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Adopted Rules: Closed to Comments

Adopted Rules Content: 
 
 

Statement of Basis and Purpose of Rule

 

The Board of Health is amending Article 48 of the New York City Health Code, which governs summer camps operating in New York City (“NYC”) for children under age 16.  Article 48 provides standards of service and operational requirements designed to protect the health and well-being of children while camping and has not been significantly updated since its repeal and reenactment in 1982.  In 2016, the New York State (“NYS”) Department of Health substantially updated its regulations relating to children’s camps contained in the NYS Sanitary Code (“Sanitary Code”), located in 10 NYCRR Part 7, Subpart 7-2, particularly as to camps that serve children with developmental disabilities.

 

The Board adopts these changes primarily to be consistent with NYS Department of Health regulations adopted in 2016 relating to children’s camps contained in the NYS Sanitary Code (“Sanitary Code”), located in 10 NYCRR Part 7, Subpart 7-2, particularly as to its updated requirements for camps serving children with disabilities. Sanitary Code protections for developmentally disabled children that are being adopted in these rules provide that:

  • Staff that have direct care responsibilities of campers with disabilities must receive training relevant to the specific needs of the campers in their charge;
  • Camps must obtain and implement, as appropriate, care and treatment plans for campers with disabilities that have such plans as well as obtain other available information relevant to the care and specific needs of a camper with disabilities including pre-existing medical conditions, allergies, modified diets, and activity restrictions;
  • During swimming activities, camps must provide one counselor for each camper who is non-ambulatory or has a disability that may result in an increased risk for an emergency in the water;
  • Camps must obtain parent/guardian’s written permission to allow campers with developmentally disabilities to participate in swimming activities;
  • Camps must develop procedures and training for handling seizures or aspiration of water by campers with developmental disabilities that may occur during swimming activities;
  • All lavatories and showers used by campers with physical disabilities must be equipped with specialized features and grab bars;
  • Lavatories and showers used by campers with a disability, who are unable to moderate water temperature safely, shall have a water temperature not greater than 110 degrees Fahrenheit;
  • Buildings housing non-ambulatory campers shall have ramps to facilitate access.
  • Non-ambulatory campers may not have housing above ground level; and
  • Exterior paths must be constructed and maintained, as appropriate for the camp population served, to provide for safe travel during inclement weather.

Specifically, these Article 48 amendments include, among other things:

  • a revised and expanded definitions section (§48.03)
  • revised record keeping and due process requirements (§§48.07, 48.09)
  • updated staffing, screening, training and ratio requirements (§§48.09, 48.11 and 48.12)
  • elimination of religious exemptions from child vaccination requirements (§48.17)
  • updated developmental disability camp requirements, including for incident reporting, investigation and enforcement (§48.25).

 

Legal Authority

These amendments to the Health Code are adopted pursuant to §§ 558 and 1043 of the NYC Charter.  Sections 558 (b) and (c) of the Charter empower the Board to amend the Health Code and to include in the Health Code all matters to which the authority of the Department extends.  § 1043 grants the Department rule-making authority. 

“Shall” and “must” denote mandatory requirements and may be used interchangeably in the text below, unless otherwise specified or unless the context clearly indicates otherwise.

 
Effective Date: 
Mon, 01/27/2020

Adopted Rules: Closed to Comments

Adopted Rules Content: 
 
 

Statement of Basis and Purpose

 

The New York City Board of Health is amending Article 47 of the New York City Health Code .  These amendments align the Health Code with recent legislative changes to the New York State (“NYS”) Public Health Law and the New York City (“NYC”) Administrative Code.  On June 13, 2019, NYS Public Health Law § 2164 was amended to remove the exemption from childhood immunization requirements due to religious beliefs.  Article 47 (§ 47.25) of the Health Code is being amended to incorporate this change.  On March 13, 2019, the NYC Council passed multiple amendments to the NYC Administrative Code, which among other things, updated the requirements for conducting an annual survey for lead-based paint hazards for all day care services (See Local Laws 64, 66, 67 and 71 of 2019).  As per Local Law 64 of 2019, “day care service” means “a program or service regulated by articles 43 and 47 of the New York city health code.”  Accordingly, Article 47 (§47.63) of the Health Code is being amended to incorporate these updated annual survey requirements. Changes to the Health Code are also being made in response to other recent state legislation prohibiting use of crib bumper pads and to require anchors for furniture that could topple over.  Other Health Code amendments have been made to provide greater clarity and to remove text which was inadvertently included in prior amendments. 

 

Legal Authority

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

 
 
Effective Date: 
Mon, 01/27/2020

Adopted Rules: Closed to Comments

Adopted Rules Content: 
 
 

Statement of Basis and Purpose

 

The Board of Health (“Board”) is adopting certain child health and safety amendments to Article 43 of the New York City Health Code (“Health Code”).  Article 43 provides health and safety requirements for children ages 3 to 5 attending a kindergarten or pre-K program located within a school or that is part of a school. Article 43 requirements are intended to supplement regulations in the Health Code that currently apply to all schools. 

Historically, Article 43 programs were previously regulated under Health Code Article 47 (“Child Care Programs and Family Shelter-Based Drop-Off Child Supervision Programs”) except that they were not required to obtain a permit. However, many of the provisions in Article 43 have not been updated since 2008, whereas Article 47 is and has been far more frequently updated.  These amendments align Article 43 with some of the more current child health and safety requirements provided in Article 47 and supported by the larger childcare sector.

 

These amendments make changes to conform the Health Code with recent changes in state and local law, including updated immunization and lead-based paint hazards requirements.  On June 13, 2019, NYS Public Health Law § 2164 was amended to remove the religious exemption from childhood immunization requirements.  Article 43 (§43.17) of the Health Code is now amended to incorporate this state legislative change.  On March 13, 2019, the NYC Council passed multiple amendments to the NYC Administrative Code concerning child care programs, which among other things, updated the requirements for conducting an annual survey for lead-based paint hazards for all day care services (See, for example, Local Laws 64, 66, 67 and 71 of 2019).  As per Local Law 64 of 2019, “day care service” means “a program or service regulated by articles 43 and 47 of the New York city health code.”  Accordingly, Article 43 (§43.23) of the Health Code is now amended to incorporate these updated annual survey requirements.

Legal Authority

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

 

Effective Date: 
Mon, 01/27/2020

Proposed Rules: Closed to Comments

Agency:
Comment By: 
Friday, November 15, 2019
Proposed Rules Content: 
 
 

Statement of Basis and Purpose

Article 49 of the New York City Health Code governs health and safety requirements for schools. The Department of Health and Mental Hygiene (DOHMH) proposes that the Board of Health amend Article 49 Section 49.05 to establish child immunization requirements that conform with § 2164 of the New York State Public Health Law. DOHMH further proposes amending Article 49 Section 49.07 to require each school to have a medical room so that health professionals may properly perform their duties.  Finally, the Department proposes that Article 49 Section 49.01 be amended to confirm that the proposed changes concerning child immunization also apply to public and private high schools.

Legal Authority

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

This proposal was not included in the Department’s Fiscal Year 2020 regulatory agenda as its need was not required at the time of publication.

 
 
Subject: 

Proposed resolution to amend Article 49 (Schools) of the New York City Health Code.

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

Download Copy of Proposed Rule (.pdf): 

Proposed Rules: Closed to Comments

Agency:
Comment By: 
Friday, November 15, 2019
Proposed Rules Content: 
 
 

Statement of Basis and Purpose of Proposed Rule

 

The New York City Department of Health and Mental Hygiene (“Department”) is proposing that the Board of Health (“Board”) amend Article 48 of the New York City Health Code (“Health Code”), which governs summer camps operating in New York City (“NYC”) for children under age 16.

The Department proposes these changes primarily to be consistent with applicable New York State (“NYS”) Department of Health regulations relating to children’s camps contained in the NYS Sanitary Code (“Sanitary Code”), located in 10 NYCRR Part 7, Subpart 7-2.  

Specifically, the proposed rules include, among other things:

  • a revised and expanded definitions section (§48.03)
  • revised record keeping and due process requirements (§§48.07, 48.09)
  • updated staffing, screening, training and ratio requirements (§§48.09, 48.11 and 48.12)
  • elimination of religious exemptions from child vaccination requirements (§48.17)
  • updated developmental disability camp requirements, including for incident reporting, investigation and enforcement (§48.25).

Legal Authority

These amendments to the Health Code are proposed pursuant to §§ 558 and 1043 of the NYC Charter.  Sections 558 (b) and (c) of the Charter empower the Board to amend the Health Code and to include in the Health Code all matters to which the authority of the Department extends.  §1043 grants the Department rule-making authority. 

This proposal was included in the Department’s FY2020 regulatory agenda.

 
Subject: 

Proposed resolution to amend Article 48 (Summer Camps) of the New York City Health Code.

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

Download Copy of Proposed Rule (.pdf): 

Proposed Rules: Closed to Comments

Agency:
Comment By: 
Friday, November 15, 2019
Proposed Rules Content: 
 
 

Statement of Basis and Purpose

 

The New York City Department of Health and Mental Hygiene (“Department”) is proposing that the New York City Board of Health (“Board”) amend Article 47 of the New York City Health Code (“Health Code”).  The proposed amendments would align the Health Code with recent legislative changes to the New York State Public Health Law and New York City Administrative Code.  On June 13, 2019, NYS Public Health Law § 2164 was amended to remove the exemption from childhood immunization requirements due to religious beliefs.  Article 47 (§ 47.25) of the Health Code is being amended to incorporate this change.  On March 13, 2019, the NYC Council passed multiple amendments to the NYC Administrative Code, which among other things, updated the requirements for conducting an annual survey for lead-based paint hazards for all day care services (See Local Laws 64, 66, 67 and 71 of 2019).  As per Local Law 64 of 2019, “day care service” means “a program or service regulated by articles 43 and 47 of the New York city health code.”  Accordingly, Article 47 (§47.63) of the Health Code is being amended to incorporate these updated annual survey requirements. Changes to the Health Code are also being proposed in response to other recent local legislation prohibiting use of crib bumper pads and to require anchors for furniture that could topple over.  Other changes are being proposed, for example, for child-to-staff ratios to be consistent with those in the federal Head Start program, as well as to provide greater clarity and to remove text which was inadvertently included in prior amendments. 

 

Legal Authority

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

 
 
Subject: 

Proposed resolution to amend Article 47 (Child Care Programs and Family Shelter-Based Drop-off Child Supervision Programs) of the New York City Health Code.

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

Download Copy of Proposed Rule (.pdf): 

Proposed Rules: Closed to Comments

Agency:
Comment By: 
Friday, November 15, 2019
Proposed Rules Content: 
 
 

Statement of Basis and Purpose

 

The New York City Department of Health and Mental Hygiene (“Department”) is proposing that the Board of Health (“Board”) amend Article 43 of the New York City Health Code (“Health Code”).  Article 43 provides health and safety requirements for children ages 3 to 5 attending a kindergarten or pre-K program located within a school or that is part of a school.  These programs were previously regulated under Article 47 (“Child Care Programs and Family Shelter-Based Drop-Off Child Supervision Programs”) of the Health Code, and were, with certain exceptions, required to hold permits as day care services.  Article 43 is intended to supplement regulations in the Health Code that currently apply to all schools.  Many of the provisions in Article 43 have not been updated since 2008, whereas Article 47 is and has been far more frequently updated.  The proposed amendments would align Article 43 with the more current child health and safety requirements provided in Article 47.

 

The proposed amendments would also make changes to conform existing rules with recent legislative changes in state and local law, including updated immunization and lead-based paint hazards requirements.  On June 13, 2019, NYS Public Health Law § 2164 was amended to remove the exemption from childhood immunization requirements due to religious beliefs.  Article 43 (§43.17) of the Health Code is being amended to incorporate this state legislative change.  On March 13, 2019, the NYC Council passed multiple amendments to the NYC Administrative Code, which among other things, updated the requirements for conducting an annual survey for lead-based paint hazards for all day care services (See, for example, Local Laws 64, 66, 67 and 71 of 2019).  As per Local Law 64 of 2019, “day care service” means “a program or service regulated by articles 43 and 47 of the New York city health code.”  Accordingly, Article 43 (§43.23) of the Health Code is being amended to incorporate these updated annual survey requirements.

 

Legal Authority

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

 

“Shall” and “must” denote mandatory requirements and may be used interchangeably in the text below, unless otherwise specified or unless the context clearly indicates otherwise.

 

 
Subject: 

Proposed resolution to amend Article 43 (School Based Programs for Children Ages 3-5) of the New York City Health Code.

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 at (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

In 2018, Chapter 7 of 24 RCNY was repealed and restated to, among other things, provide a list of monetary penalties associated with violations of the New York City Health Code (“Health Code”) and other applicable law or regulations enforced by the Department.

This rule change amends the penalty associated with failure to remove canine waste by aligning it with the maximum penalty prescribed in state law.  With certain exceptions, New York State Public Health Law §1310 (“PHL §1310”) requires the dog owner or person having possession, control or custody of a dog to remove any feces left by such dog from any public area.  PHL § 1310 provides that a violation of that duty is punishable by a fine of not more than $250.  Currently, Appendix 7-A of Chapter 7 of 24 RCNY sets the initial penalty for failure to remove canine waste at $100 with a default penalty of $200. The Department now amends the penalty for both an initial and default violation to match the $250 penalty provided in PHL §1310.

 

Statutory Authority

This rule amendment is authorized by PHL § 1310; Charter §§ 555(b)(2), 556, 558(b) and (e) and 1043 and § 3.11 of the Health Code.

  • PHL § 1310 provides that a failure to remove canine waste from a public area is punishable by a fine not exceeding $250.
  • Charter § 555(b)(2) authorizes the Commissioner of Health and Mental Hygiene to assess penalties for health-related regulations.
  • Charter § 556 authorizes the Department to regulate all matters affecting health in the City of New York. 
  • Charter § 558 authorizes the Board of Health to set civil penalties for the enforcement of the Health Code.
  • Charter § 1043 gives the Department rulemaking powers.
  • Health Code § 3.11 provides the penalty range for violations of the Health Code or other applicable law or regulation enforced by the Department.
 
 
Effective Date: 
Mon, 11/18/2019

Adopted Rules: Closed to Comments

Adopted Rules Content: 
 

                                                                       Statement of Basis and Purpose    

 

Statutory Authority

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

Background       

The Department is responsible under the Charter for supervising matters affecting the health of New Yorkers.  Through its Division of Disease Control, the Department conducts disease surveillance and control activities for most of the diseases listed in Article 11 (Reportable Diseases and Conditions) of the Health Code.  The same Division also enforces Article 13 (Clinical Laboratories) of the Health Code, which regulates the performance of laboratory tests 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 (NYCRR), with respect to the control of communicable diseases.

To conduct more effective, timely, and complete disease surveillance and control, the Department proposed to the Board and the Board is amending Health Code Articles 11 and 13 as follows:

Tuberculosis Infection Reporting

The Board is amending Health Code Sections 11.03(a) and 13.03(b)(1) to require laboratories to report all test results for tuberculosis (TB) infection, including negative results. Prior to the adoption of these amendments, the Health Code required reporting only of test results and other information attendant to active TB disease, and tests positive for TB infection and related information for children under five years old.

TB is a disease caused by the bacterium Mycobacterium tuberculosis, which is spread person-to-person through the air. Most commonly, TB disease affects the lungs, but it can also affect other parts of the body. Individuals who have a positive test for TB infection but do not have symptoms or other test results consistent with active TB disease are diagnosed with latent TB infection (LTBI). Persons with LTBI are asymptomatic and cannot transmit the infection to others. It is estimated that approximately 10 percent of individuals with LTBI will develop active TB disease at some point in their life. Treating LTBI is the only way to significantly reduce the risk of developing active disease and thus is a vital component of TB prevention efforts.

There is no reliable data on the prevalence of LTBI in the United States or New York City. National estimates from the National Health and Nutrition Examination Survey study, when combined with New York City population data, result in an estimate of approximately 700,000 people with LTBI in the City. However, data from the Department’s TB clinics suggests there could be as many as 1.8 million people in New York City with LTBI. Based on these estimates, there is a large reservoir of TB infection in New York City, some of which will result in future cases of active TB disease.

While the Department has made major strides in reducing the number of active TB cases in New York City – from 3,755 at the height of the TB epidemic in 1992 to 559 in 2018 – the number of TB cases has largely plateaued in the last 10 years. The Department is working to expand its efforts to identify and treat people with LTBI to further reduce the burden of TB in New York City, and reporting of test results for TB infection will help focus that effort.

Reporting of tests for TB infection will give the Department a better understanding of the prevalence of TB infection in order to better direct public health resources. Also, the data collected will provide information about testing practices, which will help inform provider outreach. Reports of laboratory tests negative for TB infection will provide the Department with a more complete picture of testing practices and allow for better estimates of testing prevalence to inform the Department’s programming.

In addition, the Board has made minor related language changes to Health Code § 11.21(a) for consistency.

In response to public comments received, the language of the Department’s proposal as to this provision has been revised to clarify that laboratories must report all test results, including negatives, for tests for TB infection only, and not tests performed in connection with diagnosing or monitoring active TB disease, such as mycobacteria culture tests.

Syphilis Amendment Proposal

The Board is adding a new Section 11.33 to the Health Code to require healthcare providers to test pregnant persons for syphilis at 28 weeks of pregnancy, or as soon thereafter as reasonably possible but no later than at 32 weeks of pregnancy, and that test results and a treatment plan be documented.

Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. Untreated syphilis during pregnancy can result in devastating health outcomes, including stillbirth.  Infants with congenital syphilis may manifest abnormalities of the central nervous system, bones and joints, teeth, eyes, and skin. In New York City, the number of congenital syphilis cases increased 186% between 2017 (7 cases) and 2018 (20 cases). Twenty is the largest number of congenital syphilis cases reported in the City in over ten years and included one syphilitic stillbirth at 31 weeks. In general, New York City has much higher rates of primary, secondary, and early latent syphilis as compared to the U.S. population. In 2017, the rate of syphilis at all stages was 95.33 per 100,000 in NYC vs. 31.4 cases per 100,000 nationally. Syphilis is increasing among New York City women; from 2017 to 2018, the number of primary, secondary, and early latent syphilis cases among NYC women increased 44%, from 219 to 315 cases.

Congenital syphilis can be prevented by timely treatment of maternal syphilis. However, symptoms of maternal syphilis during pregnancy may not be apparent, so serologic screening during pregnancy is critical. New York State mandates syphilis screening at the first prenatal care examination (NYS Public Health Law § 2308) and at delivery (10 NYCRR § 69-2.2). Increasingly, the Department has documented congenital cases resulting from maternal syphilis infections acquired subsequent to screening negative earlier during pregnancy; this accounted for 11 cases (55%) of congenital syphilis cases in 2018. At least half of these cases may have been averted by screening women at 28 weeks of pregnancy.

The Board adopts the Department’s proposal to require an additional syphilis test at 28 to 32 weeks of pregnancy to identify pregnant people who become infected subsequent to initial mandatory screening, which will enable treatment, improve the health of the pregnant person, and prevent potentially grave health outcomes attendant to vertical transmission. Requiring documentation of test results and a treatment plan will help ensure appropriate follow-up care. Twenty-eight weeks is the most appropriate time for third trimester re-screening because other screening tests are routinely performed at 28 weeks, and because screening at this time would allow sufficient time to treat pregnant people who have syphilis prior to delivery. These changes now align the Health Code with laws in several other states that require third trimester syphilis testing of all pregnant persons. 

Exclusion of Cases and Carriers of Enteric Pathogens

The Board is amending Health Code § 11.15(a) to provide the Department with the discretion to end “exclusion” of people infected with enteric pathogens when doing so is appropriate under the circumstances.

Under the Health Code, individuals infected with or carrying certain enteric pathogens were required to be excluded from certain settings where there was an elevated risk of disease transmission. Thus, cases and carriers who are food handlers or health care workers have to be excluded from their place of work, and staff and attendees of schools, child care programs, camps, and other facilities attended by children under five years of age had to be excluded from those facilities. Under the current provision, the Health Code provides that exclusion can end only when the excluded person no longer has symptoms and the Department had received two or three (depending on the pathogen) successive negative stool specimens demonstrating that transmission is no longer likely and that the excluded person’s illness is no longer a public health concern.

The enteric diseases addressed in Health Code § 11.15 – Campylobacteriosis, Cholera, Escherichia (E.) coli 0157:H7 and other Shiga toxin-producing E. coli (STEC) infections, Salmonellosis (other than typhoid), Shigellosis, Yersiniosis, Amebiasis, Cryptosporidiosis, and Giardiasis – are transmitted via the fecal-oral route. People infected with or carrying enteric pathogens who are food handlers, health care workers providing oral care or feeding, child care workers, or child care attendees can shed the organism in their stool and transmit the infection to others if they have poor hand hygiene practices. Exclusion can last from days to months.

The number of people identified requiring exclusion has increased significantly in recent years. In 2018, there were 187 exclusions ranging in duration from 1 to 135 days, with a mean length of 22 days, as compared to 69 exclusions in 2015. The increase in exclusions is due to improved surveillance practices and increased use of culture-independent diagnostic tests (CIDT), a testing method that is more sensitive than other types of traditional tests, leading to more positive test results. Stool samples can be positive by a CIDT but negative by traditional tests, such as bacterial culture, indicating that although the organism’s DNA is detectible, it may not be alive and capable of being transmitted. However, under the Health Code provision prior to the adoption of these changes, individuals have to be excluded based on the positive CIDT result while awaiting for multiple follow-up culture results. Also, some individuals shed the organism in the stool for many weeks or months even after symptoms have ended, and experience suggests that the risk of transmission in that circumstance is low. As there are no clear national guidelines on exclusion, exclusion requirements of jurisdictions vary. Many jurisdictions, including New York State, are less strict than New York City without any measured increase in disease transmission.

For these reasons the Department proposes a more flexible approach that takes into consideration the circumstances of a particular case, including the type of infection, the type of test used to detect the pathogen, the presence or absence of symptoms, the individual’s treatment with antimicrobial drugs, the individual’s job responsibilities, and the likelihood of infectiousness based on the length of time since symptom onset. The adoption of this proposal still allows the Department to exclude people with enteric pathogens until consecutive negative test results are received if, in the view of Department experts, there remained a public health threat. However, the Department would have the discretion to allow people to return to work or school sooner if their illness no longer poses a risk to others.

In addition, the Board is adopting is minor language changes to this provision for consistency and clarity, and to correct typographical errors.


Campylobacter Testing and Reporting

The Board is amending Health Code § 13.03(b) to no longer require laboratories to perform culture testing on all specimens found to be positive for Campylobacter by CIDT. Culture testing involves a laboratory using a specimen to grow the pathogen; a sample of the pathogen grown by culture is termed an “isolate”.

In January 2017, the Health Code was amended to require follow-up culture tests on the following enteric pathogens: Campylobacter, Listeria monocytogenes, Salmonella, Shigella, Vibrio, Yersinia, and Shiga toxin-producing Escherichia coli. The laboratory must report the results of the culture and submit any resulting isolates to the Department. The Department proposed the amendment to enable it to obtain information about the pathogens not available from CIDT and used to assist in outbreak detection and response.

Campylobacter bacteria can be transmitted to people through contaminated food and liquid or contact with certain animal feces. It causes diarrhea, fever, and abdominal cramps and, in rare cases, more serious illness. Compared to other enteric pathogens, Campylobacter is difficult to isolate and found relatively frequently, particularly given an increase in positive test results stemming from more expansive use of CIDT. Further, other enteric pathogens that are required to be cultured per the Health Code, including Salmonella and Shiga toxin-producing Escherichia coli, have more significant public health consequences than Campylobacter, including that they are more likely to be part of local and multi-state disease outbreaks.

The Department has determined that appropriate monitoring of Campylobacter can occur without routine culture testing and isolate submission. Given the high number of Campylobacter reports (approximately 2500 cases in New York City in 2018), the Department generally has been able to investigate only clusters, as opposed to isolated cases. Accordingly, the Department does not make use of most of the isolates received from laboratories. The Department can request additional testing and isolates from laboratories in the event of a suspected cluster or outbreak, rather than requiring laboratories to perform the additional testing as a matter of course. The Department believes this approach better balances laboratory burden and public health needs.

In addition, in order to address questions raised by reporting laboratories, the Board is adopting minor language changes to clarify that reports must be sent to the Department.

 
 
Effective Date: 
Fri, 11/15/2019

Adopted Rules: Closed to Comments

Adopted Rules Content: 
 

Statement of Basis and Purpose

 

Local Law 71 of 2018 added a new Section 18-148 to Chapter 1 of Title 18 of the New York City Administrative Code to require that, within 24 hours of the City spraying a pesticide near a playground operated by or under the jurisdiction of the New York City Department of Parks and Recreation (“Parks Department”), the Parks Department clean the playground equipment located in that playground.  Local Law 71 requires the New York City Department of Health and Mental Hygiene (“Department”) to prescribe by rule the distance between the spraying and the playground equipment that will trigger the cleaning requirement.

 

Citywide policy and Chapter 12 of Title 17 of the Administrative Code, as added by Local Law 37 of 2005, promote the reduction of pesticide use by City agencies.  Utilizing an integrated pest management (“IPM”) approach at all times, City agencies implement a variety of strategies to control pests, and when pesticides are necessary to protect public health, use the least toxic products in the smallest amounts possible. As agencies rely on IPM techniques, the Department is aware of few circumstances when City agencies spray pesticides that have even the possibility of depositing on Parks Department playground equipment. Those circumstances include, for example, spraying to control mosquitoes to protect the public from West Nile virus and other mosquito-borne disease; to control stinging insects, such as wasps and hornets; and, starting in 2019, to assess approaches to control ticks. In addition, the Parks Department uses a variety of techniques to control weeds such as poison ivy. For example, when poison ivy is growing inside or within the area immediately outside of a playground, the Parks Department either manually removes the poison ivy or cuts the vine at the base and then paints the cut stem with herbicide.  Spray is only used to control poison ivy in areas outside a playground.

 

The Department is not aware of any standard or guidance addressing whether and when to clean playground equipment in order to protect health following the spraying of pesticide. Two types of standards, however, may be relevant and provide guidance for this. First, the U.S. Environmental Protection Agency (EPA) uses the “No-Observed-Adverse-Effect-Level” (“NOAEL”) as a benchmark for risk classification and assessment of pesticides. The NOAEL is based on research demonstrating that there are pesticide exposure amounts that do not result in an observed harmful effect. Where a pesticide is applied in an amount that could not reasonably exceed the NOAEL, there is no public health basis to clean playground equipment.  Applying the NOAEL to the circumstances here, the Department is requiring that the Parks Department not be required to clean playground equipment where the pesticide is sprayed in an amount that could not reasonably exceed the NOAEL.

 

Second, EPA pesticide labeling requirements and U.S. Fish and Wildlife Service guidance set out buffer zones, which are areas within which pesticides must not or should not be sprayed in order to avoid pesticide drift into waterways, agricultural fields, and other areas that could result in exposures that could be toxic to living organisms. Buffer zones of 30 feet—or 80 feet for ultra-low volume application—have been established in a context that could be considered analogous to this one.[1] In the absence of specific standards or guidance regarding cleaning of playground equipment following pesticide spraying, the Department is applying these analogous standards regarding buffer zones for these rules.

 

The Department is adopting a new Chapter 14 to Title 24 of the Rules of the City of New York to implement the provisions of Section 18-148 of Chapter 1 of Title 18 of the Administrative Code, as added by Local Law 71 of 2018.




[1] See, e.g.¸US EPA (2008). Updated spray drift language for pyrethroid agricultural use products U.S. Environmental Protection Agency, Washington, DC. See, https://www.epa.gov/sites/production/files/2015-08/documents/epapyrethroidletter.pdf ; US EPA (2014). Final Registration of Enlist DuoTM Herbicide. Washington, DC. EPA docket, EPA-HQ-OPP-2014-0195. See, https://www.regulations.gov/contentStreamer?documentId=EPA-HQ-OPP-2014-0195-0010&contentType=pdf;  White, J.A. 2004. Recommended Protection Measures for Pesticide Applications in Region 2 of the U.S. Fish and Wildlife Service, U.S. Fish and Wildlife Service, Region 2, Environmental Contaminants Program. 203p. See: https://www.fws.gov/southwest/es/arizona/documents/ecreports/rpmpa_2007.pdf.

 
Effective Date: 
Sun, 07/28/2019

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