Reduce Asthma and Lung Disease

Section 1. This act enacts into law major components of legislation which combat the incidence of asthma and other respiratory diseases such as emphysema and chronic bronchitis. Each component is wholly contained within a Part identified as Parts A through K. 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

EXPLANATION--Matter in italics (underscored) is new; matter in brackets

[ ] is old law to be omitted.

LBD08181-01-7

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a Part, including 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.

§ 2. Legislative findings and purpose. The legislature finds that asthma is a chronic, potentially life-threatening, respiratory illness that affects over a million New Yorkers, including thousands of children and adolescents. Asthma is the leading cause of school absences attributed to chronic conditions. Asthma is also directly linked to large and growing inpatient bills for medicaid and other health care payers. Therefore, the legislature finds that establishing a comprehensive statewide asthma prevention management and control program which coordinates the efforts of individuals, families, health care providers, schools and community-based organizations is in the public interest and would benefit the people of the state of New York.

PART A

Section 1. The public health law is amended by adding a new article 27-BB to read as follows:

ARTICLE 27-BB

ASTHMA DISEASE MANAGEMENT AND CONTROL Section 2725. Asthma disease management and control program.

2726. Study of asthma incidence and prevalence.

2727. Annual report.

§ 2725. Asthma disease management and control program. 1. There is hereby created within the department the asthma disease management and control program (hereinafter referred to in this article as the "program"). The purpose of the program is to promote asthma disease management and education and outreach about asthma to people who suffer from asthma and their families, health care providers, and the general public.

2. Services to be provided by the program may include:

(a) asthma disease management and case management for patients and their families;

(b) asthma outreach and screening;

(c) the promotion of awareness of the causes of asthma;

(d) education on prevention strategies;

(e) education on proper disease management practices; and

(f) education on available treatment modalities.

3. The commissioner shall make grants within the amounts appropriated therefor to local health agencies, health care providers, schools, school based health centers and community-based organizations, and other organizations with demonstrated interest and expertise in serving persons with asthma to provide the services set out in this section. Grant recipients shall be government entities or not-for-profit organizations.

The commissioner may coordinate grants under this subdivision with the availability of grants from other sources. The commissioner may also accept or seek grants from other sources to enhance the amounts appropriated to the program.

§ 2726. Study of asthma incidence and prevalence. 1. The department shall study the incidence and prevalence of asthma in the state's population and current disease management practices. Such study shall

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utilize information obtained pursuant to article twenty-four-F of this chapter, and include:

(a) the cause and nature of the disease;

(b) behavioral and environmental triggers;

(c) an assessment of the need for patient-centered case management to meet specific physical and environmental needs of patients;

(d) outcome evaluations, including, but not limited to, patient perceptions of improvement, signs and symptoms of asthma, pulmonary function, history of asthma exacerbations, pharmacotherapy, assessment of hospital emergency room visits for asthma, and patient-provider communication; and

(e) an assessment of the ability of providers, including non-professionals and health care professionals such as physicians, nurses, pharmacists and respiratory therapists, to systemically instruct and develop asthma management plans for patients and frequently review with patients and their families how to manage and control their asthma.

2. The department shall gather data for monitoring the occurrence, frequency, incidence, cause, effect and severity of asthma.

(a) The department may require the following to report data under this subdivision:

i. the statewide planning and research cooperative system (SPARCS);

ii. health maintenance organizations licensed pursuant to article forty-three of the insurance law or certified pursuant to this chapter or an independent practice association certified or recognized pursuant to this chapter;

iii. other insurers;

iv. the Medicaid (title XIX of the federal social security act) program;

v. health facilities;

vi. health care practitioners;

vii. patients: self reporting;

viii. the department of environmental conservation; and

ix. any other source the commissioner deems appropriate.

(b) The department shall compile and analyze data gathered under paragraph (a) of this subdivision and article twenty-four-F of this chapter, and correlate it with data as to places of employment, areas of residence, schools attended, ages of those afflicted, environmental factors including proximity to source of pollution and such other data as the department deems appropriate.

(c) The department shall maintain and compile reported data in a manner suitable for research purposes and shall collect and make such data available to persons in the manner set forth in subdivision three of this section.

3. Any data collected or reported shall not contain the name of any patient, his or her social security number, or any other information which would permit a patient to be identified. The department shall develop a unique, confidential identifier to be used in the collection of patient information as required by this section.

§ 2727. Annual report. On or before the first of January during the two calendar years next succeeding the effective date of this section and biennially thereafter, the commissioner shall submit a report regarding the status and accomplishments of the program and provide recommendations to the governor, the temporary president and the minority leader of the senate, and the speaker and the minority leader of the assembly. Such report may be submitted in conjunction with the report required by article twenty-four-F of this chapter.

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§ 2. This act shall take effect on the one hundred eightieth day after it shall have become a law. Effective immediately the commissioner of health is authorized 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 B

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.

§ 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 developmental 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.

§ 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.

§ 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 C

Section 1. The public health law is amended by adding a new article 24-F to read as follows:

ARTICLE 24-F

ASTHMA REPORTING Section 2499-b. Asthma; duty to report.

2499-c. Reporting.

2499-d. Asthma; reports confidential.

§ 2499-b. Asthma; duty to report. 1. Every physician and other health care provider shall give notice to the department within thirty days of every incident of an asthma attack coming under his or her care, except as otherwise provided.

2. The person in charge of every asthma reporting facility shall give notice to the department within thirty days of every incident of an asthma attack coming under the care of such facility.

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3. The department shall establish regulations designating which specific information shall be reported to the department pursuant to this section.

4. A physician or health care provider or asthma reporting facility which violates any provision of this section shall be subject to a civil penalty pursuant to section twelve of this chapter.

5. The notices required by this section shall be upon forms supplied by the commissioner and shall contain such information as shall be required by the commissioner.

6. For the purposes of this section, an "asthma reporting facility" means a hospital as defined in article twenty-eight of this chapter, clinic, any organization certified pursuant to article forty-four of this chapter, or other similar public or private institution.

§ 2499-c. Reporting. 1. The commissioner shall submit biennial reports to the governor, the temporary president of the senate, the speaker of the assembly, the minority leader of the senate and the minority leader of the assembly. The reports shall include an evaluation of the asthma registry as it relates to timeliness, quality and completeness; an evaluation of the utility of the registry for scientific research; an evaluation of the access, timeliness and quality of reporting information to researchers and other similar individuals; an evaluation of the registry's data elements, including treatment, severity of disease, occupation, age and residence; an evaluation of the feasibility and utility of inclusion of occupational history and residence history; and an evaluation of integrating the registry with other databases maintained by state agencies and departments, including the statewide planning and research cooperative system.

2. The commissioner shall submit an annual report to the governor, the temporary president of the senate, the speaker of the assembly, the minority leader of the senate and the minority leader of the assembly. Such report shall include an evaluation of whether the registry is achieving asthma incidence registry goals established by a nationally recognized asthma registry organization, including numerical goals concerning timeliness, quality, and completeness.

§ 2499-d. Asthma; reports confidential. The reports of asthma attacks made pursuant to the provisions of this article shall not be divulged or made public by any person so as to disclose the identity of any person to whom they relate, except in so far as may be authorized in the sanitary code.

§ 2. This act shall take effect on the one hundred eightieth day after it shall have become a law. Effective immediately, the commissioner of health is authorized to promulgate any and all rules and regulations and take any other measures necessary to implement this act on its effective date on or before such date.

PART D

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

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