Provides for respiratory disease and obesity managements

Summary of provisions

This bill is an inter-disciplinary approach to address the high incidence of childhood obesity in New York State.

Part a

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 emphysema, obesity, chronic bronchitis, and other chronic respiratory diseases.

Part b

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 c

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.

Part d

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 conduct educational activities 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.

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. 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 Financial Services, the Office of Children and Family Services coordinate their current activities to curb this problem.

Prior legislative history

This bill has some similar elements as S. 2374-A / A. 5322-A (Klein/Crespo).

Effective date

Immediate.