CO-SPONSORS

S7169 - DETAILS

S7169 - SUMMARY

Establishes a pilot program for Lyme and tick-borne disease testing in children.

S7169 - SPONSOR MEMO

BILL NUMBER: S7169 TITLE OF BILL : An act to amend the public health law, in relation to creating a pilot program for Lyme and tick-borne disease testing in children PURPOSE OR GENERAL IDEA OF BILL : Amends the public health law, in relation to creating a pilot program for Lyme and tick-borne disease testing in children SUMMARY OF PROVISIONS : Section 1 of the bill provides for a pilot program to be established by the Commissioner of Health for the purposes of providing testing to exclude Lyme and tick-borne diseases in children who have clinical diagnoses that have similar symptom presentation. The qualified medical institution or laboratory chosen for the pilot program shall provide for the exclusionary tests, as well as develop graduate medical education curriculum that can be used to instruct medical students on Lyme and tick-borne diseases in children. Section 2 of the bill provides for the effective date. JUSTIFICATION :

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S T A T E O F N E W Y O R K ________________________________________________________________________ 7169 I N S E N A T E (PREFILED) January 3, 2018 ___________ Introduced by Sens. SERINO, HANNON, AMEDORE, AVELLA, FUNKE, HELMING, LITTLE, MARCHIONE, O'MARA, PHILLIPS, RITCHIE, SEWARD, TEDISCO, VALESKY -- read twice and ordered printed, and when printed to be committed to the Committee on Health AN ACT to amend the public health law, in relation to creating a pilot program for Lyme and tick-borne disease testing in children THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Section 206-b of the public health law, as added by chapter 260 of the laws of 1988, is amended to read as follows: S 206-b. LYME AND TICK-BORNE DISEASE. 1. Special requirements with respect to Lyme disease diagnosis.

[1.] A. Within thirty days after the effective date of this section, the commissioner shall, in writing, order every physician practicing in Suffolk, Westchester and Nassau counties to review the medical records of any patient such physician treated during the period commencing January first, nineteen hundred seventy-five and ending on the date of such order wherein such physician made a diagnosis of juvenile rheumatoid arthritis and to review the circumstances of such diagnosis to reconsider whether such patient has suffered, or is suffering, from the complex, multi-system disorder caused by the bacterium Borrelia burgdorferi, which disease is transmit- ted by the Ixodes dammini tick and is commonly referred to as "Lyme disease".

MY NOTE- {They will be using/depending on Lyme tests

known and proven to miss 74.9% of those infected. And many people who

shouldn't, will have access to thoe medical records of patients and will

be able to use that info against the treating doctors.}

In any case where a hospital or other health care institution or provider has custody or control of the medical records for a patient so diagnosed, upon request such physician shall be entitled to review such medical records for purposes of complying with such order or the commissioner may order any such hospital or other health care institu- tion or provider wherever situated within the state to review such records to reconsider a diagnosis of Lyme disease.

MY NOTE {This will insult physicians who think they got it

right the first time around and cause them not to comply, as has happened

in Maryland and Virginia with those worthless 'hand the patients a slip

of paper telling them the tests may be wrong". They don't comply

and are now even more angry at Lyme patients.

IF doctors who misdiagnosed patients were wrong initially,

which this could prove they were,

they would be open for legal actions against them-

which is not a good incentive for them to review these past cases.}

[2.] B. The commissioner, upon a showing that there is a reasonable basis to believe that the order provided for herein has not been complied with, shall be entitled to apply to a justice of the supreme court for an order requiring any such physician to submit for the EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets

[ ] is old law to be omitted. LBD13805-01-7 S. 7169 2 commissioner's consideration such records, charts or other pertinent data which will enable him to determine whether there has been full compliance with such order.

[3.] C. In any case where a review of such records indicates that a patient may have been, or is, suffering from Lyme disease, such physi- cian shall, consistent with customary and acceptable medical standards, take such action he deems necessary to inform such patient or in the case of a minor, his or her parent or guardian of his findings, conduct additional tests, administer other necessary treatments or refer such patient to another physician for further diagnosis and/or treatment.

2. PILOT PROGRAM FOR LYME AND TICK-BORNE DISEASE TESTING IN CHILDREN. A. SUBJECT TO APPROPRIATION, THE COMMISSIONER IS HEREBY AUTHORIZED TO ESTABLISH A PILOT PROGRAM TO TEST FOR LYME AND TICK-BORNE DISEASES IN CHILDREN WITH QUALIFYING DIAGNOSES WHO PRESENT WITH SIMILAR SYMPTOMS. SUCH PROGRAM, SUBJECT TO THE RULES AND REGULATIONS OF THE COMMISSIONER, SHALL PROVIDE FOR A TEST TO RULE OUT LYME AND TICK-BORNE DISEASES IN CHILDREN WITH A QUALIFYING DIAGNOSIS BY AN APPROVED NEW YORK STATE

QUAL-IFIED MEDICAL RESEARCH INSTITUTION OR LABORATORY,

AT THE REQUEST OF A PATIENT, MEDICAL PROVIDER, PRACTITIONER, HOSPITAL, OR HEALTH CARE FACIL- ITY.

THE QUALIFIED MEDICAL RESEARCH INSTITUTION OR LABORATORY SHALL

BE RESPONSIBLE FOR CONDUCTING SEROLOGY TESTING, OR OTHER LYME

AND TICK-BORNE DISEASE TESTS APPROVED BY THE COMMISSIONER, TO DETERMINE

THE ESTIMATED RATE OF MISDIAGNOSIS AND CO-INFECTIONS IN CHILDREN

AND FOR THE DEVELOPMENT OF CONTINUING GRADUATE MEDICAL EDUCATION CURRICULUM

ADDRESS-ING THE SYMPTOMS AND DIAGNOSTIC TOOLS THAT CAN ASSIST IN

ACCURATELY IDENTIFYING AND TESTING FOR LYME AND TICK-BORNE DISEASES IN CHILDREN. THE QUALIFIED MEDICAL RESEARCH INSTITUTION OR LABORATORY MAY WORK

WITH NOT-FOR-PROFITS, PROFESSIONAL ASSOCIATIONS, OR ACADEMIC INSTITUTIONS

TO DEVELOP THE CONTINUING GRADUATE MEDICAL EDUCATION CURRICULUM.

MY NOTE- [NON-PROFITS, MEDICAL RESEARCH INSTITUTIONS OR

LABS OR ACADEMIC INSTITUTIONS INCLUDES WORMSER AND

SEVERAL OTHER IDSA LYME GUIDELINE AUTHORS' HOME BASE,

THE NY LAB SYSTEM THAT CONTINUES TO REFUSE TO

ALLOW/ACCEPT IGENEX AND OTHER OUTSIDE TESTS TO BE USED IN NY,

AND THE TESTS JUST RECENTLY DEVELOPED BY NY STATE ITSELF,

WHICH WOULD BE VERY PROFITABLE TO THEM PERSONALLY.

THIS WORDING ELIMINATES OUR LLMD'S AND THEIR

PREFERRED LABS AND RESEARCH INSTITUTIONS.}

B. FOR PURPOSES OF THIS SUBDIVISION, THE FOLLOWING TERMS SHALL HAVE THE FOLLOWING MEANINGS: (I) "QUALIFIED MEDICAL RESEARCH INSTITUTION OR LABORATORY" MAY INCLUDE ACADEMIC MEDICAL INSTITUTIONS, AGENCIES, PUBLIC OR PRIVATE ORGANIZA- TIONS, PUBLIC OR PRIVATE LABORATORIES OR ANY OTHER INSTITUTION OR LABO- RATORY APPROVED BY THE DEPARTMENT THAT IS CONDUCTING LYME AND

TICK-BORNE DISEASE RESEARCH, INCLUDING BUT NOT LIMITED TO, TESTING FOR THE PRESENCE OF SUCH INFECTIONS; (II) "QUALIFYING DIAGNOSES" SHALL MEAN JUVENILE RHEUMATOID ARTHRITIS OR ANY OTHER COMMON MEDICAL DIAGNOSIS THAT PRESENTS WITH SIMILAR

SYMP- TOMS TO LYME AND TICK-BORNE DISEASE INFECTIONS THAT THE COMMISSIONER DEEMS RELEVANT; AND (III) "CHILDREN" SHALL MEAN ALL INDIVIDUALS UNDER THE AGE OF EIGHTEEN WHO HAVE A QUALIFYING DIAGNOSIS. C. THE COMMISSIONER SHALL REQUIRE THE QUALIFIED MEDICAL RESEARCH INSTITUTION OR LABORATORY UNDER THE PILOT PROGRAM TO SUBMIT AN ANNUAL REPORT, WHICH SHALL INCLUDE DATA ANALYZING THE COST, EFFICIENCY, AND ACCURACY OF TESTS PROVIDED UNDER SUCH PROGRAM. THE REPORT SHALL ALSO INCLUDE ESTIMATED RATES OF MISDIAGNOSIS OR CO-INFECTIONS OF LYME AND TICK-BORNE DISEASES OF CHILDREN WITH QUALIFYING DIAGNOSES. ON OR BEFORE DECEMBER THIRTY-FIRST, TWO THOUSAND NINETEEN, AND ANNUALLY THEREAFTER, THE COMMISSIONER SHALL SUBMIT SUCH REPORT TO THE GOVERNOR, THE TEMPORARY PRESIDENT OF THE SENATE AND THE SPEAKER OF THE ASSEMBLY. D. PARTICIPATION IN THE PILOT PROGRAM SHALL BE VOLUNTARY AND SUBJECT TO PARTICIPATION GUIDELINES ESTABLISHED BY THE DEPARTMENT. NOTHING IN THIS SUBDIVISION SHALL ESTABLISH LIABILITY FOR ANY REASONABLE

ACTS OR S. 7169 3 OMISSIONS ON THE PART OF A HOSPITAL, HEALTH CARE INSTITUTION, OR

PROVIDER PARTICIPATING IN THE PROGRAM.

S 2. This act shall take effect on the ninetieth day after it shall have become a law.

CO-SPONSORS

S7168 - DETAILS

S7168 - SUMMARY

Relates to reporting Lyme and tick-borne disease infection after death to the department of health according to the manner prescribed by the commissioner.

S7168 - SPONSOR MEMO

BILL NUMBER: S7168 TITLE OF BILL : An act to amend the public health law, in relation to the reporting of lyme and tick-borne disease infection after death PURPOSE : Relates to reporting Lyme and tick-borne disease infections after death SUMMARY OF PROVISIONS : Section 1: Amends the public health law to add a new section 2799 to require that if a coroner, pathologist, medical examiner, or other person qualified to conduct an examination of a deceased person discovers that at the time of death the individual was afflicted with Lyme or other tick-borne diseases they shall report the case promptly to the Health Department. Section 2: Establishes the effective date. JUSTIFICATION : In August 2017, the Senate Task Force on Lyme and Tick-Borne Diseases,

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S T A T E O F N E W Y O R K ________________________________________________________________________ 7168 I N S E N A T E (PREFILED) January 3, 2018 ___________ Introduced by Sens. SERINO, HANNON, AMEDORE, AVELLA, HELMING, LITTLE, MARCHIONE, O'MARA, PHILLIPS, RITCHIE, SEWARD, TEDISCO, VALESKY -- read twice and ordered printed, and when printed to be committed to the Committee on Health AN ACT to amend the public health law, in relation to the reporting of lyme and tick-borne disease infection after death THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Article 27-H of the public health law is amended by adding a new section 2799 to read as follows: S 2799. REPORTING OF LYME AND TICK-BORNE DISEASE INFECTION AFTER DEATH. IF A CORONER, PATHOLOGIST, MEDICAL EXAMINER, OR OTHER PERSON QUALIFIED TO CONDUCT AN EXAMINATION OF A DECEASED PERSON DISCOVERS

THAT AT THE TIME OF DEATH THE INDIVIDUAL WAS AFFLICTED WITH LYME

OR OTHER TICK-BORNE DISEASES, HE OR SHE SHALL REPORT THE CASE

PROMPTLY TO THE DEPARTMENT ACCORDING TO THE MANNER

PRESCRIBED BY THE COMMISSIONER. S 2. This act shall take effect on the ninetieth day after it shall have become a law. EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD13684-01-7

CO-SPONSORS

S2588 - DETAILS

S2588 - SUMMARY

Relates to guidelines for best practices in treating residential properties

for integrated pest management to assist in the prevention of ticks.

S2588 - SPONSOR MEMO

BILL NUMBER: S2588 TITLE OF BILL : An act to amend the environmental conservation law, in relation to guidelines for best practices in treating residential properties for integrated pest management PURPOSE : This bill directs the Commissioner of Environmental Conservation to develop guidelines for best practices in treating residential properties for integrated pest management to assist in the prevention of ticks that contribute to Lyme disease and tick-borne infections. SUMMARY OF PROVISIONS : Section 1: Amends Section 33-0303 of the Environmental Conservation Law to direct the Commissioner of Environmental Conservation to develop guidelines for best practices in treating residential properties to reduce exposure to ticks. The guidelines shall be updated annually with current best practices and available on the Department's website. Section 2: Establishes the bill will be effective 90 days after it shall have become a law.

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S T A T E O F N E W Y O R K ________________________________________________________________________ 2588 2017-2018 Regular Sessions I N S E N A T E January 13, 2017 ___________ Introduced by Sens. SERINO, AMEDORE, BONACIC, LARKIN, LAVALLE, MARCHIONE, RITCHIE -- read twice and ordered printed, and when printed to be committed to the Committee on Environmental Conservation AN ACT to amend the environmental conservation law, in relation to guidelines for best practices in treating residential properties for integrated pest management THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Section 33-0303 of the environmental conservation law is amended by adding a new subdivision 8 to read as follows: 8. THE COMMISSIONER SHALL DEVELOP GUIDELINES FOR BEST PRACTICES IN TREATING RESIDENTIAL PROPERTIES FOR INTEGRATED PEST MANAGEMENT TO ASSIST IN THE PREVENTION OF TICKS THAT CONTRIBUTE TO TICK-BORNE INFECTIONS.

SUCH GUIDELINES SHALL INCLUDE BUT NOT BE LIMITED TO THE USE OF LANDSCAPE TECHNIQUES, METHODS TO DISCOURAGE RODENT ACTIVITY AND EFFECTIVE

PESTI-CIDE APPLICATIONS. THE GUIDELINES SHALL BE AVAILABLE ON THE

DEPARTMENT'S WEBSITE AND SHALL BE REVIEWED AND REVISED ANNUALLY

WITH CURRENT BEST PRACTICES. S 2. This act shall take effect on the ninetieth day after it shall have become a law. EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD08274-01-7

CO-SPONSORS

S7208 - DETAILS

S7208 - SUMMARY

Establishes that the council on human blood and transfusion services shall

review all current medical research and guidance regarding the

donation of blood by patients with a history of Lyme or tick-borne illnesses.

S7208 - SPONSOR MEMO

BILL NUMBER: S7208 TITLE OF BILL : An act to amend the public health law, in relation to donation of blood by patients with a history of Lyme or tick-borne illnesses PURPOSE : Relates to review of blood donations of patients with certain illnesses SUMMARY OF PROVISIONS : Section 1: Amends section 3121 of the public health law to add a new subdivision 6 to require the council on human blood and transfusion services in the Department of Health to review current medical research and guidance related to the donation of blood by patients with a history of Lyme and tick-borne diseases and issue recommendations to the Commissioner related to the collection and distribution of such blood. Section 2: Establishes the effective date. JUSTIFICATION :

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S T A T E O F N E W Y O R K ________________________________________________________________________ 7208 I N S E N A T E January 3, 2018 ___________ Introduced by Sens. SERINO, HANNON, LAVALLE -- read twice and ordered printed, and when printed to be committed to the Committee on Health AN ACT to amend the public health law, in relation to donation of blood by patients with a history of Lyme or tick-borne illnesses THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Section 3121 of the public health law is amended by adding a new subdivision 6 to read as follows: 6. (A) THE COUNCIL SHALL REVIEW ALL CURRENT MEDICAL RESEARCH AND GUID- ANCE REGARDING THE DONATION OF BLOOD BY PATIENTS WITH A HISTORY OF LYME OR TICK-BORNE ILLNESSES, INCLUDING BUT NOT LIMITED TO: (I) HUMAN ANAPLASMOSIS; (II) BABESIOSIS; (III) HUMAN EHRLICHIOSIS; (IV) ROCKY MOUNTAIN SPOTTED FEVER; (V) POWASSAN VIRUS; (VI) SOUTHERN TICK-ASSOCIATED RASH ILLNESS; AND (VII) OTHER RELATED ILLNESSES AND CO-INFECTIONS. (B) (I) THE COUNCIL SHALL, WITHIN NINETY DAYS AFTER THE EFFECTIVE DATE OF THIS SUBDIVISION, ISSUE RECOMMENDATIONS TO THE COMMISSIONER

REGARDING THE COLLECTION, TESTING, AND DISTRIBUTION OF BLOOD

DONATIONS WITH LYME AND TICK-BORNE ILLNESSES PRESENT OR

REPORTED IN A PATIENT HISTORY, INCLUDING BUT NOT LIMITED TO: (1) CONSIDERATIONS OF THE CURRENT STATE OF MEDICAL RESEARCH; AND (2) RECOMMENDATIONS FOR TEMPORARY OR PERMANENT MORATORIUMS

ON THE COLLECTION OF BLOOD WITH LYME AND TICK-BORNE RELATED

ILLNESSES PRESENT. (II) UPON IMMEDIATE RECEIPT OF SUCH RECOMMENDATION, THE COMMISSIONER SHALL PROVIDE A COPY OF SUCH TO THE SPEAKER OF THE ASSEMBLY AND THE TEMPORARY PRESIDENT OF THE SENATE. S 2. This act shall take effect immediately. EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD13988-03-7

CO-SPONSORS

S7242 - DETAILS

S7242 - SUMMARY

Relates to installing Lyme and tick-borne disease warning signs at all

state-managed parks including trail entryways and campgrounds

due to the increased presence of such diseases within the state.

S7242 - SPONSOR MEMO

BILL NUMBER: S7242 TITLE OF BILL : An act to amend the parks, recreation and historic preservation law, in relation to installing Lyme and tick-borne disease warning signs at all state-managed parks PURPOSE OR GENERAL IDEA OF BILL : The purpose of this bill is to reduce Lyme and other tick-borne disease infection rates by posting tick warning signs at state parks, including trail entryways and campgrounds. SUMMARY OF PROVISIONS : The bill adds a new section 13.28 to the parks, recreation and historic preservation law directing the New York State Office of Parks, Recreation and Historic Preservation to install and maintain tick warning signs at all state-managed parks, including trail entryways and campgrounds.

The signs will inform the public that ticks may be found in such areas and that they can spread Lyme or other tick borne diseases. The office may use models already in use when determining the design and content of the signs.

MY NOTE- {CDC already has signs available that refer people back to the CDC

for its diagnostic and treatment information- just what we DON'T want.}

JUSTIFICATION :

JUSTIFICATION :

New York boasts more than 2,000 miles of mapped trails in state parks and historic sites. These parks are often a favorite destination for New Yorkers, as well as visitors coming from out of state, with visitors of state parks and historic sites totaling nearly 70 million in 2016-a 6% increase over 2015, and a 21% increase from six years prior. Attracting visitors to these parks is vital for many upstate communities and the upstate economy. Unfortunately, New York's parks attract more than just tourists; they are also home to ticks that can spread Lyme and other tick-borne diseases (TBDs). While New Yorkers and tourists should continue enjoying all the parks our state has to offer, it is important that they are aware of the risks so they can take appropriate precautions, such as wearing pants and long-sleeved clothing, avoiding dense woods and bushy areas, and checking for ticks after hiking. Lyme and other TBDs are much rarer in most other states, and within New York have traditionally been limited to the Hudson Valley and Long Island, although the epidemic has been expanding geographically.

As such, visitors from areas out of the area may be unaware of the risks posed by ticks. At a hearing on Lyme and TBDs held by the State Senate Standing Committee on Lyme and Tick Borne Diseases, in conjunction with the Committee on Health, the Commissioner of the Department of Health pointed out that there are more than 9,000 cases of tick-borne diseases in New York State reported to the Department each year, and it is estimated that this is an underestimation of the true number of infections. This legislation is one of a package of bills aimed at a multi-prong approach of prevention, treatment, and education. By posting warning signs in state parks at trail entryways and campgrounds, we can help ensure that residents and visitors can continue to enjoy our parks safely and reduce the spread of tick-borne diseases. PRIOR LEGISLATIVE HISTORY : New bill FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS : TBD EFFECTIVE DATE : 90 days after enactment, provided that any rule or regulation needed to implement the provisions of the bill may be made immediately.

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S T A T E O F N E W Y O R K ________________________________________________________________________ 7242 I N S E N A T E January 5, 2018 ___________ Introduced by Sen. SERINO -- read twice and ordered printed, and when printed to be committed to the Committee on Cultural Affairs, Tourism, Parks and Recreation AN ACT to amend the parks, recreation and historic preservation law, in relation to installing Lyme and tick-borne disease warning signs at all state-managed parks

MY NOTE {Not earth shattering news here, but this bill may be argued against by

those in, around and related to parks, historic preservation, possibly hiking and

conservation clubs, and wilderness preservation, as well as the

tourism industry. The budget necessary for accomplishing this

project may be prohibitively high and be fought against and/or denied also.

Income from park fees & campgrounds will be reduced also.

A typical argument is often that there are no signs warning about all

of the other dangers (cliffs, bears, snakes, rabies, coyotes, etc.), so why have signs

for Lyme and ticks and will it open the doors to many other signs

being installed in "natural areas"?}

THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Legislative intent. The legislature hereby finds that the number of Lyme disease and tick-borne related diseases in New York state is increasing every day with certain areas of the state having some of the highest numbers of reported incidents in the United States. Proper notification through the use of signs warning of the prevalence of ticks in the area and the potential for tick transmitted diseases is imper- ative to help combat this growing problem.

S 2. The parks, recreation and historic preservation law is amended by adding a new section 13.28 to read as follows:

S 13.28 LYME AND TICK-BORNE DISEASE WARNING SIGNS. THE OFFICE SHALL INSTALL AND MAINTAIN SIGNS AT ALL STATE-MANAGED PARKS, INCLUDING, BUT NOT LIMITED TO, TRAIL ENTRYWAYS AND CAMPGROUNDS, WARNING INDIVIDUALS THAT TICKS MAY BE FOUND IN SUCH AREAS AND MAY RESULT IN LYME DISEASE OR OTHER TICK-BORNE DISEASES.

MY NOTE- {CDC already has signs available that provide questionable

info (rash related for example) and refer people directly to the CDC

for its information- just what we DON'T want.}

SUCH OFFICE MAY USE MODELS ALREADY IN USE THROUGHOUT THE STATE WHEN DETERMINING THE DESIGN FOR SUCH SIGNAGE. FOR

THE PURPOSES OF THIS SUBDIVISION, "TRAIL" SHALL INCLUDE FOOTPATHS, BIKE WAYS, SNOWMOBILE TRAILS, HORSE TRAILS, CROSS COUNTRY SKI TRAILS, ROADS AND OTHER RIGHTS-OF-WAY SUITABLE FOR HIKING, STROLLING, CYCLING, HORSE- BACK RIDING, SKIING AND OTHER MEANS OF MOTORIZED AND NON-MOTORIZED

TRAV-EL FOR RECREATIONAL PURPOSES AND SHALL INCLUDE COMBINATIONS

AND SYSTEMSOF TRAILS, INCLUDING CONNECTING AND SIDE TRAILS, AND

TRAILS LEADING TO SCENIC AND RECREATIONAL AREAS LOCATED WITHIN AND MAINTAINED BY THE STATE.

MY NOTE- {NY's budget for Parks/Rec decreased in 2017 by $20 MILLION

from 2016. No additional people were hired in 2017 to handle an

increased work load. NY has over 100 parks/rec areas and thousands of

miles of trails.}

S 3. This act shall take effect on the ninetieth day after it shall have become a law; provided, however, that effective immediately, the addition, amendment and/or repeal of any rule or regulation necessary for the implementation of this act on its effective date are authorized and directed to be made and completed on or before such effective date.

EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD13920-04-7

Link Here

CO-SPONSORS

S6926 - DETAILS

S6926 - SUMMARY

Directs the commissioner of health to establish a standard protocol for the

diagnosis and treatment of Lyme disease and other tick borne diseases

identified by such commissioner; such protocol shall require the

provision of written notification to each patient being treated for

Lyme disease or other tick borne diseases relating to symptoms,

risk factors, diagnosis and other information relating to such diseases.

S6926 - SPONSOR MEMO

BILL NUMBER: S6926 TITLE OF BILL : An act to amend the public health law, in relation to the diagnosis and treatment of Lyme disease and other tick borne diseases PURPOSE : To ensure New York is taking the lead in the fight against Lyme and tick borne diseases (TBDs) by requiring the Commissioner of Health to work with health care providers and experts to develop a standard protocol and patient notification for the diagnosis and treatment of this public health epidemic. SUMMARY OF PROVISIONS : Section one adds a new subsection to § 206-b of the Public Health Law to require the Commissioner of Health, in consultation with health care providers and experts, to develop a standardized protocol for the diagnosis and treatment of Lyme disease, and other TBDs as identified by the Commissioner.

As part of this protocol, the Commissioner shall develop a standardized notification form to be distributed by providers to each person under their care being tested for Lyme disease, or other TBDs identified by the Commissioner. Such protocol and notification are to be developed and prepared for distribution

within 120 days of the enactment of this law. Section two provides that the act shall take effect immediately. JUSTIFICATION : New York residents continue to struggle with Lyme and other tick borne diseases (TBDs), as these diseases continue to spread and reach new areas of the state. The despair of patients struggling to get the proper diagnosis and treatment was a constant theme from those who testified at the Senate hearing on Lyme and TBDs this August.

Patients continue to come forward with stories where they present with symptoms, which may include a "bull's-eye" rash, but providers refuse to test them for Lyme, or refuse to provide antibiotics until symptoms are confirmed by a test, or where a test comes back negative and treatment is denied or discontinued. In these scenarios patients spend months, or sometimes years, seeking care from many different specialist in an effort to ascertain the reason for the symptoms they suffer. The federal Centers for Disease Control and Prevention (CDC) currently recommends a two-tiered testing for Lyme Disease. They recommend only performing the second test if the first test is positive in order to avoid false positives.

However, it is universally accepted that the first test performed, the enzyme Immunoassay (EIA) or Immunofluorescence Assay (IFA) have a false negative rate of nearly 50%.

The CDC advises that cases where the test yields a negative result, the provider should, "consider alternative diagnosis. Or in cases where the patient has had symptoms for less than or equal to 30 days, the provider may treat the patient and follow up with a convalescent serum."

The CDC also cautions that Lyme should be diagnosed based on signs and symptoms, history of possible exposure to ticks, and "laboratory blood tests are helpful if used correctly and performed with validated methods." At the Senate hearing, physicians representing both the Infectious Disease Society of America (IDSA) and the International Lyme and Associated Disease Society (ILADS) testified that if an initial Lyme test is negative, but there is still a high suspicion of Lyme based on symptoms, antibiotic treatment should begin and the test repeated in 2-4 weeks. They cautioned against physicians ignoring clinical symptoms and relying too heavily on what are often inaccurate test results. Given the complicated nature of diagnosis due to the inadequacy of current testing mechanisms, the long term consequences to patients, and fact that New York is at the epicenter of this epidemic, it is imperative that the state develop its own protocol to educate and guide providers in properly diagnosing and treating Lyme disease and other TBDs.

Patient accounts clearly demonstrate the need for a universal approach and well informed providers and patients. As these diseases continue to spread into new areas of the state where health care providers have not previously had to deal with them, this need will continue to grow.

Enactment of a statewide protocol, as well as a patient notification form, that will educate both providers and patients will relieve many patients from the despair and unnecessary care they go through to obtain a diagnosis and will result in the more timely diagnosis and effective treatment of these diseases. LEGISLATIVE HISTORY : New bill. FISCAL IMPLICATIONS : None. EFFECTIVE DATE : Immediately.

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S T A T E O F N E W Y O R K ________________________________________________________________________ 6926 2017-2018 Regular Sessions I N S E N A T E October 20, 2017 ___________ Introduced by Sens. HANNON, SERINO, HELMING, AMEDORE, AVELLA, BONACIC, BOYLE, CARLUCCI, DeFRANCISCO, GOLDEN, LANZA, LARKIN, LAVALLE, LITTLE, MARCELLINO, O'MARA, RITCHIE, TEDISCO, VALESKY, YOUNG -- read twice and ordered printed, and when printed to be committed to the Committee on Rules AN ACT to amend the public health law, in relation to the diagnosis and treatment of Lyme disease and other tick borne diseases THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Section 206-b of the public health law, as added by chapter 260 of the laws of 1988, is amended to read as follows: S 206-b. Special requirements with respect to Lyme disease diagnosis. 1. (A) Within thirty days after the effective date of this section, the commissioner shall, in writing, order every physician practicing in Suffolk, Westchester and Nassau counties to review the medical records of any patient such physician treated during the period commencing Janu- ary first, nineteen hundred seventy-five and ending on the date of such order wherein such physician made a diagnosis of juvenile rheumatoid arthritis and to review the circumstances of such diagnosis to reconsid- er whether such patient has suffered, or is suffering, from the complex, multi-system disorder caused by the bacterium Borrelia burgdorferi, which disease is transmitted by the Ixodes dammini tick and is commonly referred to as "Lyme disease".

In any case where a hospital or other health care institution or provider has custody or control of the medical records for a patient so diagnosed, upon request such physician shall be entitled to review such medical records for purposes of comply- ing with such order or the commissioner may order any such hospital or other health care institution or provider wherever situated within the state to review such records to reconsider a diagnosis of Lyme disease.

[2.] (B) The commissioner, upon a showing that there is a reasonable basis to believe that the order provided for [herein] IN THIS SUBDIVI- EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD13579-02-7

S. 6926 2 SION has not been complied with, shall be entitled to apply to a justice of the supreme court for an order requiring any such physician to submit for the commissioner's consideration such records, charts or other pertinent data which will enable him to determine whether there has been full compliance with such order.

[3.] (C) In any case where a review of such records indicates that a patient may have been, or is, suffering from Lyme disease, such physi- cian shall, consistent with customary and acceptable medical standards, take such action he OR SHE deems necessary to inform such patient or in the case of a minor, his or her parent or guardian of his OR HER find- ings, conduct additional tests, administer other necessary treatments or refer such patient to another physician for further diagnosis and/or treatment.

2. (A) THE COMMISSIONER SHALL, IN CONSULTATION WITH HEALTH CARE PROVIDERS, RESEARCH EXPERTS, RELEVANT ADVISORY BODIES AND OTHER STAKE- HOLDERS, DEVELOP A STANDARDIZED PROTOCOL FOR THE DIAGNOSIS AND TREATMENT OF LYME DISEASE AND SUCH OTHER TICK BORNE DISEASES THAT MAY BE IDENTI- FIED BY THE COMMISSIONER.

SUCH PROTOCOL SHALL INCLUDE, BUT NOT BE LIMITED TO, GUIDANCE TO BE

UTILIZED BY HEALTH CARE PROVIDERS WHEN A SEROLOGI- CAL TEST COMES BACK NEGATIVE BUT SYMPTOMS OF ANY SUCH DISEASE PERSIST.

THE PROTOCOL SHALL BE UPDATED UPON ANY ADVANCEMENTS IN THE FIELD OF LYME DISEASE, OR OTHER IDENTIFIED TICK BORNE DISEASE, TESTING AND TREATMENT.

AS PART OF THE PROTOCOL, THE COMMISSIONER SHALL DEVELOP, UPDATE AS NECESSARY AND ENSURE PROVIDERS DISTRIBUTE TO EACH PERSON UNDER THEIR CARE BEING TESTED FOR LYME DISEASE OR OTHER IDENTIFIED TICK BORNE DISEASE, A STANDARDIZED NOTIFICATION FORM, WHICH SHALL EXPLAIN, IN PLAIN NON-TECHNICAL LANGUAGE, THE FOLLOWING:

(I) THE SYMPTOMS AND RISK FACTORS FOR LYME DISEASE AND SUCH OTHER IDENTIFIED TICK BORNE DISEASES;

(II) THE AVAILABLE METHODS FOR THE DETECTION AND DIAGNOSIS OF LYME DISEASE AND SUCH OTHER IDENTIFIED TICK BORNE DISEASE, INCLUDING INFORMA- TION ON THE RELATIVE ACCURACY OF THE AVAILABLE DETECTION AND DIAGNOSTIC TECHNIQUES;

(III) THE MEDICAL PROTOCOL ADOPTED UNDER THIS SUBDIVISION; AND

(IV) RELEVANT MEDICAL INFORMATION DEEMED NECESSARY BY THE COMMISSIONER AND SHALL CONTAIN INFORMATION ON LYME DISEASE AND SUCH OTHER

IDENTIFIED TICK BORNE DISEASES RISK, POSSIBLE CO-INFECTIONS AND OTHER PERTINENT INFORMATION.

THE COMMISSIONER SHALL HAVE THE PROTOCOL AND STANDARDIZED

NOTIFICATION FORM, REQUIRED BY THIS SUBDIVISION, DEVELOPED AND PREPARED FOR DISTRIB- UTION WITHIN ONE HUNDRED TWENTY DAYS OF THE EFFECTIVE DATE OF THIS SUBDIVISION. (B) NOTHING IN THIS SUBDIVISION SHALL BE CONSTRUED TO CREATE A CAUSE OF ACTION FOR LACK OF INFORMED CONSENT IN ANY INSTANCE IN WHICH

SUCH CAUSE OF ACTION WOULD BE LIMITED BY SECTION TWENTY-EIGHT HUNDRED

FIVE-D OF THIS CHAPTER. S 2. This act shall take effect immediately.

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S8534 - DETAILS

S8534 - SUMMARY

Directs promulgation of rules and regulations concerning removal of ticks from pupils and notification to parents.

S8534 - SPONSOR MEMO

BILL NUMBER: S8534 TITLE OF BILL : An act to amend the education law, in relation to rules and regulations concerning removal of ticks from pupils PURPOSE : To promulgate and review rules and regulations related to pupils who have a tick removed from them during school or a school sponsored activity. SUMMARY OF PROVISIONS : Section 1: Directs the Commissioner of Education, in conjunction with the Commissioner of Health, to promulgate and review rules and regulations related to pupils who have a tick removed from them during school or a school sponsored activity. Such regulations shall include tick removal guidelines, procedures for written notification to a parent or guardian after removing a tick and the development of informational materials for school districts and parents. Such rules and regulations shall be deemed to be the minimum standards for public schools and may be implemented by nonpublic schools if they so authorize. Section 2: Provides the effective date.

JUSTIFICATION : Lyme and tick-borne diseases (TBDs) continue to spread across the state at an alarming rate, and often impact children the most as they play and explore outside. While these diseases have devastating impacts to all of those infected, they can present serious and even life-threatening symptoms in children. As such, it is important that our schools and educators are equipped with the knowledge and guidance to handle tick infections in students as they are often the first line of recognition and identification of health care concerns besides parents. This legislation will require the Commissioner of Health to issue guidance for educators, particularly school nurses, regarding the removal of ticks from students and notification of parents. Because timely identification of a tick bite, and immediate medical treatment, can be significant in the development of Lyme and TBDs, this legislation provides a vital step in the timeline of treating these infections in children. For example, the safe removal of ticks is incredibly important for the prevention of spreading Lyme, as the chances of contracting the disease are reduced if the tick is attached to the skin for less than 24 hours. Moreover, this legislation will provide for informational materials to be made available to parents so they are aware of the symptoms of TBDs, especially since they are commonly misdiagnosed and many erroneously believe that a bull's-eye rash need be present to indicate the contraction of Lyme. By providing parents or guardians with a notification that a tick was removed from their child, along with information regarding Lyme and other TBDs, parents can be on the lookout for signs and symptoms. LEGISLATIVE HISTORY : New bill. FISCAL IMPLICATIONS : None. EFFECTIVE DATE : This act shall take effect immediately on the one hundred twentieth day after it shall have become law.

• VIEW LESS

S T A T E O F N E W Y O R K ________________________________________________________________________ 8534 I N S E N A T E May 9, 2018 ___________ Introduced by Sen. SERINO -- read twice and ordered printed, and when printed to be committed to the Committee on Education AN ACT to amend the education law, in relation to rules and regulations concerning removal of ticks from pupils THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Section 305 of the education law is amended by adding a new subdivision 59 to read as follows: 59. THE COMMISSIONER, IN CONJUNCTION WITH THE COMMISSIONER OF

HEALTH, SHALL PROMULGATE AND REVIEW AS NECESSARY RULES AND REGULATIONS

RELATED TO PUPILS WHO HAVE A TICK REMOVED FROM THEM WHILE RECEIVING

INSTRUCTION OR ENGAGING IN ANY SCHOOL SPONSORED OR RELATED ACTIVITY.

SUCH REGU- LATIONS SHALL INCLUDE BUT NOT BE LIMITED TO: (A) TICK REMOVAL GUIDELINES FOR SCHOOL NURSES, SCHOOL PHYSICIANS, TEACHERS OR EMPLOYEES OF A SCHOOL DISTRICT TO BE DEVELOPED BY THE COMMISSIONER OF HEALTH. (B) PROCEDURES FOR WRITTEN NOTIFICATION TO A PARENT OR GUARDIAN AFTER A TICK HAS BEEN REMOVED FROM A PUPIL. WRITTEN NOTIFICATION SHALL INCLUDE, BUT NOT BE LIMITED TO, THE INCLUSION OF INFORMATIONAL MATERIALS DEVELOPED BY THE COMMISSIONER OF HEALTH ABOUT THE SPREAD OF LYME DISEASE AND TICK-BORNE DISEASE, SIGNS AND SYMPTOMS OF LYME OR TICK-BORNE DISEASES, AND RECOMMENDATIONS FOR HOW AND WHEN TO SEEK MEDICAL

TREATMENT IF NEEDED. (C) THE DEVELOPMENT OF INFORMATIONAL MATERIALS FOR SCHOOL DISTRICTS AND PARENTS TO BE PROVIDED ON THE WEBSITES OF THE DEPARTMENT AND THE DEPARTMENT OF HEALTH. THE RULES AND REGULATIONS ESTABLISHED PURSUANT TO THIS SUBDIVISION SHALL BE DEEMED TO BE THE MINIMUM STANDARDS THAT MUST BE COMPLIED

WITH BY EVERY PUBLIC SCHOOL RELATING TO THE REMOVAL OF TICKS ON PUPILS. SUCH RULES AND REGULATIONS MAY ALSO BE IMPLEMENTED BY NONPUBLIC SCHOOLS IF THEY SO AUTHORIZE. S 2. This act shall take effect on the one hundred twentieth day after it shall have become a law. EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD15745-01-8

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