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Department of Health and Mental Hygiene
Codified Title: 
Title 24: Department of Health and Mental Hygiene

Proposed Rules: Open to Comments

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Agency:
Comment By: 
Monday, August 6, 2018
Proposed Rules Content: 
 

Statement of Basis and Purpose of Proposed Rule

Statutory Authority

The repeal and restatement of Chapter 7 of Title 24 of the Rules of the City of New York and repeal of   Title 25 of the Rules of the City of New York is authorized by §§555(b)(2), 556, 558(b) and (e), and 1043 of the New York City Charter (the “Charter”) and §3.11 of the New York City Health Code.

    • Section 556 of the Charter authorizes the Department of Health and Mental Hygiene (the “Department”) to regulate all matters affecting health in the City of New York. 

    • Section 555(b)(2) of the Charter authorizes the Commissioner of Health and Mental Hygiene to assess penalties for health-related regulations.

    • Section 558 of the Charter authorizes the Board of Health to set civil penalties for the enforcement of the Health Code.

    • Section 1043 of the Charter gives the Department rulemaking powers.

 

Background of Proposed Rule

    1. Repeal and restate Chapter 7 of Title 24 of the Rules of the City of New York

Historically, civil violations of the Health Code were adjudicated at a tribunal established by the Board of Health pursuant to §558(e) of the New York City Charter.  On November 2, 2010, however, New York City voters approved an amendment to the Charter authorizing the Mayor to consolidate certain administrative tribunals into the Office of Administrative Trials and Hearings (OATH) by Executive Order.

On July 3, 2011, the Department’s Administrative Tribunal established by the Board of Health was transferred to OATH by Executive Order No. 148 (June 8, 2011) (the “Executive Order”) and renamed the Health Tribunal at OATH. Subsequently, in 2015, the Tribunal became part of the OATH Hearings Division, which now hears and adjudicates violations issued by other City agencies as well as the Department.   

After the Department’s Administrative Tribunal was transferred into OATH, on December 13, 2011 the Board of Health repealed Article 7 (“Administrative Tribunal”) of the Health Code, which contained provisions for conduct of the Administrative Tribunal.  OATH has its own rules of procedure for the Health Tribunal at OATH, which are found in Chapter 6 of Title 48 of the Rules of the City of New York. Subdivision (b) of Health Code §3.12 (“Administrative Tribunal and Environmental Control Board proceedings”) now confers jurisdiction on the Health Tribunal at OATH  and the Environmental Control Board (“ECB”) to hear all violations of the Health Code or any other State or local law or regulation that the Department enforces by seeking fines and monetary penalties. The same subdivision also provides that any such proceeding will be adjudicated in accordance with applicable procedures of the Health Tribunal at OATH or ECB. 

Chapter 7 of the Department’s rules pre-dates the transfer of the Administrative Tribunal to OATH and the Board of Health’s repeal of Article 7 of the Health Code.  Accordingly, Chapter 7 still refers to the Department’s former Administrative Tribunal and must be amended to accurately reflect that OATH’s Hearings Division now adjudicates all cases where the Department is seeking monetary penalties for violations of the Health Code.  

Chapter 7 also authorizes the Commissioner to delegate authority to OATH to hear cases and make findings of fact and recommendations in due process or “show cause” hearings.  These adjudications request reports and recommendations to the Commissioner of Health regarding such matters as permit and license revocations and employee misconduct and discipline and will continue to be held at the OATH Trials Division, and thus this authorization will remain in the restated Chapter 7.  

Because the changes to Chapter 7 are so extensive, the Chapter is being repealed and restated. 

   2. Codify violation penalties

Section 6-02 of OATH’s rules requires that it impose fines and other penalties in accordance with applicable law. Penalties for the violations adjudicated in ECB have been established in ECB’s (and now OATH’s) rules for many years. 

The Health Code establishes penalty ranges for violations adjudicated in the OATH Hearings Division.  OATH hearing officers continue to exercise discretion in deciding penalty amounts to be imposed for violations they sustain, provided the amounts are within the range prescribed by the Health Code.

OATH, however, is requesting that all City agencies establish by rule fixed penalties for the violations they are adjudicating in its Hearings Division.  OATH has also indicated that it will be repealing the penalty schedules in its rules for ECB cases and that agencies should also adopt by rule penalties for violations being adjudicated in that tribunal.

In 2014, the Department amended Chapter 23 of Title 24 to establish penalties for violations issued to food service establishments.  The Department is now proposing to amend Chapter 7 to set penalties for other violations of the Health Code, Department rules and other applicable law enforced by various Department programs. The new fixed penalties include those for violations currently adjudicated at the OATH Hearings Division.  Food service establishment penalties will remain in Chapter 23. Mobile food vending penalties are not included in this Chapter, but the Department expects to incorporate them in a new appendix to Chapter 6 of these rules.

To further promote compliance and prompt correction of hazardous conditions, the penalties proposed by the Department are heightened for some repeat offenses, considered continuous for others and in the case of standing water violations, the penalties reflect the magnitude of the violation.  These terms are defined in the rules and specified in the violation descriptions.  Sustained repeat violations citing rats, rat signs, rat harborage and conditions conducive to rats carry minimum, maximum and accelerated penalties in accordance with §17-133.1 of the Administrative Code of the City of New York. 

Penalties for violations of repealed Health Code and other provisions of law contained in current ECB rules have been excluded from the proposed penalty table, including those for violations of Article 153 and §§139.05, 139.07 and 181.03. Also excluded are penalties for violations that are already specified in a provision of the Health Code or Administrative Code, or in a particular Department rule or other applicable law.

   3. Repeal Title 25 of the Rules of the City of New York

In the November 2001 general election, New York City voters approved an amendment of the Charter to establish a “Department of Public Health” (later changed to the “Department of Health and Mental Hygiene”) combining the former Departments of Health (DOH) and Mental Health, Mental Retardation, and Alcoholism Services (DMHMRAS). All employees of both agencies became employees of the combined DOHMH.  The only existing provision in Title 25 of the Rules of the City of New York of the former DMHMRAS is §1-01 (Conduct of Adjudicatory Hearings) of Chapter 1 (Adjudications), relating to employee fitness and disciplinary hearings. Title 25 is no longer necessary because of the merger of the two agencies, and the Department proposes to repeal it.

 

 

Subject: 

Proposal to repeal and restate Chapter 7 (Adjudicatory Hearings) of Title 24 of the Rules of the City of New York regarding penalty schedule.

Location: 
New York City Department of Health and Mental Hygiene, Gotham Center
42-09 28th Street, 3rd Floor, Room 3-32
Queens, NY 11101
Contact: 

Svetlana Burdeynik, (347) 396-6078, resolutioncomments@health.nyc.gov

Download Copy of Proposed Rule (.pdf): 

Proposed Rules: Open to Comments

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Agency:
Comment By: 
Thursday, August 2, 2018
Proposed Rules Content: 
 
 

Statement of Basis and Purpose of Proposed Rule

Tobacco use is a leading cause of premature, preventable death in the City, killing an estimated 12,000 people annually. All tobacco products—including cigars, smokeless tobacco, tobacco containing shisha and others—are inherently dangerous, and contain nicotine, which is addictive. Despite the City’s progress in reducing cigarette smoking among youth and adults, an increasing percentage of youth are using other tobacco products (OTP) like cigars, waterpipes (hookahs), and smokeless tobacco.

According to the World Health Organization, raising prices through tobacco taxes is the single most effective way to decrease tobacco use. Taxation reduces tobacco use by reducing youth initiation, encouraging tobacco users to quit, and reducing consumption among those who do not quit. Similarly, increased minimum prices for tobacco products can also decrease tobacco consumption. Given relatively high levels of taxation on cigarettes at the federal, state, and local levels, OTP are generally less expensive than cigarettes, increasing their attractiveness as cheaper alternatives. In 2017, Local Law 145 was enacted to reduce the prevalence of OTP use, particularly among youth, utilizing two strategies: first, it establishes price floors for OTP and second, it imposes taxes on OTP.  The proposed rules address the OTP price floors.

In contrast to cigarettes, which are required to be packaged and sold in packages of 20, the OTP regulated by Local Law 145 are not packaged or sold in a standardized manner, with the exception of little cigars which are sold and packaged like cigarettes. The Department is proposing these rules to publicize the price floors of the OTP products for a range of quantities to account for the variation in the packaging and quantity of the products sold.

Local Law 145 sets minimum pack sizes for OTP, complementing the price floors. When OTP is offered for sale in relatively small, inexpensive quantities, it may facilitate experimentation with tobacco by non-tobacco users, potentially contributing to addiction, and help tobacco users to sustain their addiction at little cost. 

The proposed amendment is as follows:

 “Shall” and “must” denote mandatory requirements and may be used interchangeably in the rules of this department, unless otherwise specified or unless the context clearly indicates otherwise.

 

Subject: 

Proposal to amend Chapter 13 of Title 24 of the Rules of the City of New York to clarify requirements related to Local Law 145 of 2017, which imposes a tax on tobacco products other than cigarettes (OTP), creates minimum prices for cigarettes and OTP, and sets minimum pack sizes for various OTP.

Location: 
New York City Department of Health and Mental Hygiene, Gotham Center
42-09 28th Street, 8th Floor, Room 8-25
Queens, NY 11101
Contact: 

Svetlana Burdeynik, (347) 396-6078, resolutioncomments@health.nyc.gov

Download Copy of Proposed Rule (.pdf): 

Proposed Rules: Open to Comments

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Agency:
Comment By: 
Tuesday, July 24, 2018
Proposed Rules Content: 
 
 

Statement of Basis and Purpose of Proposed Rule

Background

In 1971, the Board of Health amended section 207.05 of the New York City Health Code to allow the Department to file a new birth certificate with a corrected gender marker of male or female for a person who both obtained a court order changing his or her name and who underwent “convertive” surgery.  The Department had, generally but not exclusively, interpreted the requirement for convertive surgery to mean genital surgery.  As a result, transgender applicants requesting new birth certificates were required to submit medical records demonstrating that they had undergone genital surgery to change sex and the number of requests for a corrected birth certificate was relatively small.  For example, in 2012, the number of new birth certificates approved and issued to transgender applicants was 20 and, in 2013, only 22 new birth certificates were issued.

In 2014, the Board of Health amended Section 207.05(a)(5) to eliminate the requirement for convertive surgery.  This amendment allowed the Department to issue a new birth certificate with a changed gender marker of male or female based on an affirmation from a physician licensed to practice in the United States, or an affidavit from a doctoral-level psychologist clinical social worker, physician assistant, nurse practitioner, marriage and family therapist, mental health counselor, or midwife, licensed to practice in the United States.  Eliminating the surgery requirement led to a dramatic increase in requests for new birth certificates; from January 2015, when the amendment became effective, through February 2018, the Department issued 1,047 new birth certificates to transgender applicants.

Proposed Amendment

The Department is now proposing to eliminate the requirement that a person requesting a change to the sex designation on a birth certificate present proof from a health professional.  Instead, applicants would be able to self-attest as to their gender.  Additionally, the Department is proposing that the Board approve “X” as an additional sex designation for persons who do not identify as exclusively female or male.

The Department, in discussion with other states and advocates, has found that having practitioners affirm or attest to a person applicant’s gender identity is both a potential barrier for persons without access to a practitioner and does not add sufficient value in the process of deciding whether a new birth certificate should be issued.  Anecdotal evidence suggests that practitioners simply comply with their patients’ requests when asked to affirm or attest to a patient’s request for a change of gender.  Consequently, the Department proposes to rely on the applicant’s attestation that would require notarization.

The Department is also proposing that the Board approve “X” as an additional sex designation option that is not exclusively female or male for birth certificate sex change requests.  The sex designation on the US Standard Certificate of Live Birth is completed by the hospital or attendant at the time of birth.  The four choices are male, female, unknown and undetermined.  These are “sex” categories and not gender categories. The original public health data reported by the hospital is not changed under this proposal.

“Gender” categories are only applied on the birth certificate during an amendment process.  When the gender on a birth certificate is amended the original record is placed under seal and a new record is created.  There is no indication on the record of the amendment history.  The Department is proposing to allow “X” for those applicants who want a designation other than female or male on their birth certificate.

 
 
Subject: 

Proposed resolution to amend Section 207.05 of Article 207 (General Vital Statistics Provisions) of the New York City Health Code to eliminate the requirement that a person requesting a change to the sex designation on a birth certificate present proof from a health professional, and instead require self-attestation.

Location: 
New York City Department of Health and Mental Hygiene, Gotham Center
42-09 28th Street, 3rd Floor, Room 3-32
Queens, NY 11101
Contact: 

Svetlana Burdeynik, (347) 396-6078, resolutioncomments@health.nyc.gov

Download Copy of Proposed Rule (.pdf): 

Proposed Rules: Open to Comments (View Public Comments Received:3)

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Agency:
Comment By: 
Monday, July 16, 2018
Proposed Rules Content: 
 
 

Statement of Basis and Purpose

 

Section 274 of the federal Atomic Energy Act of 1954 [42 USC §2021 et seq.] (“Atomic Energy Act”) authorizes “Agreement States” to regulate byproduct material, source material and special nuclear material in quantities not sufficient to form a critical mass.  New York State is an “Agreement State” within the meaning of the Atomic Energy Act, and the New York City Department of Health and Mental Hygiene (“Department” or “DOHMH”) operates a component of the New York State Agreement.  Under this Agreement State structure, the DOHMH, through its Office of Radiological Health (“ORH”), regulates radioactive material for medical, research and academic purposes within the five boroughs of New York City.

New York State (NYS) Public Health Law §§225(5)(p) and (q) allows the NYS Commissioner of Health and the NYS Public Health and Planning Council to establish regulations with respect to ionizing radiation and nonionizing electromagnetic radiation and to authorize appropriate officers or agencies to register radiation installations, issue licenses for the transfer, receipt, possession and use of radioactive materials, other than special nuclear materials in quantities sufficient to form a critical mass, render such inspection and other radiation protection services as may be necessary in the interest of public health, safety and welfare. The NYS regulations are set out in Part 16 of the NYS Sanitary Code.

The Sanitary Code, in 10 NYCRR §16.1(b)(3), allows New York City to establish its own radiation licensure requirements in place of State regulations, so long as the local requirements are consistent with Sanitary Code requirements. 

New York City Charter (“Charter”) Section 556(c)(11) authorizes the Department to supervise and regulate the public health aspects of ionizing radiation, the handling and disposal of radioactive wastes, and the activities within the city affecting radioactive material.   

 

Background

Article 175 of the New York City Health Code (“Health Code”) applies to all radiation-producing equipment and radioactive material within NYC.  The Article contains general provisions applicable to both radiation equipment registrants and radioactive materials licensees, and specific requirements for such equipment and materials. The purpose of Article 175 is to protect the public, as well as workers in radiation installation facilities, from the potential hazards of ionizing radiation.  The Article’s requirements for radiation control reflects the coordination of radiation control activities with the U.S. Nuclear Regulatory Commission (“NRC”), the U.S. Food and Drug Administration, the NYS Department of Health and the NYS Department of Environmental Conservation, and other relevant city, state and federal agencies.  

The proposed reenacted Article 175 of the Health Code incorporates federal requirements contained in Title 10 of the Code of Federal Regulations (“CFR”) and reflects and is consistent with state regulations contained in the NYS Sanitary Code [10 NYCRR Part 16], and sets forth ORH-specific best practices requirements.   By law, the City must maintain compatibility with applicable federal requirements and consistency with applicable state regulations.  The Health Code may, and Article 175 as proposed does, in certain instances, mandate more stringent requirements as to health and safety radiation control measures than those required by federal and state authorities.

In NYC, there are about 6500 registered facilities with radiation-producing machines and 375 licensed sites with radioactive material for medical, academic and research purposes. Of the registered facilities, approximately 6440 are diagnostic X-ray facilities and 60 are therapeutic X-ray facilities. ORH inspects these facilities at varying frequencies depending on the type of usage.  Current inspection fees are unchanged under this proposed reenactment.

Radiation equipment

Prior to this rulemaking, Article 175 of the Health Code has not been substantially updated, particularly as to its radiation equipment requirements, since its last enactment in 1994.  Similar to that last reenactment, the Department has based much of this proposed reenacted text on the model code maintained by the Conference of Radiation Control Program Directors (CRCPD). The CRCPD is a 501(c)(3) nonprofit professional organization whose primary membership is made up of radiation professionals in state and local government that regulate the use of radiation sources in their jurisdictions.  CRCPD's mission is "to promote consistency in addressing and resolving radiation protection issues, to encourage high standards of quality in radiation protection programs, and to provide leadership in radiation safety and education".[1]  Since the reenactment of Article 175 in 1994, improved best practices have been developed and implemented for radiation control measures.  Many of these measures are reflected in the current CRCPD model code, which has provided the basis for much of the text related to radiation equipment in the new proposed Article 175.

Radioactive materials

As noted above, Article 175 of the Health Code incorporates federal requirements from Title 10 of the CFR.  New York State is an Agreement State with the U.S. NRC which means that the NRC has delegated authority to NYS to regulate radioactive material at non-reactor sites within its jurisdiction.  The New York State Agreement is comprised of the regulatory programs of three agencies:

1. the New York State Department of Health,

2. the New York State Department of Environmental Conservation, and

3. the New York City Department of Health and Mental Hygiene.

Under the NYS Agreement and § 16.1 of the State Sanitary Code, the Department, through its Office of Radiological Health (ORH), regulates radioactive material for medical, research and academic purposes within the five boroughs of New York City.  Each Agreement State program is required to maintain compatibility with the NRC regulatory program. The NRC regulatory program utilizes Compatibility Categories to specify the type of wording to be used in the corresponding State program regulations.[2]

 

As noted above, the last significant revision of Article 175 requirements occurred over 20 years ago.  Since then, NRC has made numerous updates of its requirements contained in Title 10 of the CFR.  In order for the Department to maintain its compatibility status with the NRC regulatory program, each time the NRC has updated its regulations in Title 10 of the CFR, the Board has had to make corresponding updates to Article 175, which has been an inefficient and time–consuming process.  In many instances, and because of the compatibility designations, the Board updated Article 175 by reproducing the actual CFR text directly into its requirements. The Board believes that continuing to update its rules this way is redundant and unnecessary and that it makes more sense to incorporate by reference the relevant CFR regulations, which will still provide the same legal force and effect as if the Board had actually reproduced such requirements directly into Article 175.  This incorporation by reference process avoids duplication and provides uniform, accurate guidance to the regulated community, as well as making for a less unwieldy and more manageable Code.

Accordingly, the Department proposes the Board repeal and reenact Article 175 primarily to:

  • update the quality assurance requirements to reflect industry-wide best practices for the installation, operation and maintenance of  both diagnostic and therapeutic radiation equipment required to be registered with the Department, and which is used for medical, academic and research purposes, and
  • more efficiently adopt and enforce NRC requirements for the possession and use of radioactive materials required to be licensed by the Department by incorporating by reference applicable federal regulations contained in Title 10 of the CFR for radioactive materials.

Statutory Authority

This repeal and reenactment of Article 175 of the Health Code is proposed pursuant to Sections 556, 558 and 1043 of the Charter and applicable state and federal law.  Section 556 of the Charter grants the Department jurisdiction to regulate matters affecting health in New York City.  Specifically, Section 556(c)(11) of the Charter authorizes the Department to supervise and regulate the public health aspects of ionizing radiation within the five boroughs of New York City.  Sections 558(b) and (c) of the Charter empower the Board of Health to amend the Health Code and to include in the Health Code all matters to which the Department’s authority extends.  Section 1043 of the Charter grants rule-making powers to the Department.

 




[1] See, http://c.ymcdn.com/sites/www.crcpd.org/resource/collection/665D6792-2EB4-4AF6-8134-1173A394FE28/Constitution10-25-04.pdf (describing the goals of the CRCPD to, among other things, promote radiological health in all aspects and phases and to promote and foster uniformity of radiation control laws and regulations).

[2] See, https://scp.nrc.gov/procedures/sa200.pdf  (providing NRC compatibility categories and health and safety components assigned for determining whether an agreement state is maintaining a compatible radiation safety control program with NRC).

 
 
Subject: 

Proposed resolution to repeal and reenact Article 175 (Radiation Control) of the New York City Health Code

Location: 
New York City Department of Health and Mental Hygiene, Gotham Center
42-09 28th Street 14th Floor, Room 14-43
Queens, NY 11101
Contact: 

Svetlana Burdeynik, (347) 396-6078, resolutioncomments@health.nyc.gov

Download Copy of Proposed Rule (.pdf): 

Adopted Rules: Closed to Comments

Adopted Rules Content: 
 
 

Statement of Basis and Purpose

Background

Adoption of schedule for transfer of vital records

            Birth and death records are considered private records.  During a person’s life and for an appropriate period after death, birth and death records are protected from being accessed by the general public because they contain individually identifiable information. These records, however, eventually become historical documents of interest to family members and persons researching their ancestries. For these reasons, the Board of Health recently fixed schedules for making these records public and transferring them to the Department of Records and Information Services (“DORIS”):  section 207.21 of the Health Code now makes birth records public records after 125 years after birth, and death records public records after 75 years after death.

           The schedule set in section 207.21 of the Health Code drew numerous comments from the public. Many of these comments emphasized a keen community interest in third parties being able to access birth and death records prior to their transfer to DORIS.  The comments also made a variety of different suggestions, from making all birth and death records immediately available to the public, to releasing birth and death records to family members prior to the records becoming public, to creating a special category for release of records to genealogist. The Department agreed that certain family members should have access to birth and death records prior to the records becoming public, and therefore proposed amending section 207.11 of the Health Code for this purpose.  The Board now adopts those amendments. The Department believes these new provisions will allow family members to access information while protecting the confidentiality of vital records for appropriate periods of time. 

Current Administrative and Health Code provisions allowing release of birth and death records

Section 17-169(a) of the Administrative Code delineates who may access birth records.  While section 17-169(a)(1) restricts who may obtain a certified copy of a record of birth, section 17-169(a)(2) authorizes the Department to honor requests for certifications of birth when providing the information is “necessary or required for a proper purpose.”  As noted below, the Department believes that ascertaining facts related to one’s family history is a proper purpose.

            Section 17-169(b) of the Administrative Code provides for access to death records when “necessary or required for a proper purpose.”  Section 207.1(b) of the Health Code provides that death records can be made available to the following persons:

(1) the spouse, domestic partner, parent, child, sibling, grandparent or grandchild of the decedent;

(2) the legal representative of the estate of the decedent, or the individual identified on a death certificate filed with the Department as the person in control of the disposition;

(3) a party with a property right who demonstrates to the Department that information beyond the fact of the death of the decedent is necessary to protect or assert a right of that party;

(4) a funeral director who requests the record or information within twelve (12) months of when the death of his or her client was registered; or

(5) persons or government agencies who otherwise establish that such records are necessary or required for a judicial or other proper purpose, or to prevent the misuse or misappropriation of City, state or federal governmental funds.    

Health Code Amendment

            The Board is expanding the group of family members who can access birth and death records prior to their public release.  This new group is within a close degree of consanguinity (blood relation) to the individual whose records are sought.  Specifically, the Board is expanding the list of relatives given in Health Code section 207.11(b)(1) who can request a death certificate to also include great-great grandchildren, nephews, nieces, aunts, uncles, grandnephews, and grandnieces. The Board is also expanding access to allow spouses, domestic partners, parents of children over the age of 18, children, siblings, nieces, nephews, aunts, uncles, grandchildren, great grandchildren, grandnieces, and grandnephews to request of the certification of birth of a deceased individual.  The Board finds that allowing such access is within the meaning of “proper purpose” as used in the Administrative and Health Codes. 

            Most of the comments on the proposed rule requested that the Board give additional categories of individuals access to birth and death records prior to their transfer to DORIS.  Some comments suggested that professional researchers with no family connection to the people’s histories they are researching should have broad access to birth and death records. Other comments requested that additional family and social relationships be added to the list of individuals with such access.  The Department believes that the amendment appropriately balances the privacy and historical interests at stake, does not agree that any additional changes should be made to the amendment.  The Board is making these amendments effective January 1, 2019.

Statutory Authority

Pursuant to section 556(c) of the Charter and section 17-166 of the Administrative Code, the Department is responsible for supervising and controlling the registration of births and deaths that occur in New York City. Section 558(c) of the Charter requires the Board to include in the Health Code provisions related to maintaining a registry of births and deaths, as well as provisions related to changes or alterations of any birth or death certificate upon proof satisfactory to the Commissioner of Health and the manner in which these certificates may be issued and otherwise examined.  Administrative Code section 17-169 and Health Code sections 3.25 and 207.11 make birth and death records confidential and restrict access to these records beyond certain classes of specified people.  Section 207.21 of the Health Code sets the time periods by which birth and death records are transferred to DORIS and become public records.  Section 558(b) of the Charter specifically authorizes the Board to add to, alter, and amend the Health Code.

           

 

Effective Date: 
Tue, 01/01/2019

Adopted Rules: Closed to Comments

Adopted Rules Content: 
 
 

Statement of Basis and Purpose

 

Statutory Authority

The Board’s authority to codify these proposed amendments is found in Sections, 556, 558, and 1043 of the New York City Charter (the “Charter”). Sections 558(b) and (c) of the Charter empower the Board to amend the Health Code and to include all matters to which the Department’s authority extends. Section 556 of the Charter provides the Department with jurisdiction to protect and promote the health of all persons in the City of New York. Section 1043 grants the Department rule-making authority.

Background

Article 43 of the New York City Health Code governs school-based programs for children aged three through five. The Board is amending Article 43 to add requirements for maintaining epinephrine auto-injectors on site and for certain teacher training. The basis for the changes is set forth below.

 

Emergency Medical Care and Epinephrine Auto-Injectors

The Centers for Disease Control and Prevention estimates that four to six percent of children nationally have a food allergy; such food allergies include ones that are life-threatening. Rapid administration of an epinephrine auto-injector following a life-threatening allergen exposure is critical to preventing significant negative outcomes, including death. Having epinephrine auto-injectors on the premises at all times can save the lives of children with life-threatening food allergies who do not bring an epinephrine auto-injector with them to the school-based program, and of children who have life-threatening food allergies identified for the first time while the child is there.

In 2016, the New York State Public Health Law was amended[1] to allow certain entities, including child care providers, to obtain non-patient specific epinephrine auto-injectors and to administer them in an emergency. This new State law creates the opportunity for such programs to have this critical, lifesaving program enrolling a child whose enrollment is paid for by federal child care subsidies.

The rule language is modified to include training regarding prevention of and response to emergencies related to food or allergic reaction, and prevention and control of infectious diseases (including immunization).

 

Other requirements

            In order to come into alignment with federal requirements and state policy regarding the vulnerabilities and special needs of children who are homeless or in foster care and thus require accommodations for compliance with certain rules, the proposed language has been modified to provide for a reasonable grace period for certain provisions pertaining to providing medical records.

Tooth Brushing

The provisions regarding tooth brushing that were included in the original proposal are not included in these amendments. The Department has determined that further consideration is warranted.

The Department’s authority to promulgate these proposed amendments is found in Sections 556, 558, and 1043 medication available. Accordingly, the amendments clarify requirements for emergency medical care and add a mandate that school-based programs maintain on site at least two unexpired epinephrine auto-injectors in each dosage appropriate for children who may be in the program, stored so they are easily accessible to staff and inaccessible to children. Whenever children are present, programs are required to have at least one staff person on site trained to recognize signs and symptoms of anaphylactic shock and to administer epinephrine as appropriate. The amendments also require programs to monitor the auto-injectors’ expiration dates and call 911 after any administration, as required by the medication directions; to obtain parental consent at the time the child is enrolled in the program; and to have all staff trained in preventing and responding to emergencies related to food allergies. 

The proposed language is modified to require that epinephrine auto-injectors have retractable needles and to clarify storage requirements.

Training requirements

The amendments expand teacher training requirements to enhance child safety and assure alignment with the health and safety training requirements in the federal Child Care Development Block Grant Act (CCDBG) Act of 2014. Sections 558(b) and (c) of the Charter empower the Board to amend the Health Code and to include all matters to which the Department’s authority extends. Section 556 of the Charter provides the Department with jurisdiction to protect and promote the health of all persons in the City of New York. Section 1043 grants the Department rule-making authority.

                                                                 




[1][1] NYS Public Health §3000-C. Epinephrine Auto-injector devices. Effective March 28, 2017.

 
Effective Date: 
Thu, 07/12/2018

Proposed Rules: Closed to Comments (View Public Comments Received:9)

Agency:
Comment By: 
Monday, July 9, 2018
Proposed Rules Content: 
 
 

Statement of Basis and Purpose of Proposed Rule

 

Introduction

At its meeting on March 16, 2010, the Board of Health amended section 81.51 of the New York City Health Code and authorized the Department of Health and Mental Hygiene (DOHMH) to establish a letter grading program for restaurants. The Board determined that providing restaurant grading information will inform consumer choice and will improve restaurants’ compliance with the Health Code and promote high food safety standards. Rules implementing letter grading for restaurants were promulgated in Chapter 23 (Food Service Establishment Sanitary Inspection Procedures and Letter Grading) of the Department’s rules.

Since July 2010, the Department has been grading restaurants to provide New Yorkers with information about the results of sanitary inspections. A restaurant’s grade A, B or C depends on how well the restaurant follows food safety requirements.

Local Law 108 of 2017 requires the Department to extend the grading program to mobile food vending units. It requires the program to be consistent with the restaurant grading program where practicable. These proposed rules comply with those directives by amending Chapter 6 (Mobile Food Vending) of the Department’s rules.

Additional amendments are being proposed to Chapter 6 to update and clarify certain other provisions as described below.

Mobile Food Vending Unit Grading Program Amendments

Mobile Food Grading System

The proposed amendments create a program to grade mobile food vending units to indicate their degree of compliance with the New York City Health Code, New York State Sanitary Code, and these rules at the time of inspection. Section 17-325.3 of the Administrative Code, as added by Local Law 108, requires the Department to design and implement a program consistent with restaurant grading to the extent practicable. The restaurant grading program incentivized New York City restaurants to improve food safety practices and led to greater compliance with the New York City Health Code and New York State Sanitary Code, including a 41 percent drop in sanitary violations in fiscal 2017 from the peak in fiscal year 2012. As elaborated below, and as consistent with restaurant grading program as possible, the program incorporates a prescribed cycle of inspections that generate scores, a scoring system that determines the grade, and the process for posting grades at various points in the inspection cycle.

The scoring system that will determine the grade for mobile units is the same as for restaurants: a score of less than 14 points earns an “A” grade, a score between 14-27 points earns a “B,” and a score of more than 27 earns a grade of “C.”

The annual inspection cycle begins when a unit undergoes an initial inspection. If the unit receives an A grade, the Department will immediately post the A grade on the unit. If the unit fails to earn an “A,” no grade will be assigned and the Department must reinspect the unit seven or more days later. If, at the reinspection, the unit receives an A grade, the Department will immediately post the A grade on the unit. If the unit again fails to earn an “A,” a grade pending card will be posted on the unit by the Department while the unit appeals the grade to the Office of Administrative Trials and Hearings (OATH). (The unit’s operator may choose to post the grade of “B” or “C” earned at the reinspection instead of a grade pending card, in which case the unit must be brought to the Department for it to post the appropriate letter grade.[1]) A unit with a “grade pending” will be required to post its final grade following the opportunity for adjudication at OATH. This inspection scheme is the same for restaurants.

 

Locating Mobile Food Vending Units

Unlike restaurants, which exist at a fixed location, mobile units move and are not required to operate on a set schedule. If the Department cannot locate all of the mobile units that require grades, the grading program will fail; not every unit will be graded and the grades that are posted may not be current. The successful implementation of the mobile food vending grading program, and the ability to mirror restaurant grading as closely as possible, requires adhering to the prescribed inspection schedule and ensuring that accurate and current grades are posted and timely on all units. That necessitates the Department being able to find and inspect units across the City.  To accomplish this and to check for compliance with grade posting requirements, the Department requires each vending unit to be equipped with a location sharing device that will enable the Department to pinpoint the unit’s location when it is to be inspected.

The ability to locate a mobile food vending unit is necessary to implement the mobile food vending unit grading program.  If the Department cannot find a unit to conduct an initial inspection or a reinspection, that unit will not have a current grade. The Department’s historical data reveals that it currently is only able to locate and inspect approximately 80% of the units that have permits to vend food in the City. For about one of every five units, the Department has been unsuccessful at predicting where the unit can be found, based solely on information it has about each unit’s vending locations. The inability to locate units will undermine the purpose of a grading system if a significant number of units are not graded or are posting grades that are inaccurate or out of date, which could degrade the reliability of the mobile food grades and the public’s confidence in the program.  By requiring all units to install location sharing devices, the Department will be able to inspect and grade a sufficient number of units to ensure the integrity of the grading program.

Grading promotes high food safety standards by leveraging consumer purchasing power, which, in turn motivates vendors to comply with food safety rules and achieve A grades. That system -- harnessing consumer interest in A grades to motivate vendors to comply with food safety rules to promote high food safety practices to protect public health -- is only achieved if the grade are accurate and reliable. In order to conduct inspections and keep grades accurate and reliable, the Department must be able to locate the vending units.

Additional Mobile Food Vending Grading Amendments

Amendments related to grading include additional definitions in section 6-02 and new sections 6-16 to 6-21, using a scheme similar to the one in Chapter 23 of the Department’s rules for grading restaurants. New appendices 6-A and 6-B are being added to Chapter 6 to implement scoring of inspection results. Appendices 6-C, 6-C-2 and 6-C-3 set out penalties for civil violation summonses for mobile food vending violations that are adjudicated and sustained at OATH, using a schedule similar to that of Chapter 23 Appendix C (Food Service Establishment and Non Retail Food Service Establishment Penalty Schedule). These new appendices will replace the current penalty schedules for the same violations currently in OATH’s rules.

Other Proposed Amendments to Chapter 6

Amending paragraph (3) of subdivision (b) of section 6-04 to require all mobile food vending units to have a permit-decal space that is a flat, smooth metal surface, which is the best material for the permit decal adhesive.

Amending subdivision (f) of section 6-04 to clarify and extend the deadline for water tank upgrades, and include a new requirement for a mechanical or electronic device to allow vendors to monitor water levels.

Repealing paragraphs (1) and (2) of subdivision (a) of section 6-06 to remove expired provisions related to with the allowable sizes for units other than trucks.

Amending section 6-07(a) to remove the requirement that decals be placed on two sides of a green cart.

Amending section 6-07(b) to remove the requirement of a green cart umbrella.

Amending subdivisions (d) and (h) of section 6-11 to delete the references to reinspection.

Amending section 6-11(l) to allow for revocation or denial of a permit for failing to have or tampering with grade cards or location sharing devices.

Statutory Authority

Section 17-325.3 of the Administrative Code requires the Department to “establish and implement a system for grading and classifying inspection results for each vending vehicle or pushcart using letters to identify and represent a vending vehicle or pushcart’s degree of compliance with laws and rules that require such vending vehicle and pushcart to operate in a sanitary matter to protect public health.”  In addition, section 17-311 of the Administrative Code authorizes the Department to issues rules related to affixing permit plates and letter grades to mobile food carts, and section 17-324 provides authority for any rules necessary pursuant to the mobile food vending requirements in the Administrative Code.

 


[1] Unlike at a restaurant inspection, the Department is requiring operators that choose to post a “B” or “C” grade following a reinspection to bring the unit to the Department to post the grade because the vendor staffing a unit at the time of the reinspection may not be the permit holder with the authority to make the decision. Based on experiences in the preferences of restaurant owners, the Department proposes to immediately post the “grade pending” sign following a reinspection that does not result in an “A” grade as the default, and allow permit holders who would prefer a letter-grade to arrange for it to be posted on the unit by the Department. 

 
 
Subject: 

Proposal to adopt rules governing the grading of mobile food vending units as provided in section 17-325.3 of the Administrative Code of the City of New York. Additional amendments to update and clarify other provisions related to mobile food vending are also proposed.

Location: 
New York City Department of Health and Mental Hygiene, Gotham Center
42-09 28th Street, 3rd Floor, Room 3-32
Queens, NY 11101
Contact: 

Svetlana Burdeynik, (347) 396-6078, ResolutionComments@health.nyc.gov

Download Copy of Proposed Rule (.pdf): 

Adopted Rules: Closed to Comments

Adopted Rules Content: 
 
 

Statement of Basis and Purpose

Introduction

Smoking is a leading cause of preventable premature death in New York City, increasing the risks of lung cancer, heart disease, and many other health hazards. To counter this threat, in 1988 the City enacted the Smoke-Free Air Act (SFAA), which has been amended several times.  The 2002 amendments restricted tobacco smoking in various indoor and outdoor public places. Despite the substantial progress in reducing both environmental smoke exposure and smoking, hookah smoking has been increasing in popularity as more establishments serve hookah, and its prevalence has been increasing, in particular, among the City’s youth.

Hookah or water pipe smoking involves heating “shisha”, which is typically composed of tobacco and/or other flavored or unflavored herbal substances, over burning charcoal, to create smoke that travels through a pipe immersed in cooling water, and that is inhaled by the smoker through a mouthpiece.  Regardless of whether the shisha contains tobacco, hookah smoking poses significant health risks to smokers and nonsmokers, including employees, at establishments that serve hookah. Hookah smoking produces emissions from burning both charcoal and shisha. Burning charcoal creates health hazards by emitting carbon monoxide, fine particulate matter, and various toxicants. Burning shisha has also been shown to emit multiple harmful substances regardless of its tobacco content, including carbon monoxide, polycyclic aromatic hydrocarbons, fine particulate matter, tar, and volatile aldehydes.

While risks associated with non-tobacco hookah smoking are established, air quality in the City’s hookah establishments is further compromised by evidence that many of them have been found to be serving shisha that contains tobacco. Tobacco-containing shisha has been shown to emit phenols, nicotine, and NNAL, a tobacco-specific nitrosamine. Therefore, patrons of hookah establishments may be smoking tobacco unwittingly, in addition to inhaling the harmful substances emitted by charcoal and shisha. To address these concerns, Local Law 187 of 2017 amended the SFAA to ban the smoking of non-tobacco shisha except at existing establishments that require a permit from the Department.  Local Law 190 of 2017 also requires establishments that obtain a permit for serving non-tobacco shisha to post signage developed by the Department that warns of its risks. These proposed amendments implement these laws.

Furthermore, given the health risks posed by non-tobacco smoking, Local Law 191 increases the minimum age for legal sales to 21 years of age for non-tobacco smoking products, including shisha that does not contain tobacco, pipes, water pipes, rolling papers, and herbal cigarettes. 

No Changes Made in Response to Comments Received by the Department

Approximately 20 people commented on the proposed rule at the public hearing held on March 14, 2018. Nearly all of the comments related to the requirement that an establishment generate at least 50% of its annual gross sales from the on-site sale of non-tobacco smoking products in order to obtain or renew a permit to operate as a non-tobacco hookah establishment. However, Local Law 187 already added this requirement to the Administrative Code:

To obtain and renew a permit issued pursuant to this section for a non-tobacco hookah establishment, a person shall demonstrate that: 1. Such non-tobacco hookah establishment generated 50 percent or more of its total annual gross sales during the preceding calendar from the on-site sale of non-tobacco smoking products. . . .

See Administrative Code § 17-513.5(g)(1). The Department does not have the authority to eliminate this requirement.  Thus, no changes are being made to the definition of a non-tobacco hookah establishment in subdivision (bb) of section 10-01 or to the requirement in section 10-18 that a non-tobacco hookah establishment generated 50% or more of its total annual gross sales during the preceding calendar year from the on-site sale of non-tobacco smoking products in order to obtain a permit.

The Department has made two additional changes to the proposed rule to clarify their application.

Section 10-21(c) has been amended to provide that the required warning signs, which will be provided by the Department and will vary in content, must contain two of four possible warning statements.

Section 10-23(b) has been amended to provide that a person is responsible for expert costs incurred by the Department only in the event that the Department proves at a hearing that such person violated subdivision (a) of section 17-508 of the New York City Administrative Code or subdivision 1 of section 1399-s of the New York State Public Health Law.    

Statutory Authority

The Department’s authority for these rules is found in section 1043 of the New York City Charter and sections 17-513 and 17-706 of the New York City Administrative Code.

Amendments

The Department amends subdivision (p) of section 10-01 of Title 24 of the Rules of the City of New York, adds paragraphs (aa) through (ee) to section10-01, and adds new sections 10-18 to 10-24. The Department also amends section 13-06 of Title 24 of the Rules of the City of New York.

 
 
Effective Date: 
Thu, 05/10/2018

Proposed Rules: Closed to Comments (View Public Comments Received:22)

Agency:
Comment By: 
Monday, April 23, 2018
Proposed Rules Content: 
 
 

Statement of Basis and Purpose

Introduction

            Birth and death records are considered private records during a person life and for an appropriate period after death, and are protected from access by the general public because they contain individually identifiable information. However, they are also historical documents of interest to family members and persons researching their ancestries. For these reasons, the Board of Health recently fixed schedules for making these records public and transferring them to the Department of Records and Information Services (“DORIS”).  Section 207.21 of the Health Code makes birth records public records after 125 years after birth, and death records public records after 75 years after death.

           

            The schedule set in section 207.21 of the Health Code drew numerous comments from the public. Many of these comments emphasized a keen community interest in third parties being able to access birth and death records prior to their transfer to DORIS.  The comments also made a variety of different suggestions, from making all birth and death records immediately available to the public, to releasing birth and death records to family members prior to the records becoming public. The Department agrees that certain family members should have access to birth and death records prior to the records becoming public, and is therefore now proposing amendments to section 207.11 of the Health Code for this purpose.  The Department believes these new provisions will allow family members to access information while protecting the confidentiality of vital records for appropriate periods of time. 

Current Administrative and Health Code provisions allowing release of birth and death records

The proposal is consistent with Administrative Code section 17-169(a), which delineates who may have access to birth records.  While section 17-169(a)(1) restricts who may obtain a certified copy of a record of birth, section 17-169(a)(2) authorizes the Department to honor requests for certifications of birth when providing the information is “necessary or required for a proper purpose.”  As noted below, the Department believes that ascertaining facts related to one’s family history is a proper purpose.

         Section 17-169(b) of the Administrative Code provides for access to death records when “necessary or required for a proper purpose.”  Section 207.1(b) of the Health Code provides that death records can be made available to the following persons:

    (1) the spouse, domestic partner, parent, child, sibling, grandparent or grandchild of the decedent;

    (2) the legal representative of the estate of the decedent, or the individual identified on a death certificate filed with the Department as the person in control of the disposition;

    (3) a party with a property right who demonstrates to the Department that information beyond the fact of the death of the decedent is necessary to protect or assert a right of that party;

    (4) a funeral director who requests the record or information within twelve (12) months of when the death of his or her client was registered; or

    (5) persons or government agencies who otherwise establish that such records are necessary or required for a judicial or other proper purpose, or to prevent the misuse or misappropriation of City, state or federal governmental funds.

 

Proposed amendments to expand vital records access to certain family members 

            The Department is proposing to expand the group of family members who can access birth and death records prior to their public release.  The proposed group is within a close degree of consanguinity (blood relation) to the individual whose records are sought.  Specifically, the Department proposes to expand the list of relatives given in Health Code section 207.11(b)(1) who can request a death certificate to also include great-great grandchildren, nephews, nieces, aunts, uncles, grandnephews, and grandnieces, and to allow spouses, domestic partners, parents of a children over the age of 18, children, siblings, nieces, nephews, aunts, uncles, grandchildren, great grandchildren, grandnieces, and grandnephews to request of the certification of birth of a deceased individual. As noted in the comments received related to the proposed adoption of Health Code section 207.21, this group often seeks such documents for genealogic and various official purposes.  The Department proposes that allowing such access is within the meaning of “proper purpose” as used in the Administrative and Health Codes. 

Statutory Authority

Pursuant to section 556(c) of the Charter and section 17-166 of the Administrative Code, the Department is responsible for supervising and controlling the registration of births and deaths that occur in New York City. Section 558(c) of the Charter requires the Board to include in the Health Code provisions related to maintaining a registry of births and deaths, as well as provisions related to changes or alterations of any birth or death certificate upon proof satisfactory to the Commissioner of Health and the manner in which these certificates may be issued and otherwise examined.  Administrative Code section 17-169 and Health Code sections 3.25 and 207.11 make birth and death records confidential and restrict access to these records beyond certain classes of specified people.  Section 207.21 of the Health Code sets the time periods by which birth and death records are transferred to DORIS and become public records.  Section 558(b) of the Charter specifically authorizes the Board to add to, alter, and amend the Health Code.

 
Subject: 

Proposed amendment to Article 207 (General Vital Statistics Provisions) of the New York City Health Code to allow certain direct descendants and other family members to access the birth and death records of their deceased relatives prior to those records becoming public.

Location: 
New York City Department of Health and Mental Hygiene, Gotham Center
42-09 28th Street, 3rd Floor, Room 3-32
Queens, NY 11101
Contact: 

Svetlana Burdeynik, (347) 396-6078, resolutioncomments@health.nyc.gov

Download Copy of Proposed Rule (.pdf): 

Proposed Rules: Closed to Comments (View Public Comments Received:18)

Agency:
Comment By: 
Wednesday, April 18, 2018
Proposed Rules Content: 
 
 

Statement of Basis and Purpose

 

 Article 47 of the Health Code governs center-based child care. The Department proposes to clarify the Article’s requirements by simplifying terminology and reorganizing certain provisions, and to add requirements for tooth brushing, maintaining epinephrine auto-injectors on site, and for training of staff. The basis for the proposed changes is set forth below.

Clarifying Requirements    

The Department proposes several amendments to clarify requirements and facilitate compliance. For example, the proposed clarifying changes include adding definitions for “certified group teacher” and “corporal punishment,” and adding details to current definitions, including for “assistant teacher” and “education director.”

Currently, the Code requires that documentation be provided under certain provisions but not under others. The proposed changes create uniformity and enable the Department to effectively evaluate compliance with documentation requirements.

The Department is also proposing to add specificity to certain requirements, such as those regarding program capacity, supervision, and response to medical emergencies.  

Tooth Brushing

The Department is proposing to mandate that child care programs and family shelter-based child supervision programs assist children aged two or older with brushing their teeth at least once each day. Tooth decay (caries) is the most common chronic childhood disease. Consequences of early childhood caries include a higher risk of developing additional caries in both primary and permanent teeth,[1] difficulty eating and speaking,[2] increased hospitalizations and emergency room visits[3] and greater risk for delayed physical growth and development.[4] National data show that nearly one in four preschool-age children has had caries.[5] The Department’s 2014 Child Dental Health Survey (CDHS) found that at least 15 percent[6] of children in New York City child care programs had experienced caries and 45 percent of children consumed between-meal sugary snacks or sugary drinks four or more times a day, a major risk factor for caries. Caries prevalence increases as children get older, with 42 percent of third grade children having experiencing caries.[7]

Caries is a preventable disease. Relatively simple measures such as tooth brushing can significantly reduce risk. The American Dental Association recommends that tooth brushing twice per day begin at the eruption of a child’s first tooth. Despite the established benefits of tooth brushing, the oral hygiene practices of young children in New York City remain inadequate.  According to the CDHS[8], among those surveyed, 40 percent of children aged 0 to 6 years brushed their teeth only once a day or less frequently, and 45 percent of children ages 0 to 2 years did not use fluoride toothpaste. 

Requiring tooth brushing while in child care or child supervision programs will promote tooth brushing and help prevent caries. CDHS findings indicate that children with at least one tooth who are enrolled in Early Learn centers—which are required under the federal Head Start program to have a daily tooth brushing routine—are two and a half times as likely to brush their teeth the recommended two or more times per day than children in other programs. Including tooth brushing requirements in Article 47 will set children up for a lifetime of good oral hygiene practices.

Epinephrine Auto-Injectors

The Centers for Disease Control and Prevention estimates that four to six percent of children nationally have a food allergy; such food allergies include ones that are life-threatening. Rapid administration of an epinephrine auto-injector following a life-threatening allergen exposure is critical to preventing significant negative outcomes, including death. Having epinephrine auto-injectors on the premises at all times can save the lives of children with life-threatening food allergies who do not bring an epinephrine auto-injector with them to child care or shelter-base child supervision programs, and of children who have life-threatening food allergies identified for the first time while the child is in such programs.

In 2016, the New York State Public Health Law was amended[9] to allow certain entities, including child care providers, to obtain non-patient specific epinephrine auto-injectors and to administer them in an emergency. This new State law creates the opportunity for such programs to have this critical, lifesaving medication available. Accordingly, the Department is proposing to add a mandate that child care and child supervision programs maintain on site at least two unexpired epinephrine auto-injectors in each dosage appropriate for children who may be in the program, stored so they are easily accessible to staff and inaccessible to children. Programs would be required to have at least one staff person on site, whenever children are present, trained to recognize signs and symptoms of anaphylactic shock and to administer epinephrine as appropriate. The proposal also requires the program to monitor the auto-injectors’ expiration dates and call 911 after any administration, as required by the medication directions. Programs would be mandated to obtain parental consent at the time the child is enrolled in the program. All staff would be required to be trained in preventing and responding to emergencies related to food allergies.

Training requirements

The Department is proposing to expand staff training requirements to promote high quality learning environments, enhance child health and safety, and align with the health and safety training requirements in the federal Child Care Development Block Grant (CCDBG) Act of 2014, which apply to any program enrolling a child whose enrollment is paid for by CCDBG subsidies.

First, the Department is proposing to require that trainings currently required only for assistant teachers be mandated for all teaching staff. These core trainings address fundamental issues including preventing, recognizing signs and reporting injuries, infectious disease, lead poisoning and asthma; scheduling and conducting guided and structured physical activity; and childhood growth and development.

The Board’s authority to codify these proposed amendments is found in Sections, 556, 558, and 1043 of the New York City Charter (the “Charter”). Sections 558(b) and (c) of the Charter empower the Board to amend the Health Code and to include all matters to which the Department’s authority extends. Section 556 of the Charter provides the Department with jurisdiction to protect and promote the health of all persons in the City of New York. Section 1043 grants the Department rule-making authority.




[1] Al-Shalan TA, Erickson PR, Hardie NA. Primary incisor decay before age 4 as a risk factor for future dental caries. Pediatr Dent 1997;19(1):37-41.

[2] American Academy on Pediatric Dentistry; Policy on early childhood caries (ECC): classifications, consequences, and preventive strategies. Pediatr Dent. 2008-2009;30 (7 Suppl):40-3.

[3] Ladrillo TE, Hobdell MH, Caviness C. Increasing prevalence of emergency department visits for pediatric dental care 1997-2001. J Am Dent Assoc 2006;137(3):379-85.

[4] Acs G, Lodolini G, Kaminsky S, Cisneros GJ. Effect of nursing caries on body weight in a pediatric population. Pediatr Dent 1992;14(5):302-5.

[5] Dye BA, Thornton-Evans G, Li X, Iafolla TJ. Dental caries and sealant prevalence in children and adolescents in the United States, 2011–2012. NCHS data brief, no 191. Hyattsville, MD: National Center for Health Statistics. 2015.

[6] This is likely underreported as it is self-reported information and children may have had undiagnosed caries (of which parents were unaware) when parents responded to the survey.

[7] New York State Department of Health Third Grade Survey.

[8]DOHMH’s Oral Health Program conducted a survey to determine risk and protective behaviors for tooth decay among children in New York City group daycare centers. Over 1,800 parents and caregivers from 67 daycare centers reported risk and protective behaviors for tooth decay of their children and themselves.

[9] NYS Public Health §3000-C. Epinephrine Auto-injector devices. Effective March 28, 2017.

 
Subject: 

Proposed Amendment to Child Care Programs and Family Shelter-Based Drop-off Child Supervision Programs (Article 47 of the NYC Health Code) to promote the health and safety of children under six years old attending child care programs or family shelter-based drop-off child supervision programs.

Location: 
New York City Department of Health and Mental Hygiene, Gotham Center
42-09 28th Street, 3rd Floor, Room 3-32
Queens, NY 11101
Contact: 

Svetlana Burdeynik, (347) 396-6078, resolutioncomments@health.nyc.gov

Download Copy of Proposed Rule (.pdf): 

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