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

Proposed Rules: Closed to Comments

Agency:
Comment By: 
Friday, October 20, 2017
Proposed Rules Content: 
 
 

Statement of Basis and Purpose of Proposed Rule

 

      Chapter 11 of Title 24 of the New York City Rules applies to food service establishments and other businesses that operate pursuant to licenses and permits issued by the Department.  To conserve water, it prohibits these businesses from serving water, unless requested by a customer, and commands that they immediately repair leaks, drips, seepages and other losses of water.  The chapter establishes a penalty of $500 for a violation of its rules and provides that repeated wastes of water can result in the business being closed.    

      Chapter 11 is not actively enforced by the Department. It does not issue violations to businesses for having leaky sinks, or seek to determine whether water it observes flowing “is in actual and immediate use in the conduct of the permittee’s business….”  Nor is Chapter 11 needed.  Pursuant to federal and state law, fixtures now used must meet certain flow requirements.[1]  Businesses pay for water and, thus, have a financial interest in fixing dripping and linking faucets and toilets.  Larger leaks can be addressed by the City’s Department of Environmental Protection pursuant to Administrative Code section 24-316.  In times of drought, the City has other rules that limit consumption and the Commissioner or Board of Health could through their nuisance authorities direct in such times that leaks and other seepages be immediately repaired and that restaurants stop freely serving water.  

     Absent such conditions, water should be readily served.  The Department encourages New Yorkers to consume tap water as a healthier drinking option.[2]  To the extent that Chapter 11 prohibits businesses from offering water unless specifically requested, it is inconsistent with this encouragement.  Studies suggest that making heathier beverages, like water, more convenient increases their selection.[3][4][5] Freely providing water may thus lead to it being chosen over less healthy choices. 

     Working with the City’s rulemaking agencies, the Law Department, and OMB, the Office of Operations conducted a retrospective rules review of the City’s existing rules, identifying those rules that will be repealed or modified to reduce regulatory burdens, increase equity, support small businesses, and simplify and update content to help support public understanding and compliance. Chapter 11 was identified as a chapter of rules that should be repealed through this initiative.

     The Department’s authority for this repeal is found in section 1043 of the New York City Charter. Because the Department is not required to provide waivers under the CIAA, there is no reason to have public testimony on whether this rule should be repealed.  




[1] ECL section 15-0314 and 10 CRF Part 430.

[2] www1.nyc.gov/site/doh/health/health-topics/sugary-drinks.page.

[3] Thorndike AN, Riis J, Sonnenberg LM, Levy ED.  Traffic-light labels and choice architecture: promoting healthy food choices.  AJPM 2014; 46)2_143-9.

[4] Thorndike AN, Sonnenberg L, Riis J, Barraclough S, Levy DE. A 2-phase labeling and choice architecture intervention to improve healthy food and beverage choices. AJPH 2012; 102(3): 527–33.

[5] Eibel B, Mijanovich T, Abrams C, Dunn L, Nonas C, Cappola K, Onufrak S, Park S. A water availability intervention in the New York City public schools: influence on youths’ water and milk behaviors. AJPH 2015; 105(2): 365-72.

 

 

Subject: 

Proposal to repeal Conservation of Water Rule - Chapter 11 to Title 24 of the Rules of the City of New York. The Department has determined that there is no public purpose to holding a hearing.

Location: 
New York City Department of Health and Mental Hygiene, Gotham Center
42-09 28th Street,14th Floor, CN31
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:51)

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Agency:
Comment By: 
Tuesday, October 24, 2017
Proposed Rules Content: 
 
 

Statement of Basis and Purpose

Introduction

            Birth and death records are protected from access by the general public because they contain individually identifiable information, which is considered private.  A birth certificate contains the first and last name of the person whose birth is being registered, date of birth, sex, home address, and mother’s maiden name.  In addition to information about the decedent, a death certificate contains the first and last name of parents, surviving spouse, and individual reporting the death.  All of this information is individually identifiable information within the meaning of Health Code section 3.25, which as the notes accompanying that section’s adoption state, “will be treated with the utmost confidentiality.”  Yet, birth and death records are also important historical documents that at some point should be available to historians and families researching their ancestries.  For this reason, Administrative Code section 17-170(b) charges the Board with deciding when the original records of births and deaths filed with the Department, and the indexes to such records, should become public records and transferred to the Department of Records and Information Services (“DORIS”).

The proposed rule amendment would, if approved by the Board of Health, amend the Health Code to establish fixed schedules for making these records public and transferring them to DORIS. Specifically, the Department is proposing that:

    • a birth record become a public record on January 31st of the year following 125 years after the date of birth, and
    • a death record becomes a public record on January 31st of the year following 75 years after the date of death.

The Department believes that these proposed schedules balance the need to protect the personal information of people who may be alive, especially as it relates to the problem of identity theft as well as other privacy issues, with the public’s right to access historically important records, including the specific interests of families, genealogists and other researchers.  The proposed schedule would also avoid the transfer of records to DORIS that are, in the Department’s experience, still subject to amendment by the individual to whom the record pertains, the Office of Chief Medical Examiner, the courts, or family members. 

If the Board adopts this proposal to commence amending the Health Code, the Department is very interested in receiving comments about the appropriateness of these time periods, in particular both from privacy groups and genealogists, and about adopting a 50-year confidentiality period for death records rather than the 75-year period proposed here. 

Background and New Requirements

Birth and death records

In New York City, as in most vital records jurisdictions nationwide, the certificate of birth collects a wealth of information, pertaining both to the person registered on the record and their family members. On the birth record, this includes: the registrant’s date of birth, location of birth, and sex; the mother’s and father’s names prior to first marriage, places of birth, and dates of birth; as well as the number of children delivered at the time of birth, and a home address.  Death certificates, in addition to presenting date and cause of death, include date of birth, location of death, names of parents, as well as information on the surviving spouse and the living person known as the  informant, including their name, relationship to decedent and mailing address.  This type of personal identifying information (“PII”) is protected in other contexts under multiple federal, State, and local privacy laws.

Necessary and appropriate use of birth and death certificates and information

Information included in birth records and actual copies of birth certifications are required by multiple governmental agencies and private entities to receive a benefit or service, or to support the issuance of other documents often used for identity purposes such as obtaining a driver’s license. Birth records are considered “foundational documents,” meaning they are often the first document obtained that enables the holder to then obtain other important documents.  For example, the information contained in a birth certificate can also be used as part of the process to get a U.S. passport or Social Security card and to access public benefits such as Medicaid.

Death records and the PII included in them are used to open or close decedents’ bank accounts, notify federal agencies such as the Internal Revenue Service and the Social Security Administration of a death, and to start the probate process in court.  They are also needed to access payments such as life insurance and various survivor’s benefits in pensions and other programs. 

Fraudulent and inappropriate use of birth and death certificates and information

            The PII found on birth and death certificates has the potential to be used in various fraudulent ways, including identity theft.  Identity theft involves appropriating PII and, in the name of that person, incurring debt, taking money from financial accounts, opening new accounts, accessing medical information or services, or receiving a tax refund, among other things.   Indeed, birth certificates are often referred to as “breeder documents” because they can be used to obtain other valid forms of identity.   Information from death certificates can be used in a similar manner, sometimes referred to as “ghosting.”     

Amendment and correction of birth and death records/issuance of new birth certificates

Birth and death certificates are considered “living” documents in that their content can be changed in certain circumstances.  Pursuant to Article 207 of the Health Code, their contents may be amended or corrected, or a new birth certificate issued, to correct errors made in the originals or to reflect changes in circumstances, such as adoption or change in gender.  These are common requests from Vital Records customers.  During the five-year period from 2012 to 2016, the Department processed 1,030 birth record corrections and amendments for individuals born in 1940 and earlier, including 24 delayed registrations of birth and amendments for individuals aged 90 and above.  During the same five year period, the Department also processed 257 death record corrections and amendments for individuals who died in 1970 and earlier.  These are legal changes to records requested by living New Yorkers or their survivors.  Pursuant to Health Code § 207.01(a), only the Commissioner of Health or his or her designee may make these changes.  Similarly, death certificates may be changed by the Office of Chief Medical Examiner when a cause or manner of death is amended, an important function as new facts come to light.  

When such changes are made to birth certificates, Administrative Code section 17-167(c) requires the substitution of the new birth record for the one on file.  The Department must place the original birth certificate under seal, which may not be broken except by order of a court of competent jurisdiction, and must provide the new birth certificate when a certified copy of the record is issued.  Amending a birth certificate after it has been released into the public domain undermines the Department’s ability to fully substitute the amended certificate for the original and effectively seal the prior records, as the law describes. Over time, multiple versions of the same birth records could even be circulating in the public domain, diminishing the reliability of these records and creating confusion around authenticity.  For these reasons, as well as similar risks to death certificates, it is important the Department not make these documents publically available while they are likely to still be amended.  

Privacy concerns

In addition to the financial and security concerns discussed above, simple privacy concerns argue for maintaining the confidentiality of birth and death certificate PII during a person’s lifetime and for an appropriate period after.  For example, a teenage mother named on the death certificate of an infant may still be alive 75 years after her infant had died or the birth certificate of a transgender person may reveal information that person may prefer to keep private, especially if the certificate has not been amended.  

New Yorkers are living longer

New Yorkers are living longer than ever before. The 2010 US Census shows that almost a half-million New Yorkers are over the age of 75.

Age

Total

75 – 79

178,019

80 – 84

142,272

85 – 89

90,375

90 – 94

37,270

95 – 99

11,665

100+

2,096

Total

461,697

 

Another half million were between the ages of 65 and 74.   Since 2010, the American Community Survey estimates that the total number of New York City residents age 75 and over had increased to more than 492,000, with more than 1.25 million over the age of 65.   In 2005, 585 New Yorkers died between the ages of 100 and 114.  In 2014, that number rose to 806 deaths between the ages of 100 and 114, a 38% increase, and in 2015 the number rose to 901.  Birth and death data should be protected to adequately reflect these trends to guard against identity theft and fraud.  

Model State Vital Statistics Act and Regulations (2011 Revision)

The Model State Vital Statistics Act and Regulations (“Model Law”)  were developed to serve as models for vital records jurisdictions in preparing their own laws and regulations.  Now in its sixth revision, the Model Law is a cooperative effort among state governments and the federal National Center for Health Statistics of the Centers for Disease Control and Prevention.  In 2011 the Model Law was revised to reflect the increase in life expectancy since the prior revision in 1992.  In order to ensure that no person’s PII becomes public prior to a person’s death, the Model Law now recommends that birth records not be released until 125 years after the date of birth and death records not be released until 75 years after the date of death.  

Proposed transfer of records

The Department proposes to adopt the Model Law as it applies to birth and death records: death records that are in the possession of the Department would be transferred to DORIS  75 years after death, and birth records in the possession of the Department would be transferred 125 years after birth.  Previously, these documents had been made public and released to DORIS at inconsistent intervals.  The earliest death records in the possession of the Department that have not been transferred to DORIS are from 1949 and would be made public beginning in 2024.  The earliest birth records in the possession of the Department that have not been transferred to DORIS are from 1910 and would be made public beginning in 2035.  The Department’s proposal is not intended to effect birth and death records already at DORIS, even if these records would not have been transferred had this proposed Health Code provision been in effect at the time of their transfer. 

Statutory Authority

Pursuant to section 556(c) of the Charter and section 17-166 of the NYC Administrative Code, the Department is responsible for supervising and controlling the registration of births and deaths that occur in the City of New York. 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 17-170(b) of the Administrative Code authorizes the Board to determine when birth and death records are transferred to DORIS.  And finally, section 558(b) of the Charter specifically authorizes the Board to add to, alter, and amend the Health Code.

 

Subject: 

Proposed resolution to amend Article 207 (General Vital Statistics Provisions) of the New York City Health Code to establish a schedule for making birth and death records public and transferring them to the Department of Records and Information Services (“DORIS”)

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: 
Wednesday, October 25, 2017
Proposed Rules Content: 
 
 

Statement of Basis and Purpose

 

 The Department’s Division of Disease Control conducts disease surveillance and control activities for most of the diseases listed in Article 11 (Reportable Diseases and Conditions) of the Health Code. The Division of Disease Control also enforces Article 13 (Clinical Laboratories) of the Health Code, which regulates how laboratory tests must be performed and the reporting of test results. In addition, the Department must comply with various provisions of Part 2 of the New York State Sanitary Code, found in Title 10 of the New York Codes, Rules and Regulations, with respect to control of communicable diseases.

To conduct more effective, timely, and complete disease surveillance and control, the Department is proposing that the Board amend Health Code Article 13 as follows:

Hepatitis B Reporting

The Department is proposing that the Board amend Health Code §13.03(b)(3)(A) to require laboratories to report all hepatitis B virus (HBV) DNA test results, including negative results. The Health Department currently requires laboratories to report only positive HBV DNA results, in addition to other positive HBV test results.

HBV DNA testing is performed on individuals who have tested positive for HBV. HBV DNA tests measure viral load and whether the patient has chronic (active) HBV, requiring treatment. For patients already diagnosed with chronic HBV, DNA test results provide important information regarding infectiousness, treatment eligibility, and risk for development of liver cancer. For patients being treated for HBV, DNA test results provide information regarding treatment outcome (i.e., the extent to which the patient cleared the infection).

The number of HBV cases is rising nationally and in New York City. More than 100,000 New Yorkers are estimated to be living with chronic HBV, with 8,439 new cases diagnosed in 2016, an increase of 18.8% since 2013. The majority of individuals infected with HBV as adults will clear the virus on their own but many New Yorkers will develop chronic HBV. Chronic HBV can lead to serious health issues, including cirrhosis and liver cancer. All persons with chronic HBV infection require linkage to care and regular monitoring for liver damage and other complications; a subset require treatment with antiviral medications.

Without negative HBV DNA test results, the Health Department has limited knowledge regarding whether patients who have tested positive for HBV are receiving appropriate follow-up testing and treatment. Mandated reporting of negative HBV DNA test results will allow the Health Department to estimate the proportion of New Yorkers infected with HBV who are appropriately tested and linked to care; identify gaps in access to care; develop targeted interventions to increase linkage to care and improve provider knowledge of HBV testing and treatment guidelines; and increase monitoring to reduce HBV-related morbidity and mortality.

Carbapenem-resistant Enterobacteriaceae Reporting

The Department is proposing that the Board amend Health Code §11.03(a) to require laboratories to report carbapenem-resistant Enterobacteriaceae (CRE), an emerging bacterial threat. CRE are a family of bacteria that are difficult to treat because they have high levels of resistance to many antibiotics including carbapenem antibiotics. Carbapenem antibiotics are often used as the last line of treatment for infections caused by highly resistant bacteria, including those in the Enterobacteriaceae family.

As explained by the Centers for Disease Control and Prevention (CDC): “The emergence and dissemination of carbapenem resistance among Enterobacteriaceae in the United States represents a serious threat to public health. These organisms cause infections that are associated with high mortality rates and they have the potential to spread widely. Decreasing the impact of these organisms will require a coordinated effort involving all stakeholders including healthcare facilities and providers, public health, and industry.”[1] CDC has designated CRE an “urgent” threat, the highest threat level in its list of antibiotic resistance threats in the United States.[2]

CRE infections are common in hospitals, nursing homes, and other healthcare settings. Patients whose care requires devices like ventilators, urinary catheters, or intravenous catheters, and patients who are taking long courses of certain antibiotics are most at risk for CRE infections.[3] In 2015, hospitals in NYS reported 3,618 CRE cases via the CDC’s National Healthcare Safety Network (NHSN); 1,727 of these were reported by the 51 participating New York City facilities.[4] As only hospitals submit data to the NHSN, the number of CRE infections in New York is probably significantly larger.

Mandated reporting will provide vital epidemiological information regarding incidence and evolution of CRE and assist in the identification of new strains, clusters, and outbreaks. This will enable the Health Department to help ensure infection control precautions are being taken. Mandated reporting of CRE is also aligned with recently released Council of State and Territorial Epidemiologists guidelines.[5] Based on a 2016 survey, 27 jurisdictions require some form of CRE reporting.[6]

Minor changes to other parts of §11.03(a) are proposed for purposes of consistency.

 

Statutory Authority

The Health Department’s authority to promulgate 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] Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases. Facility Guidance for Control of Carbapenem-resistant Enterobacteriaceae (CRE). November 2015 Update – CRE Toolkit. https://www.cdc.gov/hai/pdfs/cre/cre-guidance-508.pdf.

[2] Centers for Disease Control and Prevention. Antibiotic Resistant Threats in the United States, 2013. https://www.cdc.gov/drugresistance/pdf/ar-threats-2013-508.pdf.

[3] Centers for Disease Control and Prevention. Carbapenem-resistant Enterobacteriaceae in Healthcare Settings. CDC website. https://www.cdc.gov/hai/organisms/cre/index.html.

[4] NYS Healthcare Associated Infections in New York State, 2015. Part 2: Technical Report. March 2017.

[5] Council of State and Territorial Epidemiologists. Infectious Disease Committee Position Statement 17-ID-04: Public Health Reporting and National notification of Carbapenemase Producing Carbapenem-Resistant Enterobacteriaceae for E. coli, Klebsiella spp. and Enterobacter spp. July 2017.

[6] Council of State and Territorial Epidemiologists. State Reportable Conditions Assessment (SRCA). http://srca.querytool.cste.org/.

 

 

Subject: 

Proposed resolution to amend Article 11 (Reportable Deceases and Conditions) and Article 13 (Laboratories) 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

Service Dog Tags

As part of a comprehensive review and update of the Health Code, on March 16, 2010, the Board of Health adopted several amendments to Article 161 of the Health Code.  The amendments included  adding a definition of the term “service dog” in section 161.02 and a new subdivision (d) in section 161.04 that authorized the Department to provide, at no additional cost, a second tag in addition to a regular license to the owner of a service dog.  Such tags were available in other parts of the State.  The amendments were intended to make them similarly available to people with disabilities residing in the City who might want to alert others that their dogs were service animals and thus should be allowed to accompany them.

            While the provisions of the Health Code allowing the Department to issue service dog tag were well-intentioned, their existence may actually be frustrating the purposes of the ADA[1] and New York State and City Human Rights Laws.[2] [3]  The ADA prohibits places of business or other public accommodation, landlords, and employers from discriminating against people with disabilities.  Such discrimination includes refusal to allow entrance of a service animal, which the ADA defines as any dog that is individually trained to do work or perform tasks for the benefit of an individual with disabilities, without regard to whether the animal has a specific tag identifying it as a service dog.[4]  Because the Department offered the optional service dog tags, some entities are confused and mistakenly only accommodated individuals whose service dogs are wearing them.  Similarly, the Department was informed that some individuals with disabilities mistakenly believed they must have service dog tags in order to exercise their rights under the law.  Indeed, the ADA regulations specifically provide that a public accommodation or entity “shall not require documentation, such as proof that the animal has been certified, trained, or licensed as a service animal.”[5]  Thus, rather than facilitating compliance with disability laws, the tags may have impeded individuals from exercising their rights and might have inadvertently led a business to refuse service to a person with a disability whose dog did not have a tag.

         In order to remove the inadvertent barriers created by the service dog tag provision of the Health Code, the Board of Health is repealing the provision and remove the definition of “service dog” from Article 161 of the Health Code. The Mayor’s Office for People with Disabilities and the City Commission on Human Rights agree that the Department should stop issuing service dog tags because the tags are not necessary; both agencies are concerned that the tags could actually work to the disadvantage of people with disabilities and tend to confuse some business owners, leading them to unintentionally violate the ADA.

Simplifying language and other amendments

            The Mayor’s Office of Operations, working with the City’s rulemaking agencies, the Law Department, and the Office of Management and Budget, conducted a retrospective review of the Health Code and City rules to identify provisions that should be, among other possible changes, simplified to help support public understanding and compliance. The amendments to sections 161.15 and 161.17 were identified through this initiative. 

            As part of this text simplification process, the Board of Health is acting to alleviate confusion whether small animals may be sold, groomed, trained, or boarded in homes.  This confusion has arisen due to the use of the word “room” in Health Code section 161.15(a) rather than the word “dwelling.” The definition of “home occupation” in section 12-10 of the New York City Zoning Resolution[6] specifically provides that commercial animal kennels are not permitted as “home occupations.”  Health Code section 161.02 defines a “boarding kennel business” as a facility other than an animal shelter where animals not owned by the proprietor are sheltered, harbored, maintained, groomed, exercised, fed, or watered in return for a fee.  The Board is amending subdivision (a) of section 161.15 to replace the word “room” with the word “dwelling” and adding the phrase “in return for a fee” to clarify where the sale, boarding, grooming, and/or training of small animals for a fee is allowed.

Similarly, the other changes being made, except the following two amendments, improve clarity.  The two substantive changes are:

        1.     Changes to Health Code subdivision 161.15(d)

            Previously, subdivision (d) only prohibited the sale or holding for sale, boarding, grooming or training any dog or cat that has, or has been exposed to, a communicable disease.  The Board is replacing the phrase “a dog or cat” with “any animal” so that communicable disease among all types of animals can be better controlled and avoided.

         2.     Changes to Health Code section 161.17

            The Board is adding parasites communicable to other animals and humans to the conditions prohibited for dogs and cats in group socialization or play areas operated by permitted entities.  The goal of this addition is to better protect the health of animals and humans from communicable conditions.

Statutory Authority

The authority for these amendments is found in sections 556, 558, and 1043 of the Charter.  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 558 of the Charter empowers the Board to amend the Health Code and to include in the Health Code all matters to which the authority of Department extends. Section 1043 grants the Department rulemaking authority. 




[1] Americans with Disabilities Act of 1990, Pub. L. No. 101-336 (1990).

[2] NYS Executive Law § 290, et seq.; see §§ 296(2) and 296(14); NYS Civil Rights Law §§ 47 and 47-b.

[3] NYC Administrative Code § 8-107(4).

[4] 28 C.F.R. § 36.104; see also at § 35.104.  As noted recently by the New York City and State Bar Associations Joint Task Force on Service Animals in New York State (accessible online at http://documents.nycbar.org/files/guide-to-the-use-of-service-animals-in-new-york-state.html#_edn1), the New York City Human Rights Law does not define “service animal.”

[5] 28 C.F.R. § 36.302(c)(6); see also at § 35.136(f). 

Effective Date: 
Fri, 10/20/2017

Adopted Rules: Closed to Comments

Adopted Rules Content: 
 
 

Statement of Basis and Purpose

          The Department of Health and Mental Hygiene (the “Department”) enforces Article 47 of the Health Code, which regulates certain child care services provided to children under six years of age.  

          The Board of Health is amending Article 47 of the Health Code as follows to also regulate the provision of child supervision services in family homeless shelters in order to enhance the health, safety, and supervision of children receiving services in such facilities.

Adopted Changes

             Tier II homeless shelters for families are required by 18 NYCRR 900.10(c)(5) to provide access to child care services to enable the resident parent or caretaker relative of a child to seek employment and/or permanent housing or to attend school or training. For Tier II homeless shelters that choose to provide such child care services on site, the Department will regulate the programs to provide for the health, safety, and supervision of the children receiving the services. Unlike those child care programs currently regulated by the Department, these on-site programs are not designed to provide for the early education or full-time, long-term care of children; accordingly, the amendments limit the amount of time that any child may attend such a program. The amendments also establish health and safety standards for family shelter-based drop-off child supervision programs similar to those for the child care programs currently regulated by the Department. In response to comments received, the Department has revised the amendments to extend the amount of time that a child may attend such programs, and has added additional responsibilities to the role of the child care liaisons working in such programs. The Department has also added training requirements for child care liaisons.

Statutory Authority

          The authority for these amendments is found in Sections 556, 558, and 1043 of the New York City Charter (the “Charter”). 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. 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.

 

 

Effective Date: 
Fri, 10/20/2017

Adopted Rules: Closed to Comments

Adopted Rules Content: 
 
 

Statement of Basis and Purpose

             Pursuant to New York Public Health Law Section 580(3), the City has the authority to regulate clinical laboratories. The Department’s Division of Disease Control enforces Article 13 (Clinical Laboratories) of the Health Code, which regulates how laboratory tests must be performed and the reporting of test results.

To conduct more effective, timely, and complete surveillance and control of hepatitis C, the Board is amending Health Code Article 13 as follows:

Hepatitis C Testing and Reporting

            The Board is amending Health Code §13.03(b)(3) to require laboratories to routinely perform a confirmatory RNA hepatitis C virus (HCV) test if an antibody test is positive for hepatitis C virus. The confirmatory test must be performed on the same specimen or a second specimen collected at the same time as the initial specimen. This requirement completes diagnostic testing and helps ensure that patients infected with HCV are aware of their status, referred to appropriate medical care and treatment, and cured, thus reducing the risk of further transmission.

           Most patients are first screened for HCV via an antibody test, which shows whether the patient has ever been infected with HCV. When a patient tests positive, a confirmatory RNA test is required to establish whether the individual is currently infected with the virus. If the provider does not order the confirmatory test at the same time as the antibody test, the patient must return for an additional blood draw for the RNA test. This multi-step testing process results in treatment delays and in patients not receiving needed care.

           In 2016, only 48% of patients newly diagnosed and testing antibody positive who were reported to the Department had a confirmatory RNA test performed on the same specimen; and a review of 2015 data shows that 22% of New York City patients newly reported as HCV antibody positive never received confirmatory RNA testing at all. A 2016 Department survey found that 33% of 21 acute care NYC hospitals do not automatically order confirmatory RNA testing for patients with a positive antibody test.

          Routine performance of a confirmatory RNA test follows Centers for Disease Control and Prevention guidelines, and will ensure that patients are accurately diagnosed, promptly treated for HCV, and receive critical related care, such as regular liver cancer screening.  (Centers for Disease Control and Prevention. Testing for HCV infection: an update of guidance for clinicians and laboratorians. MMWR. 2013; 62(18):362)

 

 

Effective Date: 
Fri, 10/20/2017

Adopted Rules: Closed to Comments

Adopted Rules Content: 
 
 

Statement of Basis and Purpose 

Health Code §3.11 currently limits the monetary penalty that can be imposed for a violation of the Health Code to $2,000.  In egregious cases, where dangerous conduct is repeated or a violation results in serious harm, a more severe penalty is warranted.  New York State Public Health Law § 12, for instance, authorizes the New York State Department of Health to impose a penalty of $5,000 against recidivists who violate rules in cases where the violation poses a serious threat to health or safety.  The Public Health Law also authorizes a penalty of $10,000 if the violation of a rule results in serious physical harm to a patient. 

The Board is amending Health Code §3.11 to add two new subdivisions to enhance penalties in similar circumstances.  New subdivision (d), similar to Public Health Law § 12, allows a maximum penalty of $5,000 for a repeat violation of any section of the Health Code that poses a serious risk of harm to others.  New subdivision (e) authorizes a penalty of up to $10,000 in cases where a violation of the Health Code causes serious physical injury to any person, also similar to Public Health Law § 12.

The Board is also amending subdivision (c) of §3.11 to delete a reference to Article 7 of the Health Code, which has been repealed since 2012 and making other technical edits to the section.

 

 

Effective Date: 
Fri, 10/20/2017

Adopted Rules: Closed to Comments

Adopted Rules Content: 
 
 

Statement of Basis and Purpose of Proposed Rule

 

Smoking is banned in certain indoor and outdoor locations both by the City’s Smoke-Free Air Act (SFAA) and by New York State’s Clean Indoor Air Act (CIAA).  These laws are enforced in New York City by the Department.  Pursuant to New York State Public Health Law §1399-u, the Department has the discretion to waive in a specific instance any provision of the CIAA if satisfied that its application will cause undue hardship or that there are other factors that make compliance with the provision unreasonable.

The Department enacted section 24 RCNY §10-15 in 2004 setting forth how the Department would consider requests for such waivers.  The rule allows any entity where smoking is permitted by the CIAA, but allowed by the SFAA, to request a waiver.  Requests based on financial hardship must include financial records and demonstrate financial losses attributable to the State restriction.  If claiming that compliance with the State provision is otherwise unreasonable, an applicant must clearly demonstrate the existence of factors that make this so.  The rule also imposes a fee for an application and limits the term of a waiver to two years.   

The stated basis and purpose of §10-15 was to provide a mechanism for harmonizing enforcement of the CIAA, which had just taken effect, with the restrictions on smoking that were already in place in New York City under the SFAA.[1]  In fact, the CIAA and SFAA are largely harmonious and there are no waivers currently in place.  While one was granted to a tobacco company operating a product testing room in 2005, and renewed thereafter until 2012, no other entity has even requested a waiver.  The Department does not foresee any situation in the future where it would waive a provision of the CIAA and thus is proposing to repeal §10-15 as unnecessary.

Working with the City’s rulemaking agencies, the Law Department, and OMB, the Office of Operations conducted a retrospective rules review of the City’s existing rules, identifying those rules that will be repealed or modified to reduce regulatory burdens, increase equity, support small businesses, and simplify and update content to help support public understanding and compliance. This proposed rule repeal was identified as one that should be repealed through this initiative.

 


[1] City Record, March 24, 2004.  RCNY Volume 8, Statements of Basis and Purpose at page 492.   

Effective Date: 
Mon, 08/21/2017

Proposed Rules: Closed to Comments (View Public Comments Received:5)

Agency:
Comment By: 
Thursday, July 27, 2017
Proposed Rules Content: 
 
                                                                 Statement of Basis and Purpose

 

 Pursuant to New York Public Health Law Section 580(c), the City has the authority to regulate clinical laboratories. The Department’s Division of Disease Control enforces Article 13 (Clinical Laboratories) of the Health Code, which regulates the manner in which laboratory tests must be performed and the reporting of test results.

To conduct more effective, timely, and complete disease surveillance and control in regard to Hepatitis C, the Department is proposing that the Board amend Health Code Article 13 as follows:

                                                                 Hepatitis C Testing and Reporting

            The Department is requesting that the Board amend Health Code §13.03(b)(3) to require laboratories to routinely perform a confirmatory RNA hepatitis C virus (HCV) test if an antibody tests is positive for hepatitis C virus.. The confirmatory test must be performed on the same specimen or a second specimen collected at the same time as the initial specimen. This requirement completes diagnostic testing and helps ensure that patients infected with HCV are aware of their status, linked to appropriate medical care and treatment, and cured, thus reducing the risk of further transmission.

Most patients are first screened for HCV via an antibody test, which shows whether the patient has ever been infected with HCV. When a patient tests positive, a confirmatory RNA test is required to establish whether the individual is currently infected with the virus. If the provider does not order the confirmatory test at the same time as the antibody test, the patient must return for an additional blood draw for the RNA test. This multi-step testing process results in treatment delays and patients being lost to care.

In 2016, only 48% of patients newly diagnosed and testing antibody positive who were reported to the Department had a confirmatory RNA test on the same specimen; and a review of 2015 data shows that 22% of New York City patients newly reported as HCV antibody positive never received confirmatory RNA testing at all. A 2016 Department survey found that 33% of 21 acute care NYC hospitals do not automatically order confirmatory RNA testing for patients with a positive antibody test.

Routine performance of a confirmatory RNA tests is aligned with Centers for Disease Control and Prevention guidelines, and will ensure that patients are accurately diagnosed, promptly treated for HCV,  and receive critical related care, such as regular liver cancer screening.  (Centers for Disease Control and Prevention. Testing for HCV infection: an update of guidance for clinicians and laboratorians. MMWR. 2013; 62(18):362)

                                                                     Statutory Authority

The authority for these proposed amendments is found in Sections 556 and 558 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 1043 grants the Department rule-making authority.

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.

                                                                 Statement pursuant to Charter §1043

This proposal was not included in the Department’s Regulatory Agenda for FY 2017 because the need for the proposal was not known at the time the Regulatory Agenda was promulgated.

 

 

Subject: 

Proposed resolution to amend Article 13 (Laboratories) of the New York City Health Code regarding the performance of confirmatory Hepatitis C RNA testing.

Location: 
New York City Department of Health and Mental Hygiene, Gotham Center
42-09 28th Street 14th Floor, Room 3-32
Queens, NY 11101
Contact: 

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

Download Copy of Proposed Rule (.pdf): 

Proposed Rules: Closed to Comments

Agency:
Comment By: 
Wednesday, July 26, 2017
Proposed Rules Content: 
 
 

Statement of Basis and Purpose of Proposed Rule

 

Health Code §3.11 currently limits the monetary penalty that can be imposed for a violation of the Health Code to two thousand dollars.  In egregious cases, where dangerous conduct is repeated or a violation results in serious physical harm, a more severe penalty is warranted.  New York State Public Health Law §12, for instance, authorizes the New York State Department of Health to impose a penalty of five thousand dollars against recidivists who violate rules in cases where the violation poses a serious threat to health or safety.  The Public Health Law also authorizes a penalty of ten thousand dollars if the violation of a rule results in serious physical harm to a patient. 

 

The Department proposes that two new subdivisions be added to Health Code §3.11 to enhance penalties in similar circumstances.  Similar to Public Health Law §12, a new subdivision (d) would allow a maximum penalty of five thousand dollars for a repeat violation of any section of the Health Code that poses a serious risk of harm to others, and a new subdivision (e) would authorize a penalty of up to ten thousand dollars in cases where a violation of the Health Code causes serious physical injury to any person. The Department also proposes to amend Health Code §3.11(c) to delete a reference to Article 7 of the Health Code, which has been repealed since 2012.

 

The Board of Health’s authority to make changes to the Health Code is found in § 558 of the New York City Charter.

 

 

Subject: 

Proposed resolution to amend Article 3 (General Provisions) of the New York City Health Code to increase monetary penalties.

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 at (347) 396-6078 or resolutioncomments@health.nyc.gov

Download Copy of Proposed Rule (.pdf): 

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