALTH CARE IN THIS STATE. PROVIDED FURTHER, THAT THE LEGISLATURE HEREBY REAFFIRMS THE LEGISLATIVE INTENT CONTAINED IN SECTION TWO HUNDRED SIXTY-ONE OF THIS CHAPTER CONCERNING OBESITY. 2. THE COMMISSIONER MAY ESTABLISH, FOR USE BY PEDIATRIC PRIMARY CARE PROVIDERS AND HOSPITALS, BEST PRACTICE PROTOCOLS FOR THE EARLY SCREEN- ING, IDENTIFICATION AND TREATMENT OF CHILDREN WHO HAVE LOW BIRTH WEIGHTS OR MAY BECOME SUSCEPTIBLE TO CONTRACTING ASTHMA OR MANIFEST TO HAVE CHILDHOOD OBESITY CONDITIONS. SUCH PROTOCOLS SHALL INCORPORATE STANDARDS AND GUIDELINES ESTABLISHED BY THE AMERICAN ACADEMY OF PEDIATRICIANS, THE FEDERAL DEPARTMENT OF AGRICULTURE, THE FEDERAL DEPARTMENT OF HEALTH AND HUMAN SERVICES, THE SURGEON GENERAL, AND THE CENTERS FOR DISEASE CONTROL AND PREVENTION. 3. THE DEPARTMENT, IN ORDER TO SUPPORT QUALITY CARE IN ALL HOSPITALS WITH OBSTETRIC SERVICES AND FOR ALL PEDIATRIC PRIMARY CARE PROVIDERS, IS AUTHORIZED TO PROVIDE NON-PATIENT SPECIFIC INFORMATION FOR ALL BIRTHS AT EACH AFFILIATE HOSPITAL IN EACH REGIONAL PERINATAL CENTER'S NETWORK TO THE REGIONAL PERINATAL CENTER AND THE AFFILIATE, EXCEPT THAT SUCH INFOR- MATION SHALL INCLUDE ZIP CODE AND A UNIQUE IDENTIFIER, SUCH AS MEDICAL RECORD NUMBER. 4. THE INFORMATION WHEN RECEIVED BY THE DEPARTMENT SHALL BE USED SOLE- LY FOR THE PURPOSE OF IMPROVING QUALITY OF CARE AND SHALL NOT BE SUBJECT TO RELEASE UNDER ARTICLE SIX OF THE PUBLIC OFFICERS LAW, AND WHERE APPLICABLE, SHALL BE SUBJECT TO THE CONFIDENTIALITY PROVISIONS OF SECTION TWENTY-EIGHT HUNDRED FIVE-M OF THIS CHAPTER, EXCEPT THAT THE RELEASE OF BIRTH CERTIFICATE INFORMATION SHALL BE SUBJECT TO SECTION FORTY-ONE HUNDRED SEVENTY-FOUR OF THIS CHAPTER. 5. THE COMMISSIONER MAY RELEASE INFORMATION COLLECTED THROUGH THE STATEWIDE PERINATAL DATA SYSTEM, PURSUANT TO SECTION TWENTY-FIVE HUNDRED-H OF THIS TITLE AND CORRESPONDING INFORMATION RELATED TO ASTHMA, CHILDHOOD OBESITY OR UNDERWEIGHT BABIES TO HIS OR HER DESIGNEES, INCLUD- ING PERSONS OR ENTITIES UNDER CONTRACT WITH THE DEPARTMENT TO REVIEW QUALITY OF CARE ISSUES, AS RELATED TO THE PROVISIONS OF THIS SECTION, AND TO CONDUCT QUALITY IMPROVEMENT INITIATIVES AS NEEDED TO MONITOR, EVALUATE AND IMPROVE PATIENT CARE AND OUTCOMES. SUCH DESIGNEE OR PERSON OR ENTITY UNDER CONTRACT WITH THE DEPARTMENT TO REVIEW QUALITY OF CARE
ISSUES SHALL MAINTAIN THE CONFIDENTIALITY OF ALL SUCH INFORMATION AND SHALL USE IT ONLY TO IMPROVE QUALITY OF CARE, AS APPROVED BY THE DEPART- MENT, AND TO IMPLEMENT THE PROVISIONS OF TITLE FIVE OF ARTICLE TWO OF THIS CHAPTER, AS ADDED BY CHAPTER FIVE HUNDRED THIRTY-EIGHT OF THE LAWS OF TWO THOUSAND TWO. 6. THE DEPARTMENT MAY PRODUCE AND DISTRIBUTE EDUCATIONAL MATERIALS ON CHILDHOOD OBESITY AND ASTHMA RISKS AND PRECAUTIONS. SUCH MATERIALS MAY BE MADE AVAILABLE TO CHILD CARE CENTERS, PEDIATRICIANS AND NURSERY, ELEMENTARY AND SECONDARY SCHOOLS FOR DISTRIBUTION TO PERSONS IN PARENTAL RELATION TO CHILDREN, AND TO HOSPITALS, BIRTHING CENTERS AND OTHER APPROPRIATE HEALTH CARE PROVIDERS FOR DISTRIBUTION TO MATERNITY PATIENTS. IN ADDITION, SUCH MATERIALS MAY BE PROVIDED TO HEALTH CARE PROFESSIONALS ENGAGED IN THE CARE AND TREATMENT OF CHILDREN FOR DISTRIB- UTION TO SUCH CHILDREN AND PERSONS IN PARENTAL RELATION. THE DEPARTMENT MAY ALSO PROVIDE INFORMATION ON CHILDHOOD OBESITY AND ASTHMA RISKS AND PRECAUTIONS ON THE DEPARTMENT'S INTERNET WEBSITE. NO PROVISION OF THIS SUBDIVISION SHALL BE DEEMED TO PROHIBIT THE UTILIZATION AND DISTRIBUTION OF EDUCATIONAL MATERIALS RELATING THERETO PRODUCED BY ANY PUBLIC, PRIVATE OR GOVERNMENTAL ENTITY, IN LIEU OF THE DEPARTMENT'S PRODUCTION OF SUCH MATERIALS. 7. THE DEPARTMENT SHALL PERIODICALLY REVIEW AVAILABLE DATA ON OBESITY AND ASTHMA IN CHILDREN AND UPDATE THE INFORMATION ON CHILDHOOD OBESITY AND ASTHMA RISKS AND PRECAUTIONARY MEASURES PROVIDED IN ITS EDUCATIONAL MATERIALS AND ON ITS INTERNET WEBSITE, AS APPROPRIATE. S 4. This act shall take effect immediately. PART K Section 1. Section 2505-a of the public health law, as added by chap- ter 292 of the laws of 2009, is amended to read as follows: S 2505-a. Rights of breastfeeding mothers. 1. The principles enunci- ated in subdivision three of this section are declared to be the public policy of the state and a copy of such statement of rights shall be posted conspicuously in a public place in each maternal health care facility AND CHILD DAY CARE FACILITY. For purposes of this section, "maternal health care provider" means a physician, midwife, or other authorized practitioner attending a pregnant woman; and "maternal health care facility" includes hospitals and freestanding birthing centers providing perinatal services in accordance with article twenty-eight of this chapter and applicable regulations. 2. The commissioner shall make available to every maternal health care provider [and], maternal health care facility AND CHILD DAY CARE FACILI- TY, on the health department's website for the purpose of health care facilities to include such rights in the maternity information leaflet as described in section twenty-eight hundred three-j of this chapter, a copy of the statement of rights provided in subdivision three of this section in the top six languages other than English spoken in the state according to the latest available data from the U.S. Bureau of Census, and shall adopt any rules and regulations necessary to ensure that such patients are treated in accordance with the provisions of such state- ment. 3. The statement of rights shall consist of the following: "Breastfeeding Mothers' Bill of Rights" Choosing the way you will feed your new baby is one of the important decisions you will make in preparing for your infant's arrival. Doctors agree that for most women breastfeeding is the safest and most healthy
choice. It is your right to be informed about the benefits of breast- feeding and have your health care provider [and], maternal health care facility AND CHILD DAY CARE FACILITY encourage and support breastfeed- ing. You have the right to make your own choice about breastfeeding. Whether you choose to breastfeed or not you have the following basic rights regardless of your race, creed, national origin, sexual orien- tation, gender identity or expression, or source of payment for your health care. Maternal health care facilities have a responsibility to ensure that you understand these rights. They must provide this informa- tion clearly for you and must provide an interpreter if necessary. These rights may only be limited in cases where your health or the health of your baby requires it. If any of the following things are not medically right for you or your baby, you should be fully informed of the facts and be consulted. (1) Before You Deliver, if you attend prenatal childbirth education classes provided by the maternal health care facility and all hospital clinics and diagnostic and treatment centers providing prenatal services in accordance with article 28 of the public health law you must receive the breastfeeding mothers' bill of rights. Each maternal health care facility shall provide the maternity information leaflet, including the Breastfeeding Mothers' Bill of Rights, in accordance with section twen- ty-eight hundred three-i of this chapter to each patient or to the appointed personal representative at the time of prebooking or time of admission to a maternal health care facility. Each maternal health care provider shall give a copy of the Breastfeeding Mothers' Bill of Rights to each patient at or prior to the medically appropriate time. You have the right to complete information about the benefits of breastfeeding for yourself and your baby. This will help you make an informed choice on how to feed your baby. You have the right to receive information that is free of commercial interests and includes: * How breastfeeding benefits you and your baby nutritionally, medically and emotionally; * How to prepare yourself for breastfeeding; * How to understand some of the problems you may face and how to solve them. (2) In The Maternal Health Care Facility: * You have the right to have your baby stay with you right after birth whether you deliver vaginally or by cesarean section. You have the right to begin breastfeeding within one hour after birth. * You have the right to have someone trained to help you in breast- feeding give you information and help you when you need it. * You have the right to have your baby not receive any bottle feeding or pacifiers. * You have the right to know about and refuse any drugs that may dry up your milk. * You have the right to have your baby in your room with you 24 hours a day. * You have the right to breastfeed your baby at any time day or night. * You have the right to know if your doctor or your baby's pediatri- cian is advising against breastfeeding before any feeding decisions are made. * You have the right to have a sign on your baby's crib clearly stat- ing that your baby is breastfeeding and that no bottle feeding of any type is to be offered.
* You have the right to receive full information about how you are doing with breastfeeding and get help on how to improve. * You have the right to breastfeed your baby in the neonatal intensive care unit. If nursing is not possible, every attempt will be made to have your baby receive your pumped or expressed milk. * If you, or your baby, are re-hospitalized in a maternal care facili- ty after the initial delivery stay, the hospital will make every effort to continue to support breastfeeding, to provide hospital grade electric pumps and rooming in facilities. * You have the right to have help from someone specially trained in breastfeeding support and expressing breast milk if your baby has special needs. * You have the right to have a family member or friend receive breast- feeding information from a staff member if you request it. (3) When You Leave The Maternal Health Care Facility: * You have the right to printed breastfeeding information free of commercial material. * You have the right, unless specifically requested by you, and avail- able at the facility, to be discharged from the facility without discharge packs containing infant formula, or formula coupons unless ordered by your baby's health care provider. * You have the right to get information about breastfeeding resources in your community including information on availability of breastfeeding consultants, support groups and breast pumps. * You have the right to have the facility give you information to help choose a medical provider for your baby and understand the importance of a follow-up appointment. * You have the right to receive information about safely collecting and storing your breast milk. * You have the right to breastfeed your baby in any location, public or private, where you are otherwise authorized to be. Complaints can be directed to the New York State Division of Human Rights. * YOU HAVE A RIGHT TO BREASTFEED YOUR BABY AT YOUR PLACE OF EMPLOYMENT OR CHILD DAY CARE CENTER IN AN ENVIRONMENT THAT DOES NOT DISCOURAGE BREASTFEEDING OR THE PROVISION OF BREAST MILK. All the above are your rights. If the maternal health care facility does not honor these rights you can seek help by contacting the New York state department of health or by contacting the hospital complaint hotline or via email. 4. The commissioner shall make regulations reasonably necessary to implement this section. S 2. Section 2505 of the public health law, as added by chapter 479 of the laws of 1980, is amended to read as follows: S 2505. Human breast milk; collection, storage and distribution; general powers of the commissioner. The commissioner is hereby empowered to: (a) adopt regulations and guidelines including, but not limited to donor standards, methods of collection, and standards for storage, and distribution of human breast milk; (b) conduct educational activities to inform the public and health care providers of the availability of human breast milk for infants determined to require such milk and to inform potential donors of the opportunities for proper donation; (c) ADOPT REGULATIONS AND GUIDELINES TO ENCOURAGE AND FACILITATE EMPLOYERS AND CHILD DAY CARE CENTERS TO ESTABLISH ENVIRONMENTS THAT DO NOT DISCOURAGE BREASTFEEDING AND THE PROVISION OF BREAST MILK. SUCH
ENVIRONMENTS SHALL INCLUDE SANITARY LOCATIONS FOR BREASTFEEDING, REFRI- GERATORS, AND TRAINED STAFF TO ASSIST IN BREASTFEEDING AND FEEDING BABIES WITH EXPRESSED BREAST MILK; (D) COLLECT AND COMPILE DATA ON THE PREVALENCE OF BREASTFEEDING IN THE STATE AND THE HEALTH CONDITION OF CHILDREN FED BREAST MILK IN COMPARISON TO THOSE WHO WERE NOT; AND (E) establish rules and regulations to effectuate the provisions of this section. S 3. Subdivision 2 of section 2515 of the public health law, as added by section 20 of part A of chapter 58 of the laws of 2008, is amended to read as follows: 2. "Services for eligible adolescents" means those services, including but not limited to: vocational and educational counseling, job skills training, family life and parenting education, life skills development, coordination, case management, primary preventive health care, PREGNANCY AND CHILD NUTRITION COUNSELING FOR EXPECTANT MOTHERS TO CURB THE INCI- DENCE OF CHILDHOOD OBESITY, family planning, social and recreational programs, child care, outreach and advocacy, follow-up on service utili- zation, crisis intervention, and efforts to stimulate community interest and involvement. S 4. Paragraph (c) of subdivision 2 of section 2515-a of the public health law, as added by section 20 of part A of chapter 58 of the laws of 2008, is amended to read as follows: (c) serve a geographic area where the incidence of infant mortality, LOW BIRTH WEIGHT INFANTS, CHILDHOOD OBESITY and the prevalence of low- income families are high and where the availability or accessibility of services for eligible adolescents is low; S 5. Subdivision (b) of section 2522 of the public health law, as amended by chapter 484 of the laws of 2009, is amended and a new subdi- vision (e-1) is added to read as follows: (b) promotion of community awareness of the benefits TO THE MOTHER AND CHILD of preconception health and early and continuous prenatal care; (E-1) HEALTH AND NUTRITIONAL EDUCATION AND SERVICES FOR BOTH PARENTS, REGARDING CHILDHOOD AND ADULT OBESITY AND ASTHMA, AND THE PREVENTION OR MITIGATION THEREOF; S 6. This act shall take effect immediately. PART L Section 1. Section 916 of the education law, as amended by chapter 524 of the laws of 2006, is amended to read as follows: S 916. Pupils afflicted with asthma OR OTHER POTENTIALLY LIFE-THREAT- ENING RESPIRATORY ILLNESSES. The board of education or trustees of each school district and board of cooperative educational services shall allow pupils who have been diagnosed by a physician or other duly authorized health care provider with a severe OR MODERATELY SEVERE asth- matic condition OR OTHER POTENTIALLY LIFE-THREATENING RESPIRATORY ILLNESS to carry and use a prescribed inhaler during the school day, with the written permission of a physician or other duly authorized health care provider, and parental consent, based on such physician's or provider's determination that such pupil is subject to sudden asthmatic attacks [severe enough to] THAT CAN debilitate such pupil. A record of such permission shall be maintained in the school office. In addition, upon the written request of a parent or person in parental relation, the board of education or trustees of a school district and board of cooper- ative educational services shall allow such pupils to maintain an extra
such inhaler in the care and custody of a registered professional nurse OR OTHER DESIGNATED RESPONSIBLE PERSON employed by such district or board of cooperative educational services. Nothing in this section shall require a school district or board of cooperative educational services to retain a school nurse solely for the purpose of taking custody of a spare inhaler, or require that a school nurse be available at all times in a school building for such purpose. S 2. The education law is amended by adding a new section 921 to read as follows: S 921. USE OF NEBULIZER. 1. EVERY SCHOOL DISTRICT AND BOARD OF COOPER- ATIVE EDUCATIONAL SERVICES IN THIS STATE MAY MAINTAIN ONE OR MORE NEBU- LIZERS IN THE OFFICE OF THE SCHOOL NURSE OR IN A SIMILAR ACCESSIBLE LOCATION. 2. THE COMMISSIONER, IN CONSULTATION WITH THE COMMISSIONER OF HEALTH, MAY PROMULGATE REGULATIONS FOR THE ADMINISTRATION OF ASTHMA MEDICATION THROUGH THE USE OF A NEBULIZER BY THE SCHOOL NURSE OR PERSON AUTHORIZED BY REGULATION. THE REGULATIONS MAY INCLUDE: A. A REQUIREMENT THAT EACH CERTIFIED NURSE OR OTHER PERSON AUTHORIZED TO ADMINISTER ASTHMA MEDICATION IN SCHOOLS RECEIVE TRAINING IN AIRWAY MANAGEMENT AND IN THE USE OF NEBULIZERS AND INHALERS CONSISTENT WITH NATIONALLY RECOGNIZED STANDARDS; AND B. A REQUIREMENT THAT EACH PUPIL AUTHORIZED TO USE ASTHMA MEDICATION PURSUANT TO 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 M 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 N Section 1. The state finance law is amended by adding a new section 91-h to read as follows: S 91-H. OBESITY AND RESPIRATORY DISEASE RESEARCH AND EDUCATION FUND. 1. THERE IS HEREBY ESTABLISHED IN THE JOINT CUSTODY OF THE COMMISSIONER OF TAXATION AND FINANCE AND THE COMPTROLLER, A SPECIAL FUND TO BE KNOWN AS THE "OBESITY AND RESPIRATORY DISEASE RESEARCH AND EDUCATION FUND".
2. SUCH FUND SHALL CONSIST OF ALL REVENUE RECEIVED PURSUANT TO AN APPROPRIATION THERETO, AND ALL OTHER MONEYS APPROPRIATED, CREDITED OR TRANSFERRED THERETO FROM ANY OTHER FUND OR SOURCE PURSUANT TO LAW. NOTHING IN THIS SECTION SHALL BE DEEMED TO PREVENT THE STATE FROM RECEIVING GRANTS, GIFTS OR BEQUESTS FOR THE PURPOSES OF THE FUND AND DEPOSITING THEM INTO THE FUND ACCORDING TO LAW. 3. MONIES OF THE FUND SHALL BE EXPENDED ONLY FOR ADULT AND CHILDHOOD OBESITY, ASTHMA, CHRONIC BRONCHITIS OR OTHER CHRONIC RESPIRATORY DISEASE RESEARCH AND EDUCATIONAL PROJECTS CONDUCTED PURSUANT TO SECTIONS TWEN- TY-FOUR HUNDRED ELEVEN, TWENTY-FIVE HUNDRED AND TWENTY-FIVE HUNDRED-K OF THE PUBLIC HEALTH LAW. 4. MONIES SHALL BE PAYABLE FROM THE FUND ON THE AUDIT AND WARRANT OF THE COMPTROLLER ON VOUCHERS APPROVED OR CERTIFIED BY THE COMMISSIONER OF HEALTH. S 2. This act shall take effect immediately. PART O Section 1. Paragraphs 6 and 7 of subsection (b) of section 3239 of the insurance law, as added by chapter 592 of the laws of 2008, are amended and a new paragraph 8 is added to read as follows: (6) a nutrition education program; [and] (7) health or fitness incentive programs[.]; AND (8) A COORDINATED WEIGHT MANAGEMENT, NUTRITION, STRESS MANAGEMENT AND PHYSICAL FITNESS PROGRAM TO COMBAT THE HIGH INCIDENCE OF ADULT AND CHILDHOOD OBESITY, ASTHMA AND OTHER CHRONIC RESPIRATORY CONDITIONS. S 2. Subparagraphs (C) and (D) of paragraph 2 of subsection (c) of section 3239 of the insurance law, as added by chapter 592 of the laws of 2008, are amended and two new subparagraphs (E) and (F) are added to read as follows: (C) the waiver or reduction of copayments, coinsurance and deductibles for preventive services covered under the group policy or subscriber contract; [and] (D) monetary rewards in the form of gift cards or gift certificates, so long as the recipient of the reward is encouraged to use the reward for a product or a service that promotes good health, such as healthy cook books, over the counter vitamins or exercise equipment[.]; (E) FULL OR PARTIAL REIMBURSEMENT OF THE COST OF PARTICIPATING IN A STRESS MANAGEMENT PROGRAM OR ACTIVITY; AND (F) FULL OR PARTIAL REIMBURSEMENT OF THE COST OF PARTICIPATING IN A HEALTH OR FITNESS PROGRAM. S 3. This act shall take effect immediately. PART P Section 1. Subparagraph 4 of paragraph (o) of subdivision 4 of section 366 of the social services law is amended by adding a new clause (vi-a) to read as follows: (VI-A) HEALTH AND NUTRITIONAL EDUCATION AND SERVICES FOR BOTH PARENTS, REGARDING CHILDHOOD AND ADULT OBESITY, ASTHMA AND THE MITIGATION THERE- OF; S 2. Paragraph (a) of subdivision 2-a of section 390 of the social services law, as added by chapter 416 of the laws of 2000, is amended to read as follows: (a) The office of children and family services shall promulgate regu- lations which establish minimum quality program requirements for
licensed and registered child day care homes, programs and facilities. Such requirements shall include but not be limited to (i) the need for age appropriate activities, materials and equipment to promote cogni- tive, educational, social, cultural, physical, emotional, language and recreational development of children in care in a safe, healthy and caring environment (ii) principles of childhood development (iii) appro- priate staff/child ratios for family day care homes, group family day care homes, school age day care programs and day care centers, provided however that such staff/child ratios shall not be less stringent than applicable staff/child ratios as set forth in part four hundred four- teen, four hundred sixteen, four hundred seventeen or four hundred eigh- teen of title eighteen of the New York code of rules and regulations as of January first, two thousand (iv) appropriate levels of supervision of children in care (v) APPROPRIATE PHYSICAL ACTIVITY, NUTRITIONAL OFFER- INGS, AND LOW CALORIE AND LOW SUGAR BEVERAGES TO LOWER THE INCIDENCE OF CHILDHOOD OBESITY (VI) minimum standards for sanitation, health, infection control, nutrition, buildings and equipment, safety, security procedures, first aid, fire prevention, fire safety, evacuation plans and drills, prevention of child abuse and maltreatment, staff qualifica- tions and training, record keeping, and child behavior management. S 3. Section 390-a of the social services law is amended by adding a new subdivision 6 to read as follows: 6. NO FAMILY DAY CARE HOME, GROUP FAMILY DAY CARE HOME, SCHOOL AGE CHILD CARE PROGRAM OR CHILD DAY CARE CENTER SHALL DISCRIMINATE AGAINST ANY CHILD WHO IS BREAST FED OR WHO IS FED WITH EXPRESSED BREAST MILK. S 4. Subdivision 1 of section 224-b of the county law, as added by chapter 575 of the laws of 1989, is amended to read as follows: 1. Agreements to employ and manage area program specialists. Notwith- standing the provisions of subdivision eight of section two hundred twenty-four of this article, two or more county cooperative extension associations may enter into a separate agreement with Cornell university to employ area program specialists. Examples of program areas which could be funded and delivered through the Cornell cooperative extension system could include but not be limited to water quality, solid waste management, commercial and alternative agricultural technologies inte- grated pest management, nutrition, diet and health, ADULT AND CHILDHOOD OBESITY, ASTHMA AND CHRONIC RESPIRATORY ILLNESS PREVENTION, community and rural development, housing availability and affordability, family and economic well being, and the complex problems of youth at risk. Such annual agreements shall identify the titles of the positions to be supported and the program areas for which they will provide leadership. Standards for the employment of area program specialists, including salaries, shall be established by Cornell university, through the direc- tor of extension in consultation with county cooperative extension asso- ciations, apart from standards for the employment of professional staff under section two hundred twenty-four of this article. Area program specialists shall, for administrative purposes, receive salary payments through the Cornell university payroll and for such purposes shall be deemed employees of Cornell university; provided, however, that their program activities shall be directed and managed jointly by the partic- ipating associations and Cornell university under the terms of the annu- al memorandum of agreement. Area program specialists shall be eligible to receive the same state or federal fringe benefits as professional staff employed by the cooperative extension associations under the terms of section two hundred twenty-four of this article.
S 5. This act shall take effect on the first of January next succeed- ing the date on which it shall have become a law; provided that, effec- tive immediately, any rules and regulations necessary to implement the provisions of this act on its effective date are authorized and directed to be completed on or before such date. S 3. Severability clause. If any clause, sentence, paragraph, subdi- vision, section or part of this act shall be adjudged by any court of competent jurisdiction to be invalid, such judgment shall not affect, impair, or invalidate the remainder thereof, but shall be confined in its operation to the clause, sentence, paragraph, subdivision, section or part thereof directly involved in the controversy in which such judg- ment shall have been rendered. It is hereby declared to be the intent of the legislature that this act would have been enacted even if such invalid provisions had not been included herein. S 4. This act shall take effect immediately provided, however, that the applicable effective date of Parts A through P of this act shall be as specifically set forth in the last section of such Parts.

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