Establishes the health care practitioner hygienic dress code program within the department of health to address clothing and jewelry that may cause infections

Summary of provisions

Section 1: Amends Article 2 of the Public Health Law by adding new title 6, "Health Care Practitioner Hygienic Dress Code." This section creates a State health care practitioner hygienic dress code council comprised of twenty-five members appointed by the commissioner of health with the advice of the commissioner of education and financial services. This council is to advise the health and education commissioners on (i) the best practices for mitigating and eliminating the spread of disease among the health-care practitioner community and to their patients via garments and accessories, (ii) the promotion of better coordinated interdisciplinary policies to ensure hygienic practices, (iii) establish materials and curricula to be used in continuing education programs related to hygienic dress codes.

This council also may provide guidance to practitioners and health care facilities on the best practices to mitigate and eliminate the spread of infection and disease by vectors related to health care practitioners' clothes and identification tags. The council should examine and consider the adoption of rules and regulations including education and instruction to patients and practitioners, provision of clean scrubs and uniforms, implementation of best-practices dress codes, and prohibition of wearing clothing worn during treatment outside of the health care facility.

This section also creates Health care practitioner hygienic resource centers as the commissioner may designate. These centers shall act as a source of support and information for practitioners in the area of sanitary and hygienic conditions for patient treatment. These centers may be contracted for with not-for-profit organizations at the discretion of the Health Department and with the council's consultation.

The council, in consultation with the health and education departments, as well as practitioner professional organizations, is to develop course materials on sanitary dress code policies and practices and, within two years, make recommendations for inclusions into the continuing education curriculum of such policies or practices. Lastly, every other year, the council shall submit a report on activities or accomplishments on sanitary and hygienic conditions recommended by the council in health care facilities, including legislative proposals.

Section 2: Amends section 6507 of the education law and adds new paragraph d to subdivision 3. It establishes standards for continuing education for health care practitioners on the best practices and approaches for mitigating and eliminating the spread of disease by health care practitioners by implementing to the extent practicable the recommendations of the state health care practitioner hygienic dress code council.

Section 3: Amends 2343 of the insurance law by adding subsection (f) which instructs the superintendent to approve and implement programs to encourage health care facilities and practitioners to adopt hygienic dress codes to obtain better or cheaper medical malpractice coverage. Such programs can include enhanced coverage levels, lower deductibles, or an actuarially appropriate premium reduction for facilities and health care providers which have implemented a successful practitioner dress code.

Section 4: Amends 3436 of the insurance law by adding subsection (f) to chapter 266 which instructs insurers to provide for actuarially appropriate premium reductions or other medical malpractice insurance enhancements such as enhanced coverage levels and lower deductibles for health care providers and facilities which implement a successful practitioner dress code.

Section 5: Amends section 5505 of the insurance law by adding subsection e which provides for an actuarially appropriate premium discounts or other medical malpractice insurance enhancements such as enhanced coverage levels and lower deductibles by the association for facilities and practitioners which implement a successful practitioner dress code.

Section 6: This act is effective on the first on January next succeeding date on which is shall have become law and section one expires January 1, 2023.

Justification

Approaches to improve patient and practitioner safety have been increasingly researched for curtailing medical malpractice liability costs. Addressing the issue of costs through the lens of infection rates not only is a viable method of combating an underlying cause of increases, but also enhances practitioner and patient safety.

New York is facing a crisis with regard to the availability and affordability of medical liability insurance coverage. New York health care providers pay the highest premium rates in the country for their medical liability insurance and those rates continue to rise.

Malpractice claims that involve preventable injuries often result in large jury awards. information indicates that, rather than increased frequency of claims, the soaring amount of individual malpractice awards accounts for increasing malpractice costs. Therefore, it is logical to reduce, and, when possible, eliminate preventable injuries to curtail medical malpractice costs and accompanying premium rates.

In a report issued by Senator Klein, it was found that while other methods and avenues for addressing rising medical malpractice costs and overall health care costs, such as attempting to cap damages in medical malpractice suits or other methods of tort reform, there were

other ways to address the underlying causes of increased insurance rates. Namely, that by addressing some of the underlying causes of injury rates in patients such as the spread of infections, such as nosocomial infections like methicillin resistant staphylococcus aureus (MRSA), that these reduced incidence rates would necessarily reduce the number of claims and thus the rising costs of medical malpractice insurance.

One major way of curtailing the number of these infections among patients and practitioners alike involves avoiding having to treat drug-resistant afflictions altogether and work to mitigate their initial spread. That is, mitigating the spread of these infections is an effective method of Combating them. Thus, as research indicates that the health care practitioners themselves may be unwitting agents of these infections, examining how they are being spread and then addressing that cause may be an effective tool.

Exploring and possibly implementing all or some of a health care practitioner dress code may lead to fewer injuries to practitioners and patients as well as lowered insurance premiums. Further, this can lessen the practice of defensive medicine-that is, care tailored toward preventing lawsuits and not carefully planned to a patient's needs which also drives up the cost of care.

Legislative history

2013 - S.2376, Referred to Health 2011 - S.4909, Referred to Finance

Fiscal implications

This bill is designed to lower rising medical malpractice costs by targeting some of the underlying causes such as the spread of several types of infection. Lowering such rates should also lead to fewer claims and less time in the hospital, thus alleviating associated health care costs to all parties involved, including the state.

Effective date

This act shall take effect on the first of January next succeeding the date on which it shall have become law and section one of this act shall expire and be deemed repealed January 1, 2023.