Provides for the screening for childhood obesity by elementary and secondary schools; requires instruction in schools on good health practices.
TITLE OF BILL: An act to amend the education law, in relation to screening for childhood obesity and instruction in good health and reducing the incidence of obesity
PURPOSE OR GENERAL IDEA OF BILL: The incidence of childhood obesity is a rapidly growing public health, social, and economic concern that is adversely affecting the overall health and well-being 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 bill attempts to more fully integrate activities conducted by the Education Department to better educate students and parents on the important economic and health reasons for eating 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 should more actively provide 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.
SUMMARY OF PROVISIONS:
Section 1: Amends Education Law section 901 which relates to school health services to be provided. This section expands the types of services that may be provided by school health services to include examining students for the existence, in addition to diseases or disabilities, 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 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 health and welfare services to all children, may also include childhood obesity screening.
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: 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 7: 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 8: 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 9: 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.
Section 10: Effective Date.
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 70% of diagnosed cases of cardiovascular disease are related to obesity.
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.
PRIOR LEGISLATIVE HISTORY: Related to S.6423 of 2012 (Klein) that contains a more comprehensive expansion of obesity programs to combat obesity in adults and children. Same as S. 7113 of 2012
EFFECTIVE DATE: See relevant sections at the end of each Part of this bill.
STATE OF NEW YORK ________________________________________________________________________ 2437 2013-2014 Regular Sessions IN SENATE January 17, 2013 ___________Introduced by Sen. KLEIN -- read twice and ordered printed, and when printed to be committed to the Committee on Education AN ACT to amend the education law, in relation to screening for child- hood obesity and instruction in good health and reducing the incidence of obesity THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: 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-EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD00971-01-3 S. 2437 2
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 healthS. 2437 3
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 factS. 2437 4
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. 2437 5
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. 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 7. The section heading and subdivision 1 of section 804 of the education law, the section heading as amended by chapter 401 of the lawsS. 2437 6
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 8. 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 9. 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 10. This act shall take effect immediately, except that sections one, two, three, four and five of this act shall take effect two years after this act shall have become a law.