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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: 
Tuesday, February 24, 2015
Proposed Rules Content: 

 

Statement of Basis and Purpose

 

 

Background

The Administrative Code requires that any owner of a building that has a water tank as part of its drinking water delivery system must have the water tank inspected at least once a year. The inspection must comply with all applicable laws and regulations, including provisions of the Health Code. The results from these inspections must be recorded in a manner set out by the Department’s Commissioner and maintained for at least five years.

 

Water for thousands of New York City buildings is kept in water storage tanks. The Health Code sets out requirements for maintaining the purity and sanitary condition of the City’s drinkable water supply. The Health Code requires that these tanks be inspected annually and that the person in control of a building serviced by a water storage tank keep copies of the inspection records and make them available to the Department upon request.

 

Building owners with water tanks must report annually to the Department after the tanks have been inspected that the inspection has occurred. Annual reporting promotes building owner compliance with the inspection requirement and facilitates the Department’s ability to monitor compliance.  The Department will make data from the reports publically available.  These proposed rules specify how the recording and reporting of the water tank inspection must be communicated to the Department.

 

Proposed Changes

The following proposed rules will:

·        Allow for both electronic and paper-based reporting of annual water tank inspection results through either an interactive online form or a printable form available on the Department’s website.

·        Set the deadline for annual water tank inspection result submissions to be no later than January 15 of the following calendar year for which the inspection is due.

·        Provide that water tank inspection documents filed with the Department will be available to the public.

 

Statutory Authority

The Department of Health and Mental Hygiene proposes to amend Title 24 of the Rules of the City of New York as it is authorized to do by sections 556 and 1043 of the New York City Charter, section17-194 of the Administrative Code of the City of New York, and section 141.07 of the New York City Health Code.  Section 556 of the Charter provides the Department jurisdiction to regulate all matters affecting health in the City of New York, and specifically to supervise and regulate the purity and public health aspects of the water supplied in the City.  Section 1043 of the Charter gives the Department rulemaking powers. Subdivision (b) of section17-194 of the Administrative Code authorizes rulemaking by the Commissioner of the Department with regard to annual water tank inspection recording. Subdivision (b) of section141.07 of the Health Code requires the Department to collect reports of such inspections in accordance with its Rules.

 

 

Subject: 

Proposed resolution to add new Chapter 31 (Water Tank Inspections) to Title 24 of the Rules of the City of New York. The new Water Tank Inspections chapter will provide rules for the manner and timeframe that building owners or their agents must report the results of their annual inspections of drinking water tanks.

Location: 
New York City Department of Health and Mental Hygiene, Gotham Center
42-09 28th Street 14th Floor, Room 14-31
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 (View Public Comments Received:1)

Agency:
Comment By: 
Thursday, January 22, 2015
Proposed Rules Content: 

 

 

Statement of Basis and Purpose

 

 

Statutory Authority

 

            These amendments to the New York City Health Code (“the Health Code”) are promulgated pursuant to Sections 558 and 1043 of the New York City Charter (“the Charter”).  Section 558(b) and (c) of the Charter empowers the Board of Health (“the Board”) to amend the Health Code and to include in the Health Code all matters to which the authority of the New York City Department of Health and Mental Hygiene (“the Department”) extends. Section 1043 grants the Department rulemaking authority. 

 

Background and New Requirements

           

            Currently all facilities in the City of New York that report 25 or more deaths per year, including hospitals, hospices, funeral homes and the Office of Chief Medical Examiner, must submit reports of death to the Department electronically.  This system of electronic death registration enables reporting of 94% of all deaths in New York City.  In order to increase the number of deaths reported electronically, the Department proposes:

 

  1. To require that all hospitals and hospices reporting ten or more deaths per year (reduced from 25) report them electronically;
  2. To require that skilled nursing facilities reporting ten or more deaths per year also submit reports of death electronically;
  3. To require that all facilities that voluntarily report deaths electronically continue to do so;
  4. To eliminate the fee currently charged for both processing interim disposition permits and for correcting a final disposition as a result of an interim disposition.

 

The new requirements will increase the number of deaths reported electronically each year.  Furthermore, the elimination of fees charged for both filing interim disposition permits and correcting the final disposition as a result of an interim disposition will encourage filing of interim disposition permits.  Currently, charging these fees discourages funeral directors from filing interim disposition permits, which results in delayed reporting of deaths.

 

At its meeting on December 9, 2014, the Board adopted a resolution that included amendments to Section 207.13 of Article 207 of the Health Code, which is also proposed to be amended below.  The amendments proposed below reflect Article 207 of the Health Code as it exists at the time this proposal was approved for publication, and do not yet reflect the changes approved for adoption on December 9, 2014.                     

 

 

 

 

Subject: 

Proposed resolution to amend Section 205.03 of Article 205 of the New York City Health Code to increase the number of users who are required to submit electronic death records, and Section 207.13 of Article 207 of the New York City Health Code to eliminate the fees charged for interim disposition permits and for correcting a final disposition as a result of an interim disposition.

Location: 
New York City Department of Health and Mental Hygiene, Gotham Center
42-09 28th Street 8th Floor, Room 8-25
Queens, NY 11101-4132
Contact: 

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

Download Copy of Proposed Rule (.pdf): 

Proposed Rules: Closed to Comments (View Public Comments Received:95)

Agency:
Comment By: 
Wednesday, January 21, 2015
Proposed Rules Content: 

 

 

Statement of Basis and Purpose

 

 

Statutory Authority

 

These amendments to the New York City Health Code (the Health Code) are authorized by sections 558 and 1043 of the New York City Charter (the Charter).  Sections 558(b) and (c) of the Charter empower the Board of Health (the Board) to amend the Health Code and to include in the Health Code all matters to which the authority of the New York City Department of Health and Mental Hygiene (the Department) extends. Section 1043 grants the Department rule-making authority. 

 

Background

 

In May 2014, the Commissioner of the Department of Health and Mental Hygiene granted a petition from an individual asking that the Board consider amending Article 161 to remove ferrets from the list of animals prohibited as pets in the City of New York.  This proposal would initiate the process of amending the Health Code and begin a public comment period on whether ferret ownership should be legalized. 

 

The Department’s Bureau of Veterinary and Pest Control Services enforces Article 161 pertaining to the control of animals in the City.  It requests that the Board of Health also amend various other provisions of Article 161 and Article 11 of the Health Code related to animal control.

 

Amendments to Health Code §161.01(a)—Circuses and Other Animal Exhibitions

 

Health Code §161.01 prohibits the possession of wild and other animals that present hazards to human health and safety.  Subdivision (a) allows for certain exceptions and requires permits for temporary exhibitions, displays and other uses of prohibited animals.  Circuses and wildlife rehabilitators are currently exempt from this section’s permit requirements, and while many voluntarily obtain permits from the Department, they are not obligated to do so. 

 

Recently, the Department identified some circuses and a wildlife rehabilitator who intended to exhibit or use animals to entertain the public in settings that were not safe.  In one instance, circus animals had not been tested to rule out infection with a disease that could be transferred to humans. In other instances, circus animals were kept in enclosures that either did not adequately protect the public or were too small.  Although circuses are required to comply with the federal Animal Welfare Act, 7 U.S.C. 2131 et seq., administered by the U.S. Department of Agriculture, this law only imposes limited animal care, animal health and public safety requirements.  In yet another instance, a wildlife rehabilitator proposed to  present adult performing bears on a theatre stage without barriers to protect the audience from the animals, and without adequate enclosures for the bears to stay in when they were not performing. The Department was able to use its general nuisance authority to address exhibitions and performances that do not adequately protect the public.

 

The Department believes circuses and wildlife rehabilitators should be required to have appropriate measures in place to adequately protect the public; and they should only be permitted to perform in the City if they comply with requirements that the City deems necessary to protect public health and safety.  Federal law does not preempt the local

regulation of circuses.[1] The Department therefore requests that the Board amend subdivision (a) of section 161.01 of

 

the Health Code to require that circuses

 

and wildlife rehabilitators in the City obtain permits from the Department in all cases when they intend to exhibit or use performing animals.

 

Amendments to Health Code §§161.01(b)(4)—Prohibited Animals

 

Health Code §161.01(b)(4) currently prohibits persons from harboring ferrets in New York City. Following the procedures described in Health Code §9.05, an individual petitioned the Board of Health to amend Article 161 to remove ferrets from the list of animals that cannot be kept in the City.  By letter dated May 16, 2014, the Commissioner, as the Board’s Chairperson, granted the petition and responded that the Board would consider an amendment to legalize ferrets no later than December 2014.  The proposed amendment would remove the prohibition on keeping domestic ferrets as pets, but would require certain safeguards. The proposed amendment requires that these pets:

  • Be immunized against rabies in accordance with Health Code §11.29;
  • Be sterilized to prevent their reproduction, and
  • Be restrained when outdoors.

The requirement to sterilize is being proposed to prevent an overpopulation of ferrets that could become a burden on the animal shelter system and as a part of responsible pet ownership. Additionally, sterilization may help reduce aggression and musky odor, and provide health benefits to the animal.  The Department is also proposing that this provision be effective September 1, 2015, roughly six months after the expected adoption of this provision, if the Board of Health adopts this proposal, to allow time for government and non-government agencies and property owners to develop and put into effect appropriate policies and guidance.

Amendment to Health Code §§161.21 and 11.29—Rabies Vaccinations

In 2010, Health Code §161.21 was amended to require that stables keep current rabies vaccination certificates for the horses they house. The Department is requesting that the Board further amend this section to require that horses’ owners, as well as the stables where they are kept, maintain proof that their horses are vaccinated.  

 

The Department also proposes that Health Code §11.29 be amended to:

1.     Add ferrets and horses to the list of animals that must be immunized against rabies and

2.      Change the terms “dogs” and “cats” in this section to “animals” to reflect that other animals would be specifically required to be currently vaccinated against rabies.

 

Amendment to Health Code §161.02—Definitions

 

The Department is proposing that the Board add a definition for “operating” or “in operation” to clarify that an animal business or facility regulated by the Health Code is required to comply with all of the provisions of the Health Code that apply to it regardless of whether the facility or business is open to the public.      

 

Amendments to §161.15—Cage or Box Dryers

 

This section currently requires boarding kennels to obtain proof from the owners of the dogs for which they care that the animals have been vaccinated against rabies and certain other diseases. The Department is proposing that the Board amend this section to clarify that this requirement is applicable to grooming parlors and training establishments.  In addition, these businesses would have to obtain proof from the owners of cats and ferrets that these types of animals have been vaccinated against rabies.

 

The Department is also proposing that the Board add a provision mirroring a State law requirement that prohibits grooming parlors and other facilities that handle small animals from drying an animal using the heating element contained in a cage or box dryer. These types of dryers have been associated with injuries and deaths of pets left unattended during drying. State Agriculture & Markets Law §353-e already prohibits their use in grooming facilities; this amendment would enable the Department to enforce this ban in the businesses it regulates.  

This section is being repealed.




[1] See, e.g., 7 U.S.C. 2145(b); Dehart v. Town of Austin, 39 F.3d 718, 722 (7th Cir. 1994) (“[T]he Animal Welfare Act expressly contemplates state and local regulation of animals.”)

 

 

Subject: 

Proposed resolution to amend Animals (Article 161) and Reportable Diseases and Conditions (Article 11) of the New York City Health Code

Location: 
New York City Department of Health and Mental Hygiene, Gotham Center
42-09 28th Street, Room 3-32
Queens, NY 11101-4132
Contact: 

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

Download Copy of Proposed Rule (.pdf): 

Proposed Rules: Closed to Comments (View Public Comments Received:1)

Agency:
Comment By: 
Thursday, January 29, 2015
Proposed Rules Content: 

 

 

Statement of Basis and Purpose

 

 

Statutory Authority

 

These amendments to the New York City Health Code (the Health Code) are promulgated pursuant to §§558 and 1043 of the New York City Charter (the Charter).  Sections 558(b) and (c) of the Charter empower the Board of Health (the Board) to amend the Health Code and to include in the Health Code all matters to which the authority of the New York City Department of Health and Mental Hygiene (the Department) extends.  Section 556 of the Charter authorizes the Department to supervise and regulate the City’s food supply.  Section 1043 grants the Department rule-making authority. 

 

Background

 

The Commissioner of the Department of Health and Mental Hygiene is the “permit issuing official” designated in the State Sanitary Code (10 NYCRR Chapter 1) Subpart 14-1 to enforce provisions of the Sanitary Code applicable to the operation of food service establishments in the City of New York (the City).  In the City, food service establishments are also subject to provisions of the New York City Health Code and Chapter 23 of Title 24 of the Rules of the City of New York, and mobile food vendors are also subject to subchapter 2 of chapter 3 of title 17 of the New York City Administrative Code.  The Department’s Division of Environmental Health enforces the provisions of the Administrative, Sanitary and Health Codes and the Department’s rules applicable to such establishments.  

 

The Department is proposing that the Board of Health amend Article 81 of the Health Code to update certain requirements to reflect changes in food science recommendations found in the 2013 US FDA Model Food Code (“2013 Food Code”) and to c­­­­­larify various provisions to help  establishment operators comply with the requirements.

 

Proposed Changes

 

The following changes are proposed:

 

§81.03 Definitions.

 

Amends the definition of sanitization in subdivision (ii) to add submersion in a quaternary ammonium solution as an approved method of chemically sanitizing tableware, utensils and equipment.  The method is included in the 2013 Food Code and will give operators another option for sanitization.

 

§81.04 Approved sources of food.  

 

Amends subdivision (c) to add scallops sold with their roe (eggs) to the list of shellfish for which identification tags must be retained. 

Subdivision (d) is being added to require that exotic game meats served in food service establishments be inspected and acquired from commercially regulated sources, such as those described in regulations of the State Department of Agriculture and Markets found at 1 NYCRR §271-2.2, and will be made consistent with the 2013 Food Code.

Subdivision (e) is being added to address the fact that many food service establishments are producing their own packaged juice products, and will require that juice produced in retail establishments (including food service establishments) bear warnings stating that the juice has not been produced in a manner that prevents, reduces or eliminates the presence of pathogens. 

 

§81.05 Technical review and pre-permitting inspections for food service establishments and non-retail food processing establishments.  

 

The Department is proposing that the name of this section be amended to indicate that a permit is required to operate a food service establishment.  The first sentence of current subdivision (c), which states that a permit is needed to operate a food service or non-retail food processing establishment, has been re-lettered as subdivision (a) and the entire section has been re-lettered accordingly.  Certain language in current subdivision (c), re-lettered here as subdivision (d), is being added to conform this provision with State Sanitary Code §14-1.190, and make clear that an establishment may not begin operating for 21-days after it applies for an initial permit, unless the Department has inspected it.

 

§ 81.06 Prevention of imminent or public health hazards.

 

Subdivision (c) is being amended to clarify that the Department’s approval of a food service establishment’s Hazard Analysis and Critical Control Point (HACCP) plan is not required when food is controlled according to the time and temperature requirements of §81.09.

 

§81.07 Food; sanitary preparation, protection against contamination.

 

Paragraph (2) of subdivision (a) is being deleted because it is duplicative of §81.17(d).

Subdivision (c) is being amended to prohibit establishments from keeping, as well as using, non-pasteurized liquid, frozen or dry eggs.

Subdivision (d) is being amended to delete the sentence that begins with the phrase “Food removed from original containers or packages…” which is unnecessary because subdivision (a) of this section already mandates that all food, regardless of packaging, be protected from contamination. 

Subdivision (h) is being amended to add an additional method of storing utensils that is recommended in the 2013 Food Code §4-602.11.  Establishments would be able to place them in water maintained at or above 135 degrees Fahrenheit.  This subdivision is also being amended to clarify that utensils used for dispensing ready to eat foods must have handles to prevent food contamination. 

Subdivision (o), currently entitled “Drinking straws,” is being retitled “Single service articles” and amended to require that these items, which include paper coffee cups and plastic cutlery, also be dispensed in ways that prevent possible contamination.  This rule change is being proposed in response to a petition to the Board to commence rulemaking about preventing contamination of single service articles.

  Several other amendments are being made to this section to clarify its provisions.

 

§81.09 Potentially hazardous foods; temperature control for safety.

 

This section is being repealed and replaced with one that is better organized and specifies the temperatures required for various processes.

Temperatures for cooking meats have been updated in accordance with the 2013 Food Code recommendations.

Subdivision (b) will require freezing of fish to destroy parasites before serving such fish raw, raw-marinated (e.g. ceviche) or undercooked. Parasites (in the larval stage) consumed in uncooked or undercooked fish present a risk or food borne illness. Among parasites, nematodes or roundworms (Anisakis spp.), cestodes or tapeworms (Diphyllobothrium spp.) and trematodes or flukes are of most concern.  The FDA Food Code recommends that fish that is not going to be adequately cooked be frozen to destroy parasites before service because visual inspection techniques cannot adequately detect the presence of parasites.  The effectiveness of freezing fish to kill parasites depends on several factors, including the temperature at which and length of time the fish is frozen, as well as the type of parasite. Establishments will be required to maintain and follow standard operating procedures for freezing all fish;  if they buy fish frozen, the establishment must obtain statements from the supplier that the fish was frozen.  

 

§81.10 Time as a public health control.

 

The Department is proposing amendments to clarify several provisions of the section, but it will otherwise remain substantively unchanged.

The section title is being amended to indicate that time can be used as a control as an alternative to maintaining the time and temperature requirements of §81.09.

Subdivision (b) is being amended to add the date as an element that must be noted on labels when food is being held out of temperature.  Additional amendments are being made to subdivisions (b) and (c) to clarify their provisions.

Paragraph (2) of subdivision (d) has been amended to clarify that, if food previously held under §81.10 is returned to temperature control, it is considered contaminated and in violation of §81.07.

Table 1 is being amended to reflect the changes made to this section.

 

§81.11 Consumer advisory. 

 

This section is new.  Section 81.09 currently requires that an establishment tell consumers about the dangers of food borne illness when potentially hazardous/time and temperature control for safety foods are being served raw or undercooked.  The 2013 Food Code recommends a written advisory, which has been adopted and included in this new section, effective January 1, 2016.  Until that time, establishments may continue to verbally warn consumers of the risk posed by eating raw or undercooked foods.

 

§81.12 Reduced oxygen packaging; cook chill and sous vide processing.

 

            The heading of subdivision (c) is being retitled to more accurately reflect its content.

 

§81.13 Food workers; health; hygienic practices. 

 

This section is being amended to clarify the activities during which workers must wear hair coverings. Also, consistent with recent amendments to the Smoke-Free Air Act made by Local Law 152 of 2013, the use of electronic cigarettes will also be prohibited.  Provisions on the use of gloves have been moved from subdivision (d) of this section to §81.07(j).

 

§81.17 General requirements: design, construction, materials and maintenance. 

 

Minor changes are proposed to clarify some provisions and reorganize this section.  In addition, a new subdivision (g) is being added to include the provisions on handling toxic and hazardous substances that are currently in §81.23.  Provisions governing single service articles are being deleted to reflect their inclusion in the new §81.07(o).

 

§81.18 Cold and hot storage and holding facilities. 

 

The proposed amendment would correct an error to require that thermometers and other temperature measuring devices be calibrated to be accurate to (+) or (-) 2 degrees, rather than the current (+) or (-) 3 degrees.

 

§81.20 Plumbing and water supply

 

Subdivision (a) is being amended to add a requirement that an establishment have adequate supplies of potable water at all times.

Subdivisions (b) and (c) are being combined and provisions related to condensation, clarified, and the remainder of the section re-lettered appropriately.

 

§81.21 Hand wash sinks.

 

Subdivision (a) is being amended to require that hand sinks be supplied with potable running water.

Subdivision (b) is being amended to delete the requirement that waste receptacles be foot operated and covered.

 

§81.22 Employee and patron toilets.

 

This section is being amended to clarify its provisions but remains substantively unchanged.

 

§81.23 Integrated pest management.

 

Subdivision (d) is being amended to clarify the provisions of paragraph (3) and add a new paragraph (4) prohibiting use of unprotected bait stations, consistent with State Sanitary Code §14-1.60(e).

Subdivision (e), relating to toxic materials, is being moved to §81.17. 

 

§81.24 Garbage and waste disposal.

 

The proposal deletes the current requirement that garbage and wastes be either removed from the food establishment daily or placed in a separate pest-proof room.  Garbage and waste stored for removal would need to be kept in pest-proof containers but need not be in a pest proof room.  The provisions of this section are also being reorganized.

 

§81.27 Cleaning of premises, equipment and utensils.  

 

This section is being amended to clarify its requirements. The cleaning of food contact surfaces is vital in preventing bacterial growth and contamination.  The proposed amendments clarify that cleaning requirements apply to all food contact surfaces.

 

§81.29 Dishwashing and ware washing.  

 

This section is being repealed and restated to clarify its provisions.  It deletes provisions referring to sanitizing in accordance with manufacturers’ instructions for use of various chemical solutions and equipment, and requires that when items are chemically sanitized, chemicals registered as anti-microbial pesticides with the US Environmental Protection Agency for food service be used..  

 

§81.31 Outdoor cooking, food and beverage preparation facilities.  

 

No substantive changes have been made to this section, but its provisions are being clarified to facilitate compliance.

 

§81.46 Refillable, returnable containers.  

 

This section is new.  It sets out procedures for establishments that allow consumers to re-use their own beverage containers or that provide food/beverage containers to consumers that may be refilled at the establishment, as an environmental conservation measure.  Re-using food containers exposes food workers and consumers to increased public health risks and food to potential contamination and this section establishes procedures to reduce those risks. These provisions are consistent with 2013 Food Code §3-304.17.

 

§81.53 Maximum Beverage Size.

 

This section is being repealed.

 

 

Subject: 

Proposed resolution to amend Food Preparation and Food Establishments of the New York City Health Code (Article 81) deleting, amending and clarifying certain requirements for operation of restaurants and other food service establishments.

Location: 
New York City Department of Health and Mental Hygiene, Gotham Center
42-09 28th Street, 3rd Floor, Room 3-32
Queens, NY 11101-4132
Contact: 

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

Download Copy of Proposed Rule (.pdf): 

Proposed Rules: Closed to Comments (View Public Comments Received:4)

Agency:
Comment By: 
Thursday, January 22, 2015
Proposed Rules Content: 

 

Statement of Basis and Purpose

Statutory Authority

These amendments to the New York City Health Code (the Health Code) are promulgated pursuant to §§558 and 1043 of the New York City Charter (the Charter).  Sections 558(b) and (c) of the Charter empower the Board of Health (the Board) to amend the Health Code and to include in the Health Code all matters to which the authority of the New York City Department of Health and Mental Hygiene (the Department) extends. Section 1043 grants the Department rule-making authority. 

Background

The Charter provides the Department with jurisdiction over all matters concerning health in the City of New York.  The Department’s Division of Environmental Health includes the Bureau of Child Care, which issues permits to non-residential based child care services in accordance with Article 47 of the Health Code, and which regulates school based programs for children aged 3-5 in accordance with Article 43 of the Health Code.  Child care providers who provide child care services in homes or apartments are regulated by the State Office of Children and Family Services, and are not subject to either Article 43 or Article 47.

The Department is proposing that the Board amend multiple provisions of Article 47 of the Health Code in order to improve supervision of children in child care services regulated by Article 47.

Promoting accountability for children’s whereabouts

The Department is proposing that the Board amend the Health Code to enhance child safety within child care services.  The proposed amendments strengthen the requirements to account for a child’s whereabouts at all times while in care, when children are transported to and from the child care services or during off-site trips, and when children arrive and depart from the child care service.  The Department has, on occasion, been notified by child care service permittees, the police, and parents that children have gone missing for a period of time during the child care day.  These incidents may have occurred because a child exited the service unobserved by staff, was left on transportation vehicles, or was left in a playground or at another off-site trip location.  Additionally, at least one child was discharged to an adult who did not have authority to take the child from the child care service. Though no child was harmed, these incidents are troubling and reflect a need for stronger procedures to monitor the whereabouts of children.

The Department has issued guidelines and provided training to assist child care services account for all of the children under their care at all times. When the Department learns that a child care service has been unable to account for a child for any period of time, the Department orders the service to cease operation. Only after the child care service demonstrates that it has determined why the incident happened and that it has instituted concrete measures to prevent it from happening again does the Department authorize it to reopen. 

To help child care services implement systems designed to prevent these incidents, the Department is proposing to amend Article 47 of the Health Code. The amendments reflect best practices already in place at many child care services. They would be required at all establishments if approved.

  • Written safety plan: Amend §47.11 to add procedural requirements that promote child safety in child care services, establish accountability so that child care services permittees know and can document where any child is at any given time, particularly when children arrive and leave the child care service, whether they are taken on trips offsite, on foot or by other means, or are leaving the service at the end of the day.
  • Criminal justice and child abuse screening: Amend §47.19 to add screening with the State Registry for Child Abuse and Maltreatment (SCR) and for criminal history for personnel of child transportation services under contract to a child care service. The current provision requires screening for school bus drivers and all other staff employed by the permitted child care service, but not for personnel employed by transportation services operating under contract with a permittee.  This provision would explicitly exclude from screening persons providing transportation arranged by parents. 
  • Health; daily requirements; communicable diseases: Amend §47.27(a), (c) and (d)  to require that permittees maintain child attendance records and obtain earlier parental notifications of absences to promote greater accountability for children.  This provision currently requires parents to contact permittees after their children are absent for three days in order to capture information about children who may have contracted certain communicable diseases. The Department is proposing that this be changed to require the parent to notify the child care service the same day when a child will not attend on a scheduled day to promote better accountability for children and more rapid investigation of children who fail to show up at the child care service and who may have been lost.
  • Indoor physical facilities: Amend §47.41 to add new subdivisions (k) and (l) to require monitoring of entrances and exits and establishing other security measures. The Department has found that the majority of incidents demonstrating poor child accountability reported between 2008 to 2013 occurred when children wandered out of the child care service entrance door, alone or with another child and that child’s parent, or were left at an off-site location. In some cases, children left the child care service unaccompanied because they were able to open the front door by themselves, even though that door was closed. Locking a means of egress, however, is not permitted under the New York City Fire Code. In order to secure the door in a manner that prevents a child from exiting while also maintaining emergency access, the Department is proposing that the child care service be required to install a panic bar on all doors that lead to the outside. Panic bars allow adults to easily open a door but are too high or require too much force for young children. To allow time to comply this provision will become effective May 1, 2016.
  • Safety; general requirements: Amend §47.57 to establish requirements for adults escorting children out of the child care service and for enhanced off-site trip supervision, since such trips present a substantive risk of children being left behind.  From 2008 to 2013, incidents of inadequate child supervision occurred when children left child care services with adults who were not authorized by parents to take them out of the child care service or when children were left at playgrounds, parks or on other offsite trips.  The Department proposes that the Board amend subdivision (h) of  this section to require that permittees maintain information on all adults authorized by parents to take children out of a child care service and add a new subdivision (j) to require that the permittee appoint a staff member as a trip coordinator who will be responsible for assessing supervision needs, developing guidelines and procedures for when additional staff or volunteers should accompany children on off-site trips, and incorporate those procedures in the written safety plan. Trip coordinators would also be required to accompany children on offsite trips to improve accountability and lower the risk of leaving children unsupervised.
  • Transportation: Amend §47.65 to clarify parental consent requirements and add new procedures for verifying children’s attendance and identity during transportation.  Several incidents of poor accountability have involved children who were left on a vehicle, dropped off at the wrong child care service or at a closed child care service, or simply left outside the child care service unsupervised.

Imminent or public health hazards

The Department is requesting that the Board amend the list of imminent or public health hazards in the definition in §47.01(k) to modify paragraph (10) to specify that use of a pillow by a child younger than two years of age is a public health hazard; and to delete paragraph (13), which addresses holding potentially hazardous foods out of temperature. Children can safely use pillows after age two.  The amendment to §47.01(k)(10) is intended to update the current definition of a public health hazard to incorporate the prohibition of pillows in infants’ sleep environments as required by the safe sleep practices of the National Resource Center for Health and Safety in Child Care and Early Education Guidelines for Early Care and Education Programs.[i]  Additionally, the Department is proposing that the Board amend §47.55(b)(4) and (7) to allow pillows to be used by children two years of age or older and to require that when pillows are used they be stored with each child’s other bedding.  In addition, the Department is requesting that the Board delete paragraph (13) of §47.01(k), because requirements for holding food are addressed in more detail in Article 81, which is also applicable to child care services.

Medical records

Health Code §47.25(d) requires that permittees maintain a cumulative, comprehensive medical record for each child.  Section 47.33 requires that permittees also maintain staff physical examination certificates and vaccination records.  The Department is requesting that the Board amend these provisions to clarify that comprehensive medical records of children and staff must be kept on the premises and made available to the Department upon request. Frequently, Department Early Childhood Educational Consultants who are conducting inspections are told that these records are not immediately available for review.  

Fire safety

Currently, Health Code §47.59(a) only requires that exit signs at child care services be clear and legible “when required by Department of Buildings.”  New York City Building Code §BC-1011 requires that all facilities housing child care services (occupancy use group E) have exit signs that are illuminated internally or externally. Accordingly, the Department is requesting that the Board amend this section to reflect current Building Code requirements.

Nutrition and physical activity updates

The Department proposes that the Board of Health amend §47.61(b) of the Health Code to update requirements limiting children’s juice consumption and §47.71(a) and (d) to further restrict sedentary time and television viewing.

Dietary and lifestyle habits and preferences developed at a very early age can often persist and may have a profound impact on an individual’s health later in life. Among preschoolers enrolled in the Women, Infants and Children program in NYC in 2011, 14.5% of 3 year olds and 16.9% of 4 year olds were obese.[ii]  Obese children are more likely than normal-weight children to have risk factors for heart disease,[iii] type 2 diabetes,[iv]and many other disorders and conditions.[v] Obese children are more likely to become obese adults,[vi],[vii]and obesity in adulthood is associated with serious diseases and conditions, and with higher rates of death.[viii] Consequently, it is important to optimize the nutritional quality of the food and beverage offerings in early childhood settings and employ practices that serve to cultivate healthy lifestyle habits. The amendment is intended to update the current requirements for juice, sedentary time and screen time based on current expert recommendations and the best available evidence.

  • Juice

Currently Health Code §47.61(b) authorizes child care services to provide children over the age of eight months up to six fluid ounces of 100% juice per day. The proposed amendment will increase the age that 100% juice is permitted to 2 years of age, and reduce the amount of 100% juice that may be served to four ounces per day.

This amendment would make the Health Code provision consistent with current standards of the federal Child and Adult Care Food Program (CACFP), allowing four ounces of 100% juice per day for children ages 2 – 5 years old.[ix] Numerous health organizations including the United States Department of Agriculture (USDA)[x], the Institute of Medicine (IOM)[xi], the American Heart Association (AHA)[xii] and the American Academy of Pediatrics (AAP)[xiii] recommend limiting children’s intake of 100% juice. When consumed in moderation, 100% juice can be a healthy beverage; however, the USDA recommends that the majority of a child’s recommended fruit servings should come from whole fruit.[xiv] Despite this recommendation, current data suggest that 100% juice overconsumption by young children is commonplace. Daily per capita caloric intake from 100% fruit juice is increasing among children, including toddlers, and children who consume juice typically consume quantities that far exceed the cited recommendations.[xv],[xvi] A 2002 study of the sources of energy among over 3,000 infants and toddlers demonstrated that 100% fruit juice was the second largest source of energy among toddlers ages 12-24 months and the fourth largest source of energy among infants 4 to 5 months old.[xvii] Despite being offered 100% juice in small quantities, it is likely that children consume juice in multiple settings and at multiple occasions throughout the day, causing overall daily consumption to be above recommended levels.  Water and low-fat milk are the healthiest beverages for children over 2 years of age.[xviii]

  • Television viewing

Currently Health Code §47.71(d) prohibits screen time for children under 2 years of age and requires that screen time for children 2 years of age and older be restricted to 60 minutes per day of programming that is educational or actively engages children in movement. The proposed amendment would further limit the amount of screen time for children 2 years and older to no more than 30 minutes per week.

Research suggests that more than 80% of children ages 6 months to 6 years are exposed to some type of screen-based media on a typical day,[xix] and caregivers report that preschool age children spend 2 to 3 hours per day on screen time,[xx],[xxi],[xxii]which exceeds recommended levels of screen time exposure. [xxiii] Surveys reveal that child care centers vary widely in the average amount of screen time provided, from small amounts or none at all[xxiv],[xxv],[xxvi] to 1 or more hours per day.[xxvii],[xxviii]Studies have found that increased screen time exposure in early childhood is related to risk of obesity later in childhood[xxix],[xxx],[xxxi],[xxxii],[xxxiii] and even into adulthood.[xxxiv],[xxxv],[xxxvi] In recognition that children are exposed to screen time in various settings throughout the day, the AAP, American Public Health Association (APHA), and National Resource Center for Health and Safety in Child Care and Early Education Guidelines for Early Care and Education Programs, the First Lady’s Let’s Move initiative, and the USDA Provider Handbook for the Child and Adult Care Food Program recommend that early care settings limit screen time to 30 minutes per week.[xxxvii],[xxxviii],[xxxix]

  • Sedentary time

Currently Health Code §47.71(a) requires that children not be allowed to remain sedentary or to sit passively for more than 60 minutes continuously, except during scheduled rest or naptime. The proposed amendment would reduce the amount of sedentary time to no more than 30 minutes continuously except during scheduled rest or naptime.

In an effort to combat early childhood obesity, the IOM recommends that child care providers and early childhood educators implement activities for toddlers and preschoolers that limit passively sitting or standing to no more than 30 minutes at a time.[xl] Limiting time spent on sedentary activities is important, as sedentary activities may take the place of time spent being physically active or otherwise actively engaged. Studies show that children spend a significant amount of time being sedentary in preschool and child care settings[xli],[xlii],[xliii] and that sedentary activities, such as television viewing, may be linked to increased BMI and adiposity in children.[xliv],[xlv]

 




[i] American Academy of Pediatrics, American Public Health Association, National Resource Center for Health and Safety in Child Care and Early Education. 2011. Caring for our children: National health and safety performance standards; Guidelines for early care and education programs. 3rd edition. Elk Grove Village, IL: American Academy of Pediatrics; Washington, DC: American Public Health Association. Also available at http://nrckids.org.

[ii] Centers for Disease Control and Prevention. Obesity prevalence among low-income, preschool-aged children — New York City and Los Angeles County, 2003–2011. MMWR 2013;62(2):17-22.

[iii] Freedman DS, Mei Z, Srinivasan SR, Berenson GS, Dietz WH. Cardiovascular risk factors and excess adiposity among overweight children and adolescents: The Bogalusa Heart Study. J Pediatr. 2007;150:12-17.e2.

[iv] Hannon TS, Rao G, Arslanian SA. Childhood obesity and type 2 diabetes mellitus. Pediatrics. 2005;116:473-480.

[v] Han JC, Lawlor DA, Kimm SY. Childhood obesity. Lancet. 2010;375:1737-1748.

[vi] Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH. Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med. 1997;37:869-873.

[vii] Serdula MK, Ivery D, Coates RJ, Freedman DS. Williamson DF, Byers T. Do obese children become obese adults? A review of the literature. Prev Med. 1993;22:167-177.

[viii] National Institutes of Health. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: the Evidence Report. Bethesda, MD: National Institutes of Health, U.S. Department of Health and Human Services; 1998.

[ix] New York State Department of Health, Child and Adult Care Food Program. Healthy Child Meal Pattern. March 2012. Available at: https://www.health.ny.gov/prevention/nutrition/cacfp/docs/cacfp-102.pdf. Accessed April 21, 2014.

[x] U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2010. 7th Edition, Washington, DC: U.S. Government Printing Office, December 2010.

[xi] Institute of Medicine (IOM). 2011. Early childhood obesity prevention policies. Washington, DC: The National Academies Press.

[xii] Gidding SS, et al; AHA; AAP. Dietary recommendations for children and adolescents: a guide for practitioners: consensus statement from the AHA. Circulation. 2005 Sep 27;112(13):2061-75.

[xiii] Committee on Nutrition. American Academy of Pediatrics: The use and misuse of fruit juice in pediatrics. Pediatrics. 2001 May;107(5):1210-3. Reaffirmed August 2013.

http://pediatrics.aappublications.org/content/107/5/1210.full

[xiv] U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2010. 7th Edition, Washington, DC: U.S. Government Printing Office, December 2010.

[xv] Wang YC, Bleich SN, Gortmaker SL. Increasing caloric contribution from sugar-sweetened beverages and 100% fruit juices among US children and adolescents, 1988-2004. Pediatrics 2008;121(6):e1604-e1614.

[xvi] Fulgoni VL, Quann EE. National trends in beverage consumption in children from birth to 5 years: analysis of NHANES across three decades. Nutr J 2012;11:92.

[xvii] Fox MK, Reidy K, Novak T, Ziegler P. Sources of energy and nutrients in the diets of infants. J Am Diet Assoc. 2006;106(1, suppl 1):S28-S42.

[xviii] Beverages Let’s Move Childcare. Available at: http://www.healthykidshealthyfuture.org/content/hkhf/home/nutrition/beve.... Accessed April 22, 2014.

[xix] Rideout V, Hamel E. The media family: electronic media in the lives of infants, toddlers, preschoolers and their parents. The Kaiser Family Foundation; May 2006.

[xx] Rideout V, Hamel E. The media family: electronic media in the lives of infants, toddlers, preschoolers and their parents. The Kaiser Family Foundation; May 2006.

[xxi] Common Sense Media. Zero to eight: children’s media use in America 2013. A Common Sense Media Research Study; Fall 2013.

[xxii] Christakis DA, Ebel BE, Rivara FP, Zimmerman FJ. Television, video, and computer game usage in children under 11 years of age. J Pediatr 2004;145(5):652-6.

[xxiii] American Academy of Pediatrics. Children, adolescents, and the media. Pediatrics 2013;132:958-961.

[xxiv] Christakis DA, Garrison MM, Zimmerman FJ. Television viewing in child care programs: a national survey. Communication Reports 2006;19(2):111-120.

[xxv] Christakis DA, Garrison MM. Preschool-aged children's television viewing in child care settings. Pediatrics 2009;124(6):1627-32.

[xxvi] Tandon PS, Zhou C, Lozano P, Christakis DA. Preschoolers' total daily screen time at home and by type of child care. J Pediatr 2011;158(2):297-300.

[xxvii] Christakis DA, Garrison MM, Zimmerman FJ. Television viewing in child care programs: a national survey. Communication Reports 2006;19(2):111-120.

[xxviii] Christakis DA, Garrison MM. Preschool-aged children's television viewing in child care settings. Pediatrics 2009;124(6):1627-32.

[xxix] Viner RM, Cole TJ. Television viewing in early childhood predicts adult body mass index. J Pediatr 2005;147(4):429-35.

[xxx] Reilly JJ, Armstrong J, Dorosty AR, et al. Early life risk factors for obesity in childhood: cohort study. BMJ 2005;330(7504):1357.

[xxxi] Proctor MH, Moore LL, Gao D, et al. Television viewing and change in body fat from preschool to early adolescence: The Framingham Children's Study. Int J Obes Relat Metab Disord 2003;27(7):827-33.

[xxxii] Danner FW. A national longitudinal study of the association between hours of TV viewing and the trajectory of BMI growth among US children. J Pediatr Psychol 2008;33(10):1100-7.

[xxxiii] Pagani LS, Fitzpatrick C, Barnett TA, Dubow E. Prospective associations between early childhood television exposure and academic, psychosocial, and physical well-being by middle childhood. Arch Pediatr Adolesc Med 2010;164(5):425-31.

[xxxiv] Landhuis C, Poulton R, Welch D, Hancox RJ. Programming obesity and poor fitness: the long-term impact of childhood television. Obesity 2008;16(6):1457-9.

[xxxv] Viner RM, Cole TJ. Television viewing in early childhood predicts adult body mass index. J Pediatr 2005;147(4):429-35.

[xxxvi] Hancox RJ, Milne BJ, Poulton R. Association between child and adolescent television viewing and adult health: a longitudinal birth cohort study. Lancet 2004;364:257-261

[xxxvii] American Academy of Pediatrics, American Public Health Association, National Resource Center for Health and Safety in Child Care and Early Education. 2011. Caring for our children: National health and safety performance standards; Guidelines for early care and education programs, 3rd edition. Elk Grove Village, IL: American Academy of Pediatrics; Washington, DC: American Public Health Association.

[xxxviii] Screen Time. Let’s Move Child Care. Available at: http://www.healthykidshealthyfuture.org/home/activities/screentimes.html. Accessed March 21, 2014

[xxxix] U.S. Department of Agriculture and U.S. Department of Health and Human Services. Nutrition and Wellness Tips for Young Children: Provider Handbook for the Child and Adult Care Food Program. Alexandria, VA: 2012.

[xl] Institute of Medicine (IOM). 2011. Early childhood obesity prevention policies. Washington, DC: The National Academies Press.

[xli] Pate RR, McIver K, Dowda M, Brown WH, Addy C. Directly observed physical activity levels in preschool children. J Sch Health 2008;78(8):438-44.

[xlii] Bower JK, Hales DP, Tate DF, Rubin DA, Benjamin SE, Ward DS. The childcare environment and children's physical activity. Am J Prev Med 2008;34(1):23-9.

[xliii] Pate RR, Pfeiffer KA, Trost SG, Ziegler P, Dowda M. Physical activity among children attending preschools. Pediatrics 2004;114(5):1258-63.

[xliv] Proctor MH, Moore LL, Gao D, et al. Television viewing and change in body fat from preschool to early adolescence: The Framingham Children's Study. Int J Obes Relat Metab Disord. 2003;27(7):827-33.

[xlv] Janz KF, Burns TL, Levy SM. Tracking of activity and sedentary behaviors in childhood: the Iowa Bone Development Study. Am J Prev Med 2005;29(3):171-8.

 

Subject: 

Proposed resolution to amend Child Care Services of the New York City Health Code (Article 47) in order to improve supervision of children in these services.

Location: 
New York City Department of Health and Mental Hygiene, Gotham Center
42-09 28th Street, Room 8-25
Queens, NY 11101-4132
Contact: 

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

Download Copy of Proposed Rule (.pdf): 

Adopted Rules: Closed to Comments

Adopted Rules Content: 

 

Statement of Basis and Purpose

 

 

Statutory Authority

 

These amendments to the New York City Health Code (the Health Code) are promulgated pursuant to §§558 and 1043 of the New York City Charter (the Charter).  Sections 558(b) and (c) of the Charter empower the Board of Health (the Board) to amend the Health Code and to include in the Health Code all matters to which the authority of the New York City Department of Health and Mental Hygiene (the Department) extends. Section 1043 grants the Department rule-making authority. 

 

Background

 

In 1971, the Board of Health amended New York City Health Code Section 207.05 of Article 207 to allow the Department to file a new birth certificate for a person who had legally changed his or her name and who had undergone “convertive” surgery.  The Department has interpreted the requirement for convertive surgery in paragraph (a)(5) of Section 207.05 to mean genital surgery.  As a result, the Department has required transgender applicants who desire a new birth certificate with corrected gender to submit a surgical operative record including the date of the operation; a post-operative examination report signed by a physician attesting to the applicant’s surgical change of sex; and a post-operative psychiatric evaluation signed by a psychiatrist or clinical psychologist.  Until December 2006, the Department issued new birth certificates listing the applicant’s new name, but omitting reference to any gender, to anyone who submitted acceptable documentation.  Since December 2006, when the Board of Health approved a change to the birth certificate form, the Department has provided new birth certificates that list not only an applicant’s new name but also the corrected sex designation.  Applicants are still required, however, to obtain a court ordered name change and undergo convertive surgery. 

 

This amendment eliminates the requirement that an individual must obtain a court ordered name change and undergo convertive surgery.

 

Other jurisdictions similarly have amended their laws to allow transgender people to obtain new birth certificates with corrected sex on birth certificates without having to undergo surgery.[1]  In May 2014, New York State Department of Health changed its procedures for correcting gender on birth certificates in the rest of the state (outside of New York City).  For people born in New York outside of New York City, the State Department of Health will now issue a new certificate to an applicant who submits a notarized affidavit from a physician, nurse practitioner or physician assistant licensed in the United States that either states that the applicant has undergone appropriate clinical treatment for a person diagnosed with gender dysphoria or transsexualism, or confirms that surgical procedures have been performed on the applicant to complete sex reassignment.

 

At the federal level, the U.S. Department of State in June 2010 announced a change in policy allowing the gender designation on passports to be changed for applicants producing certifications from attending internists, endocrinologists, gynecologists, urologists or psychiatrists stating that the provider has a doctor/patient relationship with the applicant and that the applicant has undergone appropriate clinical treatment for gender transition.  Likewise, as of September 2013, the Social Security Administration no longer requires proof of surgery in order to change the gender on Social Security (SSN) records.  The Social Security Administration now authorizes medical certifications of appropriate clinical treatment for gender transition from a licensed physician or doctor of osteopathy.

 

This trend reflects an understanding of the diverse expression of transgender identity, and that not all transgendered persons want surgery in order to express their gender identity.[2]  Indeed, in June 2014 the American Medical Association expressed its support for eliminating any requirement that an individual undergo surgery in order to change the sex indicated on a birth certificate.

 

The Board is amending Section 207.05 to authorize the Department to issue an applicant a new birth certificate with a changed gender marker without requiring such applicant to have undergone convertive surgery.  An affirmation from a physician licensed to practice in the United States, or an affidavit from a doctoral-level psychologist, master social worker, clinical social worker, physician assistant, nurse practitioner, marriage and family therapist, mental health counselor, or midwife, licensed to practice in the United States, is required in order to ensure the integrity of birth records when gender has been amended.  The Department recognizes it is critically important for individuals to have birth records that accurately reflect their gender for many purposes including obtaining access appropriate to care and facilities.  The rationale is as follows:  (1) birth certificates are foundational documents upon which all other official documents are based, including United States passports, driver licenses, and Social Security cards, are proof of United States citizenship, and should only be amended upon presentation and acceptance of the required documentation; (2) physicians and doctoral-level psychologists, along with master social workers, clinical social workers, physician assistants, nurse practitioners, marriage and family therapists, mental health counselors, and midwives are licensed by issuing authorities in the United States, their credentials can be evaluated and validated, and they can be subject to professional sanctions, penalties and prosecution for providing false information; and (3) New York City, as an independent vital records jurisdiction, along with New York State and the other 55 vital records jurisdictions, works in close partnership with the federal government, and federal government agencies must rely on the integrity of birth records to accurately represent the facts of birth. Without birth record integrity, passports, driver licenses and other core identity documents would be questionable.  The integrity of the birth records will be maintained with this change while making it easier for transgender individuals to obtain birth records that accurately reflect their gender. 

 

Section 207.05 is also being amended to eliminate the requirement that applicants for new birth certificates with corrected gender also change their names.  The Department recognizes that some applicants may want to change their name on their birth certificate, and such applicants would still need to show that the new name was legally changed by a court order.  Some people transitioning from one gender to another, however, may want to continue using the same name.  These applicants should not be required to go to court and legally change their names in order to obtain new birth certificates.

 

Finally, the Board is amending Section 207.13 regarding fees to simply reflect the removal of the “convertive surgery” requirement and replace it with the language consistent with the changes to Section 207.05. 

 




[1] See, e.g., California (Cal. Health & Safety §103425), Iowa (Iowa Code §144.23(3)), and Vermont (Vt. Stat. §5112).

[2] See World Professional Association for Transgender Health (WPATH), “Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People”, 7th Version (2012) at www.wpath.org.

 

 

Effective Date: 
Mon, 01/12/2015

Adopted Rules: Closed to Comments

Adopted Rules Content: 

 

 

Statement of Basis and Purpose

 

These amendments to the New York City Health Code (the Health Code) are promulgated pursuant to sections 556, 558, and 1043 of the New York City Charter (the Charter).  Section 556 of the Charter grants the Department jurisdiction to supervise and control the registration of deaths.  Sections 558(b) and 558(c) of the Charter empower the Board of Health (the Board) to amend the Health Code and to include in the Health Code all matters to which the authority of the New York City Department of Health and Mental Hygiene (the Department) extends. Section 558(c) of the Charter also empowers the Board of Health to provide for the examination and issuance of death certificates.  Section 1043 grants the Department rule-making authority.        

 

The amendments to sections 205.7, 207.11, and 207.13 of Articles 205 and 207 of the Health Code are intended to: (1) expand access to confidential medical reports of death for deaths that occurred prior to January 1, 2010; (2) clarify who may obtain a copy of a death certificate; and (3) expand access to fact-of-death information for specified benefit-paying parties, licensed doctors and attorneys, upon payment of a fee. 

 

The amendments amend Health Code section 205.07(a) to add siblings, grandparents, and grandchildren to the list of people who may access confidential medical reports of death.  Currently, section 205.07(a) allows the Department to release confidential medical reports of death for deaths occurring on or after January 1, 2010.  Because there is no reason to treat reports of deaths occurring earlier differently, the amendments also delete the reference to that date and would allow the Department to release any available confidential medical report of death to an entitled person.

 

Health Code section 207.11 currently allows “persons or their representatives, who are agents of, or who otherwise have a legal or fiduciary obligation to such persons, as a relative, person in control of disposition, heir or beneficiary…” to inspect death records.  The current language has led to confusion about who is entitled to a decedent’s death record.  The amendments to section 207.11 clarify the classes of people entitled to inspect a confidential medical report of death, and align that list with the amendments to section 205.07.

 

Finally, Health Code section 207.13(e) allows the Department to issue verifications of information contained in death certificates and other vital statistics certificates to other governmental agencies upon request.  The amendments to that section will expand access to benefit-paying parties such as annuity companies and pension plans to terminate benefits upon death of a recipient, physicians and hospitals who demonstrate that such information is needed to determine whether a patient they are treating has died, and licensed attorneys who demonstrate that the information is necessary to administer an estate.  Additionally, because the Department anticipates providing verifications through an electronic system maintained by The National Association for Public Health Statistics and Information Systems, language has been added authorizing the Department to enact rules describing how the verifications will be provided.    

 

 

 

Effective Date: 
Mon, 01/12/2015

Proposed Rules: Closed to Comments (View Public Comments Received:7)

Agency:
Comment By: 
Monday, November 17, 2014
Proposed Rules Content: 

 

 

 

Statement of Basis and Purpose

 

In 1971, the Board of Health amended New York City Health Code Section 207.05 to allow the Department to file a new birth certificate for a person who had legally changed his or her name and who had undergone “convertive” surgery.  The Department has interpreted the requirement for convertive surgery in subsection (a)(5) of Section 207.05 to mean genital surgery.  As a result, the Department has required transgender applicants who desire a new birth certificate with corrected gender to submit a surgical operative record including the date of the operation; a post-operative examination report signed by a physician attesting to the applicant’s surgical change of sex; and a post-operative psychiatric evaluation signed by a psychiatrist or clinical psychologist.  Until December 2006, the Department issued new birth certificates listing the applicant’s new name, but omitting reference to any gender, to anyone who submitted acceptable documentation.  After December 2006, when the Board of Health approved a change to the birth certificate form, the Department has provided new birth certificates that list not only an applicant’s new name but also the corrected sex designation.  Applicants are still required, however, to obtain a court ordered name change and undergo convertive surgery.  This rule proposes to eliminate the requirement that an individual must obtain a court ordered name change and undergo convertive surgery.

 

Other jurisdictions similarly have amended their laws to allow transgender people to obtain new birth certificates with corrected sex on birth certificates without having to undergo surgery.[1]  In May 2014, New York State Department of Health changed its procedures for correcting gender on birth certificates in the rest of the state (outside of New York City).  For people born in New York outside of New York City, the State Department of Health will now issue a new certificate to an applicant who submits a notarized affidavit from a physician, nurse practitioner or physician assistant licensed in the United States that either states that the applicant has undergone appropriate clinical treatment for a person diagnosed with gender dysphoria or transsexualism, or confirms that surgical procedures have been performed on the applicant to complete sex reassignment.

 

At the federal level, the U.S. Department of State in June 2010 announced a change in policy allowing the gender designation on passports to be changed for applicants producing certifications from attending internists, endocrinologists, gynecologists, urologists or psychiatrists stating that the provider has a doctor/patient relationship with the applicant and that the applicant has undergone appropriate clinical treatment for gender transition.  Likewise, as of September 2013, the Social Security Administration no longer requires proof of surgery in order to change the gender on Social Security (SSN) records.  The Social Security Administration now authorizes medical certifications of appropriate clinical treatment for gender transition from a licensed physician or doctor of osteopathy.

 

This trend reflects an understanding of the diverse expression of transgender identity, and that not all transgendered persons want surgery in order to express their gender identity.[2]  Indeed, in June 2014 the American Medical Association expressed its support for eliminating any requirement that an individual undergo surgery in order to change the sex indicated on a birth certificate.

 

The Department proposes that the Board of Health amend Section 207.05 to authorize the Department to issue an applicant a new birth certificate with a changed gender marker without requiring such applicant to have undergone convertive surgery.  The Department proposes to require 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, in order to ensure the integrity of birth records when gender has been amended.  The Department recognizes it is critically important for individuals to have birth records that accurately reflect their gender for many purposes including obtaining access appropriate to care and facilities.  The rationale is as follows:  (1) birth certificates are foundational documents upon which all other official documents are based, including United States passports, driver licenses, and Social Security cards, are proof of United States citizenship, and should only be amended upon presentation and acceptance of the required documentation; (2) physicians and doctoral-level psychologists, along with clinical social workers, physician assistants, nurse practitioners, marriage and family therapists, mental health counselors, and midwives are licensed by issuing authorities in the United States, their credentials can be evaluated and validated, and they can be subject to professional sanctions, penalties and prosecution for providing false information; and (3) New York City, as an independent vital records jurisdiction, along with New York State and the other 55 vital records jurisdictions, works in close partnership with the federal government, and federal government agencies must rely on the integrity of birth records to accurately represent the facts of birth. Without birth record integrity, passports, driver licenses and other core identity documents would be questionable.  The integrity of the birth records will be maintained with this change while making it easier for transgender individuals to obtain birth records that accurately reflect their gender.  

 

The Department is also proposing that the Board of Health amend Section 207.05 to eliminate the requirement that applicants for new birth certificates with corrected gender also change their names.  The Department recognizes that some applicants may want to change their name on their birth certificate, and such applicants would still need to show that the new name was legally changed by a court order.  Some people transitioning from one gender to another, however, may want to continue using the same name.  These applicants should not be required to go to court and legally change their names in order to obtain new birth certificates.

 

Finally, the Department is requesting that the Board of Health amend Section 207.13 regarding fees to simply reflect the proposed removal of the “convertive surgery” requirement and replace it with the language consistent with the proposed changes to Section 207.05. 

 

The proposal 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.

 

 




[1] See, e.g., California (Cal. Health & Safety §103425), Iowa (Iowa Code §144.23(3)), and Vermont (Vt. Stat. §5112).

[2] See World Professional Association for Transgender Health (WPATH), “Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People”, 7th Version (2012) at www.wpath.org.

Subject: 

Proposed resolution to amend Article 207, section 207.05 of the New York City Health Code to remove convertive surgery requirement for transgender birth certificate applicants.

Location: 
New York City Department of Health and Mental Hygiene, Gotham Center
42-09 28th Street, 3rd Floor, Room 3-32
Queens, NY 11101-4132
Contact: 

Svetlana Burdeynik at (347) 396-6078 or resolutioncomments@health.nyc.gov
New York City Department of Health and Mental Hygiene
Gotham Center, 42-09 28th Street, CN 31
Long Island City, NY 11101-4132

Download Copy of Proposed Rule (.pdf): 

Proposed Rules: Closed to Comments

Agency:
Comment By: 
Friday, November 14, 2014
Proposed Rules Content: 

 

 

Statement of Basis and Purpose

 

These amendments to the New York City Health Code (the Health Code) are promulgated pursuant to sections 556, 558, and 1043 of the New York City Charter (the Charter).  Section 556 of the Charter grants the Department jurisdiction to supervise and control the registration of deaths.  Sections 558(b) and 558(c) of the Charter empower the Board of Health (the Board) to amend the Health Code and to include in the Health Code all matters to which the authority of the New York City Department of Health and Mental Hygiene (the Department) extends. Section 558(c) of the Charter also empowers the Board of Health to provide for the examination and issuance of death certificates.  Section 1043 grants the Department rule-making authority.        

 

The proposed amendments to sections 205.7, 207.11, and 207.13 of Articles 205 and 207 of the Health Code are intended to: (1) expand access to confidential medical reports of death for deaths that occurred prior to January 1, 2010; (2) clarify who may obtain a copy of a death certificate; and (3) and expand access to fact-of-death information for specified benefit-paying parties, licensed doctors and attorneys, upon payment of a fee. 

 

The proposed amendments amend Health Code section 205.07(a) to add siblings, grandparents, and grandchildren to the list of people who may access confidential medical reports of death.  Currently, section 205.07(a) allows the Department to release confidential medical reports of death for deaths occurring on or after January 1, 2010.  Because there is no reason to treat reports of deaths occurring earlier differently, the proposed amendments also delete the reference to that date and would allow the Department to release any available confidential medical report of death to an entitled person.

 

 

Health Code section 207.11 currently allows “persons or their representatives, who are agents of, or who otherwise have a legal or fiduciary obligation to such persons, as a relative, person in control of disposition, heir or beneficiary…” to inspect death records.  The current language has led to confusion about who is entitled to a decedent’s death record.  Therefore, the Department proposes to clarify the classes of people entitled to inspect a confidential medical report of death, and align that list with the proposed amendments to section 205.07.

 

Finally, Health Code section 207.13(e) allows the Department to issue verifications of information contained in death certificates and other vital statistics certificates to other governmental agencies upon request.  The proposed amendments will expand access to benefit-paying parties such as annuity companies and pension plans to terminate benefits upon death of a recipient, physicians who demonstrate that such information is needed to determine whether a patient he or she is treating has died, and licensed attorneys who demonstrate that the information is necessary to administer an estate.  

 

The resolution 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: 

Proposed resolution to amend Articles 205 and 207 of the New York City Health Code regarding records of death information.

Location: 
New York City Department of Health and Mental Hygiene, Gotham Center
42-09 28th Street 14th Floor, Room 14-43
Queens, NY 11101-4132
Contact: 

Svetlana Burdeynik at (347) 396-6078 or resolutioncomments@health.nyc.gov
New York City Department of Health and Mental Hygiene
Gotham Center, 42-09 28th Street, CN 31
Long Island City, NY 11101-4132

Download Copy of Proposed Rule (.pdf): 

Proposed Rules: Closed to Comments

Agency:
Comment By: 
Monday, September 15, 2014
Proposed Rules Content: 

 

 

 

Statement of Basis and Purpose

 

 

On December 30, 2013, Local Law 152 was enacted.  It amended sections 17-502, 17-503, 17-504, 17-505, 17-506, 17-507, 17-508, 17-510, 17-512 and 17-513.2 of Chapter 5 of Title 17 of the New York City Administrative Code (Smoke-Free Air Act).  It also added sections 17-513.3 (Retail Tobacco Store and Retail Electronic Cigarette Store Registration), and 17-513.4 (Retail Tobacco Store and Retail Electronic Cigarette Store Verification) to Chapter 5. These changes to the Smoke-Free Air Act took effect on April 29, 2014.  The local law prohibits the use of electronic cigarettes in all locations where smoking is currently prohibited and requires establishments to post signage informing customers of these new restrictions.  Local Law 152 also requires both retail tobacco stores and retail electronic cigarette stores to register with the Department of Health and Mental Hygiene (“DOHMH”), and grants the Department authority to establish a system for verifying the total annual gross sales of retail tobacco stores and retail electronic cigarette stores to determine their eligibility for certain smoking and electronic cigarette use exemptions.

 

The Department is proposing to amend Chapter 10 of Title 24 of the Rules of the City of New York (RCNY) to reflect the amendments to the Smoke-Free Air Act in Local Law 152, and repeal provisions of Chapter 10 that are no longer applicable due to these amendments to the Smoke-Free Air Act.  The amendments proposed here will also clarify certain provisions in Chapter 10 to facilitate compliance with, and enforcement of, the Smoke-Free Air Act.  These proposed amendments, together with the provisions of Chapter 5 of Title 17 of the Administrative Code, affect the use of electronic cigarettes in enclosed areas in public places and in places of employment in New York City.

 

The proposed amendments:

·          Specify the locations where electronic cigarette use is prohibited;

·          Specify the content of the  signage required in locations where electronic cigarette use is prohibited;

·          Describe the registration requirements for retail tobacco stores and retail electronic cigarette stores; and

·          Repeal obsolete provisions of the Department’s Rules related to separate smoking rooms in bars and owner operated bars that have been repealed in the Smoke-Free Air Act.

 

DOHMH’s authority to promulgate these rules is found in section 1043 of the New York City Charter and sections 17-503, 17-504, 17-505, 17-506(a), 17-513, 17-513.3 and 17-513.4 of the New York City Administrative Code.

 

 

 

Subject: 

Proposed resolution to amend Chapter 10 (Smoking Under the New York City Clean Indoor Air Act) of Title 24 of the Rules of the City of New York to: (1) reflect amendments to the Smoke-Free Air Act made by Local Law 152 of 2013 prohibiting the use of electronic cigarettes in certain places; (2) facilitate enforcement of the Smoke-Free Air Act; and (3) repeal provisions that are out of date.

Location: 
New York City Department of Health and Mental Hygiene, Gotham Center
42-09 28th Street 14th Floor, Room 14-43
Queens, NY 11101-4132
Contact: 
Download Copy of Proposed Rule (.pdf): 

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